HomeMy WebLinkAbout5 Manor Path Unit A paper applicationApplication lor 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (5O8) 398-2231, ext. 1240
Fax (508) 760-3472 'ti',r
E-mail : epolite@yarmouth.ma.us
* rn" ,o*rn of yarmouth is excited ro announce lhat we've streamlined the online registration process to
rnake il more usor-friendty than ever before! Slmply vlrlt httosJlvarmouthma.oortal.ooenoov.com/ to get
started. There,,you can effortlessly create your account and conveniently pay the registration fe€.
Using this upgraded system, you'll have the power to engage wrth us throughout the entire process. Not only
can you securely communicate wilh our leam, but you'll also gain access to your imporlant docurnents, the
ability to upload photos, and much more! This improved platform is designed to make your registration
experience smooth and eflicient.
Smoke Oetec'tors and Carbon onoxide Dstectors are Requlrcdl
Owners: I have ensured the battenes are changed, have tested ALL Smoke D€tectorycarbon
Monoxide Detectors and verified that they are less than 10 years old. Please initial_;:a
Coflted the Bul/ditlg Dopa!1l7ienl regardi"g glestioas orl ly,€ eN tcf,zlton pno! ,o purct.sJrg -
htlps:/ rww.varmouth ma.us,/Doq{nenlcenter,ryiew/1 1221lsmoledeledor-location
Anon-refundabteapptication feeof $80 pef UniUfental is requireo.
Rental C€rtificates expire on December 3ln, 2024.
lf NOT registering online, please make checks payable to: Town of Yamqrth ald mail completed application &
payment to: Town of Yarmouth Health Department.
The Health Department will call to schedule an inspection il required, upon recdd of your application and fea.
All fields are
Rental Property lnformation
forms wiltloul a valid # or amail cennot bo
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Rental Property Address:{ n1 a-*- 3a tA U*,1 # fl Rental Period:
Seasonal Short Term (less than 31 days)ennuatX
.nrnt .Y
Trash Removal by
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Rental ot
ouded conooHouse Apartment Room
Property or ner Name:
Vs *De ; ax+- C f, 7a -.o-f'ruLe*<"/,*j ,2d d ?w-".a,,/?
Mailing Address
(required)Pnmary Phone No
Lr't-z1z- @8 Lt'1- 272 - lt / t
Altemate Phone No.
€dcs,..,---J.t,
(required)E Address: O4l
Owner's Representative/FtentalAgenVAgency 4<ttdt-e.,nc-L4a/P
Primary Phone No (required )E.Inail Address:
d I must notrty the Health Department in writing \.vhen I am no longer renting the property, or I may be
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Bylatr,
ards of
104 Anti-Noise To nofinimum Stand Fitness
Furlhermore, I understansubjecl to fines and ft€s
Revised: 10n3'/2023
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