HomeMy WebLinkAboutNOT RENTING AFFIDAVIT RECEIVED 112020252445 l
TOWN OF YARMOUT Board of
Health
I I46 ROUTE 28. SOUTH YARMOUTH. MASSACHUSETI'SO2
Telephone (508) 398-223 I , ext. 1241
Fax (508) 760-3472
AFFIDAVIT
sidential Property Not Offered for Rent
Date:-L
n
Yarmouth Property Address :gr zy
ca"r-o . am the owner of the above-referenced
Tax Records. I hereby confirm that the
th
HEATTH i,--PT
Owner's Name
Addrcss
City/St^telZlP:
Phonei Email:
Citv lStatelZ
I.
prop , as verified by the Town of Yarmou th
dwelling/unit/apartment mentioned above is not currently rented or is being oflered for
rent.
I am fully aware that according to the regulations of the Yarmouth Health Dcpartment,
any residential property that is ofI'ered 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.o Obtain a Rental Occupancy Certificate in accordance with Chapter 108 of the
Occupancy of Buildrngs regulations. A rental inspection mar be reEtired.
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 fuh-re.
Owner(s) Signature
Please return 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
-(/"
'02"/A
)
Address: 1q')