HomeMy WebLinkAboutNot Renting Affidavit 08_05_2025 134)o
TOWN OF YARMOUTH Board of
Health
Health
Division
I I46 ROUTE 28, SOUTH YARMOUTH. MASSACHUSETTSO26&-2
Telephone (508) 398-2231, ext. l24l
Fax (508) 760-3472
AFFIDAVIT
Residential Property Not Offered for Rent
Date:5
Yarmouth Property Address:
3q Dri{t*
s
4(/0 ,
'tl D,o€p.
VOwner's Name
Address
City/State/ZIP:
I,
Addrcss
City lState/ZlP
f , am the owner ofthe 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 ofl'ered for
rent-
I am fully aware that according to the regulations of the Yarmouth Health Department,
any residential property that is off-ered lbr 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 rcnr in the
future, I must adhere to the following steps:. Register with the Yarmouth Health Department.o Obtain a Rental Ocdupancy Certiflcate in accordance with Chapter 108 ofthe
Occupancy of Buildings regulations. A rental inspection mat be required.
By signing below, I acknowledge my understanding of these requirements and commit to
complying with them when and if I choo to offer my property t in the future
O ) Signature
Please retum this affidavit to the Yarmouth Health Department at the following address
Yarmouth Health Department I 146 Route 28 South Yarmouth, MA.02664
Or email: sprovos@yarmouth.ma.us
Phone/Email: