Petitioner: Applicant Information
Rooming House & Manager Information
| Establishment Information (Search for your business) |
---
|
| Owner Email address/correo electrónico |
[email protected]
|
| Owner Telephone number/Número de teléfono |
16172121880
|
| Mailing address(if different)/Dirección postal (si es diferente) |
Revere Beach Parkway
|
| Establishment physical address/Dirección física del establecimiento |
165 Hawthorn Street, Chelsea , Mass.
|
| Owner Name/Nombre del dueño(a) |
125 Chestnut Street LLC
|
| # of floors |
3
|
| # of rooms |
10 or more
|
| # of lodgers |
16
|
| Manager Name |
---
|
| Manager Home Address |
---
|
| Manager Telephone |
---
|
| Manager Email |
---
|
| Is this a new application or a renewal? |
Renewal
|
| What kind of applicant are you? |
Other type of business (LLC, etc)
|
Renewals (please complete all fields if this is an application for a renewal)
| Has any information changed from your original license application? |
No - renewal without changes
|
| Current License Number |
0000
|
Owner Information
| Owner Name |
125 Chestnut Street LLC
|
| Home Address |
---
|
| Home Telephone |
---
|
| Owner Email |
---
|
Certificates (required)
| Certificate of Worker’s Compensation OR Certificate of Compliance (must be notarized) |
---
|
| Wage Theft Certification Form |
---
|
| Certificate of occupancy or application for same |
---
|
| Business Certificate or Articles of Organization |
---
|
| Certificate of Good Standing from the Massachusetts Department of Revenue; |
---
|
Petitioner: Acknowledgement
Applicant Certification
| I have read and agreed |
Yes (Yes - accept terms and conditions)
|
| Enter telephone number |
---
|
City: Document Check
Document check
| All documents submitted |
All documents submitted
|
Application fee review
| Application fee status |
Not required (renewal application)
|
City: Internal Tracking
City Tracking
| License Commission Review Date |
2022-12-08
|
| License Commission Decision |
Award License
|
City: Issue License
City Tracking
| License application result |
Approved (issue license)
|
| License # Issued |
2023-0007
|