HomeMy WebLinkAbout615 Route 28 paper applicationAppf ication for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETT
Telephone (508) 398-2231 , exl. 1240
Fax (s08) 760-3472
E-mail : epolite@yarmouth.ma.us
4
#DEC 1 12023
HEALTH DEPI
The Town of Yarmouth is excited to announce that we've streamlined the online registrat ron process
make it more user-friendly than ever before! Simply visit https://varmouthma. oortal.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 securely communicate with our team, but you'll also gain access to ysur ii'npcrtant documents, the
ability to upload photos, and much morel This improved platform is designed to make your registration
experience smooth and efficient.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectgrs/Carbon
Monoxide Detectors and verified that they are le-ss than lO years old: P/ease initiall@
Contact the Building Department regarding qlestions on type and locatron pflor to purcha6ing.
hllos://www.varmouth ma.Lrs/DocumenlCenlerA/ieWl 1 22 1 /Smokedetector,location
A non-refundable application fee of $80 pef UniUfental is required.
Rental Certificates expire on December 31"r, 2024.
lf NOT registering online, please make checks payable to: Town ofYarnouh and rnail contseted application &
payment to: Town of Yarmouth Health Department.
The Health ment willcallto schedule an inspection if required, upon receipt of yourapplication and fee
Rental Property lnformation
All fields are re uired! lncom ete forms without a valid hone # or email cannot be rocessed
Rental Property Address,r vJ,rCri ,4tn*,-ln nnual /Seasonal Short Term less than 31 da S
Rental Period
Trash Removal by:
Owner Tena nf--'r/-ouse Room/ru lex Condo
Rental of:
Property Owner Name
I,A0 L')/"
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Mailing Address:
L-L3G ]' 17
nmaryu e Alternate Phone No
mrlo,tiwrtt-tt J.q.
(require -mail Address
eneprese
ncy
SAgenVAge Primary Phone No (required)E-mail Add
e Health Department in writing when I am no longer renting the property, or I may be
Date /u kfzt"s
rds of Fitness
inq-Prooram
tal
Sign
Renlal Bylaw (if applallof which are avai
icable) and the A. State Sanitaryco e, Chapter um Standalable on our website. httos:/i rmouth .ma enta lHo
th
n m
423tR
Yarmouth Short Term
for Human Habitation)
I have arf
Furthermore. I understand Isubject to flnes and bes.
Revised: 1