HomeMy WebLinkAbout43 Hemeon Drive paper applicationApplication for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (5OB) 398-2231 , ext. 1240
Fax (508) 760-3472
E-mail: epolite@ya rmouth. ma. us
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?Ht rn" 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. portal.openqov.com/ to get
started. There, you can effortlessly creale 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 yoii ll also gain access to your important documents, the
ability to upload photos, and much morel 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 Detectors/C
Monoxide Delectors and verified that they are less than 10 years old: Please initia
Conlact the Building Department regarding questions on type and location prior to purchasing
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A non-refundabte apptication fee of $80 pef UniUfgntal rs required
Rental Certificates expire on December 31s., 2024
lf NOT registering online, please make checks payable to Town of YarmoLrth and mail complsted apptication &
payment to: Town of Yarmouth Health Departrnent
The Health Depaiment will callto sclEdule aD inspection if required, upon receipt of your application aud fee
Rental Propefi lnformation
All fields are re uired! lncom )lete fonns without a valid hone # or email cannot be lrocessed
Rental Period:
Seasonal Short Term
Room
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Rental of:
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Trash Removal by
Rental Property Address
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Owner
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Mailing Address:
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508'gbtt- 953O
Alternate Phone No
6t'/ -1/? - 603L
(required)E-mail Address
DLRo<loQ &pa,inqlOwner's RepresentativeTRenteTA99nuA99qcy ShaDn( qrx'lfu,ltc Har e.r)
Primary Phone No tt t +
503-775-Lf{o
(required)E-mail Address
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Funhermole, I understand I must notify the Health Department in writing when I am no longer renting the prope(y, or I may besubject to fines and €es
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Slate Sanitary Co e, Chapter (l\,4inimum Standa rds of Fitnessuth.ma.us/423/RentalHousino-Ptooramhttos://www.varmo
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Revised 2023
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Property Owner Name: