HomeMy WebLinkAbout11 Bob-O-Link Lane paper application2e^8 ame.,.-\ Z(
PECTION OFALL UN ffi t(cl3
stheSq eI
**INS
Please call to schedule 508-398-2231 , ext. 1240
MON-FRl, 8:30 AM-4:30 PM
Annual Registration is an Owner Responsibill{y
2023 RENTAL/LEASE REGISTRATION
TOWN OF YARMOUTH - BOARD OF I{EALTH
1146 ROUTE 28, SOUTH YARMOUTH MA 02664
.,10I(E ALARN 5
sAVE I l\,tt3
AITENTION LANDLORDS of Houses, Apartrnents, Duplexes, Condominiums, Room Rentals. (in owner
occupied dwellings) and Short Term Rentals. Excluding Hotel/Motel, kur, 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 tiMT. Complete this form and return to the Ifealth Ofrrce. Checks payable to: 'TOWhl OF
YARMOUTH". For additional FORMS AND/OR QUESTIONS, contrct the HEALTH OI'FICE AT
508-398-2231, x1240
lL BoB- o-Ltil\
JAN 't 120ryi
HEATTH DEPT
Rental Property Address
Owner Name (Required Info)lf n *tcd Lo S Prttce,r- U 4
eu fr 60 -q tl -01q1
Email and Phone #
0 tf62
o!,EPA I
Mailing Address City/Town State ZIP
Rental Agent (if
Rental Period:
Rental of: Hou
any) Email and Phone #
AnnualI Seasonal- Short Term-
seY Duplex Condo _Apartment Room_-+
--Smoke Detectors and Carbon Monoxide Detectors Required-
ers: I have ensured the batteries are changed, and have tested ALL Smoke
Detectors/Carbon Monoxide Detectors?t S.oke/ CO detectors older than l0 yean must be replaced.
Call fire department regarding questions on new type and location prior to purchasing. 508-398-2212
Trash Removal by: Owner_
(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:
(follow online services icon, then Permits & Licenses).
Signature
(Require)
Tenant Y Disposal dSticker at Landfill
PENALTIES - Late registration of more than 30 DAYS after receipt or violations of any part of Chapter 108,
zray be subject to non-criminal citations issued as follows. Each day's violation deemed a separate offense.
lst Offense $100.00 / 2na Offense $100.00 (and each additional) $200.00. This applies to any OWNER or
Representative.
https ://yarm outh. m a. us
RBGEOVEE
Rev.10/17122