HomeMy WebLinkAbout785 Route 28 #2 paper applicationv
Application for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231, ext. 1240
Fax (508) 7 60-3472
E-mail: epolite@ya rmouth. ma. us#The Town of Yarmouth is excited to announce that we've streamlined the online registration process to
make it more userfriendly than ever before! Simply visit httos://varmouthma. portal.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 your important documents, the
ability to upload photos, and much more! 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 Detectors/Carbon
Monoxide Detectors and verified that they are less than 10 years old: P/ease initial-
Contact the Building Department regarding questions on type and location prior to purchasing.
hltos://www varmouth ma us/DocumentCenlerA/iew/1 1221lSmoke-detectoalocaton
A non-refundabte apptication fee of $80 per uniUrental is required.
Rental Certificates expire on December 31"t, 2024.
lf NOT registering online, please make checks payable to: Town of Yannoutrr and nEil mrrpleted application &
payment to: Town of Yarmouth Heallh Department.
The Health Depadment willcallto schedule an inspection if required, upon receipt of your application and fee.
Rental Property lnformation
Rental Property Address: n85 p{ Z? uni} 2
Sou+'t ya...rroL+h rPtA otOA4
All fields are re uired! lncom )lete forms without a valid hone 4 or email cannot be rocessed
Rental Period
n nual Seasonal Short Term less than 31 da S
Trash Removal by:
owner- renant J
Rental of:
House! Duplex Condo- Apartment- Room-
Property Owner Name:
?ove,r+O Hai ot S \.rwl oY
Mailing Address
Hv4hni) /
wi \t(t,l) A\rc- Uvri,t A
OL{zOl
G.1
Pt4
(required)E-mail Address
d.fi|e c4.4arr^ @ gMa I l' con
(required)Primary Phone No.
@'ato - (o'1'tL
Alternate Phone No
a6:'aL\1 -1t?q
(required)E-mail Address:
PcrS\ ci, a e :rtav4oJd! <rr7<t'Ci,' A
Owner's Representative/Rental
AgenUAgency
Pat'rdcla YlaooLlhr@.)
Primary Phone No
608 - >Gn- g7G
d I must notify the Health Department in writing when I am no longer renting the property, or I may be
I Bylaw
which a
Chapte|I
pter ll (lvli
ma.us/42
Cirapter
the NIA.anitary C ,s o
Sign
(x Anti-Mise Bylar'v, To,,tn of
nimum Standards of Fitness
read and lan" lamrlrar wrn me I or Yanmun 108 Rental HbusiI have ng Bylaw,
ode, ChaYarmouth Short Term Renta (if applic:ble) and State S oramrmouth.3/RentalHo(tn -Prore available on our website https:for Human Habitation) all of
Date: L\ lio /29
subject to lines andFurthermore, I und
Revised: 10/2312023