HomeMy WebLinkAboutRegistration Form .
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*��NSPECTION OF ALL UNIT5 A�E E IRED!�
Please call to schedule 508-398-2231, ext. 124 �`- L - � -; '
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��"���r ��� 2017 RENTAL/LEASE REGISTRATIO � JAN 2 5 2�17 �
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`��'��j TOWN OF YARMOUTH - BOARD OF HEA T��'-��' `�~"T._.�
1146 ROUTE 28, SOUTH YARMOUTH MA 02664 '�\
Register on line and SAVE $10 per unit @www.yarmouth.ma.us (Online Services)
�..• ATTENTION 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
BLTILDINGS BYLAV�. Note: Compliance with Zoning regulations is not inferred, nor
intended.
- RENTAL/LEASE R-egistrahons EXPIRE on DECEMB��t-�1 of eaeh year. FEE IS
$80 PER RENTAL/LEASE IJNIT. Complete this form and return to the Health
Office. Checks payable to: "TOWN OF YARMOUTH". For additionai 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.
. �c�r Y�ou
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Rental Property A dress
Tenant(s) Name(s) (If Annual Rental) Email or Phone #
R t�al,��f an � �E,m�ai� r Phoner�� �
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�,�,: Owner Name (Required Infp)� G��� mai�P�n (Required)
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Mailing Address City/Town tate ZIP
Rental Period: Annual , Seasonal � (Winter-Summer), Weekly �
Rental of: House�Duplex Apartment Condorrumum Room
--Smoke Detectors and Carbon Mono�tide 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 Monoaude Detectors?
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srr�acE a�n�Ms
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• TEST
� �10NTHLY (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 subject to non-criminal citations issued as follows. Each day's
violation deemed a separate offense. ls` Offense $50.00 / 2nd Offense $100.00 / 3`d Offense
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(and each additional)�200.U0. "�'lus applies to any OWNER , AGENT OR TENANT
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Trash Removal by: Owner� Tenant Disposal w/Sticker at Landf'ill
Paid Pickup� Name of Company
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