HomeMy WebLinkAboutRental Application2O2S Rental Registration Application
Important Notice (PLEASE READ CAREFULLY):
lf you do not receive your rental certificate within 30 days ofsending in your application, please contact our
office immediately! Please be aware that untilyou receive a rental certificate from the Health Department, your
property is being rented without a valid certificate, which may result in fines and other penalties.
Submitting the registration application d@l! complete the process or guarantee the automatic issuance of
a rental certificate. Your application will undergo a *review process, which includes verification of assessors'
records, septic system, the number ofbedrooms and previous inspections.
*An inspection may be required as part of this process.
Please note that occupancy limits are in place based on septic capacity and the number of
bedrooms, These measures are in place to protect our drinking water and aquifers. As
Yarmouth prepares for a future transition to a town sewer system, these steps are crucial
for preserving our water resources. Previous occupancy determinations may be subiect to
adiustrnent based on the criteria mentioned above.
Ia
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors/gilb"
Monoxide Detectors and verified that they are less than 10 years old: Pleose initiol,>#_
Contact the Bulld lng Depa rtment regard ing q uestions on type and locario n prro r to p rrchasin)l/ / {
. A notrrefundable application fee of $8O per unit/rental is required.
. Rental Certificates expire on December 31,n,2025.
. To register online and pay via credit card, visit the Town of Yarmouth Health Department
website: https://www.varmouth.ma.us/ 12 7 / Health lf you prefer to pay by check, you may begin
your application online. After completing the initiai steps, make your check payable to the Town of
Yarmouth, and be sure to include your BHR number (which will be provided during the online
application processJ and your rental address. Make a note in the notes section that you will be
sending a check. Mail the check to the address above.
If NOT registering online, please make checks payable to: Town of Yarmouth and mail
completed application (on reverse side) & payment to: Town ofYarmouth Health Department.
See Reverse Side )
TOWN OF YARMOUTH
Health Depa rtment
I I46 ROUTE 28. SOTJTH YARMOL]TH
MASSACHTISETTS 02664
Telepbone (508) 39t-2231. ert. 1240
Fax (508) 760-3772
E-mail: m da ley@va rm ou th. m a. u s
https: //wwly.varnlqgth.ma.us/Doc
Please Print Clearly
Rental Property Information
Rental Property Address:
//v Rental Period:
ear-Round/Long T "rid
eekly/Short Term (less than 31 daysJ _
Trash Removal by:
Tenaner plex_ Condo_ Apartment_ Room_,ryy'r,
4ntlnp T3e-atry
roperty Owner Fu Name:(required) Entire Mailing Address
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ary one erureq u re Alternate Phone Number:
,ab*;?7{-3.s3 (required)E-mail Address:arVe-rlQ eo/.
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Representative's Primary Phone
Number:
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Representative's E-mail Address
Habitation) These documents are available for reference on the Town's website and may also be obtained uponrequest from the Yarmouth Health Department.
Furthermore, I understand I must noti6, the Health Department in writing when I am no longer renting theproperty, or I may be subject to fines & fees.
h recb cakn ed teh ah e Tev ed naci Dl ftrv fanl ra thwi h To onf av rm LIoth Cs ah te 1r I0p
eR tan H LIo ns hC e If 40 nti oN BByla a eth oTwnp o Yf rma uo h hSv rto eT rnl eR tan B a h recyl
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JAN 06 rotr.
DEPTHEALTH
JAN 0I 2024
EALTH OEPT,H
BtrGtr[\Y LE19
Revised: 11 024
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