No preview available
HomeMy WebLinkAboutRegistration ► 0-- SP.--)16 **INSPECTIONIRED!** OF ALL UNITS ARE REQUIRED!** ;e n Please call to schedule 508-398-2231, ext. 1240 SMOKE ALARM MON-FRI, 8:30 AM-4:30 PM �t , 'i li Annual Registration is in Owner Responsibility _ 1� 2023 RENTAL/LEASE REGISTRATION TOWN OF YARMOUTH — BOARD OF HEALTH JAN 0 3 2o2Y 1146 ROUTE 28, SOUTH YARMOUTH MA 02664 HEALTH DEPT. ATTENTION LANDLORDS of Houses,Apartments, Duplexes, Condominiums, Room Rentals. (in owner occupied dwellings) and Short Term Rentals. Excluding Hotel/Motel, Inn, Lodging House or Bed and Breakfast operations. (CHAPTER 108-OCCUPANCY OF BUILDINGS BYLAW). Note: Compliance with Zoning regulations is not inferred, nor intended. RENTAL/LEASE Registrations EXPIRE on DECEMBER 31 of each year. FEE IS $80 PER RENTAL/ LEASE UNIT. Complete this form and return to the Health Office. Checks payable to: "TOWN OF YARMOUTH". For additional FORMS AND/OR QUESTIONS, contact the HEALTH OFFICE AT 508-398-2231,x1240 .5.ChAlLej. , YwuporF Pi A- 27.E Rental Property Address i q Shun // CFi' ?m fr1 j, ?tV-06' ( C17- ,-om can A—6/in ' 6 6 Owner Na a (Required Info) Email and Phone# �( S by / ,v IJL /e-c /,i7 l(- plyl a q 7 Mailing Ad ress City/Town State / ZIP ���,,� lM !/ct F .' YI " 6t14L0.461 /`UNDO d �1ns....4,44 4, [�-v"i2 (030.A '� Rental Agent (if any) Email and Phone# Rental Period: Annual Seasonal_ Short Term_(occupancy less than 31 days) kRental of: HouseDuplex Condo Apartment Room 0191, 2 --Smoke Detectors and Carbon Monoxide Detectors Required— Owners: I have ensured the batteries are changed, and have tested ALL Smoke Detectors/Carbon Monoxide Detectors? Smoke/CO detectors older than 10 years must be replaced. Call fire department regarding questions on new type and location prior to purchasing. 508-398-2212 PENALTIES-Late registration of more than 30 DAYS after receipt or violations of any part of Chapter 108, may be subject to non-criminal citations issued as follows. Each day's violation deemed a separate offense. 1st Offense $100.00/2nd Offense $100.00 (and each additional) $200.00. This applies to any OWNER or Representative. Trash Removal by: Owner Tenant Disposal w/Sticker at Landfill (Once a week minimum) Paid Pickup Name of Company Note: Please remove trash & 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). Rev. 10/17/22 Signature (Require) // ={"'`_: - p GH 13NIJf113S 6E -1VIN3d L81Z1AN 'N JVd 831S1l and SfldOS3 T 21f V 3N0?J3f A113NOWIS 1799Z0 b'W 'ylnowm,k ynnos z I4a e.<e.+J(. .gee 9 8Z alnoa Still s3ZO.Pd 13:3143GI" 1N3W±H`dd34 H1lV3H H1flOW vA 'BOHK`18-3374-REN-05 - 39 SETUCKET ROAD - 2023 RENEWAL Help File Date: 02/06/2023 Application Status: Application Submitted Description of Work: 2023 RENEWAL Application Detail: Detail Application Type: Rental Certificate Renewal Address: 39 SETUCKET RD.YARMOUTH.MA 02675 Owner Name: SIMONETTY JEROME A JR Owner Address: 1 ESOPUS AVENUE,ULSTER PARK,NY 12487 Application Name: 39 SETUCKET ROAD-2023 RENEWAL Parcel No: 143.138 Contact Info: Name Organization Name Contact Type Relationship Address Contact Primary SIMONETTY JEROME A JR KINLAN GROVER... Rental Agent 1 ESOPUS AVE.U... Licensed Professionals Info: Primary License Number License Type Name Business Name Business License# Job Value: $0.00 Total Fee Assessed: $80.00 Total Fee Invoiced: $80.00 Balance: $0.00 Custom Fields: RENTAL UNIT INFORMATION Rental Type House Type Smoke Detecto Annual Single Family House Yes Carbon Monoxide Detectors Installed Trash Pickup Max.Occupanc Yes Owner 2 Number of Units Date of Last Inspection Internal Comm( 1 6/25/2018 Per owner reque LIST ALL OCCUPANTS Occupant Name Phone 1 Phone Type Phone 2 Phone Type 2 E-Mail Address BEDROOM SQUARE FOOTAGE Bedroom Bedroom Length(Number) Bedroom Width Closet Deduction(Number) Total(Number) Workflow Status: Task Assigned To Status Status Date Action By Application Acceptance Accepted-R... 02/06/2023 Mary A Florio-O... Health Review Inspection Awaiting Sch... 02/06/2023 Mary A Florio-O... Issuance Close Out Condition Status: Name Short Comments Status Apply Date Severity Action By Application Comments: View ID Comment Date Initiated by Product: AV360 Scheduled/Pending Inspections: Inspection Type Scheduled Date Inspector Status Comments Resulted Inspections: Inspection Type Inspection Date Inspector Status Comments � S A • c(,,f L1 /,(-ems, ,e— ctouc- /A, 4e ,42 k clQAA/ r} e(2,f /JeeJ / , ' /aff '4 1( „j( ,1 a- 3 R4J itLukA^i u0A - 9Od(J g- 0)1',/ 0 16{4- b3