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**INSPECTI ON OFALL UNITS ARE R OUIRED!**
Please call to schedule 508-398-2231, ext. 1240
MON-FRI, 8:30 AM-4:30 PM
Annual Registration is an Owner Responsibility
2023 RENTAL/LEASE REGISTRATION
TOWN OF YARMOUTH _ BOARD OF HEALTH
1146 ROUTE 28, SOI.ITH YARMOUTH MA 02564
ATTENTION LANDLORDS of Houses, Aparhents, Duplexes, Condomin!-mr, Room Renrals. (in owner
occupied dwcllings) and Short Term p"otrsls. f,aetu.ling HotelrlVfotcl, Ino" Lodging House or Bed and Breakfast
operations. (CHAPTER 108 - OCCITPANCY OF BLJILDINGS BYLAW).
Note: Compliance with Zoning regulatiotrs is not infer€d, nor inturded.
RENTAULEASE Rcgbtndonr E)PIRE otr DECEMBER 31 of cech yerr. FEE IS S&) pER RENTAU
LEASE UNTI. Complete thir form .nd r€turtr to the Eeelth Oltrce. Checkr peyeble to: .TOWN OF
YARMOUTH", For rddltlonal FORIIIS AND/OR QIJESTIONS, contrct tbe HEAITH OFTICE AT
30&39&223r,x12/,0
Property Address
0wner Neme (Req Info)Email and #5 t'Et
Melllng Address
PENALTIES - Late registration of more than 30 DAYS after receipt or violations ofany part ofChapter 108,
;ay be subject to non-criminal citations issued as follows. Each day's violation deerned a separate offense.
Itt Offense $lfil.fll / 2* Offense $Ifi).fi) (and each additional) $2(X).fi). This applies to ury OWNER or
Reprcsentative.
Trash Removal by: Owner _ Tenant_Disposal dStioker at Landfill
qrl gtn,t[,u/W!ti-Y,
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(Orc.e a week miaimum)
Paid Pickuo \C
note: Pleere Fmove
Name of Company
trerh & recycle binr from rord efter plck up dey.
$80.00 Annual fee: Owner mly aho register online:
(follow online services icon, then Permir & Licenses)
Signature
(Requlre)
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78 t74sStateanCity/Iown
k\.10/17nz
https ://yarmouth.ma.us
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Rental Agent (lf eny)
Rental Period: Annual:
Rental of:
Owners:
Email and Phone #
less than 3l days)
Room
-Smoke Detectorc rnd Crrbou Monodde Detecton Requlred-
./
Detectorr/Carbon Monorlde Detectorr?
Smoke/ CO detecton older than
-<Jen!