Safe & Healthy Neighborhoods Registration

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3. The Safe and Healthy Neighborhoods Initiative being undertaken by the Town has identified several critical health and safety goals with regard to housing and residential neighborhoods. Thank you for taking the time to complete this survey!

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6. Property Information

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9. Address (ex: 4 Boltwood Avenue)*

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11. Parcel ID*

12. Click here to lookup your Parcel ID

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21. House Type*
    1. Single Family
    2. Two Family
    3. Three Family
    4. Condominium
    5. Other

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23. Owner Occupied*
    1. Yes
    2. No

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25. Total Number of Units*

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28. Owner Contact Information

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31. Email*

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33. Phone: (ex: 413-259-3333) *

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35. Cell Phone: (ex: 413-259-3333)

36. Text Messages
    1. Yes
    2. No

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40. Other Contact Information (If Applicable)

41. Is the owner a Realty Trust, Partnership, Corporation or Limited Liability Company*
    1. Yes
    2. No

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44. If Answer to Above Question is Yes, Provide Managing Trustee, Partner, Director, or Manager Contact Information

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46. Name

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48. Address (ex: 4 Boltwood Avenue)

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50. Email

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52. Phone (ex: 413-259-3333)

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54. Cell Phone (ex: 413-259-3333)

55. Text Messages
    1. Yes
    2. No

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58. Manager/Agent Contact Information (If Applicable)

59. Property Manager or Agent Who is Employed by the Owner

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62. Name

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64. Address (ex: 4 Boltwood Avenue)

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66. Email

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68. Phone (ex: 413-259-3333)

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70. Cell Phone (ex: 413-259-3333)

71. Text Messages
    1. Yes
    2. No

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72. 1. Receive email copy
73. Email address

74. Submit

* indicates a required field