HomeMy WebLinkAboutAffidavit of Non Rental , OF.................
4‘.
iereftTOWN OF YARMOUTH Health
-"
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-244` Health
Telephone (508)398-2231, ext. 1240 Division
Fax (508) 760-3472
AFFIDAVIT
Residential Property Not Offered for Rent
s+T,ov Date: OK//2c/o2
pQR 7 ts z2A Owner's Name: C.-%/12l'L5o4v �GD il/�; - i t n�sq or
Address: 7-1 WC-bf S if./ U
‘404-
"�N " City/State/ZIP: wwr r2i "1/1-A
Phone/Email: 5og 4.0 ) 6/EM.JC)0•.i.. l k i) &A4Ae<
• (o.M
Yarmouth Property Address:
Address: 1' / U!/ b h6-t , PAi4
City/State/ZIP: 4� 6 '�
I,0Gi1142,`Ait/ l it 4qi/'am the owner of the above-referenced property, as
verified by the Town of Yarmouth Tax Records. I hereby confirm that the
dwelling/unit/apartment mentioned above is not currently rented or is being offered for
rent.
I am fully aware that according to the regulations of the Yarmouth Health Department,
any residential property that is offered for rent or lease must be registered, and a Rental
Occupancy Certificate must be issued.
Therefore, I understand that if I decide to offer my residential property for rent in the
future, I must adhere to the following steps:
• Register with the Yarmouth Health Department.
• Obtain a Rental Occupancy Certificate in accordance with Chapter 108 of the
Occupancy of Buildings regulations. A rental inspection may be required.
By signing below, I acknowledge my understanding of these requirements and commit to
complying with them when and if I choose to offer my property for rent in the future.
Owner(s)Signature: �1ee,/LI.eL pL,A,/
Please return this affidavit to the Yarmouth Health Department at the following address:
Yarmouth Health Department 1146 Route 28 South Yarmouth, MA. 02664
Or email:
VA\i. (goo 1?-lg W1 A • JS