HomeMy WebLinkAbout65 South Street paper applicationApplication tor 2024 Rental Registration
TOWN OF YARMOUTH
Health DePartment
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664.
Telephone (5OB) 398-2231 , ext- 1240 l'i il n
Fax (508) 760'3472
E-mail: ePol ite@Yarmouth.ma- us
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2023
bility to upload photos, and mu
xperience smooth and efficient
owners: I have ensured the batteries are changed, have tested ALL Smoke Detectorslcarbon
Monoxide Detectors ano verineJtnaiiney are teis t'nan 1O years old: Please initiat-=79-
Contact the Buildino Depatnent regarding questioris on type and location prior lo purchaslng
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Smoke Detectors and Carbon Monoxide Detectors are Required!
A non-refundableapplication feeof $80 per uniurental is required.
Rental Certificates expire on December 31s, 2024.
lf NoT registering online, please make checks payable to: Town of Yarmouh and nlail conpleted appication &
The Health Depaftment willcall to schedule an inspection if required,upon of your
paymenl to: Town of Yarmouth Heallh Department.
and fee.
All fields are
Rental Property lnformation
forms without a valid # or email cannot be sed.
Annual z(easonal- Short Term (less than 31 days)
Rental PeriodRental Prooertv Address:(f So-t'" SI / f" y'"n";l-a
Rental of:
House /Duplex- condo-Roo
Trash Removal by: .,/
owner- Tenarft-<
Mailino Address: ^ /rnn. )14. /t r/-63 -s--f4 C7 J0'VProperty Owner Name:Aoann. (att /t')r
An
-maE I rESSAddIuredreq)(
224ea teAltemate Phone No
f f 6- 63V- ra s s'-
-{E-{u-rEdf Pi rn a ry Pforie No
f6 y- )18-77/7
(required)E-mail Address:Primary Phone No@ner's Representative/RentalAsenuAsencv {l /t
I must notify the Health Department in writing when I am no longer renting the property, or I may be
.//
am
Date
pterStatethe
Sign
104
Yarmouth Short Term RentaI Bylaw (if applic€ble) and
which are available on ourwebsitefor Human Habitation) all of
O'J
Tom of
Fitness
Furthermore, I understand
sublect to fines and ftes
Revised: