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45 TRADERS WAY - SUBMETERING WS CERTIFICATES (2) MASSACFfUSETTS DEPARTMENT OF PtTBLIC HEALTH SUBMETERIQNG 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 following dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION T' Address: 45 Traders Way Unit# 20104 #Of units in bldr. 23 Citv/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation deices prior to a dwelling unit becoming eligible for the imposition on tenants of a charge for water and/or sewer.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2"gallons per minute(2.5 gpm) Faucets with maximum flow rate not to exceed 2="`)gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 16,11)gallons per flush(1.6 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 licensed plumber must install the water closets and submetering equipment. Submetering equipment information: Minol Minomess 130 Manufacturer Model.# Licensed Plumber Certification Michael Muise 11058 10/15/21 Print Name of Plumber License# Date I certify that(check all that apply): Ell have installed the submetering equipment listed.above in accordance with accepted plumbing standards. n I have installed one or more water closets not exceeding 1.6 gallons per flush. ❑Determined that existing water closets do not exceed 1.6 gallons per flush. ❑The plumbing permit issued by the city/town,if required,is attached. ❑ 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. /" t / Signed under the pains and penalties of perjury, l� Shmaturc of Licensed Plumbcr Property Owner Certification I certify that: (1)This dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer usage in accordance with the water submetering law(MGL c. 186. §22); (2)All showerheads,faucets,and water closets in this dwelling unit are water conservation devices that meet the standards specified above;(3)The water submeter measuring the use of water in the dwelling unit was installed by a licensed plumber and is in compliance with the standards specified above,or the water meter measuring the use of water in this dwcIling unit was installed by a"water company" as defined in 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 Conn;(6)That all information included on this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties of perjury, Thomas D.Beaton,senior Vice President_Management,CAPS,CPM r1w Dolben Company Inc.,Managing Agents for Traders Way Residential Holdings,LLC i I Print Name of Owner i gnature of Owner t 7tSoB L The property has been transferred to owner above and the unit ted remains in com liance with the rel:uirements of M.G.L.c. 186,§,22 Date: : i *THIS FORA MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SLfBMEi'ERING CITY OF SALEM MDPH-CSP Submetering Form Rev. 11.8 2021.doex BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HFAtaTH 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 11),the following dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION Address: 45 Traders Way Unit 4 20103 #Of units in bldg. 23 Citv/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation deices prior to a dwelling unit becoming eligible for the imposition on tenants of a charge for water and/or sewer. The devices must meet the following specifications: Showenccads with maximum flow rate not to exceed 2"'gallons per minute(2.5 gpm) Faucets with maximum flow rate not to exceed 2""it'gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 1. 61111 gallons per flush(1.6 gpo 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 licensed plumber must install the water closets and submetering equipment. Submetering equipment information: Minol Minomess 130 Manufacturer Model.# Licensed Plumber Certification Michael Muise 11058 10/15/21 Print Name of Plumber License# Date 1 certify,that(check all that apply): X❑1 have installed the submetering equipment listed above in accordance with accepted plumbing standards. 0 I have installed one or more water closets not exceeding 1.6 gallons per flush. ❑Determined that existing water closets do not exceed 1.6 gallons per flush. ❑The plumbing permit issued by the city/town,if required,is attached. ❑Dwelling unit is connected directly to a meter installed 6►,a water company and,in accordance with M.G.L L.c, 186,§22(p),does not require the installation of a submeter. Al/'4 f' Signed under the pains and penalties of perjury, 24s �,.-- �,l,� L (� Pit � Sienaturc of Liccnscd Plumber Property Owner Certification I certify that: (.1)This dwelling unit is eligible for die imposition on the tenants of a charge for water and/or sewer usage in accordance with.the water submetering law(MGL c. 186, §22); (2)All showerheads,faucets,and water closets in this dwelling unit are water conservation devices that meet the standards specified above;(3)The water submeter measuring the use of water in the dwelling unit was installed by a licensed plumber and is in compliance with the standards specified above,or the water meter measuring the use of water in this dwelling;unit was installed by a"water company" as defined in 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)That all information included on this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties of perjury, Thomas D.Beaton,Senior Vice President,Management,CAPS,CPM The Dolhen Company Im.Managing Agents for Traders Way Residential Holdings,LLC Print Name of Owner Signature of Owner I Orate Date ECEIV © The property has been transferred to owner above and the unit Submitte remains in compliance with the re uirements of M.G.L.c. 186. g22 Date: to BOH: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUSM0161*33 2021 MDPN-CSP Submetering Form Rev. 11.8.2021.docx CITY OF SALEM BOARD OF HEALTH MASSACHLISETTS DEPARTMENT OF PtIBLIC 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 11),the following dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION Address: 45 Traders Way Unit# 20102 #Of units in bid-R. 23 Citv/Tu%ii: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligible for the imposition on tenants of a charge for water and/or sewer. The devices must meet the following specifications: Showerheads with maximum flo►►=rate not to exceed 21 gallons per minute(2.5 gpm) Faucets with maximum flow rate not to exceed 22"0 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 1 W10 gallons per flush(1.6 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 licensed plumber must install the water closets and submetering equipment. Submetering equipment information: Minol Minomess 130 Manufacturer Model# Licensed Plumber Certification Michael Muise 11058 10/15/21 Print Name of Plumber License# Date I certify that(check all that apply): 01 have installed the submetering,equipment listed above in accordance with accepted plumbing standards. M I have installed one or more water closets not exceeding 1.6 gallons per flush. ❑Determined that existing water closets do not exceed 1.6 gallons per flush, ❑The plumbing permit issued by the city/town,if required,is attached. ❑Dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,a 22(p),does not require the installation of a submeter. ; Signed under the pains and penalties of perjury, :''r ,•>!GGC3 .f� % Sianaturc of Licensed Plumber Property Owner Certification I certify that:(1)This dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer usage in accordance with the water submetering law(MGL c. 186, §22);(2)All showencoads,faucets,and water closets in this dwelling unit are water conservation devices that meet the standards specified above;(3)The water submeter measuring the use of wager in the dwelling unit was installed by a licensed plumber and is in compliance with the standards specified above,or the water meter measuring the use of water in this dwelling unit was installed by a"water company" as defined in M.G.L.e. 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)That all information included on this certification is true and accurate to the best of my knowledge. Signed under the wins and penalties of perjury, Thomas D.Beaton,Senior Vice President,Management,CAPS,CPM The Dolben Company Inc.,Managing Agents for Traders Way Residential Holdings,LLC Print Name of Owner Si}nature of Owner U[ Date Date © The property has been transferred to owner above and the unit SubmittedR EC E Q V remains in compliance with the requirements of M.G.L.c. 186. §22 Date: to BOH: `THIS FORM MUST DE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SU6MqtTNJ33 2021 MDPN-CgP Submetering Form Rev. 11.8.202Ldocx 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 I1),the following dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION Address: 45 Traders Way Unit# 20101 #Of units in bldg. 23 Citv/Town: Salem _ MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligible for the imposition on tenants of a charge for water and/or sewer.The devices must meet the following specifications: Showenccads with maximum flow rate not to exceed 2"gallons per minute(2.5 gpm) Faucets with maximum flow rate not to exceed 2 2�10 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 16M0 gallons per flush(1.6 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 licensed plumber must install the water closets and submetcring equipment. Submetering equipment information: Minol Minomess 130 Manufacturer Model-# ' Licensed Plumber Certification Michael Muise 11058 10/15/21 Print Name of Plumber License# Date I certify that(check all that apply): ❑x I have installed the submetering equipment listed above in accordance with accepted plumbing standards. 0 I have installed one or more water closets not exceeding 1.6 gallons per flush. ❑Determined that existing water closets do not exceed 1.6 gallons per flush. ❑The plumbing permit issued by the city/town;if required,is attached. ❑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. Signed under the pains and penalties of perjury, rr Siiiature of Licensed Plumber Property Owner Certification I certify that: (1)This dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer usage in accordance with die water submetering law(MGL c. 186,§22);(2)All showerheads,faucets, and water closets.in this dwelling unit are water conservation devices that meet the standards specified above;(3)The water submeter measuring the use of water in the dwelling unit was installed by a licensed plumber and is in compliance with the standards specified above,or the water meter measuring the use of water in this dwelling unit was installed.by a"water company" as defined in M.G.L.c. 186, §22; (4)The water meter or submctcr measures the`rater 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)That all information included on this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties of perjury, camas D.Beaton,Senior Vice President,Management,CAPS,CPM Thx IJolben Com nny Inc. Managing eats for Traders Wa,Residential Holdin z LLC If Print Name of Owner 5i nature of Owner ate ___-Signature Date 0 The property has been transferred to owner above and the unit Submi ttA C E i remains in compliance with the requirements of M.G.L.c. 186, §22 Date: to BOH: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD Of HEALTH PRIOR TO INITIATING SUBIME N 't 2021 MDPH-C 0 Submetering Form Rev. 11.8.2021.docx CITY OF SALEM BOARD OF HEALTH