HomeMy WebLinkAbout31 Belle of the West Road paper applicationApplication tor 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1145 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , exl. 124O
Fax (508) 760-3472
E-mail: epolite@yarmouth. ma. us
# 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 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 communicale lxitb-ouI-tes[t. brrL+o.Jl alag,5ia -^:- ]c ,.. '- i-Fr t
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 10 years old: P/ease initial ,,4!
Conlacl lhe Building Depa(ment rega.ding queslions on type and location prror lo purchasing /
moke-deteclor-locatronhllDs.//www varmoulh ma.us/DocumenlCenlerA/aewl 1 1 221 lS
A non-refundable apptication fee of $80 pef Uniufental is required
Rental Certificates expire on December 31s', 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail completed applicalion &
payment to: Town of Yannouth Health Department.
ection if requircd, upon receipt of yourapplication atld feeThe Healut De rttnent willaallto schedule an it],sp
Rental Property lnformation
All fields are re(uiredl lncom lete forms without a valid )hone # or email cannot be rocessed
Trash Removal by:
owner fenant I/t/o'
Rental of.
lex Condo artment Roomouse
Rental Property Address:t Bdle-o+<IP \r1+?r{'Rental Period:
Seasonal Short Term (less than 31 davsnual
Property Owner Name
VYrt.c\a E. lhnson
Mailino Address.si OrkansTi/,, l-k"",;,L, wftc,ts
5o?"91.q'3o17
Alternate Phone No (required)E-mail Address
,na..i3o gw,il colry\
Primary Phone No (required)E-mail Address
understand I must nohfv the Health Department in writing when I am no longer renting the property, or I may bes and bes
2
a
Srgn
al aam ntal Housing otse law Town ontal Bylaw (if appl
of which are avai
icable) and the A State Sanilary Code,Chapte nimum Standards of Fitnesslable on our website. httDs://www.v rmouth.ma 3/Renta lHousino-Prooram
Date: //
Yarmouth Short Term Refor Human Habitation) all
have re a am m
F rtuhermo re
b ectUS fio
Revised: 10/2
(requ!red)Pfl mary Phone No.
L)wner s Reoresentative/RentalAgentiAgenby