HomeMy WebLinkAbout59 Lily Pond Drive paper applicationL
Application for 2024 Rental Registration
TOWN O F YA RMO UTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472
E-mail: epolite@yarmouth. ma. uswll'F Th" To*n 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://varmouthma. porta l.openoov.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 tear,n, but you'll also gain access to'y'our 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/Carbon
Monoxide Detectors and verified that they are less than 10 years old: P/ease lnrlial Qftt
Contact the Building Department regarding queslions on type and localion prior lo purchasing.
htlosl/www.vannoulh ma us/DocumenlCenter/V ew/1 1221lSmoke-detector-location
A non-refundableapplication feeof $80 pef Uniufental is required
Rental Certificates expire on December 31"t, 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Health Department.
Tlte Healtlt Depaftment willcallto schedule an inspectiotl if requircd, upon receipt of your application and fee.
Rental Property lnformation
All fields are re uired! lncom lete forms without a valid hone # or email cannot be rocessed
Rental Prooertv Address.
B 9 Li ly Q"J []p., "+-S - .ir^ Y,^,.,^fu-. MA D: t(V Annual SeasonalN Short Term (less than 31 days)
Rental Period
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Owner___2. Tenant_
Rental of:
House X Duplex Condo epart.ent Room
Property Owner Name:C-Lnr r..C ,v1. t-a{\e ns
Mailing Address:
AL15NV7, NI
ll 5 Sr.,tf rrla^t*in-, $lyf
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5lt t 6i A'l "t 3
Alternate Phone No (required)E-mail Address:
Lnfl^q-a s q,"y o? 8EQ",,15l ? 1tr b? 3r._
(required)Primary Phone No
Primary P hone No (required)E-mail Address:
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Owner's ReDresentative/Rental
AgenVAgenby lS,) ,\t.,i ,v\uwt !r
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I have read a"d Ia ehapte
Yarmoulh Shon Term Rental Bylaw 0f applicable) and the MA
for Human Habitation) all of whrch are available on our websrt
r 108 Rental Housing Bylaw, Chapter'104 Antr-Noise Bylaw, Town of
. State Sanitary Code, Chapter ll (lvlinimum Standards of Fitness
e. https ://www.varmouth.ma.us/423/RentalHousinq-Proqram
Funhermole, I understand I must notify the Health Department in writing when I am no longer renting the property, or I may be
subject to flnes and bes.
?,c3.:DateQ-l-o,;*-rrlSign \/uv l7r
Revised: 10i23/2023
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