HomeMy WebLinkAbout152 Bayview Apt A & B paper application\
Application tor 2024 Renta! Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSE
Telephone (508) 398-2231, ext. 1240
Fax (508) 7 60-3472
E-mail : epolite@yarmouth.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 before! Simply visit https://va rmouthma. 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 onlv
can you securely communicate with our team, but you'll also gain access to your amportant documents, the
ability to upload photos, and much morel This improved platform is designed to make your registration
experience smooth and efficient.
REGEOVED
JAN 11?0e4
HEAI.TH DEPI
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: P/ease initial:gA
Contact the Building Department regarding questions on type and tocation prior to purchasing.
11221
A non-refundabte apptication fee of $80 pef UniUfental is required.
Rental Certiflcates expire on December 3 l st, 2024.
lf NOT registering online, please make checks payable to: Town of Yannouh and rnail completed application &
paymenl to: Town of Yarmouth Health Department.
The Health Depaftment willcallto schedule an i ection if required, upon receipt of your application and fee
Rental Property Address
15) Bc
Rental Period:
Seasonal Short Termnua less than 31 d S
Renta! of:
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Property Owner Name
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SAgent/Age Primary Phone No (required)E-mail Address
Furthermore. I understand I must notiry the Health Department in writing when I am no longer renling the property, or I may besubject to lines and Ees
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Sign Date: \
All fields are uiredl lncom ete forms without a valid one # or email cannot be essed
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Revrsed 10/2312023
Rental Propefi lnformation
Mailing Address:
renant J
Nr\\,1
ANDRE CHAD M
40 FOREST RIDGE RD
WEST SPRINGFIELD, MA 01089