HomeMy WebLinkAboutrental Application2O2S Rental Registration Application
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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/Ca*bn
Monoxide Detectors and verified that they are less than 10 years old: Pleose inltiol.>#-
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. A rsrrefundable application fee of $80 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
your application online. After completing the initial steps, mak'e 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 )
you prefer to pay by check, you may beginwebsite: https://www.ya rmouth.ma.us/ 127 /Health lf
Important Notice (PLEASE READ CAREFULLY):
Ifyou do not receive your rental certificate within 30 days ofsending in your application, please contact our
ffice immediately! PIease be aware that untilyou receive a rental certificate from the Health Department, your
roperty is being rented without a valid certificate, which may result in fines and other penalties.
ubmitting the registration application does not complete the process or guarantee the automatic issuance of
rental certificate. Your application will undergo a *review process, which includes verification ofassessors'
ecords, septic system, the number of bedrooms and previous inspections.
*An inspection may be required as part of this process.
Please note that occupanry 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
Yarmoutl prepares for a future transition to a town sewer system, these steps are crucial
for preserving our water resources. Previous occupancy determinations may be sublect to
adiustment based on the criteria mentioned above.
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TOWN OF YARMOUTH
Health Depa rtment
T I46 ROLITE 28. SOI.JTH YARMOUTH
MASSACHTiSETTS 0266{
Telephone (508) 39E-2231, ext. 1240
Far (508) 760-3472
E-mail: m da lev@\'a rm outh. ma. us
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Please Print Clearly
Rental Property Information
Allfields are reqttired! lncomplete lorms without o votid phone #, oddres5 or e-mail address will not processed.
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Rental Property Address
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ear-Round/Long Term
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roperty Owner Fu Name:(requ ired ) Entire Mailins Address:33 574N io-Pe- TF;Y?
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maryreq u re one um er Alternate Phone Number:(required)E-mail Addresi:
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Representative's Primary phone
Number:
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Representative's E-mail Address
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Furthermore, I understand I must notii/ the Health Department in writing when I am no tonger renting theproperty, or I may be subject to fines & fees.
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Rental Period:
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