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Application f or 2O24 Rental Registration
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSET
Telephone (SO8) 398-223i, ext. 1240
Fax (508) 760-3472
E-mail: epolite@yarmouth.ma.us
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HEATTH DEPI
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Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners. I have ensured the batteries are changed, have tested ALL Smoke Detectors/CarbonMonoxide Detectors and verified that they are less than 10 years old: P/easeContact the Building Deparlment regard ing questions on type and location p.ior lo purchasinghllos.Yarmoulh m us/DocumentCenlet Nievl11221 ISmokedetector-localron
A non-refundabte apptication fee of $80 pef UniUfental is required, Xl_,: t /O
Rental Certificates expire on December 31"r, 2024. J ,r, ,f ; frf 6
lf NoT registering online, please make checks payable to Town of Yarmouth and mail completed application &payment to: Town of Yarmouth Health Department.
Tlte Healtll Depaftment willcallto scltedule an inspection if required. u of yout a ication and fee
Renta I Property lnformatircn
All fields are r,uired! lncom lete forms withoLl a valid ne # or email cannot be rocessedRental Pro
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ental Period:
nal Short Termnnual less than 31 d
Owner Tenant /
Trash Removal by
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Revised: 'i 3t2023
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50 ALDER RD
WESTWOOD, MA O2O9O