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HomeMy WebLinkAbout71 Swan lake Road paper application@fi14+
sl r**INSPECTION OFALLU NITS ARtr REOU IRED!**
Please call to schedule 508-398-2231, ext.1240
MON-FRI, 8:30 AM-4:30 PM
Annual Registration is an Owner Responsibility
2023 RENTAL/LEASE REGISTRATION
TOWN OFYARMOUTH-BOARD OF HEALTH
1146 ROUTE 28, SOUTH YARMOUfi{ MA 02664
310(L AL&nS
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ATTET{TION LANDLORDS of Houses, Apartnents, Duplexes, Condominiums, Room Rentals. (in owner
occupied dwellings) and Short Term Rentals. Excluding HoteyMotel, Inn, Lodging House or Bed and Breakfast
operations. (CHAPTER 108 - OCCUPANCY OF BIIILDINGS BYLAW).
Note: Compliance with Zoning regulations is not inferred, nor intended.
RENTA-L/L-E-4SE Regkratlons EXPIRE on DECEMBER 3l of each year. FEE IS $80 pER RENTAL/
LEASE UNIT. Complete this form and return to the Ilealth Olfrce. Checks payable to: (TOWN OF
YARMOUTH'. For addltionrt FoRl\{s AND/OR QUEsrIoNs, contact the HEALTH oFFIcE AT
50&398-2231, r1240
1t (,DI\ r^\ (,4 ILtr; ZOAA ., tt--Xf Y NrTH nn A
Rental Property Address
*
Owner Name (Required Info)
C lrrr^G^t . CJ rr-
Email and Phone #Z aiv{l.J
State ZI?
Rentll
Rental
Rental
Agent (ifeny) ,/ Email and phone
Period: Annual YSeasonal: Short Ternr_(occupancy less than .3 I days)
of: House^-,6ufre*-cor-do-epartnilt_noom_
-Smoke Detectors and Carbon Monoxlde Detectors Requlred-
Owners: I have ensured the batterles are chrnged, end have tested ALL Smoke
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. 509-39g-
PENALTTES - Late registration of more than 30 DAYS after receipt or violations ofany part ofChapter 108,
rray be subject to non-criminal citations issued as follows. Each day's violation deemed a separate offense.
I'r otrense $1(X).00 / 2na offense $l{x}.00 (and each additional) $200.00, This applies to any owNER or
Representative.
I
FItaom1'I
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F€c!r\oa,
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Trash Removal by: Ovner .-/
(Once a week miuimum)
Paid Pickupj Name of Company
Tenant_ Disposal Wsticker at Landlill
tJ 41lS{-T
Note: Plesse r€move trrsh & recycle bins from road after pick up day.
$80.00 Annual fee: Owner may also register online: https://yarmouth.ma.us
(follow online services icon, then Permits & Licenses
Signature
(Rcquire)
ket.lA/11n2
-rffu.{ffi @'.d I
l\.t1iling Address City/Town
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