266 CANAL STREET, BUILDING 5 - WATER & SEWER SUBMETER CERTIFICATES MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5201 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VerSaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane , / s` 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &Jek�-
Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Depart Tlt-C cC I`V e CG D
Prior Owner's Signature Date t�
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II(the"Housing;Code" ),the following.dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5202 #Of units in bldg.48
Citv/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &Jop-o-t'� Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c.I Date Submil �tA L �®
186§22- Departmen tt
Prior Owner's Signature Date
FEB 19 2026
ALEM
410-23-Submeterin of Water and Sewer Certification Form 5-12-23 CITY O HEAL
g BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitai i. Code, Chapter II(the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5203 #Of units in bldg.48
Cii\/Town: Salem MA zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VerSaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &a-dn� Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
RE*C E I V E D
186§22- two
Prior Owner's Signature Date Depar"
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter If(the"Housin<,Code" ),the followings dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5204 #Of units in bldg.48
City/Town: Salem MA zi code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
71 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane °` �T 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP Xi;�-Pa-� Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submit t�o f tiVE1 1
186§22- DepartmenFFFFQQlIII uu
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5205 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑� I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane /�/ ; 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &41a—P-M-t�
Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submittet O Offal Health
186§22- Department tl..�l ((VV''EE \VP
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the 'Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5206 #Of units in bldg.48
Ci:\/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane !, ' ,, ; 8318 02/16/2026
Licensed Plumber's Name Plumber' Si,-nature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP � Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LJThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:
Prior Owner's Signature Date i RECEIVE
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23
CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering, water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5207 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
0 1 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &dx�-
kA.�.— Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department: R EC E I V a
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5208 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services.The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP a-�_. Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22-
Department: RECEIVE
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar -Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5209 #Of units in bldg.48
Citv/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L .c. 186,§22(p),does
not require the installation of a submeter. /�
William Lane ,/l'� ,.;., 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &AJ
— Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitt�tj C� b
186§22- Department.
V
Prior Owner's Signature Date
FEB 19 2026
CITY OF
410-23-Submetering of Water and Sewer Certification Form 5-12-23
BOARDBOARDOF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar ,Code, Chapter II(the "Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5210 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.C. 186,§22(p),does
not require the installation of a submeter.
William Lane �° 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP Development Manager 2-19-2026
Name of Owner "Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:
Prior Owner's Signature Date RECEIVE
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23
CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitai ,Code, Chapter II the "Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5211 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane ° `�� 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &4J*A_Pv_t� Development Manager 2-19-2026
Name of Owner Sianature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:RECEIVEr.
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5213 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
W1I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane ,,i;;�.. 4 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP p- r.. Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- DepartmentRECEIVED
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanita)•i Code, Cha?ter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5301 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter. i
William Lane,, 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP p-k:._. Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitt� �11 th
186§22- DepartmentM t(v'
Prior Owners Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
SOAR D OF HEALT�l
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitai-i-Code Chapter II(the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5302 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &412JS6_� Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submi 0 9sgVH,gal_th
186§22- Departments LtL LC
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitam Code, Chapter II kthe"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5303 #Of units in bldg.48
Cit%,/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &dm_pa_, Y Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:RECEIVED
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5304 #Of units in bldg.48
City/Tow_n: Salem NL, Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VerSaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
❑ The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L .c. 186, §22(p),does
not require the installation of a submeter.
William Lane {, 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &� p-'kA:,— Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department: R EC E 9 V E F
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitan,Code, Cha Ater II(the"Housing Code" ,the following dwellin.-,unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5305 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.C. 186,§22(p),does
not require the installation of a submeter.
William Lane / ��� 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &dM—Pow 1— Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local health
186§22- Departmenh^Gt C E I V ED
Prior Owner's Signature Date C
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanita Code, Cha Ater II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5306 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &� p--�� Development Manager 2-19-2026
Name of Owner_ Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:R EC C I V IE
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitai ,Code, Chapter II the"Housing Code"),the following dwelling unit is eligible for submetering,water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5307 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane �%� ` ,'� 8318 02/16/2026
— - --
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP ab,+� y-t/— Development Manager 2-19-2026
Name of Owner t� 9� Signature of Owner Date
-OrThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitte���b
186§22- Department:
Prior Owner's Signature Date
FEB 19 2026
CITY OF
410-23-Submetering of Water and Sewer Certification Form 5-12-23 I
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitari Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. _
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5308 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services.The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town, if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &� p-
kA�— Development Manager 249-2026
Name of Owner Signature of Owner Date
-ElThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:REC EI VE
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitari-Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering,water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5309 #Of units in bldg.48
Cite/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ 1 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter. i
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP kA:,— Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Subm'
186§22- Departmedt
Prior Owner's Signature Date
FEB 19 2026
CITY OF SALEM
410-23-Submetering of Water and Sewer Certification Form 5-12-23 BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Cha Ater II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5310 #Of units in bldg.48
City/Town: Salem NIA zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
aI have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter. i
William Lane ��/// 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP A a'� Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:
Prior Owner's Signature DateRECEM,:4-)
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23
CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar •Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5311 #Of units in bldg.48
City/Town: Salem MA zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane , 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &dzh� _. Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
ts6§zz- Departmen13 CC E I V E D
Prior Owner's Signature Date C
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II(the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5313 #Of units in bld .48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane / 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22).
(4) The water meter or submeter measures the water usage exclusive to this unit.
(5) 1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &' dr kA:,— Development Manager 2-19-2026
Name of Owner Signature of Owner Date
Li The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submittedto Focal Health
e lth
186§z2-
Prior Owner's Signature Date Department:�L�1 EC CC
ED]
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5401 #Of units in bldg.48
City/ own: Salem MA zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter. j
William Lane , 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All Showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP K,;, Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
RECEIVE-
FEB 186§22-
Prior Owner's Signature Date Department:
19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitarj,Code, Chapter II 'the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5402 #Of units in bld .48
City/Town: Salem MA zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑� I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# _Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LJThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department EC G I V E
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Cha Ater II the"Housing, Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5403 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP AA ouM— Development Manager 2-19-2026
Name of Owner l Signature of Owner Date
_11The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:RECEIVE®
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitan-Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5404 #Of units in bldg.48
Cis\/Town: Salem MA zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services.The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does
not require the installation of a submeter.
William Lane _ 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP ua�J. a t . Development Manager 2-19-2026
Name of Owner / Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L C. Date Submitted to Local Health
186§22- Department: RECEIVE
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitari Code, Cha)ter II(the"Housing Code" ,the following dwelling unit is eligible for submetering, water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5405 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does
not require the installation of a submeter.
William Lane ; 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP X��P'kA — Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:R EC E I V E
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitai •Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering,water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5406 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services.The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William LaneA; 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP R"A_gkA,:,_ Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department: 7. �
Prior Owner's Signature Date EC E I V E
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23
CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5407 #Of units in bldg.48
City/Town: Salem MA zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
W] I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name_ Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &4p-kA:,— Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
ts6§22- Department: C R�P+��\VA�
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5408 #Of units in bldg.48
City/ own: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VerSaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑� I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
❑ The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Si nature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP a-y�'Y Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22-
Department:R EC E NUD,
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitai y Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5409 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane
�� . ` 8318 02/16/2026
, �l�; ,_.� ,,
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLPP A.ADevelopment Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local health
186§22-
Department:RECEIVEE
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitan,Code, Cha Ater II(the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5410 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# _ Date_
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP wt Y Development Manager 2-19-2026
Name of Owner Siamature of Owner Date
The property has been transferred to the owner above and the unit remains incompliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:RECEIVE'
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALE�fi
BOARD OF HEr,'-1-H
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar ,Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5411 #Of units in bldg.48
City/Town: Salem MA Zi Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 11'� �,4f! �,; �,� 8318 02/16/2026
- -lam -
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &Aek—pa--,� Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:R EC E I VE.
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the"Housing, Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5413 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services.The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VerSaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury, 1
The Residences On Canal Street,LLP P�r� Development Manager 2-19-2026
Name of Owner Si nature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to LocalpI�--Health
186§22-
Department: EC I V E
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar,Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering, water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5501 #Of units in bldg.48
City/Town: Salem MA zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# - Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP Development Manager_ 2-19-2026
Name of Owner vv" Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:R EC E I VE
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitai ,Code, Chapter II kthe"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5502 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town, if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L .c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP PDevelopment Manager 249-2026
Name of Owner Signature of Owner Date
LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department EC EIVE®
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II(the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5503 #Of units in bldg.48
City/Town: Salem MA zip code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§ 22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP 64 4,JAA �� Development Manager 2-19-2026
Name of Owner �w Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitteyd t ct�b
186§22- Department:
�'(
Prior Owner's Signature Date
FEB 1 9 2026
ALEM
410-23-Submeterin of Water and Sewer Certification Form 5-12-23 CITY O HEAL
g BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar'Code, Chapter II the"Housing* Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5504 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane j .�, 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP Development Manager_ _ 2-19-2026
Name of Owner Signature of Owner Date
LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitte to Local Health
186§zz-
Department:R ECEIVEEk'_
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Cha )ter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5505 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
❑ The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L .c. 186, §22(p),does
not require the installation of a submeter.
William Lane f' 8318 02/16/2026
Licensed Plumber's Name Plumber' Si nature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP p- Y Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Departmenll EC E I V E®
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5506 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VerSaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
❑ The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L .c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &�P"
_ Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submltte -Heahh
186§22- Department: '
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar,Code, Chapter II(the"Housing Code" ,the followin,dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5507 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town, if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP d tt Development Manager 2-19-2026
Name of Owner Signature of Owner Date
LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
Department: R
186§22-
ECEIVIE
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitai,Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering,water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5508 #Of units in bldg.48
City/Town: Salem MA zi Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C) requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
WIT have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP Development Manager 2-19-2026
Name of Owner /y Signature of Owner Date
LjThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitte�tn Vct11.
186§22- Department: �6�.J`
Prior Owner's Signature Date
FEB 1 9 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitat ,Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5509 #Of units in bldg.48
City/Town: Salem MA Zi Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services.The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane ,��� �, ;4 8318 02/16/2026
,-�
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERIN61
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP A�_. Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:Prior Owner's Signature Date RECEIVE '
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23
CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II kthe"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5510 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: NMT VersaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ 1 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William LaneI ,u, 4 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP a-t At — Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22_ Department: RECEIVEE
Prior Owners Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitar 'Code, Chapter II the"Housin.-,Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit# 5511 #Of units in bld .48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VerSaMag
Manufacturer Model#
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑� I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
❑ The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter.
William Lane `�TL 8318 02/16/2026
Licensed Plumber's Name Plumber' Signature License# Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the
separate charging of water and/or sewer service, and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP &dta-kA: Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L C. Date Submitted to Local Health
186§22- Department: Rt EC E 0 V t
Prior Owner's Signature Date
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH
MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH
SUBMETERING OF WATER AND SEWER CERTIFICATION FORM
In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State
Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: 266 Canal Street (Building 5) Unit 4 5513 #Of units in bldg.48
City/Town: Salem MA Zip Code: 01970
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services. The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm)
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf)
The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: N MT VersaMag
Manufacturer Model 4
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards.
❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards.
The plumbing permit issued by the city/town,if required,is attached.
This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does
not require the installation of a submeter. /
William Lane l/ ; _ 8318 02/16/2026
Licensed Plumber's Name Plumber' Si_nature License 4 Date
OWNER CERTIFICATION
I certify that:
(1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law
(MGL c. 186, §22).
(2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information included on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING
Signed under the pains and penalties of perjury,
The Residences On Canal Street,LLP KA/A Pan"4�— Development Manager 2-19-2026
Name of Owner Signature of Owner Date
The property has been transferred to the owner above and the unit remains incompliance with the requirements of M.G.L c. Date Submitted to Local Health
186§22- Department:R EC E I V�
Prior Owner's Signature Date 9
FEB 19 2026
410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM
BOARD OF HEALTH