Adams Street Apartment Resources 




Back to Home Page           Printable Rental Application

Date_________Unit#_________Approved by________

Subject to Owner's approval and verification of information

A.  Applicant information:

Name__________________________________Social Security___________________________

Present Address_________________________Birth Date_______________________________

City___________________________________Birth Place_______________________________

State & Zip code________________________Driver's License#__________________________

Telephone Home________________________Telephone Work___________________________


B.  Applicant Household:____ Anyone who lives in rented premises other than you

                                                  Maximum 2 persons including yourself in a mid or large studio

                                                  Small studio accommodates 1 person-Applicant only

                                                  Non-family menber must fill out separate application

Name_________________________________Social Security____________________________

Employer______________________________Telephone Work#__________________________

Relation to Applicant_____________________________________________________________

C.  Applicant's Rental History:

Dates Lived at current address:___________________________________________________

Reason for Leaving:____________________________________________________________

Name of Present Landlord___________________________Telephone #___________________

Previous Address______________________________________________________________

Dates Lived at previous address:__________________________________________________

Reason for Leaving:____________________________________________________________

Previous Landlord_________________________________Telephone#___________________

D.  Applicant's Employment / Financial Background:

Current Occupation________________________________Length of Time In Occupation_____

Employer's Name / Address________________________________________________

Employer's Contact Name / Telephone________________________________________

Current Salary___________________________________________________________

Former Employer Name / address / Tel / Contact Name__________________________


Name of Your Bank & address______________________________________________

Checking Account #________________________________Savings Account#_______________

Credit Card Type with # & Expiration date__________________________________________

Other Sources of Income_________________________________________________________



E.  Do you Smoke?_________Yes_________No

F.  Have you ever: Filed for bankruptcy?______Yes______No 

Been Sued? ______Yes_______No          Been Evicted?_____Yes______No

Been Convicted of a Crime______Yes______No

Explain any "Yes" Listed above:__________________________________________________





G.  In Case of an Eemergency Notify:

Name / Address ? telephone # Relation?___________________________________________


H.  Automobile Information:

Car / Model_______________State Registered in__________License Plate#_____________


Size of Studio Interested in________Small (Max. one occupant)________Mid-Size(max. two occupants)

____________Large (max. two occupants)____________X-Large (max. two occupants)


Unit # __________Commencing on __________and Terminating on ____________

Tenants at their Decision  must  purchase and provide their own Home (Studio Apartment Insurance). 


All Room Deposits to reserve and hold a Room are non Refundable.   We rent By the Week,  Month, or Yearly Long term Lease. There will be No Prorating,  If you rent by month you pay by Month, If you leave early you  must pay the full month.  If you need additional days It will cost you $49.00 a day.


Rent is not refundable.  Rent is paid prior to or on the date owed or next business day (if this date falls on the  weekend   or on a holiday) for weekly and monthly Tenants. If the Tenant (s) fail to pay the rent in  full to Management as previously     stated,  the  Tenant (s) will pay management a late charge of $20.00,  plus $5.00 for each additional day that the rent     remains unpaid.  The total late charge for any one-month will not exceed  $75,00.  If the Tenant is unable to make payment on time, contact management in person prior to rental payment due date.


One Month  notice in writing must be given to the office prior to vacating the premises or 50% of dollars  will be deducted from your security deposit.  Checkout time is 12:00 noon of the scheduled move-out  date or an extra day will be charged at the rate of $49.00 per day plus tax if it applies.


A 9.7% tax is required by law on your first three months of tenancy, this is for the short-term  licensing-lodging tax.


Security Deposit (1) Month equal to rent amount is required payable by Check or Cash.  Security Deposits are refunded within 15 business days upon departure-conditions:  when  all keys are returned and the room is left in the same condition as found.  If damages are found, deductions will be made accordingly. 

Cleaning a room and its contents must be done and left like the way you accepted it. You will be charge a fee if not cleaned properly.  Upon move out Floors also must be scrubbed, wash and wax or you will be charged a floor stripping and waxing fee.  Plastic Covers on all Mattress and box spring are to remain on.  If you remove these covers you will be charge a Mattress replacement Fee. If  your  application is approved, your security Deposit will be  held at  Citizens Bank in account# 1133849978.


*  A second set of keys will cost $25.00 per key.  The cost will be reimbursed when the keys are  returned.  There  will be a $25.00 charge for each missing key.


Lock Out Fee:   This Fee is Charge to you for sending someone to let you back into your Studio for what ever reason that you have been Lock Out..  At any time Office is open there will be no Lock out Fee.  At any time Office is Close the fee is $30.00 per Lock Out  per incident.  


*  A $25.00 charge will be levied for each returned check by the bank and personal checks will no longer be accepted from this point on (Cash, Money Order, Traveler Checks  will only be  accepted).  


*  Parking is on a first come first service basis.  You must display your parking permit at all times which is obtained from  the management office.  The sticker must be placed on your front windshield, driver's side, lower left corner, but high enough to see it from outside the car.  If there is not enough parking  on the premises, you must park on the street (please note the street signs and refer to the information enclosed  with the keys on move in).


*  Illegally parked vehicles, (with or without sticker) (occupied or unoccupied) will be towed at owner's expense.   A tow company monitors the premises at all hours. Do not Block or Park in Handicap Parking, You will be fined and Towed.


*  Tenant is responsible for keeping his/her studio clean.  Trash is to be removed at least once a week from your studio and placed in the Dumpster located  in the back  parking lot.  Trash is not to be left in the hallways.


*  Plugged Toilets cause by Tenant miss use, If the Tenant Plugs the toilet and causes overflow, the Tenant well be responsible for all and any damages to their room and any other room or area in building. 


*  No Pets are allowed.


*  Management has not given up the right to enter your studio with or without permission.


*  A Small studio can only accommodate one occupant, while a Mid-size, Large or extra Large studio can  accommodate maximum of two (2) occupants per Board Of Health and  Fire Code. The second person in a Medium or Large will be charge $75.00 in additon  to the rent fee. 


*  The Studio is to be used only as a private residence for Tenant (s) listed in the rental Application.  Occupancy  by guests for more than on weekend, in a small, Mid, Large or extra Large studio is prohibited without  Management's written consent and will be considered a  breach of this Agreement.


Total Number of Occupants_.  One Tenant-One application-One set of Keys.  Two tenants-Two applications-Two Sets of Keys. 


(By signing the Rental Application you have agreed to give the authorization to your Previous Landlord to Release your Rental History, Present and Past to Apartment Resources of Waltham Ma.  Also , you agree and understand all stated above.

     Signature of Applicant______________________________________________


Rental Application      Date___________

Estimate Cost of 

Living Quarters

Condition on Arrival Condition on Departure Repair/Replacement
Floors & Floor Coverings     $25.00 per sq. ft.
Shade & Curtains     $25.00
Walls     Repair Bill
Ceiling     $10.00 per sq. ft.
Light fixtures     $50.00
Window (s) & Screen (s)     Repair Bill
Entrance Door     Repair Bill
Locks on Door     Repair Bill
Intercom System     Repair Bill


Bed (Twin or Double)     $200.00
Dresser     $200.00
Table     $50.00
Chair (s)     $25.00
Desk     $75.00
Nightstand     $75.00
Lamp     $10.00

Kitchenette Unit

    $1200.00 per unit or Repair Bill
Sink w/drain stopper      
Two Burners      

Heating/A.C. Unit

    $1200.00 per unit or Repair Bill
Wall Controls      
Unit Controls      


    Repair Bill
Cabinet w/Mirrors     $25.00 per mirror
Shower     $10.00
Shower Curtain     $

 Applicant Initials _________ 

Amenities for Rent
  Amenities for Rent     Estimate Cost of
x Rentals Condition on Arrival Condition on Departure Repair/Replacement
  $35.00 TV w/Cable Monthly      
  $30.00 Cable only     $250.00
  $30.00 TV only     $200.00
  $30.00 Microwave     $150.00
  $35.00 Internet/Monthly     $30.00
  $25.00 Linen Listed below      
  Blanket     $25.00
  Pillow (s)     $25.00
  Pillow Cases     $10.00
  Sheets     $15.00
  Bedspread     $25.00
  Plastic Mattress Cover     $15.00
  $25.00 Kitchenware Listed      
  Pots, Pans     $75.00
  Silverware     $10.00
  Dishes     $25.00
- Misc Damage Charges      
- Remote Control     $75.00
- Painting Fee     $100.00
- Cleaning Fee     $50.00
- Plastering, Misc Work     $150.00 or Repair Bill
- Missing Key (each)     $25.00

Applicant's initial__________



Tenant acknowledge that the Smoke Detectors were tested in their presence and found to be in working order, and that the testing procedure was explained to them.  Tenant (s) agree to test the smoke Detector at least once a month and to report any problems to the Landlord/Property manager in writing.  (To test the smoke Detector, see if there is a flashing Red light.  If yes, the smoke Detector is working.)

Tenant Detector acknowledgement________ (Yes)

Tenant acknowledges that he/she has signed the statement of Room Condition attached to the rental application which states what the cost are to repair or replace will be if damages are caused during their occupancy, along with additional cost stated above.

Tenant Room Condition acknowledgement________(Yes)

Your Security Deposit is being held in ____________Bank, account#___________

Tenant Security Deposit acknowledgement_________(Yes)

Use this space to provide any additional explanations:



Applicant Initials_________


Statement of Condition   -   Landlord-Tenant Checklist   -   General Condition of Rental Unit & Premises


This is a Statement of Condition of the premises you have leased or rented.  You should read it carefully in order to see if it is correct.  If it is correct, you must sign it.  This will show that you agree that the list is correct and complete.  If it is not correct , you must attach a separate signed list of any damages, which you believe exists in the premises.  This statement must be returned to management within fifteen days after you move in.  If you do not return this list, within the specified time period, a court may view your failure to return this list as your agreement that the list is complete and correct in any suit which you may bring to recover the security deposit.

This Statement of condition was received by the tenant on_______________________(Date)

Landlord-tenant Checklist completed on moving in on_______________________(Date),and

Property Manager________________________and Tenant___________________________


Landlord-tenant checklist complete on moving out on________________________(Date),and

Property Manager_________________________and Tenant__________________________



References Required:   Example Use Friends, relatives, Co-Workers, Etc.


1).    Name (person status)__________________________________________


                                    Phone Number________________________________________________

2).    Name(person statues)__________________________________________


                                    Phone Number________________________________________________

3).    Name(person status____________________________________________


                                    Phone Number_________________________________________________

4).    Name(person status)___________________________________________


                                    Phone Number_________________________________________________


 Call for an Appointment 

Address:  94 Adams Street,   Waltham, Massachusetts 02453,   USA

                Tel:  (781) 893-1130                  Fax:  (781) 891-6969

Office hours - Monday thru Friday  8:00am to 3:00pm  Saturday 8:00am to 12:00pm  Sunday Closed