HomeMy WebLinkAbout41 Wood Road paper applicationApplication for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472
E-mail: epolite@yarmouth. ma. us.,Ib<atitil.T 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 before! Simply visit https:i/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 secureiy communicate with our team, but you'll also garn 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 efflcient.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors/Qalbon
Monoxide Detectors and verified that they are leis than 10 years old: P/ease initiat -/{Contact lhe Building Department rega.ding questions on type and location prior lo purchasing' /
hltos.//wwwvarmoulh ma us/DocumenlCe nter,ryieW 1 1 22 1 /Smoke-deleclor-local,on
A non-refundable apptication feeof $80 pef UniUfgnta! is requrred.
Rental Certificates expire on December 31"t, 2024.
lf NOT registering online, please make checks payable tor Town of Yarmouth and mail completed applicalion &
payment to: Town of Yarmouth Health Department.
The Health Depadmant will call to schedule an inspection if required, upon receipt of yourapplication 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:y1 daol 7?/'so -ftriSuth /1,4 /A/14
Rental Period:
Annual/ Seasonal Short Term (less than 31 davs)
TOwner
Trash Removal by
Tenant /o uplex_ Condo Apartment Room
Rental ofl
House
Property
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ownerName: dD5 RciR,Keary Tru5f'MailingAddress: 7i /lV- R/
L)zsr' Dentrs . nA ),427d(requi red)Primary Phane NIo
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Alternate Phone No (required)E-mail Address
SKear/?'rQgaat/'<
Owner's Representatite/Re-ial
Agent/Aoency Primary Phone No (required)E-mail Address
I have read and lam famrllar wrth the fown of Yarmouth CnaoteYarmoulh Shorl Term Rental Bylaw (rf appIcable) and the li,4A
for Human Habitalron) all of whrch are available on our webstt
Funhermole, I understand I musl notafy the Health Department in writing when I am no longer renting the property, or I may besubject to flnes and bes.
Date:Sign
r 108 Rental Housing Bylalv, Cha
Code, Chapter
104 Ant se Bylaw, Town of
ndards of Fitness. State Sanitarv
e. httDs;iiww\i/Minimum Stavarmouth.ma.u 423lRental Housino-Prooram
a4
Revise 10t23t2023
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