HomeMy WebLinkAbout36 Powers Lane paper applicationApplication for 2O24 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (5O8) 398-2231 , ext. 1240 REe EIVED
Fax (sO8) 760-3472
E-mail: epolite@yarmouth.ma.us j,\N 2 21 2024
HEALTH DEPl
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. oortal.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, hut you'll also gain accesa to )rour important dccuments, the
ability to upload photos, and much morel This improved platform is designed to make your regishation
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. ittlo, ,rlion prior lo purchasin! i
rr ,ka lr,l, r i.il )r 10,_ator
Contact lhe Building Deparlmenl regarding questions on type and
httos://www varmouth ma.us/DocumentCentet lV tew I 1 1221 I S
A non-refundable application feeof $80 pef UniUfgntal is required
Rental Certificates expire on December 31"r. 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 to schedule an inspectiotl if required, upotl receipt of your application and fee
Rental Propefi lnformation
All fields are uiredl lncom lete forms without a valid hone # or email cannot be ssed
Rental Property Address:
!tt, Po,aus pu.,a wts+ Yqrnu,oK nb Seasonal{ Short Term (less than 31 davs) ,Y
Rental Period
Annual
Trash R
Owner )1- Gloc Polenant
,L,Na,^s"k -
emoval by
OUSE Roomart ment
Renta of
Du lex Condo
Property
0 cr-nl a e*ro
ner Name
Ll l)ad- /nt.lr bt-r [Yft 0 tt1tz
at ling Address
n
tlt/ -r-r,l-- tlty
requr nmary one o
h
Alternate Phone No
Un-t117-171y c
required)E il Address
nSeseep
ent/enCAgAgv
Primary Phone No (requi red)E-mail Address
/-50 Ov 4) aut L^o n'-?
Furlhermore. 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 bes.
h a
423lRentalHo usino-Prooram
ar with aTm apter us ng Bylaw,
ntal Bylaw (if a
of which are a
pplicable) and the State Sanita ry Code, Chapter
vailable on our website httDs:/rmouth ma.us
Yarmouth Short Term Re
for Human Habitation) all
ave re mlanam SE ylaw
Sign Date
inimum Standards of Fitness
3-
t
t\4
Revised: 10/2312023