HomeMy WebLinkAbout21 Azalea Lane Room only applicationApplication tor 2024 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone (508) 398-2231 , ext. 124O
Fax (508) 760-3472
E-mail : epolite@yarmouth.ma.us
skT fne 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.ooenqov.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 efiicient.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Dete
Monoxide Detectors and verified that they are less than 10 years old. Please initi
Contact the Building Department regarding queslions on lype and location prio. to purch
rs/Carbon
s
httos://www varmoulh ma. us/DocumentCenlerNiewl 1221lSmoke-detector,location
A non-refundabte apptication fee of $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 rnail completed application &
payment to: Town of Yarmouth Health Department.
The Health Depaftment willcallto schedule an inspection if required, upon receipt of your application and fee.
Rental Property lnformationA tields are re uired! lncom ete forms without a valid hone # or email cannot be rocessed
?T AzALLA LaNg '/rnonr.r^(less than 31 davs\ t/
Rental Period
Annual Seasonal
Trash Removal bv:
/Owner V Tenant
Rental of:
House Duplex Condo Apartment Room
Property Owner Name:
Ien,t\reR- \//A LLLct 2T A eALLA Leue
Mailing Address
(required)Primary Phone No
Bs+hq61bLt
Alternate Phone No (required)E-mail Address
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Owner's Reoresentative/Rental
AgenUAgenby Primary Phone No (reqdired)E-mail Address
I fEVe read and larr familiar wth the Town of Yanncuh Chapter '108 Rental Flousng Ry'av\,, Chapte|lo4 AntFMise Bylav!. To\!n of
Yarmouth Short Term Rental Bylaw (rf applcable) and the MA State Sanitary Code, Chapter ll (l\4rnrmum Standards of Fitness
for Human Habitation) all of whrch are available on our website. httos://www.varmouth.ma.us/423/RentalHousinq-Proqram
notiry the Heallh Department in writing when I am no longer renting the property, or I may be
oL JVl,a\Date
n
Furthermore, I understand I must
sub and ees.
023
Rental Property Address: