HomeMy WebLinkAboutNLR Affidavit TOWN OF 1 A R M O V 1 H F3oard it
1146 ROUTE 28, SOUTH YARMOLTH, MASSACHUSFTTS 02664-244_` Health
° Telephone (508) 398-2231, ext. 1240 Dit-isiofl
Fax (508) 760-3472
AFFIDAVIT
Residential Property Not Offered for Rent
Date: --Zc" 2k
Owner's Name: S k e'11.er Scar:nee_
Address: $ CQcd2.k Lin
City/State/ZIP: V eXk- Yo.rrnoo-11, . 0203
Phone/Email: 5 bg - 4` -o- 8g y
Yarmouth Property Address:
Address: S CaceA (An
City/State/ZIP: pee YQrtneOt.h , MA- 020-3
I, Sceenen Se_elf (Se- , 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: V 4 . 74,
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: epolite@yarmouth.ma.us