HomeMy WebLinkAbout9 Connemara Way paper applicationTOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472
E-mail : epolite@yarmouth.ma.uswT fne 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.openqov.com/ to get
Ftarted. 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
[an you securely communicate with our team, but you'll also gain access to your important documents, the
bbility to upload photos, and much more! This improved platform is designed to make your registration
!xperience smooth and efficient.
Smoke Detectors and Carbon Monoxide Detectors are Required! l/.' .-</l
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors/Carbon)- .7" ,
Monoxide Detectors and verified that they are leis than 10 years old: Please initial l?L a/1 ,'/.
Conlacl the Building Department rega.ding questions on 9pe and location prior to purchasing.
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A non-refundable application fee of $80 per UniUfeflt?l is requireo
lf NOT registering online, please make checks payable tor Town of Yarmouth andmail cornpleied application &
The Health Depaftment willcallto schedule an inspection if required, upon receiptofyour
Rental Certificates expire on December 31", 2024 ?
nd feeonaa
payment to: Town of Yarmouth Health Department
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Rental Property lnformation
All fields are uired! lncom lete forms without a valid one # or email cannot be essed
Rental Property Address:
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Rental Period:
Annual /Seasonal Short Term (lessthan 31 days)
Trash Removal by:
owner- -,enant /
Rental of:
-/uHouse Duplex y'Condo Apartment Room
Property Owner Name:
R, A^,d -il/*/st + %a h'{1 .,b r.,-/,, r/,A(required)Primary PhonerNo
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(/Alternate Phone No
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(required)E-mail Address
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Owner's Representalive/Rental
AgenUAgency Primary Phone No (rduired)E-mai{ Address
d I must notify the Health Department in writing when I am no longer renting the property, or I may be
Date
ntal Bylaw
of which a
apter
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Furthermore, I unde
subject to rines and
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Sign
I have read and lam familiar with the Town of Yarmouth Ch 108 RentaI Housing Bylaw, Ch
itary Code, Chapte
104 Antr-Noise Bylaw,
inimum Standards ofTown of
(if applicable) and lheYarmouth Short Term Re State San Fitness
for Human Habitation) all re available on ourwebsite. h
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Revrsed 1 3
@ Application for 2024 Rental Registration
Mailing Address:
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