Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout30 Wampanoag Road paper application**INSPECTIO N OFALL UN ITSARE REOUIRED!**
Please call to schedule 508-398-2231 ,ext. 1240
MON-FRl, 8:30 AM-4:30 PM
Annual Registration is an Owner Responsibility
2023 RENTAL/LEASE REGISTRATION
TOWN OF YARMOUTH _ BOARD OF T{EALTH
1146 ROUTE 28, SOUTH YARMOUTH MA 02664
€,1OC ALATAS
.qQzffi--H r.rtl
AITENTION LANDLORDS of Houses, Apartrnents, Duplexes, Condominiums, Room Rentals. (in owner
occupied dwellings) and Short Terrn Rentals. Excluding Hotel/Motel, Irm, Lodging House or Bed and Breakfast
operations. (CHAPTER 108 -OCCUPANCYOF BUILDINGS BYLAW).
Note: Compliance with Zoning regulations is not inferrd nor intended.
RENTAL/LEASE Registrations EXPIRE on DECEMBER 31 of each year. FEE IS $80 pER RENTAL/
LEASE [IMT. Complete this form and return to the Health Office. Checks payable to: (TOWN OF
YARMOUTH'. For additional FoRMs AND/OR euEsrloNs, contact the HEALTH SFFICE AT
508-398-2231, x1240
AO wA,n0AN OAG RD S . Yarnn o.^11.,A^l o ebGn
Rental Property Address
Twt\i,.o\d
Owner Name (Required Info)
o:\oud @- ( .h^4aiL. c-a$^
Email and Phone # 5og a3T 58 5q6a
Mailing Address City/Town
Trash Removal by: Owner
(Once a week minimum)
Paid Pickup K Name of Company
{r D.. S ".)t',/qe oa6c
State ZIP
Zru
Rental Agent (if any)
Rental Period: Annual - Seasona{Short Tenn_(oc cupancy less than 3l dt
Email and P
Smo
Rental of: Houserl, Duplgx a Condo_Aparhnent_Room_
-Smoke Detectors and Carbon Monoxide Detectors Required-
Owners: I have ensured the batteries are changed, and have tested ALL
Detectors/Carbon Monoxide Detectors?
Smoke/ CO detectors older than l0 years must be replaced.
Call fire department regarding questions on new type and location prior to purchasing. 5
PENALTIES - Late registration of more than 30 DAYS after receipt or violations of any part of Chapter 108,
nray be subject to non-criminal citations issued as follows. Each day's violation deemed a separate offense.
1't Offense S100,00 / 2na Offense $100.00 (and each additional) $200.00. This applies ro any OWNER or
Representative.
08-398-221
Tenant
r(
Disposal ilSticker at Landfill
i5 Q
Note: Please remove trash & recycle bins from road after pick up
$80.00 Annual fee: owner may also register online: https://yarmouth.ma.us
(follow online services icon, then Permits & License
Signature
(Require)
Re\.lill1D2
,v