HomeMy WebLinkAbout501 Higgins Crowell Road paper applicationTOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472
E-mail: epolite@ya rmouth.ma. us
..J*4
ZHt rn" ro*n 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 ycu securely ccrnmunicate with our team, but you'll also gain access to yo'.ii important documents, 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/Qarbon
Monoxide Detectors and verified that they are teis than 1O years old: P/ease initiat S l/.
Contact the Building Department regarding questions on type and tocalion prior to purchasing.
nter/VreW1 1221 /Smoke-delector-localionhltos //www.varmouth.ma.us/DocumentC
A non,refundabte apptication feeof $80 pef Uniufental is required
Rental Cedificates expire on December 31'', 2024.
lf NOT registering online, please makechecks payable tor Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depadment will call to schedule an iDspection if reqLtired. upoD receipt of your application and fee.
Rental Property lnformation
All fields are re uired! lncom )lete forn$ without a valid )hone # or email cannot be rocessed
Rental Property Address
t'l,fi,nt (,1swll6l Hco"L"
Rental Period:
Annual,k Seasonal Short Term (tess than 31 days)
Trash Removal by:
Owner Tenant
Rental of.
Duplex_ Condo Apartment RoomHouse]-
Property Owner Name:
1Yga,/, cL Tdnt rr fu p 7,' r (,4 uroA-f9 I llrtr7tnl Cro,.a<il froq,L-
Mailing Address
(required)Primary Phone No
17f f{7-t3oo
Alternate Phone No (reguired)E-mail Address
51 fiatlltt aSm";'l ccrn
Owner's Representative/Renta,AsenuAsency Sfo,e lTa tl Primary Phone No
11Y -+r1 '8300
(required)E-mail Addressi
SJh4tt 717 €. jna'/.ct'n
Furthermore, I understand I must notify the Health Department in writing when I am no longer renting the property, or I may be
subject to lin'es and tes
// /t,i /^3,d-.frn^+ /lrtL Date
p1er 104 Anti-Noise Byiaw Town of
l\4inimum Standards of FitnessI Bylaw (if
which are
Sign
apter 108 Rental Housing Bylaw
MA. State Sanitary Code, Cha
I have read and lam fami|ar with the Town ofYarmouth Ch Cha
Yarmouth Short Term Renta applicable) and the pter
for Human Habitation) all of available on our website. h
Revised: 10/2312023
Application for 2024 Rental Registration