HomeMy WebLinkAbout25 Embassy Lane paper applicationApplication tor 2O24 Renta! Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472
rlz E-mail: epo lite@yarm outh. ma. uswfll\ fne 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 httos://varmouthma.portal.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 vrith us throughout the entire process. Not only
can you securely communicate with our team, but you'll also gain access to your 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 Oetectors 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
Contact the Euilding Department regarding questions on type and location prior to pu.chasing.
hllDS //www.yarmouth ma us/DocumentCenlerA/iew1 122'1lSmokedetector-location
A non-refundableapptication feeof $80 pef Uniufental is required.
Rental Certificates expire on December 31"t, 2024.
lf NOT registering online, please make checks payable to: Town of Yannoudl and rnail conpleted application &
payment to: Town of Yarmouth Health Department.
The Health Department willcallto schedule an inspection if required, upon receipt of yourapplication and fee
Rental Property lnformation
All fields are uired! lncom lete forms without a valid hone # or email cannot be rocessed
Rental Property Address:
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Rental Period:
Seasonal Short Term (less than 31 davs)An nual (
Trash Removal by:
Owner Tenant v
Rental of:
House! Duplex- Condo Apartment Room
Property Owner Name
AN(E L. +{AE.qAJJN , -ig;\E(dE QO aox tlos
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N4ailing Address
(required)Primary Phone No
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Alternate Phone No.
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(required)E-mail Address
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Owner's Representative/RentalAgenUAgencycFSoL yr+ELfi<
Primary Phone No
Sow 635'7s55
(required)E-mail Address;
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riting when I am no longer renling the property, or I may be
,, /.r^ /o <t / / .^L// 4\ J
rtment in w
Date:
Rental Bvlaw (if
all of which aie
Iry
u
I llave read and larr familiar with the To,vnif
Yarmouth Short Term applicable) and the A. State Sanita r (Mi
sl42nimum Standards of Fitnessfo. Human Habitation)available on our website hftDs://w$/i-3/R€ntalHousino-Prooram
Furthermore, I understand I must notify the Health Depaand fues.
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Revised: 10/2312023
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