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HomeMy WebLinkAboutMass DEP Public Health - Submetering of Water and Sewer Certification - Correspondence - 505 SUTTON STREET 5/22/2024 MASSAC,HU SETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATiON FORM *In accordance with M.G.L. c. 186, §22 and 105 CMR 4 10.000: MilliCuLlul Standards of Fitness for I lumen 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: 507 Sutton St. Unit 0 #-Of unit in bldg. 58 —city/Town: North Andover MA ,ZipCode: 01845 EQUIPMENTINSTAiTLATION INFO—RMAI'ION 105 CMR 410.000 requires the installation ofwater conservation devices prior to a dwelling unit becoming eligible fior tile imposition oil tenants of a charge for water and/or sewer. The devices must meet the following specifications: Showerheads with rnaxinlurn flow rate not to exceed 2 "gallons per minute(2.5 gpm) Faucets with niaxitrulul flow rate not to exceed 2 2/10 ga I I oils per in i n ute(2.2 gpin) Ultra-low flush water closets(toilets) not to exceed 1 6/10 gallons per flush (1.6 gpf) The SUbtiletering equipment used to measure the quantity ofwater used for each dwelling unit and common area must meet the standards ofaccuracy and testing of file American Water Works Association or similar accredited association. A licensed plumber must install file water closets and submetering equipment, Submetering equipment information: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 ---------- Print Name Of Plumber License# Date I certil�that(check all that apply): WI have installed the submetering eqUipoient listed above in accordance with accepted plumbing standards. 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 file city/town, ifrequired, is attached, Ej Dwelling unit is connected directly to a meter installed by a water company and, in accordance with M-GJ-, . c. 186, § 22(p), does not require the installation ol'a submeter. Signed under file pains and penalties of'perjUry, N fXlavz.�t e, Si nature of Licensed Plumber Property Ownci-Certification I certify that: (1)'rhis dwelling unit is eligible for the imposition oil the tenants of7a charge for water and/or sewer usage in accordance with the water subinetering law(MGL c. 186, §22); (2) All showerheads, iaUcets, and water closets in this dwelling I 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 in186, § 22; (4)'Fhe 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 tile separate charging of water and/or sewer service,and a copy of this certification liorm; (6)'Fhat all information included oil this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties of perjury, utton Street Redevelopment, LLC, by its Project Manager `rint ne f()wll(.r al- 'n —rint Naiine_of0wner Sinature ofOwner Date 0 fit prop t I EJ , c property y Date Is to , fhe property has been transferred A the unit Submitted , ,-n as been tral ferrc to owner above al remains in 'n -�2) to 1301-1: )6F HEALTH PRIOR TO INITIATING SUB MET ERING 18(of M -aticeiwi�h file re el ell Date: COZ 1�THIS FOR IJS',B, ,L,"D—X--1rT—H--"r—Ht-1 LOC� ��A—R-D-- MDPH-CSI>Stibmetering Form Rev. 11.8.2021 docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L. c. 186, § 22 and 105 CMR 4 10.000: 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 set-vice. PROPERTY INFORMATION Address: 507 Sutton St. Unit# 4 Of units in bldg. 58 Ci! /Town: North Andover MA ZipCodc: 01845 EQUIPMENT INSTALLATION INFORMATION 105 CMR 4 10.000 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 flow rate not to exceed 2 /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 1 6/10 gallons per flush (1.6 gpt) 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: Next Century Submetering Solutions M201C — Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber License# Date I certify that(check all that apply): FS-11 have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Fo� 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 subrileter. Signed under the pains and penalties of per jury, Signature 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 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.1—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)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, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Si mature of Owner Date nDate 'The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to BOH: *THIS FORM MUST BE FILED WITI-ITHE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDP14-CSP Sul.)metering Form Rev. 11.8.202 Ldocx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.I.- c. 186, § 22 and 105 CMR 410.000: Minima 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: 507 Sutton St. Unit# _15 #Of units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 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 flow rate not to exceed 2 Y,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 1 6/10 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: Next Century Submetering Solutions M201C Manufacturer Model # Licensed Plumber Certification Michael W Harrison, Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): Wl have installed the submetering equipment listed above in accordance with accepted plumbing standards. jj I have installed one or more water closets not exceeding 1.6 gallons per flush. Ni Determined that existing water closets do not exceed 1.6 gallons per flush. Fe-1 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.I., . c. 186, §22(p), does not require the installation of a submeter. Signed under the pains and penalties of perjury, Signature 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 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)'Fhe 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 pains and penalties of perjury, Sutton Street Redevelop i_ent LLC, by its Project Manager Print Name of Owner Signature of Owner 7D Date Date S I"he property has been transferred to owner above and the unit Submitted to I remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 1330H: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PMOR TO 114MATlNG SUBMETERING N4DPH-CSP Submetering Forni Rev. 11.8.202 Ldoex 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: Minirnurn Standards of Fitness for Fluman 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: 507 Sutton St. Unit# 0 #Of units in bldg. 58 City/Town: North Andover MA ZiPCOde: 01845 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 flow rate not to exceed 2 "gallons per minute(2.5 gpnn) Faucets with maximum -flow rate not to exceed 2 2/10 gallons per minute(2.2 gpiri) Ultra-low flush water closets (toilets) not to exceed 1 6/10 gallons per flush (1.6 gpl) 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: Next Century Submetering Solutions M201 C —Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certity that(check all that apply): RI have installed the submetering equipment listed above in accordance with accepted Plumbing standards. I have installed one or more water closets not exceeding 1.6 gallons per (lush. Determined that existing water closets do not exceed 1.6 gallons per flush. Re The plumbing permit issued by the city/town, if required, is attached. El Dwelling unit is connected directly to a meter installed by a water company and, in accordance with M.GJ, . c. 186, §22(p), does not require the installation of a subiricter. Signed under the pains and penalties of perjury, Property Owner Certification Signature of Licensed Plumber— 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, fill,=t$, 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) 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 I-brin; (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, putton Street Redevelopment, LLC, by its Project Manager Print Narne of Owner Signature of Owner Date- 171 Date The property has been transferred to owner above and the unit Submitted rernams in compliance with the requirements of M.G.L. c. 186, `22 Date: to 13011: *TI-IIS FORM MUST BE FILED INITF1 THE LOCAL BOARD OF 1-lEALTf1 PRIOR TO INITIATING SUBMETERING MDPH-CSII Subinetering Form Rev. 11.8.202 1 docx 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 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: 507 Sutton St. Unit 0 C'1. #ff units in,bldg, 58 North Andover MA ZipCode.-. Q1845 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 rnaximurn flow rate not to exceed 2 111'gallons per minute(2.5 gpm) Faucets with maxii"nLIM flow rate not to exceed 2 2/10 gallons per minute(2.2 gpin) Ultra-low flush water closets (toilets)not to exceed 1 6/10 gallons per flush('1.6 gpt) The submetering equipment used to measure the quantity of water used Im-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 subirietering equipment. Submetering equipment infion-nation: Next Century Submetering Solutions M201 C — Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License#t Date I certify that(check all that apply): FOR have installed the subriletering equipment listed above in accordance with accepted Plumbing standards. 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, no The plumbing permit issued by the city/town, if required, is attached. El Dwelling unit is connected directly to a meter installed by a water company and, in accordance with M.G.1, . c. 186, § 22(p),does not require the installation of a Silboleter. Signed Linder the pains and penalties of perjury, Sj nature 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 subirietering law(MG1, 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 rneasuring 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 SUbrneter 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 Linder the pains and penalties of perjury, I�utton Street Redevelopment, LLC, by its Project Manager 4&e� Print Narne of Owner Signature of Owner Date 0 Date The property has been transferred to owner above and the unit Submitted remains in corn L)Iiance with the requirements Of M.G.L. c. 186, §22 Date: to 1301-1: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF I-1EALTH PRIOR TO INITIATING SUBMETERINN MDPFI-('SP Submeteriug Form Rev. 11.8.202 Ldocx 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 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: 507 Sutton St. L)nit# 4 Of units in bldg. 58 City/Town: North Andover MA Zip Code., 0 1845 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 ora charge 11or water and/or sewer. 'File devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2 1/�gallons per minute(2.5 gprn) Faucets with maximum flow rate not to exceed 2 2110 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 1 6/10 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. Subinetering equipment information: Next CenLug_Submetering Solutions M201C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber 1,iccnse# Date I certify that(check all that apply): Fe-11 have installed the submetering equipment listed above in accordance with accepted Plumbing standards. 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. Re Tile plumbing permit issued by the city/town, if required, is attached. El 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 tile pains and penalties of perjury, Si mature of Licensed Plumber Property Owner Certirleatiol, 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 subirleter measuring tile 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 SUbilleter measures tile 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 tile separate charging of water and/or sewer service, and a copy of this certification florm; (6) That all inforl-nation included on this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Managee4Aea� Print Narne of Owner Si nature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 1,86, §22 Date: to BOH: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO MITIATING SUBMETERTN-G MDPI-I-CSP Submetering Form Rev. 11.8.202 Ldoex MASSACI-IUSETTS DEPARTMENT OF PURLIC 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 set-vice. PIZO13ERTY INFORMATION Address: 507 Sutton St. Unit 4 J #Of units in bldg. 58 Ci!X/Town: North Andover MA ZipCode: 01845 EQUIPMENT INSTALLATION INFORMATION - 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligible for the imposition oil tenants of a charge for water and/or sewer. The devices must meet the following specifications: Showerheads with maxil-111,1111 flow rate not to exceed 2 /�gallons per minute(2.5 gpin) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)riot to exceed 1 6/10 gallons per flush (1.6 gpf) The subinctering 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 SLibi-netering equipment. Subirictering equipment inforrnation: Next Century Submeteri!lg Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber I.Jcense# Date I certify that(check all that apply): [el have installed the SUbilletering equipment listed above in accordance with accepted plumbing standards. 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. 0 The plumbing permit issued by the city/town, ifrequired, is attached. E] 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 SLibrileter. Signed under the pains and penalties of per',jury, Si mature 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 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 SUbt-neter 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 tinder the pains and penalties of perjury, I�utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains incompliance with the requirements of M.G.L. c. 186,..§22 Date. to BOH: *THIS FORM MUST BE FILED�AIITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPI-I-CSP Subriletering Form Rev. 11.8.202 l.docx MASSACHUSETTS DEPARTMENT OF PtJBLIC HEALTH StJBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.I... c. 186, §22 and 105 CMR 410.000: Minimum Standards of Fitness for HUrnan 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: 507 Sutton St. Unit# #Of units.,in bldg. 58 City/Town: North Andover MA ZipCode: 01845 EQUIP MENT 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 flow rate not to exceed 2 1 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 1 6/10 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. SLibrrietcring equipment information: Next Century Submetering Solutions M201C Manufacturer Model 11 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License 9 Date I certify that(check all that apply): nel have installed the SUbinetering equipment listed above in accordance with accepted plumbing standards. 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. no 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.1- . c. 186, § 22(p), does not require the installation of a subincter. Signed Linder the pains and penalties ofper' 'Jury, Si nature msed 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 SUbt-netering 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 subineter 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 tile 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, 3utton Street Redevelopment, LLC, by its Project Manager Print Narne of Owner Si r7ature ofOwner` Date El Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirernents of M.G.L- c. 186, §22 Date: to BOH: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPH-CSP SUbi-netering Form Rev. 11.8.2021 docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTI-1 SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *Ili 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 ror the imposition on the tenants of a charge for Water and/or sewer service. PROPERTY INFORMATION I Address: 507 Sutton St. Unit H C Of units in bldg. 58 Cit f["own: North Andover MA Zip Code: 01845 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 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 Hush water closets(toilets)not to exceed 1 6/10 gallons per flush (1.6 gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and cornmon 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: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): RI have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Fel 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 Linder the pains and penalties of perjury, jug Signature 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 subilletering 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 ofwater 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.[— 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)That all information included oil this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Manage Print Name of Owner Signature of Owner Date Date rhe property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to BOH: THIS FORM mus"r BE FILED WITH THE ILOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPI-I-CSP Submetering Form Rev. 11.8.202 Ldoex MASSACHUSETTS DEPARTMENT OFT 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 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: 507 Sutton St. Unit# 1 1110 #Of units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligible for the imposition oil 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 `1 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 1 6/10 gallons per flush (1.6 gpf) The subinetering 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: Next Centua Submeteri!1g.Solutions M201C Manufacturer Model Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of PlUrnber License# Date I certify that(check all that apply): fe-11 have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Re The Plumbing permit issued by the city/town, if required, is attached. EJ 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 Linder the pains and penalties of perju ry,Ll ry, 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 subriletering 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 subrileter 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)'I'he water meter or subirLeter measures the water usage exclusive to this unit; (5) f 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. J Signed under the pains and penalties of pegury, utton Street Redevelopment, LLC, by its Project Manager Print Narne of'�OwnermatureOwner Date EJ Date The property has been transferred to owner above and the unit Submitted remains in corn pliance with the requirements of M.G.L. c. 186, §22 Date: to BOW *THIS FORM mus"'r BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING ,SLID THING MDPFI-CSP Submetering Form Rev. 11.8.2021 doex MASS ACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.I.- c. 186, § 22 and 105 CIVIR 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 set-vice. PROPERTY INFORMATION Address: 507 Sutton St. Unit 4 90f units in bid g. 58 City/Town: North Andover MA Zip Code: 01845 EQUIPMENT INSTALLATION INFORMATION 105 CIVIR 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 maximurn flow rate not to exceed 2 1/r 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 1 6/10 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. Subirietering equipment information: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber IJccnsc Date I certify that(check all that apply): WI have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. R The plumbing pert-nit 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.I., . c. 186, § 22(p), does not require the installation of a submeter. Signed under the pains and penalties of perjury,. fzuavt� Signature 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 showerheads, faucets,and water closets in this dwelling unit are water conservation devices that meet tile 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 subjueter measures the water usage exclusive to this unit; (5) 1 will provide to the tenants ofthis dwelling unit, prior to occupancy,a written rental agreement that clearly provides to]-the separate charging of water and/or sewer service, and a copy ofthis certification forill; (6)That all information included on this certification is true and accurate to the best of my knowledge. J Signed under the pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Manager Wit" Print Name of Owner Signature of Owner Date Date 'Tile property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 13011: 'THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPI-I-CSP Submetering Form Rev. 11.8.2021 docx 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: Minirnum Standards of Fitness for Human Habitation (State Sanitary Code Chapter 11),the following dwelling unit is eligible lor the imposition on the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit 4 Of units in bldg. 58 -City/Town: North Andover MA ZipCodc: 01845 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 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 gprn) Ultra-low flush water closets(toilets)not to exceed 1 6/10 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: _ Next Century Submetering Solutions M201 C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name OfPhlrnber License Date I certify that(check all that apply): ❑l have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. no The plumbing permit issued by the city/town, if required, is attached. El Dwelling unit is connected directly to a meter instal led by a water company and, in accordance with M.G.L . c. 186, § 22(p), does not require the installation ora submeter. Signed under the pains and penalties of per Jury, Signature of Licensed Plumber Property Owner Certification I certify that: (1)This dwelling unit is eligible for the imposition oil the tenants ofa 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) 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 peiJury, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date bake The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 1301-1: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPH-CSP Submetering Form Rev. 11.8.2021 docx 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 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: 507 Sutton St. Unit 9 #Of units in bldg. 58 City/Town: North Andover MA ZipCode: Q1845 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 111LISt 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 2/10 gallons per minute(2.2 gprn) Ultra-low flush water closets (toilets)not to exceed 1 6/10 gallons per flush (1.6 gpl) 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 most install the water closets and submetering equipment. SUbilletering equipment information: Next Century Submetering Solutions M201C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plurnber License Date I certify that(check all that apply): Fe-11 have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. no 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.I., . c. 186, §22(p), does not require the installation of a subilleter. Signed Linder the pains and penalties of perjury, Signature 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(MG1,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)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 oflierjury, Z.06t` $utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date 0 Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to BOH: "THIS FORM MUST BE FILED WITH THE LO�CAL BOARD OF HEALTH PRIOR TO INITIATING SUB METERING MDPI-I-CSP Subriletering Form Rev. 11.8.2021.docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L. c. 186, E 22 and 105 CMR 4 10.000: Minirnurn Standards of Fitness for Human Habitation (State Sanitary Code Chapter 11),the following dwelling unit is eligible for the imposition on the tenants of charge for water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit# IUI� #OfUnitS in bldg. 58 tit /'['Own: North Andover MA .......... Li Code: 01845 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 rm,lSt meet the following specifications: Showerheads with maximum flow rate not to exceed 2 14 gallons per rn i n ute(2.5 gpm) Faucets with maximurn now rate riot to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 1 6/10 gallons per flush (1.6 gpf) The SUbmetering equipment used to measure the quantity of water used for each dwelling unit and cornmon area must meet the standards of accuracy and testing ofthe American Water Works Association or similar accredited association. A licensed Plumber must install the water closets and subi-netering equipment. Submetering equipment information: Next Century Submeteri!M Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License 11 Date I certify that(check all that apply): ne I have installed the subinetering equipment listed above in accordance with accepted plumbing standards. JS I have installed one or more water closets not exceeding 1.6 gallons per flush. 16 Determined that existing water closets do not exceed 1.6 gallons per flush. no 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 per* Jury, Si nature of Licensed Plumber Property Owner Certification I certify that: (1)"Phis dwelling unit is eligible for the imposition on the tenants ofa charge for water and/or sewer usage in accordance with the water subirietering 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) 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 lbri-ri; (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, 3utton Street Redevelopment, LLC, by its Project Manager Print Narne of Owner Signature of Owner Date 0 ,Date The property has been transferred to owner above and the unit Submitted remains in compliance with-h the requirements of M.G.I.- c. 186,_'22 !?ate: to 1301+ THIS FORM MUST BE FILED WITH'THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDI)H-CSP Submetering Form Rev. 11.8,2021.docx 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 11),the following dwelling unit is eligible for the imposition oil the tenants of a charge Tor water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit 9. #Of units in bldg. 58 City/Town: North Andover MA Zi2Code: Q1545 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 charge for water and/or sewer. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2 "gallons per rn i nute(2.5 gpm) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gprn) Ultra-low flush water closets(toilets)not to exceed 1 6/10 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: Next Century Submetering Solutions M201 C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber License Date I certify that,(check all that apply): Wl have installed the SUbmetering,equipment listed above in accordance with accepted plumbing standards. 1 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. no The plumbing permit issued by the city/town, if required, is attached. F-1 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 subilleter. Signed under the pains and penalties of perjury, N Ia4A,6 ,eAf, Signature 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 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) 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 illy knowledge. Signed under the pains and penalties of peijury, 3utton Street Redevelopment, LLC, by its Project Manager Print Name of-'Owner Signature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 1301-1: THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDIIII-I-CSP Subilletering Form Rev. 1 1.8.2021.docx 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 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: 507 Sutton St. Unit 4 9 Of units in,bldg. 58 City/Town: North Andover MA ZipCode: 01845 EQUIPMENT INSTALLATION—INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligible for tile imposition on tenants of a charge for water and/or sewer. Tile devices must meet the following specifications: Showerheads with maximurn flow rate not to exceed 2 "gallons per minute(2.5 gpm) Faucets with inaximurn flow rate not to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets (toilets)not to exceed 1 6/10 gallons per flush (1.6 gpf) 'file 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 orthe American Water Works Association or similar accredited association. A licensed plumber must install the water closets and subrnetering equipment. SUbmetering equipment inibrination: Next Century Submetering Solutions M201 C — Manufacturer11 Model Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber t'icense# Date I certify that(check all that apply): Fe�l have installed the subinetering equipment listed above in accordance with accepted Plumbing standards. 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. Re 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 SUbincter. Signed under the pains and penalties of perjury, Si gnature of Licensed Plumber Property Owner Certification I certify that: (1)']'his dwelling unit is eligible for the imposition oil the tenants of a charge for water and/or sewer usage in accordance with the water SUbinetering law(MGI., 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 tile 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,subineter 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 tile pains and penalties of perjury, utton Street Redevelopment, LLC, by its Project Manager Print Name of0wner Si,mature of"Owner Date Date The property has been transferred to owner above and the unit Submitted remains in compliance with the!:equ,irements of M.G.L. c. 186, §22 Date: to BOH: *THIS FORM MUST BE FILED INITH TFIE LOCAL BOARD OF HEALT14 PRIOR TO INITIATING Sid BMETERING MDPH-(.',SP SUbmetering Form Rev. 11.8.2021 docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L. c. 186, § 22 and 105 CMR 4 10.000: 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: 507 Sutton St. Unit 4 4 Of units in bldg. 58 city/Town: North Andover MA ZipCode: 01845 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 flow rate not to exceed 2 `1 gallons per minute(2.5 gpm) Faucets with maximum flow rate not to exceed 2 21"gallons per Minute(2.2 gpm) Ultra-low flush water closets (toilets)not to exceed 1 6/10 gallons per flush (1.6 gpt) 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: Next Century Submetering Solutions M201C Manufacturer Model Licensed Plum1her Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License 4 Date I certify that(check all that apply): nel have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Fe-1 The plumbing permit issued by the city/town, if required, is attached. F-1 Dwelling unit is connected directly to a meter installed by a water company and, in accordance with M.G.I., . c. 186, § 22(p),does not require the installation of a submeter. Signed under the pains and penalties of perjury, N�a4lL� el Signature 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 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)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 rny knowledge. Signed under the pains and penalties of peijury, Sutton Street Redevelopment, LLC, by its Project Manager Pri nt Name of Owner Signature of Owner Date Date The property has been transferred to owner above and the unit Submitted 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 SUBMETERING MDPII-CSP Submetering Form Rev. 11.8.202 I.docx 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 Fluman 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: 507 Sutton St. Unit# 110D #Of units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 El QUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becorning 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 `1 gallons per minute(2.5 gprn) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gprn) Ultra-low flush water closets (toilets) not to exceed 1 (,/10 gallons per flush (1.6 gpf) 'rhe 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: Next Century Submetering Solutions M201C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): Fe-11 have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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 FILIS11. no The plumbing permit issued by the city/town, if required, is attached. F-1 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, Si?nature of Licensed Plumber Property Owner Certification I certify that: (i)This dwelling unit is eligible for the imposition on the tenants of a charge far 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)'rhe 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) 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, 3utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date 0 Date The property has been transferred to owner above and the unit Submitted I-Cularil'IS in compliance with the requirements of'' M.G.L. c. 186, '22 Date: to BOH: *THIS FORM MUST BE FILED MflTH THE LOCAL BOARD OF HEALTH PRIOR To INITIATING SUBMETERING MDPH-CSP Submetering Form Rev. 11.8.202 Lclocx 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 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: 507 Sutton St. Unit# 1 #Of units in bldg. 58 cityrrown: North Andover MA ZipCode: 01845 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 flow rate not to exceed 2 /1 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 1 6/10 gallons per flush(1.6 gpt) The subirietering 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 subt-rictering equipment. Submetering equipment information: Next Century Submetering Solutions M201C Manufacturer Model Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber License# Date I certify that(check all that apply): FOR have installed the subtuetering equipment listed above in accordance with accepted plumbing standards. NJ 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 perrnit 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.I, . c. 186, § 22(p),does not require the installation of submeter. Signed under the pains and penalties of per',jury, Signature of Licensed Plumber Property Owner Certification I certify that: (1)This dwelling unit is eligible for the imposition on the tenants of charge for water and/or sewer usage in accordance with the water subinetering law(MGI-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) 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, Rutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date 171 Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 13011: THIS FORM MUST BE FILED wrm THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDI'I[-CSP Submetering Form Rev. 11.8.202 l.docx MASSACHUSETTS DEPARTMENT OF PUBLIC IIEALTH SU BIM ETERING 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: 507 Sutton St. Unit# 4 Of units in bldg. 58 Ci!Y/Town: North Andover MA ZipCode: 01845 EQUIPMENT INSTALLATION INFORMATION 105 CMR 4 10.000 requires the installation of water conservation devices prior to a dwelling nit becorning 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 gprn) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gprn) Ultra-low flush water closets(toilets)not to exceed ] 6/10 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 inf-bri-nation: Next Century Submetering Solutions M201 C — Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of PIL—Irnber License# Date I certify that(check all that apply): WI have installed the subilietering equipment listed above in accordance with accepted plumbing standards. 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. R 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 subtlicter. Signed under the pains and penalties of perjury, i ,nature of Licensed Plumber Property Owner Certification I certify that: (1)This dwelling unit is eligible Tor the imposition on the tenants of a charge for water arid/or sewer usage in accordance with the water Submetering law(MG 1,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 SLibmeter measuring the use of water in the dwelling unit was installed by a licensed Plumber and is in compliance with the standards speci Fred 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.I.— 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)That all information included on this certification is true and accurate to the best of my knowledge. Signed Linder the pains and penalties of per- jury, 3utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date Date fie property has been transferred to owner above and the unit Submitted 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 SUBMETERING MDPH-CSP Submetering Form Rev. 11.8.2021.docx 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 Hurnan 1--labitation (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: 507 Sutton St. Unit 4 4 Cif units in bldg. 58 City/Town: North Andover MA Zip Code: 011.845 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 flow rate not to exceed 2 "gallons per minute(2.5 gpin) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpin) Ultra-low flush water closets(toilets) not to exceed 1 6/10 gallons per flush (1.6 gpt) 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 Aracrican Water Works Association or similar accredited association. A licensed plumber must install the water closets and subrnetering equipment. Subinctering equipment information: Next Century Submetering Solutions M201C Manufacturer Model 11 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Narne of Plumber License-# Date I certify that(check all that apply): ©I have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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, Re 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 ofa SUbilleter. Signed under the pains and penalties of perjury, Sitmature 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 subi-netering law(MGL c. 186, §22); (2) All showerheads, faucets,and water closets in this dwelling unit are water conservation devices that rneet 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 rneaSUring 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) 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, S)utton Street Redevelopment, LLC, by its Project Manager , Print Name of Owner ......... Signature of Owner Date Date 171 The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements or M.G.L. c. 186, §22 Date: to BOH: *TFIIS FORM mus"r BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPH-CSI1 Submetering Form Rev. 11.8.202 I.docx 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 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: 507 Sutton St. Unit kf 4 Of units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 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 ineet the following specifications: Showerheads with maxil-111.1111 flow rate not to exceed 2 1/1 gallons per minute(2.5 gpm) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpi-n) Ultra-low flush water closets(toilets)not to exceed 1 6/10 gallons per flUS11(1.6 gpf) The subriletering 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. SUbilletering equipment information: Next Century Submeteriqg_Solutions M201C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Number License# Date I certify that(check all that apply): RI have installed the subinetering equipment listed above in accordance with accepted plumbing standards. I have installed one or more water closets not exceeding 1.6 gallons per flush. Determined that existing water closets do riot exceed 1.6 gallons per flush, Re The Plumbing permit issued by the city/town, if required, is attached. EJ 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, Si rrrattrre 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 subinetering 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 subt-fieter 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 subilleter 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 set-vice, 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 Linder the pains and penalties of perju ry U ry, Litton Street Redevelopment, LLC, by its Project Manager P j rint'Narne of Owner qicynqJrJJrA of Owner Date Date 0 71 Thee p proopp erty has been transferred to owner above and tile unit Submitted 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 SUBMETERIN—G MDPH-CS11 Submetering Form Rev. 11.8.202 J.doex 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 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: 507 Sutton St. Unit# 010 6 4 Of units in bldg. 58 City/Town: North Andover MA zip Code: 1 45 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 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 gpi-n) Ultra-low flush water closets (toilets)not to exceed 1 6/10 gallons per flush (1.6 gpl-) The subrnetering 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 PlUrnber must install the water closets and submetering equipment. Submetering equipment information: Next Century Submetering Solutions M201 C Manufacturer Model # License([ Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Narne of Plumber License# Date I certify that(check a]I that apply): ®I have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Re 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 subincter. Signed under the pains and penalties of perjury, N F<lalll�,�tl Signature of Licensed Plumber ............ Property Owner Certification I certify that: (1)'['his dwelling unit is eligible for the imposition on the tenants of 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 tile 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 subineter 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 pains and penalties ofper* Jury, 3utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date [71 Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 1301-1: 'P.TIIIS FORM MUST BE FILED 1NITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDP1­1-CSP SUbinetering Forin Rev. 11.8.202 I.docx 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: MininlUrn Standards of]"'ittiess for Fluman 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 set-vice. PROPERTY INFORMATION Address: 507 Sutton St. Unit# 11011 #Of units inbldg. 58 C.ity/'Fown: North Andover MA ZipCode,:, 01845 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becorning eligible for the imposition oil 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 1/1 gallons per minute(2.5 gpm) Faucets with maximurn now rate not to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 1 6/10 gallons per flush (1.6 gpt) The subilletering 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: Next Century Submetering Solutions M201 C Manufacturer Model Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Narne of Number License fi Date I certify that(check all that apply): no❑I have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. no 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 SUbi-neter. Signed under the pains and penalties of"perjury, Sicnature of Licensed Number Property Owner Certification I certify that: (1) '['his dwelling unit is eligible for the imposition on the tenants ofa charge for water and/or sewer usage in accordance with the water subriletering 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) 1 will provide to the tenants ofthis 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 Linder the pains and penalties of perjury, rutton Street Redevelopment, LLC, by its Project Manager A4 Print Name of Owner Signature of Owner Date Date 0 CJ 'r T he e prop property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186,§22 Date: to 13011: *TIIIS FORM MUST BE FILED WITWTHE LOCAL BOARD OF HEALTI-1 PRIOR TO INITIATING SUBMETERING MDPI I-CSP Submetering I"orin Rev. I 1.8.2021.docx 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 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: 507 Sutton St. LJnit# #0f units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 EQUIPMENT INSTALLATION INFORMATIO 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligible for the imposition on tenants ofa charge for water and/or sewer. Tile devices must meet the following specifications: Showerheads with maximum flow rate riot to exceed 2 "gallons per minute(2.5 gpin) Faucets With maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)riot to exceed 1 0/10 gallons per flush (1.6 gpf-) The SUbinetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing ofthe American Water Works Association or similar accredited association. A licensed Plumber Must install the water closets arid submetering equipment. SUbinetering equipment information: Next Century Submetering Solutions M201C — Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber 1,,icense 4 Date I certify that(check all that apply): 071 have installed the SUbmetering equipment listed above in accordance with accepted plumbing standards. IM I have installed one or more water closets not exceeding 1.6 gallons per flush. WM Determined that existing water closets do not exceed 1.6 gallons per flush. 0 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 SUbincter. Signed Linder the pains and penalties of perj ury, Jury, Si)nature 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 subriletering law(MGI.,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 subincter 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) 1 will provide to the tenants of this dwelling unit, prior to Occupancy, a written rental agreement that clearly provides to]-the separate charging of water and/or sewer service, and a copy of this certification form; (16)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, Sutton Street Redevelopment, LLC, by its Project Manag&44/1�� '' Print Narne of Owner Signature of Owner Date 0 Date 'file property has been transferred to owner above and the unit Submitted remains in compliance with the.requirements of M.G]— c. 186, §22 Date: to BOH: *T111S FORM mus"r BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO II MATING SUBMETERING MDPH-CSP Submetering Form Rev. 11.8.202 l.docx 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 Hurnan 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: 507 Sutton St. Unit 4 a\ #Of units in bldg. 58 -City/Town: North Andover MA Zip Code: 1.845 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 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 1 6/10 gallons per flush (1.6 gpt) 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 subinctering equipment. Submetering equipment inrormation: Next Century Submetering Solutions M201C — Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber License 4 Date I certi fy that(check all that apply): Fe-11 have installed the Submetering equipment listed above in accordance with accepted plumbing standards. 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. RO The plumbing permit issued by the city/town, if required, is attached. M 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 per*,jury, Si Tnature ofl.,ic rased Plumber Property Owner Certification I certify that: (I)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(MG1, 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) 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, Sutton Street Redevelopment, LLC, by its Project Manager 44, Print Narne of Owner Signature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains ains in compliance with the requirements or M.G.L. c. 186, §22 Date: to BOH: *TMS FORM MUST BE FILED wrn-rTHE LOCAL BOARD OF FIEALTH PRIOR TO INITIATING SUBMETERIN_G MDPH-CSP Subiretering Form Rev. 11.8.202 I.docx 1®' AS 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 I-I uman 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 set-vice, PROPERTY INFORMATION Address: 507 Sutton St. Unit# 4 Of units in bldg. 58 Cit /Town: North Andover MA Zip Code: JQ 1845 EQUIPMENTINSTALLATION—INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becorning eligible for the imposition on tenants of a charge for water and/or sewer. The devices must meet the following specifications: Showerheads with maximurn flow rate not to exceed 2 V,gallons per minute(2.5 gpi-n) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpin) Ultra-low flush water closets (toilets) not to exceed 1 6/10 gallons per flush (1.6 gpf) The submetering equipment LISCCI to measure the quantity of water used I-br 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 SUbi-netering equipment. Subinetering equipment information: Next Century Submetering,Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plurnber License# Date I certify that(check all that apply): [0-]1 have installed the subinctering equipment listed above in accordance with accepted plumbing standards. 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, Si re 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 SUbinetering 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 ofwater 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) 1 will provide to the tenants of this dwelling unit, prior to occupancy,a written rental agreement that clearly provides for tile 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 tinder the pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project ManageV46� � 2—&6 Print Name of Owner Si mature of Owner Date Date Submitted. 5L The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 1301-1: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING N4DPH-CSI11 SUbmetering Form Rev. 11.8.202 J.docx MASSACHIJSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L. c. 186, §22 and 105 CMR 4 10.000: 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: 507 Sutton St. Unit �1) #0funits in bldg. 58 city/Town: North Andover MA Zip Code:, 0184 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becorning 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 !/1 gallons per rni flute(2.5 gpi-n) 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 1 6/10 gallons per flush (1.6 gpf) The SLibiTietering equipment used to measure the quantity ofwater used for each dwelling unit and cornmon area must meet the standards of accuracy and testing of the American Water Works Association or sirnilar accredited association. A licensed plumber must install the water closets and SUbmetering equipment. Subilletering equipment information: — Next Centu!X Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of'Plumber I.Jcense# Date I certify that(check all that apply): Rel have installed the SUbmetering equipment listed above in accordance with accepted plumbing standards. J§ I have installed one or more water closets not exceeding 1.6 gallons per flush. JJ Determined that existing water closets do not exceed 1.6 gallons per flush. Re 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, Licensed Plumber Property Owner Certification 'r I ccrtity that: (1)']'his dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer usage in this ts r 'c in accordance with the water subirietering law(MG1,c. 186, §22); (2)All showerheads, faucets, and water closets in this e 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 incter 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 ofwater and/or sewer service, and a,copy of this certification form; (6)That all information included oil this certification is true and accurate to the best of rny knowledge. Signed under the pains and penalties of perjury, 3utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Si .mature of Owner Date 0 Date The property has been transferred to owner above and the unit Submitted 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 T6 INITIATING SUBMETERING MDPFI-CSI)Stibilietering Form Rev. 11.8.2021 doex 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 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: 507 Sutton St. Unit# 0"N 4 Of units in bldg. 58 C,Jty/Town: North Andover MA ZipCodc: 01845 EQUIPMENT INSTALLATION—IINFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligible for the imposition oil 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 1/�gallons per in i n Lite(2.5 gpin) Faucets with maximum flow rate not to exceed 2 2110 gallons per minute(2.2 gprn) Ultra-low flush water closets (toilets)not to exceed 1 6/10 gallons per flush (1.6 gpi-) 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. SLibi'neteriiig equipment information: — Next Century SubmcterinOolutions M201C Manufacturer Model # Licensed Plumber Certification --Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): F011 have installed the subtrietering equipment listed above in accordance with accepted plumbing standards. 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. Fe-1 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, "r—f-lre 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-, e in accordance with the water subriletering law(MGL c. 186, §22); (2)All showerheads, faucets, andd l water closets in this at 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) 1 will provide to the tenants of this dwelling unit, prior to Occupancy, a written rental agreement that clearly provides for the separate charging ofwater 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, u utton Street Redevelopment, LLC, by its Project Manager tton Street Redevelopment' LL Print e rint Name of'Owner .nature of Owner Date 0 The p opert I , , Date The property has been transferred to owner above and the unit Submitted r a e remains in compliance with the requirements of NIX.3.L. c. 186, §22 Date: to BOH: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PMOR,ro INITIATING SUB—METERING MDPII-CSP Subinetering Forin Rev. 11.8.202 I.doex 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 itness 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: 507 Sutton St. Unit# 3 #t Of units in bldg. 58 T City/Town: North Andover MA ........... ZipCode: 01845 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation ofwater 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 flow rate not to exceed 2 "gallons per minute(2.5 gpiri) 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 1 6/10 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: _ Next Century Submeteri!!g Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber License# Date I certify that(check all that apply): ®l have installed the submetering equipment listed above in accordance with accepted plumbing standards. I have installed one or more water closets riot 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.1- . c. 186, § 22(p),does not require the installation of a subt-neter. Signed under the pains and penalties of pel',jury, Si re of 1.,icensed 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 showerheads, faucets, and water closets in this dwelling unit are water conservation devices that rneet,the standards specified above; (3)The water SUbrileter 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) 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, utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Sjonnfilt- n-COwner Date The property has been transferred to owner above and the unit Date Submitted remains incompliance with the requirements of M.G.I.- c. 186, §22 Date: to BOH: *THIS FORM 'h/i—USTBE FILED WITH THE L—OCAL BOARD OF HEAUni PRIOR TO INITIATING SUBMETERI%JG MDPH-CSP Stibrietering Forin Rev, 11.8.202 I.docx 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: Minirm,1111 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: 507 Sutton St. Unit 4 1 #Of units in bldg. 58 CitY/Town: North Andover MA Zip Code-, 01845 EQUIPMENT INSTALLATION-INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becorning eligible for the imposition oil tenants of a.charge for water and/or sewer. The devices must meet the following specifications: Showerheads with inaximurn flow rate not to exceed 2 /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 1 6/10 gallons per flush (1.6 gpi) The subilietering 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 Watcr Works Association or similar accredited association, A licensed plumber must install the water closets and subinetering equipment. Submetering equipment information: _ Next Century Submetering Solutions M201C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber License I/ Date I certify that(check all that apply): re-11 have installed the Submetering equipment listed above in accordance with accepted plumbing standards. 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. no 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 per jury, !nsed Plumber- Property Owner Certification I certify that: (1)'I'his dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer usage in accordance with the water subi-netering law(MGL c. 186, §22); (2)All showerheads, faucets, and water closets in this dwelling unit are water conservation devices that ilicet the standards specified above; (3)The water subi-neter 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.J.- 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)That all information included on this certification is true and accurate to the best ofilly knowledge. Signed under the pains and penalties of'perjury, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Slignature of Owner Date F-1 Date The property has been transferred to owner above and the unit Submitted remains in compliance with-i the 1'equirernents of M.G.L. c. 186, §22 Date: to BOH: *THIS FOR BE IVI MUST FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SLIM METERING MDPFI-CSP Submetering Forin Rev. 11.8.202 I.doex 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: Millirru,1111 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: 507 Sutton St. Unit 4 4 'Of units in bid&. 58 —CitY/Town: North Andover MA ZipCode: 01845 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 rneet the following specifications: Showerheads with maxii-nUrn flow rate not to exceed 2 1/2 gallons per minute(2.5 gpm) Faucets with rnaxirnurn flow rate not to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets (toilets) not to exceed 1 6/10 gallons per flush (1.6 gpf-) Tile submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards ofaccuracy and testing of the American Water Works Association or similar accredited association. A licensed plumber must install the water closets and submetering equipment. Subriletering equipment information: Next Century Submetering Solutions M201 C Malu.1 NCIUrer Model 4 Licensed Plumber Certification —Michael W Harrison Master 16101 3/11/2023 Print ta of PlurnberI ccrtify that(check all thaapply): —Cl7ccnse 'Date Re❑I have installed the submetering equipment listed above in accordance with accepted plumbing standards. J§ I have installed one or more water closets not exceeding 1.6 gallons per flush. JJ Determined that existing water closets do not exceed 1.6 gallons per flush. Re The Plumbing permit issued by [lie city/town, if required, is attached. El Dwelling unit is connected directly to a meter installed by a water company and, in accordance with M.G.L . c. 186, § 22(p), (foes not require the installation ofa subilleter. Signed under the pains and penalties of perjury, Si mature msed Plurnber Property Owner Certification I certify that: (I)This dwelling unit is eligible for the imposition oil the tenants of a charge for water and/or sewer usage in accordance with the water subinetering 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. § 22; (4) The water ineter or submeter measures the water usage exclusive to this unit; (5) 1 will provide to the tenants8 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, utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date Date n remainsain]"hes in property has been transferred to owner above and the unit Submitted corneliance wi ,,the requirements of M.G.L. c, 186, §22 Date: to 1301-4: *THIS FORM MUST BE FILED WITH THE LOCAL BO RD OF HEALTH PRIOR TO INITIATING SUBIVIETERli —G MDPH-('S11 SLIbilletering roan Rev. 11.8.202 1 docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.I.- c. 186, §22 and 105 CMR 410.000: Minin'11.1111 Standards of'Fitness for Human I labitation (State Sanitary Code Chapter [1), the following dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit# 0 Of units in bldg. 58 Ci!Y_/'Fown: North Andover MA ZipCode: 01845 EQUIPMEN,r INSTALLATION IN FORMATION - 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 flow rate not to exceed 2 V11 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 1 6/10 gallons per flush (1.6 gpf) The subinetering 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:infion-nation: — Next Century Submeteri!i Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License 4 Date I certify that(check all that apply): SRI have installed the submetering,equipment listed above in accordance with accepted plumbing standards, d I have installed one or more water closets not exceeding 1.6 gallons per flush. 146 Determined that existing water closets do not exceed 1.6 gallons per flush. Re 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 ofa SUbmeter. Signed under the pains and penalties of perjury, W F'Ia4A�e�, Property Owner Certification Q;, urc �nsed Plumber certify that: (1)This dwelling unit is eligible for the imposition oil 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 subilleter 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 the § atpriorto osluo1will provide to tenants of this dwelling unit, 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, utton Z Street Redevelopment, LLC, by its Project Manager AI& �&75i Print Name of Owner Signature of Owner Date "file 1) Date property has been transferred to owner above and the unit Submitted remainsin cg!jipliance with the requirements of M.G.L. c. 186, §22 Date: to BOH: ,q'THIS FORM MIST BE M.ED WITH THE LOCAI.BOARD OF HEALTH PRIOR TO IN-ITIATING SUB—METERING MDPH-(,',SP Subilietering Form Rev. 11.8.202 I.docx MASSACHUSETTS DEPARTMENT OF PUBLIC" HEALTH SUB METERING 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: 507 Sutton St. unit# V'Solk #0fLlllitS in bldg. 58 Cityffown: North Andover MA ...... Zip Code: Q.,1845 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 flow rate not to exceed 2 `1 gallons per minute(2.5 gpin) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gprn) Ultra-low flush water closets (toilets) not to exceed 1 6/10 gallons per flush (1.6 gpo The subilletcring equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards ofaccuracy and testing of the American Water Works Association or similar accredited association. A licensed plumber must install the water closets and SUbirictering equipment. Subinetering equipment information: Next Centug..Submeterin&Solutions M201 C —Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): FOR have installed the SUbmetering equipment listed above in accordance with accepted plumbing standards. 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. Re The plumbing permit issued by the city/town, if required, is attached. El Dwelling unit is connected directly to a.meter installed by a water company and, in accordance with M.G.I., . c. 186, § 22(p), does not require the installation ora submeter. Signed under the pains and penalties of perjury, Property Owner Certification Si mature of Licensed Plumber 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 oaf 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) 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 ofilly knowledge. Signed under the pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date 0 Date 'file property has been transferred to owner above and the unit Submitted 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 SUBMETER—ING MDPH-CSP Submetering Form Rev. 11.8.202 I.doex 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: MillinlUrn 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: 507 Sutton St. 0, C Unit #Of units in bldg. 58 -Ci!�yrrown: North Andover MA ZipCode: 01845 EQUIPMENT INSTALLATION 1INYORMATION 105 CMR 410.000 require,,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 flow rate not to exceed 2 !/ gallons per minute(2.5 gpm) aucets 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 1 6/10 gallons per flush (1.6 gpl) 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 andsubrnetering equipment. Submetering equipment information: — Next Centu!l,Submeterjng Solutions M201 C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License 8 Date I certify that(check all that apply): nel have installed file SUbmetering equipment listed above in accordance with accepted plumbing standards. 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. no The Plumbing pen-nit issued by the city/town, if required, is attached. El 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 oaf SUbmeter. Signed Linder the pains and penalties of perjury, `z—mature oft icensed Plumber ce' 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 SUbrileter 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 ill 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)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, Sutton Street Redevelopment, LLC, by its Project Manager print Narne of Owner ' Si. mature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains in coml2liance with the rCqUirements of M.G.L. c. 186, §22 Date: to 1301-1: THIS FORM MUST BE FILED INITH THE LOCAI. BOARD OF HEALTH PRIOR TO INITIATING SUBMETER—ING MDPH-CSP SLibilictering Form Rev. 11.8.202 I.docx MASSACHUSETTS DEPARTMENT OF PUBLIC 14EALTH SUBMETEIZING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.I.— c. 186, § 22 and 105 CMR 4 10.000: Minimum Standards of Fitness for Human Habitation (State Sanitary Code Chapter 11), the following dwelling unit is eligible for the imposition oil the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit# 150)(10 #Of units in bldg. 58 City/Town: North Andover MA Zip Code: 01.845 EQUIPMENT INSTALLATION INFORMATIC)& 105 CM R 410.000 requires,res 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 flow rate not to exceed 2 "gallons per in i nute(2.5 gprn) Faucets with maximum flow rate not to exceed 2 2/10 gallons I)Cr Minute(2.2 gprn) Ultra-low flush water closets(toilets)not to exceed 1 6/10 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. SUbrnetering equipment information: Next Century Submetering Solutions M201C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Narne of Plumber License# Date I certify that(check all that apply): RI have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Fe-1 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.J., . c. 186, § 22(p),does not require the installation of a submeter. 'Wl Signed u _N � render the pains and penalties of perjury, �i )Z, SiLniati re 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(MG1, c. 186, §22); (2) All showerheads, lbucets, 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) 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)'rhat all information included on this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date 0 Date 1 rhe property has been transferred to owner above and the unit Submitted remains in compliance with the.req uirernents of M.G.L. c. 186, §22 Date: to BOFI: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPF1-CSI-1 Subinctering Form Rev. 11.8.2021.docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L. c. 186, § 22 and 105 CMR 4 10.000: Minirru.1111 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: 507 Sutton St. Unit# # Of units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 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. ]'Ile 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 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets (toilets) not to exceed 1 6/10 gallons per flush (1.6 gpl) 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 ofthe American Water Works Association or similar accredited association. A licensed plumber must install the water closets and subilietering equipment. Submetering equipment information: _ Next Centug Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber I.Jcense# Date I certify that(check all that apply). Re❑I have installed the SUbmetering equipment listed above in accordance with accepted plumbing standards. 6 1 have installed one or more water closets not exceeding 1.6 gallons per flush. J1 Determined that existing water closets do not exceed 1.6 gallons per flush. Re 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.I., . c. 186, § 22(p), does not require the installation of a submeter. Signed under the pains and penalties of perjury, Si-l"fure of Licensed Plumber Property Owner Certification f 01 w I certify that: (1) This dwelling unit is eligible for the imposition oil the tenants of a charge for water and/or sewer usage- c closets ts in accordance with the water subinetering law(MGt,c. 186, §22); (2)All showerheads, flaucets, and water closets in this dwelling unit are water conservation devices that rneet 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) 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 per'.jury, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner .,.Signature of Owner Date Date — 171 'flie property has been transferred to owner above and the unit Submitted b m i:tted remains in compliance with,the requirements of M.G.L. c. 186, §22 Date: to:B014: *Tl-ilS FORM MUST BE FILED WITH'ME LOCAL BOARD OF KALTH PRIOR TO INITIATING SUB-METERING MDPH-CSP Submetering 1,orni Rev. 11.8.202 J.docx MASSACHUSETTS DEPARTMENTCIF' PUBLIC HEALTH SUB METERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.GJ,. c. 186, § 22 and 105 CMR 410.000: Minimum Standards of Fitness for FlUrnan 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 rN Address: 507 Sutton St. Unit# V").M Of units in blqg. _58 City/'Town: North Andover MA Zip Code: 1B45 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 rm.lSt meet the following specifications: Showerheads with maximum flow rate not to exceed 2 1/�gallons per minute(2.5 gpm) Faucets with maxil'111,117171 flow rate not to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets (toilets) not to exceed 1 6/10 gallons per flush (1.6 gpo The subirietering 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 ])lumber must install the water closets and submetering equipment. SUbinetering eqLlipinClIt infori-nation: _ Next Century.Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check al I that apply): Fe-11 have installed the submetering equipment listed above in accordance with accepted plumbing standards. JS I have installed one or more water closets not exceeding 1.6 gallons per 11LISIl. 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, El Dwelling unit is connected directly to a meter installed by a water company arid, in accordance with M.G.1, . c. 186, § 22(p), does not require the installation of a subilleter. Signed under the pains and penalties of perjury, Signature of Licensed Plumber Property Owner Certification I cerfily 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 dwelling unit was installed by a"water company" as defined in M.G.L. c. 186, § 22; (4) The water u1CtCr Or SLibincter 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 Jorm; (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, utton Street Redevelopment, LLC, by its Project Manager Print Narne of Owner Si-nature of Owner Date Date t The property has been transferred to owner above and the unit Submitted to OJ_J. 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_T0 INITIATING SUBMETERING MDPI I-CSP SUbmetering Form Rev. 11.8.202 J.docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.GJ.. c. 186, § 22 and 105 CMR 410.000: Mininjurn Standards of Fitness far 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: 507 Sutton St. unitil #Of units in bldg. 58 ci!,y/Town: North Andover MA ZipCode: 01845 ESTALLATIOAO105MR10.00 requires theinst1lllatlo ion of water conservation devices prior to a dwelling unit becorning eligible for the imposition oil tenants of"a charge for water and/or sewer. The devices must meet the following specifications: Showerheads with maxit-nurn "flow rate not to exceed 2 '/�gallons per minute(2.5 gpm) Faucets with maxill11,1111 flow rate not to exceed 2 2110 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 1 6/10 gallons per flush (1.6 gpt) The subilletering 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. Subriletering equipment information: - Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber License# Date I certify that(check all that apply): Re❑I have installed the submetering equipment listed above in accordance with accepted Plumbing standards. I have installed one or more water closets not exceeding 1.6 gallons per 11LIS11. Determined that existing water closets do not exceed 1.6 gallons per flush. Re The plumbing permit issued by the city/town, if required, is attached. E] 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 ofa submeter. Signed tinder the pains and penalties of perjury, (,,;,,nature of Licensed plumber n 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 e e water closets'ets ill this -t in accordance with the water submetering law(MGI.c. 186, §22); (2) All showerheads, flaLlCei[S, and water closets in this dwelling unit are water conservation devices that meet the standards specified above; (3)The water sUbrneter 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 rileter or subirieter 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 pains and penalties ofperjury, utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner SJ.&natUre of Owner Date hate Submitted 'The Property has been transferred to owner above and the unit ed o B0 -1. remains in coulpliance with the requirements of M.G.I,,.,c. 186, §22 Date: to 1301-1: *THIS FORM MUST BE FILED WITH THE EOCAL i6ARD OF HEALTH PRIOR TO INI TIATING S13BMETEk-1-NG MIDI-I-CSP Submetering Form Rev. 11.8.202 I.docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.1— 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 ofa charge for water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit Of units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 EQUIPMENTINSTALLATION 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 flow rate not to exceed 2 1/,gallons per minute(2.5 gpm) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpi-n) Ultra-low flush water closets(toilets) not to exceed 1 6/10 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: Next Century Submetering Solutions M201 C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): FOR have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Me The plumbing permit issued by the city/town, ifrequired, is attached. El Dwelling unit is connected directly to a meter installed by a water company and, in accordance with M.G.1_ . c, 186, §22(p), does not require the installation of a submeter. Signed Under the pains and penalties of perjury, Si vmature 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 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),rhe 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 set-vice, 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, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Si mature of Owner Date 0 Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of IVI.C31, c. 186, §22 Date: to 13011: *'THIIS FORNI MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUS METERING MDPH-CSP Submetering Form Rev. 11.8.202 I.doex 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 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: 507 Sutton it. Unit# #Of units in bldg. 58 CitY/Town: North Andover MA ZipCode: 01845 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 ofa 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 gprn) Faucets with t-riaxii-num 'flow rate not to exceed 2 2/10 gallons per minute(2.2 gpin) Ultra-low flush water closets (toilets)not to exceed 1 6/10 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 ofthe American Water Works Association or similar accredited association. A licensed plumber rnUSt install the water closets and SUbrnetering equipment. Submetering equipment information: Next Century M201C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check a,l I that apply): [611 have installed the submetering equipment listed above in accordance with accepted plumbing standards. Ji 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. F-1 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 subt-neter. Signed under the pains and penalties of per.Jury, Si mature 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 arid/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) 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, utton Street Redevelopment, LLC, by its Project Manager Print , e 0J.,I rint Narne of Owner Signature of Owner I Date E03 prop t c t Date The property has been transferred to owner above and the unit Submitted remains " 1) emains in compliance with the requirements of M.G.L. c. 186, §22 Date: to BOIJ: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO WilrIATING SUBMETER-ING MDPI I-CSP Submetering Form Rev. 11.8.202 I.docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM "In accordance with M.G.L. c. 186, §22 and 105 CMR 4 10.000: Miltimurn 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: 507 Sutton St. LJnit#.., 13D, #Of units in bldg. 58 -CitY/Towll: North Andover MA ZipCode: Q1845 EQUIPMENT INSTALLATION—INFORMATION 105 CNIR 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 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 1 6/1 G 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. Subinetering equipment information: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plurnb�er License 4 Date I certity that(check all that apply): no❑I have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Fel The plumbing permit issued by the city/town, if required, is attached. El 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 Linder the pains and penalties of perjury, Si nature of Licensed Plumber Property Owner Certification I certify that: (I)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 subi-neter 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 ofwater in this dwelling unit was installed by a"water company" as defined in M.G.L. c. 186, § 22; (4)The water meter or SUbmelter 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 pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner 0 [1 eo)i il a ft u ree no F 0 w n�e��r �—-5—ate Date Tile property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 13011: *THIS FORM MUST BE FILED WITH-THE LOCAL BOARD OF HEALTH PRIOR—TO INITIATING SUBMETERFN—G MDPH-CSP Submetering Form Rev. 11.8.2021.doex 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 11),the following dwelling unit is eligible for the imposition on the tenants ofa charge for water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit# 1 11 r 6 #Of units inbldg. 58 C,ity/Town: North Andover MA ZiPCOde: 01845 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 maximurn flow rate not to exceed 2 1/1 gallons per minute(2.5 gpin) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpin) Ultra-low flush water closets (toilets)not to exceed 1 6/10 gallons per flush (1.6 gpl-) The submetering equipment used to measure the quantity of water used I"or 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 SUbinetering equipment. SUbmetering equipment information: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Narne of Plumber L,icerise 9 Date I certify that(check all that apply): R40 I have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Re 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, Si mature msed 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 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 USC 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) 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 ofthis 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 Pe1JL11-y, Sutton Street Redevelopment, LLC, by its Project Manager Z&6� Print Name of Owner Signature of Owner Date 0Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to B0H: *7"HIS FORM MUST BE FILED WITI l THE LOCAL BOARD OF HEALTI-1 PRIOR—TO INIMATING SUBIVIETERING MDPI1-CSP Submetering Form Rev. 11.8.202 I.docx 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 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: 507 Sutton St. Unit Of units in bldg. 58 Ci!Y/Town: North Andover MA Li Code: 01845 EQUIPMENT INSTALLATION-IINFORMATION 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 flow rate not to exceed 2 1/1.gallons per minute(2.5 gpin) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gprn) Ultra-low flush water closets (toilets) not to exceed 1 6/10 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. Subinctering equipment information: Next Centua Submetering Solutions M201C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License Date I certify that(check all that apply): Fe-11 have installed the submetering equipment listed above in accordance with accepted Plumbing standards. 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 pen-nit 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.GJ, . c. 186, §22(p), does not require the installation of submeter. Signed under the pains and penalties of perjury, N Vyla44z�� Si mature 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 ShoWer"Wards, 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) 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 oil this certification is true and accurate to the best of my knowledge. Signed Under the pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Manager Z�&6� Print Name of Owner Si nature of Owner Date ❑ Date The property has been transferred to owner above and the unit Submitted remains in com2liance with the reqUirernents of M.G.L. c..,186, §22 Date: to 13011: "THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERIN-G MD111-1-CS11 Subaietering Form Rev. 11.8.202 l.docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L. c. 186, § 22 and 105 CMR 4 10.000: 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: 507 Sutton St. Unit# a 4 Of units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 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 ofa 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 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets) not to exceed ] 6/10 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 subinetering equipment. SUbrnetering equipment information: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License 4 Date I certify that(check all that apply): ❑l have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. FR 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 ofa subi-neter. Signed under the pains and penalties of perjury, Signature of Licensed Plumber Property Owner Certification I certity 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 subilieter 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) 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, Sutton Street Redevelopment, LLC, by its Project Manager ^tZ.065 Print Name of Owner Signature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 13011: *THIS, FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INMATING SUBMETERING MDPH-CSP Submetering Form Rev. 11.8.202 I.doex 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 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: 507 Sutton St. Unit Of units in bldg. 58 City/Town: North Andover MA ZipCode: 01845 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 flow rate not to exceed 2 1/1.gallons per minute(2.5 gprn) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpin) Ultra-low flush water closets (toilets) not to exceed 1 6/10 gallons per flush (1.6 gpl) 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 ofthe American Water Works Association or similar accredited association. A licensed Plumber must install the water closets and submetering equipment. SUbmetering equipment information: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): FORT have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. F1 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 SUbineter. Signed under the pains and penalties ol'perjury, Signature of Licensed Plumber Property Owner Certification I certify that. (I)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 dwelling unit was installed by a"water company" as defined in M.G.L. c. 186, § 22; (4)The water meter or subineter 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 pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date n Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to BOH: *TmS FORM MUST BE FILED WITFI THE LOCAL BOARD OF HEALTH PRIOR TO INITIA,rING SUB METERING MDPfl-CSP Subinetering Form Rev. I 1.8.2021.doex MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.I.- 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 oil the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit 4 4 Of units in bldg., 58 City/Town: North Andover MA ZipCode: Q1845 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 maxii-nurn flow rate not to exceed 2 `2 gallons per minute(2.5 gpi-n) Faucets with maximurn flow rate not to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 1 6/10 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: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Narne of Plumber License# Date I certify that(check all that apply): no I have installed the subtrictering equipment listed above in accordance with accepted plumbing standards. I have installed one or more water closets not exceeding 1.6 gallons per lush. Determined that existing water closets do not exceed 1.6 gallons per flush. no 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 subilleter. Signed under the pains and penalties of per.jury, Property Owner Certification Signature of Licensed Plumber I certil 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(MGI-,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) 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, Sutton Street Redevelopment, LLC, by its Project Manager — Print Name of Owner Signature of Owner Date [71 Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.I.-.c. 186, §22 Date: to BOH: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUB METE RINN MDPH-CS[I Subinetering Form Rev. 11.8.2021 docx 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 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: 507 Sutton St. Unit 4 #Of units in bldg. 58 City/Town: North Andover MA Ti Code: Q1845 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 flow rate not to exceed 2 v,gallons per minute(2.5 gpin) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpiri) Ultra-low flush water closets(toilets)not to exceed 1 6/10 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 subirietering equipment. Submetering equipment information: Next Century Submetering Solutions M201 C — Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name Of Plumber License Date I certify that(check all that apply): W1 have installed the subilletering equipment listed above in accordance with accepted plumbing standards. 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. no 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 subrileter. Signed Linder the pains and penalties of perjury, ........ Signature of Licensed Plumber Property Owner Certification I certify that: (1)'I"'his dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer usage in accordance with the water subilletering 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) 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),rhat all information included oil this certification is true and accurate to the best of my knowledge. Signed under the pains and penalties of'perjUry, Sutton Street Redevelopment, LLC, by its Project Manager Print Narne of Owner Signature of Owner Date 0 Date The lie property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, '22 Date: to BOI+ *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO IN' ITIATING SUB MET ERING MDI-11-1-('SP Submetering Form Rev. 11.8.202 Ldoex MA SSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L. c. 186, § 22 and 105 CMR 4 10.000: 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: 507 Sutton St. Unit 4 Of units in bldg. 58 -City/Town: North Andover MA Zip Cade:--Ql a45 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 flow rate not to exceed 2 !/z 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 1 6/10 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 subrnetering equipment. SUbmetering equipment information: Next Century Submetering Solutions M201C — ManUfaCtLircr Model Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): ❑[ have installed the subirictering equipment listed above in accordance with accepted plumbing standards. 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 111.1sh. Fe-1 The plumbing permit issued by the city/town, if required, is attached, EJ 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 subiricter. Signed under the pains and penalties of penury, fXy d44t )V qignature 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 Ribi-netering law(MG1,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 subineter 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 subincter measures the water usage exclusive to this unit; (5) 1 will provide to the tenants ref 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 per'J Ury, 3utton Street Redevelopment, LLC, by its Project Manager AI& Z�&6� Print Name of Owner Signature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirerncnts of M.G.L. c. I86,�22 _I.)at�e: .. to BOH: ,pqHIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMET—ERING MDPFI-CSI"Subinetering Form Rev. 11.8.202 I.docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.I.- 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: 507 Sutton St. (,)nit# i 9 Of units in bldg. 58 City/Town: Forth Andover MA -.ZipCode: Q1845 EQUIPMENT INSTALLATION INFORMA ION 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 flow rate not to exceed 2 `gallons per minute(2.5 gpm) Faucets with maximum now rate not to exceed 2 2/10 gallons per minute(2.2 gpi-n) Ultra-low flush water closets(toilets)not to exceed 1 6/10 gallons per flush ('1.6 gpl) 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. Subinctering equipment,information: Next Century SubmeterjnL.Solutions M201 C Manufacturer Model # Licensed Flumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License 9- Date I certify that(check all that apply): ®I have installed the subinetering equipment listed above in accordance with accepted plumbing standards. d I have installed one or more water closets not exceeding 1.6 gallons per flush. JN Determined that existing water closets do not exceed 1.6 gallons per FILIS11. Re The plumbing pen-nit 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 subrneter. Signed under the pains and penalties of perjury, N Property Owner Certification Signature of Licensed Plumber- I certify that: (1) '['his dwelling unit is eligible for the imposition on the tenants ofa 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) 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 peiJury, 3utton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date 0 Date The property has been transferred to owner above and the unit Submitted remains in compliance with the!:e_quirements of M.G.L. c. 186, §22 Date: to 1301-4: "THIS FORM mus"r BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO If- ITIATING SUBMETERING MDPl-l-CSP Subirietering Form Rev. 11.8.202 Ldocx 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 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: 507 Sutton St. Unit# #Of units in bid&. 58 City/Town: North Andover MA ZipCodc: 01845 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires tile 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 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 1 6/10 gallons per flush (1.6 gpt) The SLibilletering equipment used to measure the quantity ofwater 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. Subilletering eqLlipl'nCilt information: Next Century Submetering Solutions M201C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): RI have installed the submetering equipment listed above in accordance with accepted plumbing standards. 6 1 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 tile pains and penalties of per Signature of Licensed Plumber Property Owner Certification I certify that: (1)This dwelling unit is eligible for the imposition oil 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, fiiucets, and water closets in this dwelling unit are water conservation devices that meet the standards specified above; (3)The water SUbrneter 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(lie water meter measuring tile 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 subineter 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,arid a copy of this certification form; (6)That all information included oil this certification is true and accurate to tile best of my knowledge. Signed under the pains and penalties of perjury, 3utton Street Redevelopment, LLC, by its Project Manager 1124,K,144A, 4— Print Name of Owner Signature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 130H: *THIS FORM mus"'r BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPf I-CSP SUbinetering Form Rev. 11.8.202 Ldocx 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 11),the following dwelling unit is eligible for the imposition on the tenants of a charge for water and/or sewer set-vice. PROPERTY INFORMATION Address: 507 Sutton St. [Jnit4 1 ##01"units in bldgy. 58 North Andover MA .. ........ Zipcodc, 01845 EQUIPMEN L T INSTALLATION INFORMATION 105 CMR 410.000 requires the installation ot7water conservation devices prior to a dwelling unit becoming eligible for the imposition on tenants ol'a charge for water and/or sewer. 'The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2 `1 gallons per minute(2.5 gpi-n) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gprn) Ultra-low flush water closets(toilets)not to exceed 1 6/10 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: Next Century Submetering Solutions M201 C — Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License 4. Date I certify that(check all that apply): FOR have installed the subirictering equipment listed above in accordance with accepted Plumbing standards. J§ I have installed one or more water closets not exceeding 1.6 gallons per flush. IN Detennined that existing water closets do not exceed 1.6 gallons per Flush. Fe-1 The plumbing permit issued by the city/town, if required, is attached. R Dwelling unit is connected directly to a meter installed by a water company and, in accordance with M.G.I., . c. 186, § 22(p),does riot require the installation of a subrileter. Signed under the pains and penalties of per,Jury, Si mature of msed Plumber Property Owner Certification I certify that: (I) This dwelling unit is eligible for the imposition on the tenants of 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 incter or SUbmeter rricasures 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 knowledge. Signed under the pains and penalties of per' ,jury, Sutton Street Redevelopment, LLC, by its Project Manager 44, Print Name of Owner Signature of Owner Date Date ]"'he property has been transferred to owner above and the unit Submitted remains in compliance with the reguirements of M.G.L. c. 186, §22 Date: to BOH: *THIS FORM MUST BE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUB MET ERING MDPH-C,SP SUbinetering Form Rev. 1 1.8.2021.docx 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 11),the following dwelling unit is eligible for the imposition oil the tenants of a charge for water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit# _B06 #0f units.in bldg. 58 North Andover MA ......... Zip Code:, 01845 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becorning 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 1/1,gallons per minute(2.5 gprn) 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 I W10 gallons per flush ('1.6 gpf) The subt-netering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing ofthe American Water Works Association or similar accredited association. A licensed plL1MbCr Must install the water closets and Submetering equipment. Subtrietering equipment information: Next Century Submetering Solutions M201 C Manufacturer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber License# Date I certify that(check all that apply): RI have installed the subtrietering 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. 10 Determined that,existing water closets do not exceed 1.6 gallons per flush, Re 'file 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.subilleter. Signed under the pains and penalties of perjury, qimature of[licensed Plumber Property Owner Certification I certify that: (t)This dwelling unit is eligible for the imposition oil the tenants of charge for water and/or sewer usage in accordance with the water submetering law(MGI., c. 186, §22); (2)All showerheads, faucets, and water closets in this dwelling unit are water conservation devices that meet the standards speci(led above; (3)The water SUbirieter 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.1- c. 186, § 22; (4)The water meter or SUbirieter 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 set-vice, 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 Linder the pains and penalties of per J u ry, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner .,,Signature of Owner Date F1 Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.I.- c. 186, §22 Date: to BOH: THIS FORM MUST BE FILED WITH THE LOCAL, BOAR RD OF HEALTH PRIOR TO INITIATING SIT METERI�_G_ MDPI-I-CSP Submetering Form Rev. 11.8.202 J.docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L. c. 186, §22 and 105 CMR 4 10.000: 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: 507 Sutton St. Unit #Of units in bIdg. 58 Ci!y/'I'Owtl: North Andover MA Zip Code-. Q 1845 EQ1JIPMENT 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 maxil-111.1111`1 flow rate not to exceed 2 1/�gallons per minute(2.5 gprn) Faucets with maxil][11,1111 flow rate not to exceed 2 2/10 gallons per minute(2.2 gpm) Ultra-low flush water closets(toilets)not to exceed 1 6/10 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 Arnerican Water Works Association or similar accredited association. A licensed plumber must install the water closets and SUbmetering equipment. SUbmetering equipment information: Next CentMSubmetering Solutions M201 C Manufacturer Model 4 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber I.Jcensc# Date I certify that(check all that apply): ❑l have installed the SUbirletering equipment listed above in accordance with accepted Plumbing standards. 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. no The plumbing port-nit 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 per',Jury, Si nature msed Plumber Property Owner Certification I certify that: (1)This dwelling unit is eligible for the imposition oil the tenants of a charge for water and/or sewer usage in accordance with the water subilletering law(MGL c. 186, §22); (2)All showerheads, fiaLlcets, 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 ofwater in this dwelling unit was installed by a"water company" as defined in M.G.L. c. 186, § 22; (4)TIle 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 101-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 Linder the pains and penalties of perjury, Sutton Street Redevelopment, LLC, by its Project Manager4A�e ;,ap, Print Name of Owner Si mature nVOwner Date 0 Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.L. c. 186, §22 Date: to 1301-1: *THIS FORM MIST BF FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO-INITIATING SIJBMETERING MDPIJ-CSP SUbinetering Forrn Rev. 11.8.202 I.docx MASSACIJUSETTS DEPARTMENT OF PUBLIC FIEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM � *In accordance with KY.O.[. o. 186, § 22and lO5CMR4|O.0OU: Minimum Standards nf Fitness for Human Habitation | (State Sanitary C ode Chapter 11), the following dwelling unit is eligible for the imposition oil the tenants of a charge for water and/or sewer service. MASSACHUSETTS DEPARTMENT OF PUBLIC HEAIT1-I S UBMETERING OF ATE[ AND SEWER CERTIFI('ATION FORM *In accordance with M.G.L. c. 186, § 22 and 105 CMR 4 10.000: Minimum Standards of Fitness for Human Habitation (State Sanitary Code Chaptcr 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, 507 Sutton St. Unit# Of units in bldg. 58 C.i!y/'I'own: North Andover MA Zip Code: -Q1 a45 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.000 requires the installation of water conservation devices prior to a dwelling unit becoming eligible for the imposition oil tenants of charge for water and/or sewer. The devices must rnect the following specifications: Showerheads with maximum flow rate not to exceed 2 `1 gallons per minute(2,5 gpm) Faucets with rnaxirnurn flow rate not to exceed 2 211()gallons per rnillLft(2.2 gpi-n) Ultra-low flush water closets (toilets) not to exceed 1 6/10 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 incet the standards of accuracy and testing ofthe American Water Works Association or similar accredited association. A licensed plumber must install the water closets and subriletering equipment. Subriletering equipment information: Next Century SubmeterijIg Solutions M201 C Manufacturer Model 9 Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Plumber I.Jcense# Date I certify that(check all that apply): [0-11 have installed the subinetering equipment listed above in accordance with accepted plumbing standards. NN I have installed one or more water closets not exceeding 1.6 gallons per flush. NO Determined that existing water closets do not exceed 1.6 gallons per flush. no file 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 subirleter. Signed under the pains and penalties ofper 'Jury, Si nature of Licensed Plumber Property Owner Certification I certify that: (1)This dwelling unit is eligible for the imposition on the tenants ofa charge for water and/or sewer usage in accordance with the water SUbt-netering 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 subi-neter 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 ofwater in this dwelling unit was installed by a"water company" as defined in M.G.L. c. 186, § 22; (4)The water meter Or SUbilleter measures the water usage excILISive 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 tile 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 perju ry, Ll ry, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date Date The property has been transferred to owner above and the unit Submitted remains in compliance with the requirements of M.G.I.- c, 186, §22 ate:D, to 1301-1: *THIS FORM MkJSTBE FILED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SUBMETERING MDPH-CSP Stibilictering Form Rcv. 11.8.2021 docx MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM *In accordance with M.G.L.. c. 186, § 22 and 105 CMR 4 10.000: Millillit.inn 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 set-vice. PROPERTY INFORMATION Address: 507 Sutton St. Unit 4 #Of units in bldg. 58 Ci!Y_/T0wtl: North Andover MA Zi2 Code--01845 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 f'or 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 gpni) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2,2 gpi-n) Ultra-low plush water closets(toilets)not to exceed 1 6/10 gallons per flush (1.6 gpf) The subinetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing ofthe American Water Works Association or similar accredited association. A licensed I)ILimber must install the water closets and subilietering equipment. Subiiietei-ingeqLiipi-nentiiifoi-mation: Next Centu!J Submetering Solutions M201C Manufacturer Model Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Name of Pl-urnber License 4 Date I certify that(check all that apply): Fe-11 have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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 per'�l n ry, Signature ofI ,nsed Plumber Property Owner Certification I certify that: (1)This dwelling unit is eligible for the imposition on the tenants ofa charge for water and/or sewer usage in accordance with the water SUbmetering law(MGI.,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),rhe 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) 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, Sutton Street Redevelopment, LLC, by its Project Manager Print Name of Owner Signature of Owner Date The property has been transferred to owner above and tile unit Date remains,in compliance with the re(JUirements of M.G.t.- c. I 8�, '22 Submitted Date: to BOH: *THIS FORM N16iT BE FlIED WITH THE LOCAL BOARD OF HEALTH PRIOR TO INITIATING SLJBMETERING MDPI-I-CSP Submetering Form Rev, 1 1.8.2021.docx MASSACHUSETTS DEPARTMENT OF PIJBLIC IIEALTH 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 fior water and/or sewer service. PROPERTY INFORMATION Address: 507 Sutton St. Unit It Of units in bldg. 58 _Cjt /Town: North Andover MA ZipCode: 01845 EQUIPMENT INSTALLATION INFORMATION 105 CIVIR 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 flow rate not to exceed 2 1/ gallons per minute(2.5 gpin) Faucets with maximum flow rate not to exceed 2 2/10 gallons per minute(2.2 gpi-Ti) Ultra-low flush water closets(toilets)not to exceed 1 6110 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 ofthe American Water Works Association or similar accredited association. A licensed plumber must install the water closets and subirictering equipment. Submetering equipment information: Next Century Submetering Solutions M201 C — Mall LitaCtUrer Model # Licensed Plumber Certification Michael W Harrison Master 16101 3/11/2023 Print Narne of Plumber License 11 Date I certi Iy that(check all that apply): W1 have installed the submetering equipment listed above in accordance with accepted plumbing standards. 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. Fe-1 The plumbing permit issued by the city/town, if required, is attached. F-1 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, N e, Property Owner Certification Signature of Licensed Plumber 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(MG1, 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) 1 will provide to the tenants of this dwelling unit, prior to occupancy, a written rental agreement that clearly provides for the separate charging ofwater and/or sewer service, and a copy of this certification forrn; (6)That all information included on this certification is true and accurate to the best of my knowledge. Signed tinder the pains and penalties Of perjury, Sutton Street Redevelopment, LLC, by its Project Manager Lit Print Name of Owner ��Signai_ure.r��wner Date Date The property has been transferred to owner above and the unit Submitted 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 SUBMETERING MDPH-CSP Submetering Form Rev. 11.8.202 l.docx