HomeMy WebLinkAbout41 Bradford Road paper applicationApplication tor 2O24 Rental Registration (
TOWN OF YARMOUTH
Health Department
RECEIVEBOUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (5OB) 398-2231, ext. 1240
JAN | 2024 Fax (508) 760-3472
E-mail: epolite@yarmouth.ma.us
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 before! Simply visit https://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 10 years old: P/ease inrtial-
Contact the Building Department regarding questions on type and location prior to purchasing.
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A non-refundable application fee of $80 per uniUrental is required.
Rental Certificates expire on Oecember 31"t, 2024.
lf NOT registering online, please make checks payable to: Town of Yannouh and nrail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depadment willcallto schedule an inspection if roquired, upon receipt of yourapplication and fee.
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Rental Property lnformation
All fields are re uired! lncom ete forms without a valid hone # or email cannot be rocessed
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4tBe+orPeo frtr) rt, wama,:mtRental Property Ad Rental Period:
Annual VSeasonal Short Term (less than 31 daVS)
Trash Removal by;
owner- tenant-/ -
Rental of:
House- Duplex- Condo- Apartmen,l *oo,
ProDertv Ow
Ar'4a,,+iS-6t*d
ner Name;-Drnaoy
ER*s-'sy
Mailino Address:
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(required)Primary Phone No Alternate Phone No.(required)E-mail Address
(fwner's Representative/RentalAoenUAoenbv
[4-.4urra+r"tD&ly
Primary Phone No
58- 2e1,8436
(required)E-mail Address
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Furthermole, I understand I must notify the Health Department in writing when I am no longer renting the property, or I may besubject to fines and €es.
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Revised: 1012312023.
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