HomeMy WebLinkAbout102 Merchant Ave paper applicationApplication for 2024 Rental Registration
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 initialJfi
Contact lhe Building Deparlment regarding questions on type and location prior to purchasing
oke deteclor-location.ma us/DocLrmenlCentet Niew I 11221 lsmhllosr//www varmol
A non-refundabte application feeof $80 pef UniUfgntal is required
Rental Certificates expire on December 31s', 2024.
lf NOT registering online, please make checks payable to Town of Yarmouth and mail completed application &
payment lo: Town of Yarmouth Health Department
of yourapplication and feeThe Health Depaftmet will call to schedule atl itr.speclion if required, upon rece
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , exl. 1240
Fax (508) 760-3472
E-mail: epolite@yarmouth. ma. us llc t6 ?
TH
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23
The Town of Yarmouth is excited to announce that we've streamlined the online reg ist
make rt more user-fri endly than ever before! Simply visit httos://varmouthma. portal. ooenoov.com/ to get
tarted. 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 onl
n you securelv communicate with our team trut vou'll 3156 g2in access to yo r impotant docurnents, the
bility to upload photos, and much more! This improved platform is designed to make your registration
xperience smooth and efficient.
Rental Property lnformation
All fields are re uired! lncom lete forms without a valid hone # or email cannot be rocessed
Rental Property Address
, Od ;.r\Afcl^\ t-+-,+- *t€.hort Term (less than 3'l days)t/^5Annual Seasonal
Rental Period
Rental of:
Duplex CondoHouse rt men t Room
Property Owner Name:
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Alternate Phone No --
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(Jeouired)E-mail Address:\ ;o b' 4-1/-<r F a-+*t L4OJ b-<srvl' c-r*S+ , t-e-+
Owner's ReoieSentativeTR entEJ-Agent/Agenby Primary Phone No (required)E-mail Address
Furthermole, 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 fues
I have read and lam fa
Yarmouth Short Term
for Human Habitation)
ap
r llRenlal Bylaw
all of which a
ap
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Sign
ter 104 Antl-l{oisemiIar with the Town of Yarmouth Ch ter 108 RentatTlousrn g Bylaw Ch Byiaw fown-of(if applicable) and the A. State Sanitary Code, Chapte NIinimum Standards of Fitnessre available on our web sino-Prooramsite. httDs://www-v rmouth.ma.us 423lRentalHo
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Revi 10123/2023
Trash Removal bv
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