HomeMy WebLinkAbout83 North Dennis Road paper application,@ Application tor 2024 Renta! Registration
TOWN OF YARMOUTH
Health Department
1146 ROUrE 28, SOUTH YARMOUTH, MASSACHUSETTS o'REtEl\f i -
Telephone (508) 398-2231, ext. 1240
Fax (508) 760-3472 .lAN ir4 ZUZ,E-mail : epolite@yarmouth.ma.us
HEALTH DET
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 morel This improved platform is designed to make your registration
rience 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 leis than 1O years old: P/ease initial fu--
Contact lhe Building Deparlmenl regarding questions on type anc, locatron prior lo purchastfd
lerA/Ew/1 1221 /Smokedelector-localionhttosr//www.varmoLrth ma.us/Document
A non-refundable application fee of $80 pef Uniufental is required
Rental Certificates expire on December 31"t, 2024.
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Health Department.
rapplication and feeuired, upon receiptofftment wiltcalllo sclledule an inspection il reThe Health De a
Rental Property Address Rental Period:
Annual iXeasonal Short Term (less than 31 days)Trash Removal by:
o*n", v/ Tenant
Rental of:
House - Duolex Condo rtment Room
1 I'tD iv xsT
Property Owner Name Majling Address.
t 'a.ht*V4,1n4 z)Ll
requlre flmary oone Alternate Phone No ( req u ired )E -ma il Address
A P:nva L CaS(t\z rTa"enPrr)rtl(eneSSTEneep
net/encAgAgv Primary Phone No d)E-mail Address
t rlr talKou
(requi
5,YfiHifffi"*'ir'Srstand I must notily the Health Department in writing when I am no tonger renting the property, or I may be
anilary
ve
hs SC vc
-h,/ ./\^_LLLI'Sign I
and lam ml taa Yarmouth ha nta HousinYarmouth Short Term Re , To'rynntal Bylaw 0f a
of which are a
pplicable) and the A. State S ode, Chapte nimum Standafor Human Habitation) ail rds of FitnessS:vailable on our website. hftp varmou!h.ma 3/Re inq-Pta lHous ram
Date. I
Rental Property lnformation
All fields are re uired! lncom ete forms without a valid hone # or email cannot be rocessed
.G,/
Revised: 10/2312023
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