HomeMy WebLinkAbout6 Gardiner Lane paper applicationor\o.'i \+D €rq$re/-c
f.-l!
!
A"4 u,)
ddreos
:JlXr At^ln5.Qzrc--H ,rtt
CTI UN S I
Please call to schedule 508-398-2231. ext. 1240
MON-FRl, 8:30 Aill-4:30 PM
Annual Registration is an Owner Rcsponsibilitv
2023 RENTAL/LEASE REGISTRATION
TOWN OF YARMOUTH_BOARD OF HEAITH
1146 ROUTE 28, SOUTI{ YARMOUTH MA 02664
t**
ATTENTION LANDLORDS of Houses, Apartments, Duplexes, condominiums, Room Rentals. (in owner
occupied dwellings) and Shod Tcrm Rectals. Excluding HoteVMotel, Ina, Lodging House or Bed and Breakfast
oporations, (CHAPTffi 108 - OCCUPANCY OF BUILDINGS ByLAW).
Note: Compliance with Zoning regulations is not inferred, nor iniended.
RENTAI"/LEASE Reglstratlont EXPIRE on DECEMBER 31 of eech year, }.EE IS $30 PER RENTAL/
LEASE UNIT. Complete this form and return to the Herlth office. Chect<s payahte to: .TowN oF
YARMOUTH'. For additional FORMS A-I{D/OR QUESTIONS, cont&et the IIEALTH AT
508-398-2231, x1240
ll,^r: Jo /t,a?c,l,
1
Ren
M1+ LLtK sdr.3ryeJoxf Trpruaa Q 6a+zta'''t
Owner N3q (Required Info)
aQN &
CitylTown
Email and Phone #
/1/t&i>7i,/'
St c Z{?
PENALTIES - t ate registration of more than 30 DAYS after receipt or violations of any part of Chapter 108,
,t4l be subject to non-crimilal citations issued as follorvs. Each day's violation deemed a separatc o,)bnse.
ld Offense $100.00 / 2"4 Offense $11X),00 {and each additional) 3200.00. This applics to any OWNEI\ or
Reprcsentative.
Trash Removal by: Owner Tenant Disposal dSticker at Landfill
(Ooce a wcek minimun)
Paid Pickup_ Name of Company
Notc; Pleese remove trrgh & recycle blnt from rord after plck up day.
$80.00 Annual fee: Owner msy slso register onHne: https://yarmouth.ma, ns
(follow online services icon, then Permits & Li
S
1
key.l0ll1n2
7e aYpcx-.
o-r)
U
Mrlltng Address