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OAK. FEE $50.00
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MANAGER /SEASONAL EMPLOYEE HOUSING PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth, MA 02664
(508) 398-2231 Ext. 1261
APPLICATION FOR: MANAGER UNIT(S) SEASONAL EMPLOYEE HOUSING
HOTEL/MOTEL ADDRESS: S To d d P
SPECIFY STREET#AND NAME
OWNER: 1)11AVt71 k1 cir Pea }P.I 33 Tc4J Ra call-% Yo'r 4 4, - 02664 cMg22 I-9224
NAME LEGAL ADDRESS' TEL. #
MANAGERTDkAtaI111)..iy PQ I
NAME LEGAL ADDRESS TEL.#
ON SITE PROCTORJ) awl I kV AA14'Y Pe*f
NAME ROOM NUMBER CELL#
EMAIL CONTACT Ist1141)No9G - rcreecod ( 9N+Mcli 1• (e -
TOTAL NUMBER OF LICENSED ROOMS: Lt
NUMBER OF MANAGER/OWNER UNITS , ROOM NUMBERS NO N l)'\ Z -•
NUMBER OF SEASONAL HOUSING UNITS : (APRIL 1st—OCTOBER 315')
15% MAX
ROOM NUMBERS:
INITIAL
I will comply with all applicable Town of Yarmouth Zoning Bylaws and all other applicable laws. `-7i 'P
Seasonal employee housing shall be used solely by employees and shall not include family members or non-employees. .P'
I understand that any false statement(s)will be just cause for denial or revocation of my permit and may result in the town ' ' P
taking further legal action.
I declare under penalties of perjury that the statements herein contained are true and correct. Ip-
Applicant's Signature: Date: 0.J -1 4 - .202i
Owner's Signature(or attachment) Date:
Approved By: Date:
Building Commissioner(or designee)
Updated 3/24