HomeMy WebLinkAbout270A Old Main Street paper applicationIApplication tor 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
rr _ E-mail: epolite@yarmouth.ma.usw
'ifF fne Town of Yarmouth is excited to announce that we've streamlined the online registration process tomakeltmoreuser-friendlythaneverbefore!Simplyvisit@toget
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 regishation
experience smooth and efficient.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke D
Monoxide Detectors and verified that they are less than 10 years old: Please initi
Contact lhe Building Deparlment regarding questions on type and location prior to
hllps://www yarmoulh ma us/DocumentCenterNieM'1 1221lSmoke'deleclor I
rbon
A non-refundable application fee of $80 per uniurental is required.
Rental Certificates expire on December 31"r, 2024.
lf NOT registering online, please make checks payable to: Town of Yannouth and rnail completed application &
payment to: Town of Yarmouth Health Department.
The Health Deparlment willcallto schedule an inspection if required, upon receipt of yourapplication and fee.
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Rental Property lnformation
All fields are re uired! lncom )lete forms without a valid hone # or email cannot be rocessed
RentalProperty Address:*
;-?11' /L2 ltln,rp, 57,fitlnci,tl liltl.
Rental Period:
/Annual V Seasonal Short Term (less than 31 davs)
Trash Removal by:
Owner Tenan,/
/Rental of:
House Duplex Condo Apartmen Joo,
Property Owner Name
/D,tzzrrn) ,4,,f,t o
Mailing Address:
llo ot) 2,47xt 57 vttutrurl nl)fr
(required)Primary Phone No
??/-{7?- 0b47
Alternate Phone No
^/ r/l/tr
(required)E-mail Address:
eD)lnRtlt1D [R@ /oZAtr tr'
Owner's Representative/Rental
AgenUAgency
/y D//E
(required)E-mail Address
/t/2/18
Primary Phone No
/4/vE
d I must notify the Health Department in writing when I am no longer renting the property, or I may be
a\l!
DateSign D2.?
an'
Yarmouth Short Term
for Human Habitation)
anitaryI Bylaw
which a
tat 08 Rental
S cteStaRntaencablendaeth chaapppte
rma uo mth uas
(
haoarevatblaoeonUSbttps
Minimum Standards of Fitness
423/RentalHousino-Prooram
Furthermore, I underslansubject to flnes and €es.
Revised 10/23l2023
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