HomeMy WebLinkAbout248 Camp Street G5 2026 Rental Applicationln accorda
conta
nce with 105 cMR 410'560' and sxcapt e3 provid.d in los cMR 410.560(c) (for BuLK it€ms) , the owner of any resrdenceiningtwo or mole dwsl'ting unit!, a tooming houso, hometass shctter, ormanutrcturad housing community, shatr beresponsible forand payforths tinat coltection and ultimat€ ditposat ol refuse.
I, THE OWNER, CERTIFY THAI MY RENTAL PROPERry WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCEWITH MA STATE SANITARY CODE 105 CMR 410.560 (C) AND 105 CMR 410.560 (4)(E)
OWNER INITIALS
RENTAL PROPERry ADDRESS
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PRO PERTY OWNER EMAIL ADDRESS
PROPERW OWNER NAME
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PROPERry OWNER MAILING ADDRESS
PROPERTY OWNER PHONE #
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I REQUTRED
ALTERNATIVE PHONE #. _::- -.::_i
OWNER'S REPRESENTATVE/RENTAL AGENT
REQUIRED
REQUIRED
REQUIRED
REPRESENTATIVE ONE
R EP RESE EMAIL A RESS e/2e/
RENTAL PERIOD
TRASH REMOVAL BY
PAID PICK-UP IRASH COMPANY NAME:
G.TERM/YEAR-ROUND :SHORT-TERMA\,EEKLY
o&'^r _ TENANT
RENTALS
BE PROCESSED
INFORMATION
PHONE OR*EMAIL WILL
RENTAL OF:
E HousE tr DUpL ,, Koo a ApARTMENT o RooM
NUMBER OF UNTTS FOR RENT: I
I hereby acknowledge that lhave thoroughty reviewed and am futty famitiar with the fottowi;g regulations:Town o, Yarmouth Chapter i08 - Rantat Housing Bytaw,Town of Yarmouth Chaptcr 1 04 - Anti-Noise Bytaw, Town ofYarmouthShort-Term Rentat Bylaw (if appticabte),Massachusetts State Sanitary Code, Chapter ll -Minimum Standards of Fitness for HumanHabitation
These documents are avaitabte tor reference on the officiat Town oYarmouth Health Depanment. Funhermore, lunderstand that la
rentingthe p.operty. Faiture to do so may
f Yarmouth website and may atso be obtained upon .equest from them required to notify the Hestth Department in writing when I c6ageresutt in the imposition offin6s and/or fees.
OUESTIONS: Phone r* S08-398-2231 Ex. 1240, EmaiL rnrederberger@yarmouth.Da.us
APPLICANT SIGNATUBE
DATE
5
RENTAI-
IF APPLICABLE