HomeMy WebLinkAbout4 Ash Lane paper applicationApplication for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472
E-mail: epolite@ya rmouth. ma. uswliF 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 httos://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 efficient.
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
Contact the Building Department regarding questions on type and location prio. to purchasing.
httos //www varmoulh ma us/Documenlc nlerA/ieWl 1 221 /Smoke-deleclor-locatron
A non-refundabte apptication fee of $80 pef UniUfgntal is required.
Rental Certificates expire on December 3'1"t, 2024.
lf NOT registering online, please make checks payable to: Town of Yannouth and rnail completed applic€tion &
payment to: Town of Yarmouth Health Department.
The Health Depaiment willcallto schedule an inspection if required, upon receipt of yourapplication and fee.
Rental Property Address+ fi)h f e"p )L"'iv1 r(L
nnual less than 31 da SSeasonalShort Term
Rental Period
Trash Removal by
Owner Tenant Condo artment RoomHOUSCDUlex
Ren
Co;,t (^ (t.1."lh,)t,qr.A(
Prope Owner Name
Jta Wt th A u< +tt (aa4'u;
[.4ail Address
'r€u.
b $-vrt-\? r\requ rre .|mary one o Alternate Phone No
,1
(required)E-mail Address
lYlccll,utd toN,/nI
Nlfr
enneSeresep
U cgenAgenv
Primary Phone No (required)E-mail Address
I
5,ifi!:[1#?J.T#a"rstand I must notifv the Health Department in writing when I am no tonger renling the property, or I may be
Rental Bvlawallofwhlch a
arr
ry
ram
Yarmouth Short Term (if applicable) and the A. State Sanitafor Human Habitation)re available on our website. httDs 423/Rental ousinq-P
C ahpter
o thu am u
Co
,L,,4.-,^--n Date
Fi
SC
IVI n umm S ndata S of ne SS
Sign
Rental Property lnformationA fields are re uired! lncom ete forms wthout a valid )hone # or email cannot be rocessed
(c
4yow
I /, a.ta
Revised:10/2
@