HomeMy WebLinkAbout15 Sycamore Way paper registration$an- )v-7yy
Application for 2024 Renta! Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (5OB) 398-2231 , ext. 1240
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HEALTH OEPT
The Town of Yarmouth is excited to announce that we've streamlined the onlinBfSQi6t?5't ron process to
make it more user-friendly than ever before! Simply visit httos://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 cornn'lunicate with oui team, but you'ii aiso garn access to your impo(ant documents, tne
ability to upload photos, and much more! This improved platform is designed to make your registration
experience smooth and efficient.
Fax (508) 760-3472
E-mail: epolite@yarmouth. ma. us
*
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 leis than 1O years old: P/ease initial ,4 b .
Contact lhe Building Department regarding questions on typ€ and localion prior to purchasing.
hltos //www.varmouth ma us/DocumenlC ter^r'ieWl 1221 /Smoke-detector-location
A non-refundable application fee of $80 pef UniUfgntal is required
Rental Certificates expire on December 31s', 2024.
lf NOT registering online, please makechecks payable to: Town of Yarmouth and mail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depanment will call to schedule an inspection if required, upon receipt of your application and fee.
Rental Property Addresstl ),4*"-*-qbT Short Term (less than 31 days)Annual
Rental Period
Trash Removal byl
o*n", / Tenanl
Property Owner Name
A"rU $*,rn-
-]fr-ailrno Address:so'Fthdilr\o*p4 o(o N,
(requrred)Pn mary Phone No
,/ tz- ,7,1 22-51 77
Alternate Phone No ( requ ired ) E -ma rl Address
n) 3a at<Yt- C c''\6'1?a1
Owner's RepreAgent/Aqency aenlatrldRentd-Primary Phone No (requi red)E,mail Address
Furthermole, I under-stand I must notify the Health Department in writing when I am no longer renting the property, or I may besubject to flnes and bes
I have read and lam famiil
Yarmouth Short Term Re
for Human Habitation) all
ap
lvl
Sign
ter 108 Rental Housinar with the Town ofYarmouth Ch 0 Btrar er a!41 Town.fnlal Bylaw (if
of which are
applicable) and the A. State Sanita ry Code, Chapte s of Fitnessavailable on our website. httDs:/rmouth.ma q-Prooram
/9 A 0.9 twt,^--Date: !'l '' ^'{
Rental Property lnformation
All fields are re uired! lncom )lete forms without a valid )hone # or email cannot be rocessed
Du
I of:
ex Ccndo ertment Room
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Revised: 10/2312023
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