HomeMy WebLinkAboutRental Application2025 Rental Registration Application,
TOWN OF YARMOUTH
Health Department
I I46 ROTITE 2t, SOT]TH }'ARMOUTH
MASSACHIISETTS 02664
Telephone (50E) 398-2231, ext. 1240
Fax (508) 760-3472
E-mail: mdalevAl'a rmouth. ma.us
Important Notice (PLEASE READ CAREFULLY):
Ifyou do not receive your rental certificate within 30 days ofsending in your application, please contact our
ffice immediatelyl Please be aware that until you 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 dgeljq! complete the process or guarantee the automatic issuance of
rental certificate. Your application will undergo a *review process, which includes verification ofassessors'
ords, septic system, the number ofbedrooms and previous inspections
*An inspection may be required as part ofthis 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
Yarmout}l 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
adiustment based on the criteria mentioned above.
Ia
. A ru:rrefundable application fee of $80 per unit/rental is required.
. Rental Certificates expire on December 31"t,2025.
. To regrster online and pay via credit card, visit the Town of Yarmouth Health Department
your application online. After completing the initial steps, make your check payable to the Town o
Vr.n-Ioutt, and be sure to include your BHR number (which will be provided during the online
application process) 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 sideJ & payment to: Town ofYarmouth Health Department.
See Reverse Side
you prefer to pay by check, you may beginvarmouth.ma.us/727 / Health lf
f
)
website: https://www.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectortlj,l#on
Monoxide Detectors and verified that they are less than 10 years old: Please initiol<>f-
Contact the Buildin8 Department regarding questions on typeand locatton prior to purchasinS:
hrtosi//w\41i/.yannuLlth.ma.us/DocumenlCenter/Vie\!/11221/Smoke_delectorlocatjon
Please Print Clearly
Rental Property Information
All fields are required! lncomplete forms without o volid phone #, oddress, or e-mail address will not processed
)? a7/ 4a bz-r,prwil
Rental Property Address Rental Period:
ear-Rourd/Long T .ri{
eekly/Short Term (less than 31 days) _
Trash Removal by
wnel House- Dug+dondo- Apartment- Room-
Rental ofl
alle:
S\og-.ere-S
rope rlyrila Owner Full N
m4-s s:,(/rrl Mllling Add
e.2-5:2"E rfreurednEreq res)
Z,QP-<-
rt;a//
er t!req
T4o4rl 4bfoo
n6.)A d'//{o'a7y''-t
Ph no Nc llm ebr bl7 frequired)E-mail Addres
Agent/ VRBO, Del Mar,Need a Vacation, OtherTbSa
wne s epreseotative
acasa. We
enta Representative's Primary Ptone
Number:
76a)zzr6o
Representative's E-mail Address:
/ararchtcafu7pl
Furthermore, I understand I must notiry the Health Department in wridng when I am no longer renting theproperty, or I may be subject to fines & fees.
h reeb cakn ed th t fr vea I-e e dn n1:1 fu fant ar th h oT n tov ofm thu s hCa rte 01apeRtanHLIosnlahCe1I04ntiNBypBhTeofovhsrtoTrmRnetaBah revacbaenadehasacpphsLIttsetasenSataCdohCaTteMnryLImSmntapadsrd{o F'nt SSe rfo LIH an'l I1aHhTesdellocet'n ntS ril ae a ba c l-re Tefo ne ec h Teo sn e bs a dn am a s bo oebta lt de Li t1ovperusefrn1otheaYormuqHh.1e t Dh e rta nt np
,taN 0I ?.0?5
HEAlTH DEPT
E=GEU!N
Revised:11 024
f"n"n, d2.-
^FH
il
oise Yarmouth
bitation)on
I