HomeMy WebLinkAbout158 A Summer Street paper applicationApplication tor 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (5OB) 760-3472
E-mail: epol ite@yarmouth.ma.us
hft ps://varmouthma.portal.openqov.com/
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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 the Building Deparlment regarding questions on type and localion prior to purchasing
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A non-refundabte apptication feeof $80 pef Uniufental is requrred
Rental Cerlificates expire on December 31.'. 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail completed applrcation &
payment to: Town of Yarmouth Health Department.
an inspection if required. upon receiptof yourapplication and feeThe Health Depaftment willcall to schedule
Rental Property lnformation
All fields are re uired! lncom lete forms without a valid hone # or email cannot be ocessed
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Rental P
\58 /,.Annual asonal Short Term (less than 3'l days)
Rental Period
Trash Removal by:
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Rental of:
oomHouse DupleProperty Owner Name
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Mailing Address:
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Owner's ReoresenAgent/Agenby tive/Rental Primary Phone No (required)E-mail Address
fy the Health Department in writing when I am no longer renting the property, or I may be
apter
I Bylaw
which a
ta t of
Furthermore, I understand I must notisubject to fines a
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ter 104 Anli-NoiseI have read and lam rnl al ne lown Yarmouth Ch 108 Renta I Housing Bylaw, Chap
itary Code, Chapter il Bylaw Town ofYarmouth Short Term Renta (if applicable) and the State San l\.4inrmum Stand ards of Fitnessfor Human Habitation) all of re available on our website rm 423/Ren
Date
Revised: 1 023
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