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*�INSPECTION OF ALL UNITS ARE REQUIRED!*�
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Please call to schedule 508-398-2231, ext. 1240
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2017 RENTALILEASE REGISTRATION
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1146 ROUTE 28, SOUTH YARMOUTH MA 02664
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Register on line and SAVE $10 per unit @www.yarmouthma.us (Online Services)
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AT1'ENTION LANDLORDS of Houses, Apartments, Duplexes, Condominiums and
Room Rentals (in owner occupied dwellings). Excluding Hotel/Motel, Inn, Lodging
House or Bed and Breakfast operations. (CHAPTER 108 — OCCUPANCY OF
BUILDINGS BYLAV�. Note: Compliance with Zoning regulations is not inferred, nor
intended.
RENTAL/LEASE Registrations EXPIRE on DECEMBER 31 of each year. FEE IS
$80 PER RENTAL/LEASE UNIT. Complete this form and return to the Health
Office. Checks payable to: "TOWN OF YARMOUT�I". For additional FORMS
AND/OR QUESTIONS, contact the HEALTH OFFICE AT 508-398-2231, x1240,
MON—FRI,8:30 AM-4:30 PM. —OR- REGISTER ON LINE for $70 per unit.
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Rental Property Address
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Tenant(s) Name(s) (If Annual Rental) Email or Phone #
Rental Agent (if any) Email or Phone #
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�Owner Name (Requir d Info) Email or Phone # (Required)
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Mailing Address City/Town State ZIP
Rental Period: Annual � , Seasonal (Winter-Summer), Weekly
Rental of: House� Duplex Apartment Condominium Room
--Smoke Detectors and Carbon Monoaude Detectors Required—
Operable smoke and carbon monoxide detectors are required at each habitable level and in basements with
any appliances using fossil fuels (oil, gas, kerosene), including coal or wood stoves and enclosed or
attached garages. Owners: Have you ensured the batteries are changed, and have tested ALL your
Smoke Detectors/Carbon Monoxide Detectors?
�1oKE RLARMS
� '� Signature
I10NTHLY (Required)
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PENALTIES — Late registration of more than 30 DAYS after receipt or violations of any
_ _ part of Chapter 108, may be sub�ect to non-criminal citations issued,as follows. Each da�'s ___ __
violation deemed a separate offense. lst Offense $50.00 �2nd Offense $100.00 / 3rd Offense
-�,,and each additional} $2�.�. This applies to any "OWNER", "AGENT" OR "TENANT"
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Trash Removal by: Owner Tenant� Disposal w/Sticker at Landfill
Paid Pickup Name of Company
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