HomeMy WebLinkAbout426 Main St (6A) 2B paper application.-i ,1 -.
Application tor 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 124O
Fax (508) 760-3472
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 user-friendly than ever beforel Simply visit https://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 lhe entire process. Not only
can you seeurely communicate with our team, but you'll also gain access to your important documents, the
ability to upload photos, and much morel This improved platform is destgned 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 Please initial
Conlacl the Building Departmenl regarding questions on type and tocation prior to purchasing.
httos.//www varmoulh ma us/Oocumen lCenter^/ieW 1 1 22 1 /Smoke-detector-location
A non-refundabte apptication fee of $80 pef UniUfgntal is required
Rental Certificates expire on December 31"r, 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depadtnenl willcallto schedule an in ion if required, upon receipt of yout application and fee
Rental P roperty lnformation
All fields are re uired! lncom lete forms without a valid hone # or email cantnl be rocessed
;"U'Wil::'j? 7ot>,,*&-Rental Period:
Annualf,, Seasonal Short Term (less than 31 days)
Trash Removal by:
o*n.r--.,.K renant House- Duplex Condo Apartmentf Room
Rental of.
Property Owner Name
7/tuP4(8 5 rt-/ dt +t, /4*1 eW {tbrm+t4sq,y'tyer,rera*fra*-lvlailing Address
(required)Primary Phone No.b/7 y6t ,-.7,ib7 Alternate Phone No
C//rtfW.*fu/Drle+ca'r
Owner's Representative/RentalAgent/Agency Primary Phone No
must notify the Health Department in writing when I am no longer renting the property, or I may be
tr/z/tpuzDate
I have read and lam familiar with the Town ofYarmouth Ch E l;t eFap
e, Chapter ll
Cii 04Tnil-NoEe BrEw. T
Yarmouth Short Term Rental Bylaw (if applicable) and the
aoter 108 RentalXoLrsrno
lVlA. State Sanitary Co-d Minimum Standards of Fitness
for Human Habitation) all of which are available on our website. h
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Sign
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Revised: 10/23/2023
(required)E-mail Address:
(required)E-mail Address: