HomeMy WebLinkAbout6 Brookhill Lane AffidavitTOWN OF YARMOUTH Helht
1 146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 Health
Telephone (508) 398-2231, ext. 1240 Division
Fax (508) 760-3472
AFFIDAVIT
Residential Property Not Offered for Rent
Date: //// ;r/a
Owner's Name- Afl?-A-a t!% /voav�-
Address: Xf / St/✓aoa c.o
City/State/ZIP: GUPSi.6oe—o Lr,, Gtzx—
Phone/Email: L568 - 4/ 7--el
Yarmouth Property Address:
Address: b %J/oo A Aeff 44o�L e
City/State/ZIP: A&9 r4agot r &A 41 67j
I, Iyi cA& e the owner of the above -referenced property, as
verified by the Town of Yarmouth Tax Records. I hereby confum 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) Signatur�
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