HomeMy WebLinkAbout85 A Run Pond Road paper applicationApplication for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , exl. 1240
Fax (508) 7 60-3472
E-mail: epolite@ya rmouth. ma. us
{s4<alriL,lliF rn" 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. 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 with us throughout the entire process. Not only
can you secureiy communicate with our team, but you'il 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 efficient.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectols/Carbon
Monoxide Detectors and verified that they are less than 1O years old: P/ease initnt-fuQ--
Contacl the Building Deparlmenl regarding queslions on type and location prior lo purchasing
CealerA/,ew/1 1 221lSmoke deleclor-local,onhltosJ/www varmouth rna us/Docurnent
A non-refundabteapptication fee of $80 pef Uniufgntal is required
Rental Certificates expire on December 31s', 2024
lf NOT registering online, please make checks payable to. Town of Yarmouth and majl completed application &
payment to: Town of Yarmouth Health Department.
The Health Depanment willcallto schedule an inspection if required, upon receipt of yaur applcation and fee.
Rental Property Address Ssrxi4 Yflt/{r6oTrt.
85 * E\rJ Po-E Pb. u* ou*"{
Rental Period:
Annual{ Seasonal Short Term (less than 31 days)
Trash Removal by:
o*n", I renant
Rental of:
,/House Duplex / Condo Aoartment Room
Prooertv Owner Name:86tull'€inD 6. I{&?LWUA*WEgvutE$h\
Mailino Address2,?N,L6E\,D]DS,
?i+(- <A,NDwav\, [^A M631
( reqUrred)Primary Phone No
(an)u ro - (o6rt,
Alternate Phone No
(n0g$l'+on
( reouired )E-marlAddressi- .ty?hlt*^' . J^(\d6ll(441o^ \. ro
dqvw\e . c*t.lo'*Q,o\r&ttt. dA(Jwner's Reoresentative/Renl=lAgentiAgenby Primary Phone No (requrred)E-marl Address
I have read and lam farnrlrar wrth the Town-iYarmouth
Yarmouth Short Term Rental Bvlaw (if applicable) and
for Human Habitation) atl of whicn aie av'ailable 6n ou
rstand I must notify the Health Department in writing when I am no longer renting the property, or I may be
Date
re
S
1,'vn
subject to
Sign
deFurthe
a)\Rental P roperty lnformation
s re nconl )lete forms without a valid hone # or email cannot be rocessed
Revised: T 0/2
6-.'&xW
JE Rental Houeng By