HomeMy WebLinkAbout411 North Main Street paper application:lttor.:*t'r Application for 2024 Renta! Registration
TOWN OF YARMOUTH
Health Department
1146 RoUTE 28, soUTH YARMoUTH, MASSACHUSETTS ozseREcEIVED
Telephone (508) 398-2231 , ext. 1240
Fax (508) 760-3472 JAN U 4 2024
E-mail: epolite@ya rmouth.ma. us
HEALTH DEP]
The Town of Yarmouth is excited to announce that we've streamlined the online registration process t
ake it more user-friendly than ever before! Simply visit https://varmouthma. porta l.openqov.com/ to get
arted. There, you can effortlessly create your account and conveniently pay the registration fee.
sing this upgraded system, you'll have the power to engage with us throughout the entire process. Not only
n you securely communicate with our team, but you'll also gain access to your important documents, the
bility to upload photos, and much more! This improved platform is designed to make your registration
perience 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 1O years old: P/ease initial At -Contact the Building Department regarding queslions on type and locatron pnor to purchadng.
nler,A,/ieW 1 1 221 /Smoke-detector-locationhtlosJ/www varmoulh ma us/Documenl
A non-refundableapplication fee of $80 pef Uniufental is required
Rental Certificates expire on December 31"', 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Health Department.
n if tequired, upon receiptof yourapplication and feeThe Health Deparlment willcallto sclledule an ins ectio
Rental Property Address:tlll t.'lrrrl-tt l''( a,.*,r $f,
Rental Period:
Annual l,/Seasonal_ Short Term (less than 31 davs)Trash Removal by:
Owner t/ Tenant
Rental of:
House r' Duplex_ Condo partment_ Room
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Property Owner Name
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lvlailing Address
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(required)Primary Phone IIo Alternate Phone No (required)E-mall Address
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Owner's RepreEenIStrleTReEIET-Agent/Agenby
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Primary Phone No (required)E mail Address. 0,
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orse
tanda of Fitness
I have read and lam familrar wrth the TowntfYarmouth
Yarmouth Shorl Term Renlal Bylaw (if appIcable) and
[or Human Habitatton) all ol which are available on ou
anitary
I nta ousng
CodtheA. State S
r website httos:e,Chapte
rmouth.ma Housino-Prooram
Furthermole, I under-stand I must notify the Health Department in writing when I am no longer renting the property, or I may besubtect to fines and hes.
Sign Date L
Rental Property lnformation
All fields are re uired! lncom lete forms without a valid hone # or email cannot be )rocessed
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Revised: 10/2312023
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