HomeMy WebLinkAbout404 Route 6A paper applicationApplication for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 7 60-3472
E-mail: epolite@ya rmouth. ma. us
{s4<alltL.lliF fne 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.porta l.openqov.com/ to get
started. There, you can effortlessly create your account and conveniently pay the registration fee.
Using this uograded system, you'll have the power to engage with us throughout the entire process. Not only
can you securely communicate with ou!'team, but you'l! also gain access te ycur impcrtant dccumen$; the
ability to upload photos, and much morel This improved platform is designed to make your registration
experience smooth and efficient.
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Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors/Car on
Monoxide Detectors and verified that they are less than 10 years old.
Contact the Building Department regarding questions on type and location prior to pu
hltosl/www.varmouth ma us/DocumentC nterN ieW 1 1221lSmoke-detector location
A non-refundable apptication feeof $80 pef UniUfgntal is required
Rental Certificates expire on Decembet 31s1, 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth ard mail completed application &
paymenl lo: Town of Yarmouth Health Department.
The Health Depaftment willcallto scltedLtle an inspectiotl if requied, upon receiptof yourapplication and fee
Rental Propefi lnformation
All fields are rec uired! lncom lete forms without a valid )hone # or email cannot be rocessed
Rental Property Address
tDY Vo"ra G,4 ti*r i Rental Period:
Seasonal_ Short Term (less than 31 days)
Owner OUSC RoomDUlex Condo
Trash Removal by
Tenant
-froperty Owner Name:
SWp ()laig..,"\e
Mailing Address:t4o1 w La frrt>,Jr>)ozafS(requrred)Primary Phone No
Sbg 71e bqzl
Alternate Phone No.
I\D ilE-
(required)E-mail Address
So/t Aa' 6 o .--.^:r l' ot.'"o' J' <
owner's Representative/RentelAgenVAgency
?LT
Primary Phone No
9:K ZIS L.+ z-r+
(required)E-mail Address
:S1s ilt)ro i *.€A"f'-'' /
nd I must notify the Health Department in writing when I am no longer renting the property, or I may be
ma.us
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Sign
42
State Sanita e, Chapter
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ave a nread arn am aY ormUOWe teaYrnouShthorteTRenrmif
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Revised: 10/23l2023
Rental of: