HomeMy WebLinkAboutSubmetering of Water Sewer Certification - 10 Ashland Street Unit 12-1 - Miscellaneous - 10 ASHLAND STREET 10/23/2024 1YlAL'5bAI:lY UAL I l L'�) DEWAli l lYHUNI U14 M OL1l. IMAL In
SUBMETERING OF WATER AND.,SEWER CERTIFICATION FORM
In accordance with M.G.L.c. 186, § 22 and 105 CMR 410,000: Minirnunt Standards offitness for Hunian Habitation, Stale
Sanitaiy Corte, Chapter 11 the"Housing Code ),the following dwelling unit is eligible for submetering water and sewer.
PROPERTY INFORMATION
Address: /U 43IM4 n d St Unit 0 it Of units in bldg. y
Ci /Town: , c>l!✓c' MA Zip Code: 6/b'�..5—
EQUIPMENT INSTALLATION INFORMATION
105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for
submetering for water and/or sewer services, The devices must meet the following specifications:
Showerheads with maximum flow rate not to exceed 2,5 gallons per minute(gpin)
Faucets with maximum flow rate not to exceed 2.2 gallons per minute.(gpm). i
Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpo
The submetering equipment used to measure the quantity of water used for cacti dwelling unit and common area must
meet the standards of accuracy and testing of the American Water Works Association or similar accredited association.
A Massachusetts licensed plumber must install the toilets and submetering equipment.
Submetering equipment information: /12U W/\Ip
Manufacturer Model #
LICENSED PLUMBER CERTIFICATION
I certify that(check all that apply):
❑ 1 have installed or inspected the submetering equipment listed above and have detennined that they incet accepted plumbing standards.
L_..l I have installed or inspected all the toilets in this unit and have deternnined that they meet accepted plumbing standards,
❑ The plumbing permit issued by the city/town, if required,is attached.
❑This dwelling unit is connected directly to a meter instilled by a water company and,in accordance with M.c,L,c. 186,§22(p),does
not require the installation of.a submcter.
Licensed Plnunber's Name Plumber' Signature license# Date
OWNER CERTIFICATION
1 certify that:
(1)This dwelling unit is eligible for submetering o1'water and/or sewer usage in accordance with the water submetering law
(MOL c. 186,§22).
(2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above.
(3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and
complies with the standards of accuracy and testing required by the water subinctering law(M.G.L.. c. 186, §22).
(4)The water meter or submeter measures the water usage exclusive to this unit.
(5)1 will provide to the tenants of this.dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the
separate charging of water and/or sewer service,and a copy of this certification form.
(6) All information include on this certification is true and accurate to the best of my knowledge.
THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERINt3
Signed under the pains and penalties of perjury,
ee 49
Name of Owner __Signature of 6wner _Date
]:]The property has peen transferred to the owoer above and the trait remains in conq)tiance wide the requirements of M,61 e. Date Slab ttt to Local Talth
166§22- ❑Cpall't
Prior owner's Si}utaturw Date 1
410-23-Submetering of Water and Sewer Certification Fomi 5-12-23