HomeMy WebLinkAboutNOT_RENTING_AFFIDAVIT_Fri_Aug_8_2025_11-37-01to I I46 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTSO2664.2445I
Telephone (508) 398-2231, ext. l24l
Fax (508) 760-3472
TOWN OF YARMOUTH Board of
Health
AFFIDAVIT
Residential Property Not Offered for Rent
our", P151a5
t?t
r \t e{-
\re
Owner's Name:
Address: 3
City/State/ZIP
Phone/Email:
C ttv /StztelT.lP
3?o
o t/\
Address: I I );
Yarmouth Propcrty Addrcss
rVe
t.\.bE , am the owner of the above-referenced
property, as verified by the To of Yarmouth Tax Records. I herebv confim that thc
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 ofl'ered for rent or lease must be registered, and a Rental
Occupancy Certificate must be issued.
Therefore, I understand that ifI 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 ofthe
Occupancy of Buildings regulations. A rental inspection nru\' be require[
complying with them when and if
Owner(s) Signature:
I choose offer my p erty for rent in the future
Please retum this affidavit to the Yarmouth Health Department at the following address
Yarmouth Health Department 1146 Route 28 South Yarmouth, MA. 02664
Or email : sprovos@yarmouth.ma.us
Health
Division
By signing below, I acknowledge my understanding of these requirements and commit to