HomeMy WebLinkAbout15 Baxter Ave (upstairs) paper application (2)Application tor 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 7 60-3472
E-mail: epolite@yarmouth. ma. us !' "#
'iiF 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 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 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 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
Contact lhe Building Department regarding questions on type and location prior to purchasing.
httos /aw ry-yarmouth ma us/DocumenlCenlerA/ieW1 1221lSmoke-deleclocloaation
A non-refundable application fee of $80 pef UniUfental is required.
Rental Certificates expire on December 31"1, 2024.
lf NOT registering online, please make checks payable to: Town ofYannouh and nEil conpleted application &
payment to: Town of Yarmouth Health Department.
The Health Depaiment willcallto schedule an inspection if required, upon receipt of your application and fee.
Rental Property lnformation
All fields are re uired! lncom lete forms without a valid hone # or email cannot be rocessed
Rental Property Addresslf k Xkr fi* rJrnirs
Rental Period:
Annual y'Seasonal Short Term (less than 31 days)
Trash Removal by:
Owner Tenant
I Rental of:
./House Duplex l/Condo Apartment Room
Prooertv Owner Name(* A.*r/.,-l[t t,hr* nl {/. lr$t{rtl nl
Mailing Address
(required)PriFary Phone No
4lz-att- <t,t
Alternate Phone No
ll?- 4Ys- >vat-
(required)E-mail Addresd
ah,rtr@ qal. 6u-Owner's ReDresentative/Rental
AgenUAgenby ' (requ{led)E-mail Adaress
lqbs
I Bylaw
which a
Furthermo
subject to
re. I understand I must notify lhe Health Department in writingfines and fues.
Sign
I have read and I arr familiar with the Town of Yannctrth g4Tti5fiseBmaTo\M'-T
Yarmouth Short Term Renta (if applicable) and the nimum Standards of Fitness
for Human Habitation) all of re available on our webs 3/RentalHousino-Prooram
when I am no longer renting the property, or I may be
Date: il
Revisedr 10/2312023
Primary Phone No
er 1{J8 Rental l k)usno