HomeMy WebLinkAbout26 Grove Street paper applicationTOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 7 60-3472
E-mail: epolite@ya rmouth. ma. us
# ,n" -o*n of Yarmouth is excited to announce that we've streamtined the online registration process to
make it more user-friendly than ever before! 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 the entire process. Not only
can you securely communicate with our team, but you'll also 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 efflctent.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners. I have ensured the batteries are changed, have tested ALL Smoke Detec;LorFfcarbon
Monoxide Detectors and verified that they are less than 1O years old: P/ease initial E L-.
Contact the Building Department regarding queslions on type and location prior lo purchasing.
hltpsT/www yarmouth ma.us/Documentcenler^/iew 1 1 221 /Smoke,detectoFlocalion
A non-refundabte apprication fee of $80 pef Uniufgntal is requrred
Rental Certificates expire on December 31st, 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 Depadment willcallto schedule an inspectiotl if required. upon receipt of your application and fee
Rental Prooertv Ad7, Oo6\)t--lf dress
n nual less than 31 da SSeasonalShort Term
Rental Period
o use RoomartmentDUlex Condo
Rental of
Mailing AddressT
Prooertv Owner Name:i4&r;\pi;;)iry-c6rE^^ArJ
,Cb
Alternate Phone No.
6rils{,40nff
oflamnory
ob bnbb
( req u ired )E-ma il AddressPrimary Phone No
rstand I must notify the Health Department in writing when I am no longer renting the property, or I may be
d bes
Date
U
flal Bylaw
f which a
ah
Sign
yaw04 Antlaw.aPter ntal OUSaTmnTtthI have read and aTn inimum Standards of Fitnesse, ChapterState Sanitary Coicable) and the(if applYarmouth Short Term Rent o usin q-P r qram423lRenta Iouth.ma.uhttos:lable on our websltere avatfor Human Habitation) allo
subject to fiFurthermo
Rental Propefi lnformation
All fields are re uired! lncom lete forms without a valid hone t or email cannot be ocessed
a{
Revisedr 10/2312023
Application for 2O24 Rental Registration
Trash Removal by
o*n", / Tenant
. nn A bvSr')
,9q8i': ?1) E :T i I h$1'f h"a o CAtt a\t
Owner's Representatlve/Rental
Agent/Agency