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HomeMy WebLinkAbout64 Breezy Point Road paper applicationA
Application for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTp+26,6+
The Town of Yarmouth is excited to announce that we've streamlined the online registration process to
make it more user-friendly than ever before! Simply visit https://varmouthma. oortal. openqov.com/ to get
started. There, you can effortlessly create your account and conveniently pay the registration fee.
Using this upgraded system, you'll have the power to engage with us throughout the entire process. Not only
can you securely communrcate wrth our team, but you'll also gain access to your important documents, the
ability to upload photos, and much more! Thrs improved platform is designed to make your registration
experience smooth and efficient.
LJ#
NtJv 1 3 2023
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472
E-mail: epolite@ya rmouth.ma. us
Smoke Detectors and Carbon Monoxide Detectors are Requiredl
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detect
Monoxide Detectors and verified that they are less than 10 y
Contact the Euilding Department regarding questions on type and location prior to purchasi
httos.//www.varmouth ma.us/DocumenlCenterNreW/ 1 1221lSmoke-delectoclocalion
rs/Carbon
ears old
ng
A non-refundabte application fee of $80 pef UniUfental is requrred
Rental Certificates expire on December 31'1.2024
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depaimenl will call to schedule an inspection if required, upon receipt ol yout applicalion and fee.
Rental Property lnformation
All fields are re uired! lncom lete forms without a valid hone # or email cannot be rocessed
Rental Period:
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Owner Tenant
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Property Owner Name
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( req u ired ) E-mail Address
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AttCrnate Phone No
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fieq[r rE$P rirnary P hone No
lc00-4\L-qrqb (required)E-mail Address
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Primary Phone No
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-EwneaEtrepresentative/Rental
Agent/Agency
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understand I must notify the Health oepartment in writing when I am no longer renting the proPerty, or I may be
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subject to fines and fees
Revised 10/23i2023
Date