HomeMy WebLinkAbout785 Route 28 #4 paper applicationo
Application tor 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , exl. 1240
Fax (508) 7 60-3472
E-mail: epolite@yarmouth. ma. us t
The Town of Yarmouth is excited to announce that we've streamlined the online registration process to
make it more user-friendly than ever before! Simply visit https://varmouthma. portal.openoov.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 Departmenl regarding questions on type and location prior to purchasing.
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A non-refundable application fee of $80 per uniUrenta! is required
Rental Certificates expire on December 3'l sl, 2024.
lf NOT registering online, please make checks payable to: Town ofYannouh and rnail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depaftment willcallto schedule an inspection if required, upon receipt of your application and fee.
Rental Property lnformation
All fields are re uired! lncom ete forms without a valid hone # or email cannot be ssed
Rentat Prooerty Address: -1AA Z+ -Lg .
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Rental Period:
Seasonal Short Term (less than 31 days)Annual
Trash Removal by:
Owner- f"nrnt J
Rental of:
Duplex CondoHouse Apartment Room
Property Owner Name:
Rouar+o r.u,\or" 3!r"rlov'
Mailing Address: Cn 'v.r i \LOL^) ^\re \rY\+ A
r-^-4anrr\ 5 , t-AA C-I-CO \
(required)Primary Phone No.
6o7- G76- G,1-LZ-
Alternate Phone No.
c>8 - ZLn - '1 t 3\-\
(required)E-mail Address:
)tan1eo1na ta@ 3wrcu t ' corrt
Owner's ReDresentative/Rental
AgenVAgenby
Pahoc,t a. \<aoalha-oZ
Primary Phone No
6G -)G<t-3q3G
( requ ired )E -mail Address
@fi c) @fu .t /-caf e cd)' cDtl
I have read and larr latniliar wth the Town of Yanrputh Chapter '108 Rental Flousing B/aw Chapter 104 Anti-Mise R/la,&, To!1n of
Yarmouth Short Term Rental Bylaw (if applicable) andthe NilA State Sanitary Code. Chapter ll (l\4inimum Standards of Fitness
for Human Habilalron) all of which are available on ourwebsite. https://www.varmouth. ma.us1423/RentalHousino-Prooram
fy the Health Department in writing when I am no longer renting the property, or I may be
Sign
Fu Tthermore I understand I must noti
subject to fines and
Date: l\ l3O / Z3
Revised: 10/2312023
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