HomeMy WebLinkAbout143 Pine Grove Road paper applicationTOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (5OB) 760-3472
E-mail : epolite@yarmouth.ma.uswifF fn" 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 https://varm outhma. portal.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
yorfit-atsv gaifi-acEessto yor.rr lmpofiant docufiients, 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 Detectors/Carbon
Monoxide Detectors and verified that they are less than 1O years old: P/ease initial /fte .)Contact the Building Department aegarding questions on type and locatton p or to purchasng !
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A non-refundable apptication fee of $80 pef Uniufgntal is required.
Rental Certificates expire on December 3'1.', 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 Depafiment wiI call to scltedule an inspection if required upon receiptof yourapplication and fee
Rental P roperty lnformation
All fields are re uired! lncom ete forms without a valid hone # or email cannot be rocessed
Rental Property Address
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Rental Period
Trash Removal by
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Property Owner Name
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5,Yfi!3[1f [fl"'.T"tf rsland I must notify the Health Department in writing when I am no longer renting the property, or I may be
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ve re an am mt own o Yarm apler o!l haYarmouth Short Term Renla (if applicable) and the State S e, Chapterfor Human Habitation) allof re available on ourwebsite. httDs:outh ousino-P423/Rental
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Sign Date
Revised 1 3t2A23
Application for 2024 Rental Registration
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