Rental Inspection Consent Form printable pdf download

Rental Inspection Consent Form

THIS INSPECTION WAS REQUESTED BY YOUR PROPERTY OWNER TO COMPLY WITH CITY

OF BOSTON CODE ORDINANCE CBC 9-1.3, WHICH REQUIRES THAT RENTAL APARTMENTS

BE INSPECTED AND BROUGHT INTO COMPLIANCE WITH THE STATE SANITARY

(HOUSING) CODE.

BY SIGNING THIS DOCUMENT I REPRESENT THAT:

Initial:

I understand that I have the RIGHT TO REFUSE an inspection of my dwelling or home

without a warrant (an order signed by the Court) as explained to me, and that I agree,

voluntarily and without a warrant, to permit members of the Inspectional Services

Department (“ISD”) to inspect my dwelling or home.

I am 18 years of age or older.

I _____ live at the above-described residence; or I _____ am the authorized

representative of an adult occupant for this inspection (pursuant to 105 CMR 410.820)

This consent ONLY authorized members of the ISD to enter and/or inspect the above

residence.

Occupant’s Signature:_____________________________________ Date:_________________

AUTHORIZED REPRESENTATIVE DESIGNATION (use this section if the occupant does not

plan to attend the inspection):

I (name of occupant)___________________________________, an occupant of (address)

___________________________________________________, (Ward ___), being above the age of 18,

has consented to a rental inspection of the above-referenced residential dwelling unit. I understand my

right to be present during this inspection and my right to request that this inspection be re-scheduled to a

time and date more convenient for me. However, I do not wish to be present during this inspection, and

hereby grant permission to my property owner/agent to conduct this inspection with the ISD inspector,

without me being present. I am signing this form VOLUNTARILY, without threats or promises of

any kind, and BEFORE any inspection has taken place.

Occupant’s signature: ___________________________________ Date: _________________

Owner/Agent’s Signature:________________________________ Dave:_________________

TO BE SIGNED BY INSPECTOR:

I have explained to the occupant or representative the right to refuse an inspection and/or

photo/videotaping in the absence of a warrant and have read this form to the occupant. If the occupant

does not speak English, ISD has provided an interpreter to read this form and to explain the occupant’s

rights.

Signature:____________________________________________ Date:___________________

Printed Name:____________________________________ Inspector #:______________________

Rental Inspection Consent Form