HomeMy WebLinkAbout31 Warren Road paper applicationApplication for 2024 Rental Registration
TOWN OF YARMOUTH
Health Oepartment
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
The Town of Yarmouth is excited to announce that we've streamlined the onlin
make it more user-friendly than ever before! Simply visit httos://varmouthma. oortal.ooenqov.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 ycu securely cornmunicate with our tea!-n, but you'll also gain access to your impodant documents, the
ability to upload photos, and much more! This improved platform is designed to make your registration
experience smooth and efflcrent.
e reg oSraron process
D[0 0 7 2023
Telephone (508) 398-2231 , ext. 1240
Fax (508) 7 60-3472
E-mail: epolite@ya rmouth. ma. us
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 1O years old: P/ease initiat ?3
Conlacl the Building Department regarding queslions on type and localion prior to purchasing.
A/rew/l 1 221 /Smoke detector,locationhttos J/www.varmouth ma.us/Document
A non-refundable apptication fee of $80 pef Uniufgntal is required ck {
Rental Certificates expire on December 31"'. 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Heallh Department.
The Health Depaiment willcallto 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 ocessed
Rental Property Address
3l rJcrrer RJ. Y..oou Hr ?.cL ile o2t15
Rental Period:
'nrrlh15Seasonal Short Term (less than 31 days)Ann u al
Trash Removal by:
Owner Tenant Housef Duplex Condo Apartment Room
Rental of.
Property Owner Name
Rolrrl i filera 5'lue retot e 7.1 Crexe"t Dc tluntingtun llt ttl'13
Mailing Address
(required)Primary Phone No
6tt.Srj rore
Alternate Phone No
6tt.t77. g71j
(required)E-mail Address
fi!5 tT6loplonLle.1let
Owner's Representative/RentalAgent/Agency
Fora,n Eecl !r
Primary Phone No
5o8.!tg.rrEr .rr ril
(required)E-mail Address
Co 7 c fgdf p.rrsrt r rr . cort
iar wilh the Town ofYarmouth Chapter 108 Rental Housing Bylaw Chapter 104 Anti-Noise Bylaw Town of
ntal Bylaw (if applicable) and the MA. State Sanitary Code, Chapter ll (l\,4inimum Standards of Fitness
I of which are available on our website. https://www.yarmouth.ma.us/423lRentalHousinq-Proqram
Fufihermole, I understand I must notify the Health Department in writing when I am no longer renting the property, or I may besubject to fines and bes.
tollo,t. 26a3&r+"^rt)e baanto*Date
I have read and lam famil
Yarmouth Short Term Re
for Human Habitation) al
Sign
Revised: 10/23l2023