Petitioner: Applicant Information
Rooming House & Manager Information
Name of rooming house |
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Rooming house address |
15 Congress Ave, Chelsea MA 02150-2864
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# of floors |
4
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# of rooms |
44
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# of lodgers |
44
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Rooming House Telephone |
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Manager Name |
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Manager Home Address |
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Manager Telephone |
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Manager Email |
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Renewals (please complete all fields if this is an application for a renewal)
If this is a renewal, has any information changed from your original license application? |
No - renewal without changes
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Briefly describe any changes (renewals only) |
N/A
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Current License Number |
N/A
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Owner Information
Owner Name |
C Choice LLC Boston Universal LLC DBA Boston Universal Hotel & Hostel
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Home Address |
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Home Telephone |
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Owner Email |
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Principal Officers (if owner is a corporation)
President Name |
Amandeep Dillon
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Certificates (required)
Certificate of Worker’s Compensation OR Certificate of Compliance (must be notarized) |
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Wage Theft Certification Form |
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Certificate of occupancy or application for same |
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Business Certificate or Articles of Organization |
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Certificate of Good Standing from the Massachusetts Department of Revenue; |
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