HomeMy WebLinkAbout426 Main St (6A) 2A paper applicationD
Application lor 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
E-maal: epolite@ya rmouth.ma. us 1023
The Town of Yarmouth is excited to announce that we've streamlined the online registration process to
make it more user-frjendly lhan ever before! Simply visit https://varmouthma.porta l.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 wrth us throughout the entire process. Not only
can you securely communicate with our teanr, but yoLr'll aiso 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 leis than 1O years old: P/ease initial (A
Conlact the Building Department regarding questions on type and location prior to purchasing.
httos://www.varmoulh ma us/DocumenlCenterNieW 1 1221 /Smoke deleclor,location
A non-refundable application fee of $80 pef UniUfgntal is required
Rental Certificates expire on December 31s'. 2024.
lf NOT registering online, please make checks payable to: Town of Yamouth and mail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depaftment willcall to scltedule att iuspection if required, upon receipt of your application and fee
Rental P roperty lnformation
All fields are uired! lncom lete forms without a valid hone # or email cannot be essed
Rental Prooertv Address:
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Rental Period:
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Annuall2 Seasonal Short Term (less than 31 daVS)
Trash Remova\tl
owner /)
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lenant House Duplex Cori'do Apartmentf, Room
Rental of:
Property Owner Name
r4rukre ficl fiu.ftantr/Mailino Address:'fb%fL,-rf*
(requrred)Primary Plfone No
b/7 d56 -7117
(required)E-mail Address
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Alternate Phone No
Owner's Representative/RentalAgent/Agency Primary Phone No (;equired)E-mail 46dress
iar with the Town ofYarmouth Chapter 108 Rental Housing Bylaw Chapte
ntal Bylaw (if apphcable) and the MA. State Sanitary Code. Chapter ll (
I oI which are available on our website. https://www.varmouth.ma.us/
Furthermop, I understand I must notify the Health Department in writing when I am no longer renting the property, or I may be
subject to fines and bes
Date
I have read and lam famil
Yarmouth Short Term Re
for Human Habitation) al
Sign c, K?/
r 104 Anti Noise Bylaw Town of
lvlinimum Standards of Fitness
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