HomeMy WebLinkAboutRegistration Y= $ Application for 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231, ext. 1240
Fax (508) 760-3472
E-mail: epolite@yarmouth.ma.us
laY •
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.opengov.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/C rbon
Monoxide Detectors and verified that they are less than 10 years old: Please initial
Contact the Building Department regarding questions on type and location prior to purchas ng.
https://www.yarmouth.ma.us/DocumentCenter/View/11221/Smoke-detector-loca _ �..--s.d...
Ell—Zki:LiR LLD
• Anon-refundable application fee of$80 per unit/rental is required.
• Rental Certificates expire on December 31st, 2024. P 2024 .
• If NOT registering online, please make checks payable to: Town of Yarmouth and mail cc-nple p itiiarn 3
payment to: Town of Yarmouth Health Department.
• The Health Department will call to schedule an inspection if required, upon receipt of yourapplication and fee.
Rental Property Information
All fields are required!Incomplete terms without d 'al!u phone#or email cannot be processed.
Rental Property Address: Rental Period:
/.' <t5 #2e4.e.4---/ei,W ---,e'<' Annual Seasonal 1 Short Term (less than 31 days)
Trash Removal by: Rental of:
Owner Tenant House_Duplex_Condo✓partment_ Room_
Property Owner Name: Mailing Address:
ef- Z�
'•r.`'.-w,, -..I/ : g �._s r j1�r, /9-7X C.ti, P.2 r ,.
(required)Primary Phone No. Alternate Phone No. (required)E-mail Address:
77'-r,z'.2. - d 6-e 7/r ; ---,,,-..s'•2 d j/s to%' o (10yedirrko•.G
Owner's Representative/Rental Primary Phone No (required)E-mail Address:
Agent/Agency 4 ty�4_�f-
`: l : /. Z�Y 1'0 9' 77/-' ASi,Mei; /oi rx..zej aSea�r t'> /!o ff ire4/4-Co,
�gfty
I have read and lam familiar with the Town of Yarmouth Chapter 108 Rental Housing Bylaw, Chapter 104 Anti-Noise Bylaw, Town of
Yarmouth Short Term Rental Bylaw(if applicable)and the MA. State Sanitary Code, Chapter II (Minimum Standards of Fitness
for Human Habitation)all of which are available on our website.https://www.varmouth.ma.us/423/RentalHousinq-Program
Furthermore, I understand I must notify the Health Department in writing when I am no longer renting the property, or I may be
subject to fines and fees..
•
Sign: _• ,( -iv .fie l _ Date: fl. /�4F-
Revised: 10/23/2028
I
t
9j, - 9-fiS
f:
1
a
1'