HomeMy WebLinkAbout248 Camp Street Unit N2 paper applicationApplication lor 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (5OB) 398-2231 , ext.'124O
Fax (508) 760-3472
E-mail: epo lite@yarmouth. ma. usw
'[F fne Town of Yarmouth is excited to announce that we've streamlined the online registration process to
make it more user-friendly than ever beforel Simply visit httos://varmouthm a. porta l.ooenqov.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 communicate with our team, but you'll also gain access to your important documents. the
ability to upload photos, and much more! This improved platform is designed to make your registration
experience smooth and efficient.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke DetecJ€F/Gatbon
Monoxide Detectors and verified that they are lels than 10 years old: P/ease initiaGdE
Contact the Building Departmenl regarding questions on type and locatron prior to purchashig----
htlos://www.varmouth.ma.us/DocumenlCenler^/iew/1 1221lSmoke-delector-location
A non-refundable apptication fee of $80 pef UniUfental is required.
Rental Certificates expire on December 3'l "t, 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth and rnail mmpleted application &
paymenl to: Town of Yarmouth Health Department.
The Health Depaftment willcallto schedule an inspection if required, upon receipt of yourapplication and fee
Rental Property lnformation
All fields are r'uired! lncom )lete forms without a valid hone # or email cannot be rocessed
/S.r"on^l Short Termnnual Sless than 31 d
Rental Period
Trash Removal by:
owner-y(- Tenant OUSE rtment RoomDulex Condo
Rental of
Property Owner Name:
Brl ,t'.. B rrs. I -
Mailing Address:
\gg V.rn-^ Sl .,vi^".-rk0,. Porl h4,,\ "asz
sag -362--3 \Lj
Alternate Phone No
5-oE -\32--1\zf *.'p.g Q_, ggf,zor-. . 6 c- |
Primary Phone No
otify the Health Department in writing when I am no longer renting the property, or I may be
Z^ z-3Sign
Chapter ntmu.ma.3i Re
Date: \ t
Fitness
roo ram
a,
m daStan ofrds
nta oHus on P
(ifI Bylaw
which a t
arr ar aaYTMouthho(S eT Rrm ntae a ica ebt an Statedhe Sappl
H mufor na aH itatib no a of are a ba e oonu Sb te httDs oditanCeryImova
, I understand IFurthermore
subject to fln
Revisedr 1 3
Rental Property Address:
z$g CqaT &. tf * : t dZrr.t.J 6l',rao.,t
(requrred)Pnmary Phone No.(required)E-mail Address:
owner's Reoresentative/RentalAgenVAgenby,.lA (required)E-mail Address: