HomeMy WebLinkAbout26 Barnboard Lane paper applicationApplication for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02654
Telephone (508) 398-2231, ext. 1240
Fax (508) 760-3472
E-mail: epolite@yarmouth. ma. us
The Town of Yarmouth is excited to announce that we've streamlined the onl
sing this upgraded system, you'll have the power to engage with us throughout the entire process. Not only
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HEALTH DEPT
bility to upload photos, and much
xperience smooth and efficient.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectgrs/Carbon
Monoxide Detectors and verified that they are less than 10 years old. P/ease initial ll
Contact the Building Department regarding queslions on type and Iocatron prior to purchasfnq
httosr/www.varmouth ma us/DocumentCenter^/iew/1 1221lSmoke-detector localion
A non-refundable apptication feeof $80 pef UniUfental is required
Rental Certificates expire on December 31.', 2024.
lf NOT registering online, please make checks payable to: Town of YarmoLrth and mail completed application &
payment to: Town of Yarmouth Health Department.
Tlle Health Depaftment willcall to schedule an inspeclion if required. upon receiptof yourapplication and fee
Rental Property lnformation
All fields are re uired! lncom lete forms without a valid hone # or email cannot be rocessed
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Rental P perty d ress
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Rental Period:
Seasonal /
"non
,"r. (less than 3'1 days)Annual
Trash Removafby: -
o*nur-f Tenant-
Rental of:
Duplex Condo Apartment RoomscusJ'
Prooertv Owner Name: . .-
Fz.rt-Dc t5, LuaA, Batu'r 1-y' ,lcr+tve// r'
Mailino Address:
r; #5? tq>I nu,lk,oilrln(require!)Primary Phone trlo
l//-gr-rorL
Alternate Phone No
5or.33 l- t 71n5
Ilrequirdd)E mail Address: J
Lue Ac4<zi2t(4'ooi . (drr
Owner's Represe ntatlVeTRentETAgenUAgency Primary Phone No (required)E mail Address
tify the Health Department in writing when I am no longer renting the property, or I may be
Date
apter ap
r llI Bylaw
which a ite
S iect fines and
108 Rental HousiI have read and I arn fam liar with the Town of Yarmoulh Ch ngEyiawJh ter 104 Anti own oYarmouth Short Term Renta (if applicable) and the State Sanitary Code, Chapte l\.4inimum f Fitness
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