HomeMy WebLinkAbout94 A Pleasant Street paper applicationApplication tor 2024 Rental Registration
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke DetectqfgnDarbon
Monoxide Detectors and verified that they are leis than 1O years old: P/ease initial fW
Conlacl the Building Deparlment regarding questions on type and location prior to purchasing.
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A non-refundable apptication fee of $80 per UniUrental is required.
Rental Certificates expire on December 31st, 2024.
lf NOT registering online, please make checks payable to: Town of Yannouh and rnail conpleted application &
payment to: Town of Yarmouth Health Department.
Tha Health Department willcallto schedule an inspection if required, upon receiptof yourapplication and fee.
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02654
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472 . ,rl
E-mail: epolite@yarmouth. ma. us I
The Town of Yarmouth is excited to announce that we've streamlined the online registration process
ake it more user-friendly than ever before! Simply visit https://va rmouthma. portal.openqov.com/ to get
tarted. There, you can effortlessly create your account and conveniently pay the registration fee
sing this upgraded system, you'll have the power to enqage with us throughout the entire orocess. Not only
n you securely communicate with our team, but you'll also garn access to your important documents, the
bility to upload photos, and much more! Thrs improved platform is designed to make your registration
xperience smooth and efficient.
Rental Property lnformation
AII fields are re uired! lncom ete forms without a valid hone # or email cannot be rocessed
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Rental Property Address
?/l //rw",r {ka r Rental Period:
Annual y'Season al /Shotf erm (less than 31 days)
Trash Removal by
Owner Tenant
Rental of:
Housef Duplex Condo Apartment Room
Pfoperty Owner Name:t/uil /lr-rulnrTurtl-
Mailing Address: ^ f\"i'i4i:;"^, * l) a*^^4 mfrt
(requrred)Primary PhongrNo
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Alternate Phone No
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Owner's Representatrve/RentalAoenUAoencv
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Primary Phone No
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(required)E-mail Address
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d I must notify the Health Department in writing when I am no longer renting the property, or I may be
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Yarmouth Sh
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Furthermore, I understan
subject to fines and bes.
Revised 10/23/2023
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