HomeMy WebLinkAbout4 Connemara Way paper applications ERE UI RED!****INSPECTION OF ALL UNIT AR
Please call to schedule 508-398-2231 ,ext' 1240 .:,1O€ ALARNS
MON-FRI, 8:30 AM-4:30 PM
Annual Registration is an Owner Responsibility
Email and Phone #
TE'N
2023 RENTAL/LEASE REGISTRATION Dic 2
WN OF YARMOUTH BOARD OF HEALTH OEPI
1 146 ROUTE 28, SOUTH YARMOUTH MA 02664
ON 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 IO8 _ OCCUPANCY OF BUILDINGS BYLAW).
Note: ComP liance with Zoning regulations is not inferred, nor intended.
RENTAL/LEASE Registrations EXPIRE on DECEMBER 3l of each year' FEE IS $80 PER RENTAL/
LEASE UNIT. ComPlete this form and return to the Health Oflice' Checks payable to: "TOW\I OF
YARMOUTH". For additional FORMS AND/OR QUESTIONS, contact the HEALTH OFFICE AT
508-398-2231, x1240
4."4\AJ
AddressRental Proprty
72""
Owner Name (Required Info)
h tJ tAO
Rental Agent (if an1) /.
Rental Period: Annual / Seasonal- Short Term-
nent l of House-Duplex-Condo-Apartment-Room-
--Smoke Detectors and Carbon Monoxide Detectors Required-
-'r-"{ers: I have ensured the batteries are changed' and have tested ALL Smoke
Detectors/Carbon Monoxide Detectors?
s,nokel iO ietectors older than I 0 years must be replaced'
call firedian''ner,il;:;;;;;;*';;;;;"rypeandlocationpriortopurchasing 508-348-22I2
Maiting Address City/Town State ZIP
Email and Phone #
of more than 30 DAYS after receiPt or violations of any part of Chapter 108,
tations issued as follows. Each day's violation deemed a seParate offense
$f00.00 (and each additional) $200'00'This applies to anY OWNER or
Representative.
Trash Removal bY: Ownet _- Tenant Disposal dsticker at Landfill
-(Once a week minimum)
Paid Pickup-Name ol ComPanY
Note: Please remove trash & reci':le bins from road after pick up day'
nline: httPs://Yarmouth'ma'us
reqt:
PENALTIES - Late - ".rilratron
nay be subject ro non-o'j,tinal ci
lstOffense S100.00 / 2' flense
$80.00 Annual fee: Owner may also register o
if"ri"* "tri"e services icon, fl:en Permits & Lic
Rev. l0/l?22 Signatwe
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