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HomeMy WebLinkAbout25 West Yarmouth Road paper application0vlfi.l,L L6LA-A"UT 7t LV ?t -kts **INSPECTION OFALI NITSARE REOUIREDU t** Please csll to schedulc 50t-39&2f f , ert. 1240 MON-FRl. E:30 Alft-{;30 l'lll Antrurl Registrulion is an ()wncr Responsibility 2023 RENTAL/LEASE REGISTRATION rOWN OF YARMOI.JTH _ BOARD OF HEAAfi I146 ROUTE 28, SOUTII YARMOUTH MA 0266{ !r-u{.) lLEtfjt q A2 q ATTENIION I.ANDLORI)S of Houses. Apartments, Duplexes, Condominiums, Room Rentals. (in ou'ner rccupied dwellingst ald Short lenn Rentals. Excluding Hotelltlotel. lnn,' dging House or Bed and Breakfast operations. (CIIAPTER 108 - oCcLIPANcY oF BI' {NGS BYI-AW). Nore; Compliance rvitl Zoning regulations is nol ed nor intended. RENTAULEASE Rrgirtretions EXPIRE on DECEMBER 3l o ;ech yar. fEE IS StO PER RENTAU-LEASE IIh0T. Completc this form rnd rrlurn to lL€ Resl"h Otfice. C'tidrs peyrbte to: '"TOWN Of - YARMOLTIIP. For rdditionrl FORMS AND/OR QUESTIONS. coEhcr lhi HEALITH OFFICE AT 508-39E-223I, r1240 Reolrl Propertl Addr€ss 1-1ol,t Owner n-rme (Rcquircd hfo)I r"l ; c- (.-t o u <-.rk: E5 4t Mailing Address City/Town Slate ZI?almqloqetqt,(, ReEtrl AteDl (ifrny) Email and Phone # Rental Period: Annual *[ Seasonal- Short Tenn:(occupancy legs thsn 3l days) Renul of: House Y Duplex-Condo-Apartment-Room -Spoke Deleclors rad Crrbon Moeo{dc Dc(ectolr ltaqulrcd- Owneru: I heve cnsnrcd the b.tteri$ trt cbrnged, eed hevc lested ALL Seoke Detcctors/Cerbon Monoride Detectorr? Smoke/ CO derectoIs oldcr than l0 ye86 mu$ !e llpliEod . -.a ^r.-,;:-.*--Csll fire depsnment regarding qurstirhs on nerv type and lcation prior to purchasing. 508-i98-22 l2 PENALTIES - l.are rcgis{rarion of more rhan 30 DAYS after rcceipt or violatiom of any prt of Chapter 108 nray tre subject to non-criminal citations issued as fotlows. Each day's violation decmed a seporate offense. Ir Offense $ 100.00 / 2na Offense Slfi).00 iand each additional) $200.00. This applies to any OI*NER or Representative. Trash Removal by: Ovmer _- lOncc a *.r* minimum) Paid Pickup_ Name of Company Tenant X Disposal *y'Sticker at Landfill - Note: Plersr rrnrove tresh & rtcycle binr fmm road rfter pk{r up day $t0.00 Annual fee: Owter may also register onllne: htQ,!://ytrmouth.ms.us (follow online seryic€s icon, then Permits & Licenses). MQ,t ,14 N1- mEieG rV FEB r s 2023 tB Z r- L^J z : I !a:- a.^-, ,.: l\ A c"+._l 5 LLc_ ( la{,.t-p 1: A{a l<:^t- na4*-t-. L*r *. ,0\r: sV ,7 Enrail ard Phone # <r flrl i,1 CV1 fq1a'