HomeMy WebLinkAboutRegistration Application for 2024 Rental Registration
F 3'
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 APR 2 2024
1N 5,
SEAR. HEALTH DEPT.
The Town of Yarmouth is excited to announce that we've streamlined the online eegistration 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/ arbon
Monoxide Detectors and verified that they are less than 10 years old: Please initial 121
Contact the Building Department regarding questions on type and location prior to purchasing.
https://www.yarmouth.ma.us/DocumentCenter/View/11221/Smoke-detector-location
• Anon-refundable application fee of$80 per unit/rental is required.
• Rental Certificates expire on December 31st, 2024.
• If NOT registering online, please make checks payable to: Town of Yarmouth and mail completed application &
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 forms without a valid phone #or email cannot be processed
Rental Property Address: ,1 Rental Period:
Cif / Q5SC�C,�v s S eT> Annual Se�asonaa Short Term (less than 31 days)
Trash Removal by: —mental of:
Owner ✓ Tenant House Duplex_ Condo_Apartment_ Room_
Property Owner Name: Mailing Address:
Pa.--r i C-a H i !1 S /n Y/2-rv/9- gel rr'a-/►1/1 hey in>R. O t 7a 1
(required)Primary Phone No. Alternate Phone No. (required)E-mail Address:
Csva)33 I — 0 5 h u//p4J?& y o o.c d,n.
Owner's Representative/Rental Primary Phone No (required)E-mail Address:
Agent/Agency
VCI Vet Sa- CoK,
I have read and I am 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/RentalHousirm-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 t fines and fees. (�
Sign: t diA466, Date. ';4d 9-
Revised: 10/23/2023