HomeMy WebLinkAbout3 Perch Pond Way paper applicationApplication for 2O24 Rental Registration
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TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS O26EIL.-
Telephone (5o8) 398-2231 , ext. 1240 RECEIVED
Fax (508) 760-3472
E-mait: epotite@yarmouth.ma.us JAN 04 2024
HEALTH DEPT,
The Town of Yarmouth is excited to announce that we've streamlined the online registration process to
make it more user-friendly than ever beforel Simply visit hftps://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 1O years old: P/ease initial 6\l*
Contact the Euilding Department regarding questions on type and localron pfior lo purchasfng.
armouth ma.us/DocumentCenter/View/1 1221 nt r-l
A non-refundable application feeof $80 pef UniUfgnta! is required
Rental Certificates expire on December 31s'. 2024.
lf NOT registering online, please make checks payable to Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depaftment will call lo sclledule an inspection if required, upon receipt of your applicatiott and fee
All fields are re uired! lncom ete forms without a valid hone # or email cannot be rocessed
Rental Property Address
\\ ,,.
Rental Period:
Annual lseasonal Short Term (less than 3'l days)
Trash Removal by:
Owner t/ Tenant
Rental of:
Hous/ Duplex Condo Apartment Room
Property Owner Name:-D.v.,,,,,, l- n'' ". tl 1 l' -r lvlarl ng Address
(requrred )Pn mary Phone No.Alternate Phone No (required)E mal Address
Primary Phone No
abo- riJI (5 (5
(.equired)E mail AddressOwner's Representative/Rental
AoenVAoencv
I have read and lam familiar with the Town ofYarmouth Chapter
Yarmouth Short Term Rental Bylaw (if applicable) and the lvlA.
for Human Habitation) all of which are available on our website
hermore, I understand I must notify the Health Department in writing when I am no longer renting the property, or I may be
ect to flnes and bes
108 Rental Housing Bylaw Cha '104 Anti-Noise Bylaw Town of
State Sanrtary Code, Chapter l\,4inimum Standards of Fitness
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Furt
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Sign t:a*Datei I
Revised 10/2312023
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Rental Property lnformation