HomeMy WebLinkAbout844 Route 28 Unit 3C paper applicationsl= e tt
a)?\ )e'
@ eppri"" tiiiiizfi4 iental Resistration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231, ext. 1240 RECEIVEDFax (508) 760-3472
E-mail: epolite@yarmouth.ma.us JAN 2d 2024
The Town of Yarmouth is excited to announce that we've streamtinea ,n" "HF#[!Ui&rEfi,;',
pro.".. to
make it more user-friendly than ever before! Simply visit httos://varmouthma. portal.ooenoov.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 bafteries are changed, have tested ALL Smoke DetectorsiCarbon
Monoxide Detectors and verified that they are leis than 1O years old: P/ease initiat aQ',
Contact the Building Depadment regarding queslions on type and location prior to purchasing.
hllDs://www varmouth.ma us/DocumentCenlerNieWl 1 221 /Smoke-detector-location
A non-refundable application fee of $80 per UniUfental is required.
Rental Certiflcates expire on December 31"r, 2024.
lf NOT registering online, please make checks payable to: Town of YanrDuth and n€il cornpleted applicatjon &
payment to: Town of Yarmouth Heallh Department.
The Health Depaftment willcallto schedule an inspection if required, upon receipt of yourapplication and fee.
Rental Property lnformation
All fields are re uiredl lncom lete forms withoul a valid hone # or email cannot be ssed
!
Rental Property Address:
xqq Gl )z tJ^1LI ,-4.^,onal Short Term (less than 31 days)Annual
Rental Period
Trash Removal by:
Owner Tenan,_:Z
Rental of:
,/House Duplex Condo y'Apartment Room
\s llqc)c9a-t
rty Owner Name,r"y
2 Tr9[r' 8d $rL\ 01",^r,th ,1.* ottMailing Address
(required)Primary Phone No
sDs l5 1 q1q3
Alternate Phone No
sDg [8s 11t61
(required)E-mail Address:
i ( gD,r. 561..1 )rrc g q-e'l ' co
Owner's Representative/Rentalo'"i'lnf""'+equ i red) E-mai I A:dd ress
I must notify the Health Oepartment in writing when I am no longer renting the property, or I may be
I trave read and larr familiar with the Town of Yanrput-r CiEpterYarmoulh Short Term Rental Bylaw (if applic€ble) and the MA
for Human Habitation) allof whrch are available on ourwebsite
108 Rental Housng Ry'aw, Chader 104 Anti-l.lcise B\y'av!, Tom of
State Sanitary Code, Chapter ll (l\,linimum Standards ol Fitness
. https://www.varmouth.ma.us/423/RentalHousinq-Proqram
z\)tI
Date:Sign
Furthermore. I understand
subject to rines and ees.
Revised: 10/2312023
Primary Phone No
a-)I