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MANAGER /SEASONAL EMPLOYEE HOUSING PERMIT APPLICATIOI
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: .51 et y�C l -0.24 z-1
SPECIFY TREET##AyND NAME y�
OWNER( A/ k_��l ,LEiAL'AaDRILT./.�)S . So, #�►[� 1 O2_66
ME - ���
MANAGER: / , so. 6 C
NAME ,EGAL ADDRESS TEL.#
ON SITE PROCTOR C 77L1 o i—
NAME ROOM NUMBER CELL
EMAIL CONTACT a 60
TOTAL NUMBER OF LI ENSED ROOMS: pt•reft.CA-4-
NUMBER OF MANAGER/OWNER UNITS ROOM NUMBERS /
NUMBER OF SEASONAL HOUSING UNITS: (APRIL 1st-OCTOBER 31')
15% MAX
ROOM NUMBERS: t 1 Ol ti 7 j II cr 2- f 7 33, _39
IN
I will comply with all applicable Town of Yarmouth Zoning Bylaws and all other applicable laws.
Seasonal employee housing shall be used solely by employees and shall not include family members or non-employees.
I understand that any false statement(s)will be just c se for denial or revocation of my permit and may result in the town
taking further legal action.
I declare under penalties of perjury that the ate herein contained are true and correct.
Applicant's Signature: '" Date: 2 ...2--v
Owner's Signature(or attachment) • Date: 'S1)/24
Approved By: Date: /
Building Commissioner(or designee)
Updated 3/24