HomeMy WebLinkAboutNot Renting Affidavit 08_04_2025Y4
I 146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTSO?69-?4451
Telephone (508) 398-2231, ext. l24l
Fax (508) 760-3472
TOWN OF YARMOUTH Board of
Health
Health
Division
AFFIDAVIT
Residential Property Not Offered for Rent
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Owner's Name:
Address:
City/StatelZIP
Phonc/Email:
Address
Cirv/State/ZIP
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Yarmouth Property Address:
'{V\ e r n{- Psl e
0A ct'ao ret- 3.,,.r". +,,, , am the owner of the above-referenced
prop.i[asTorf,"a Uy tn" f*n of Yarmouth Tax Records. I hereby confirm that the
dwelling/unit/apartment mentioned above is not currently rented or is being ofl'ered for
rcnt.
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:o Register with the Yarmouth Health Department.I Obtain a Rental Occupancy Ccrtificate in accordance with Chapter 1O8 of the
Occupancy of Buildings regulations. A rental inspection ma1,be required.
By signing below, I acknowledge my understanding ofthese requirements and commit to
complying with them when and if I choose to offer my property for t in the future.
Owner(s) Signature
Please retum this affidavit to the Yarmouth Health Department at the following address
Yamrouth Health Department 1146 Route 28 South Yarmouth, MA. 02664
0r email: sprovos@yarmouth.ma.us
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