HomeMy WebLinkAboutRental Application,o 2025 Rental Registration Application
TOWN OF }'ARMOUTH
Health Depa rtment
I I46 ROUTE 28, SOT]TH YARMOIJTH
MASSACHL'SI]TTS 02664
Telephone (508) 398-2231. ext. 1240
Fax (508) 760-3472
E-mail: m dalev@\'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
office immediatelyl 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 4ggg.l!gl! complete the process or guarantee the automatic issuance of
a rental certificate. Your application will undergo a *review process, which includes verification ofassessors'
records, septic system, the number of bedrooms 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
adiustment based on the criteria mentioned above.
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Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectorsft$pn
Monoxide Detectors and verified that they are less than 10 years old: Pleose initiol.>4-
cont ct the BuildinS D€partment re8ardlng questio ns on ryp€ and location prior to purchash!// (
h Bps: / /w ww.yar mo uth.ma.us/ Docu m e n tC enter/Vr ew / 1 I 2 2 I /Smoke-detector-locatio n
A nrrrefundable application fee of $80 per unit/rental is required.
Rental Certificates expire on December 3l.t,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 If you prefer to pay by check, you may begin
your application online. After completing the initial 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 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 Yarmouti and mail
completed application (on reverse sideJ & payment to: Town ofYarmouth Health Department.
See Reverse Side -----'-----)
Please Print Clearly
Rental Property lnformation
All fields are required! lncomplete fomls without a valid phone #, oddress, or e-mail address will notprocessed.v
s,
Rental Property Address
eekly/Short Term (less than 31 days) _
Rental Period
ear-Round/Long Term
Trash Removal by
wner_ Tenan House- Duple!(Condo- Apartment- Room-/
Rental of
roperty Owner Full Name:
flosep4n'e- C4sS (requ ired) Entire Mailins Address:t2 f ulrsr/e&rrv 85,'ro-rrf *mhrzs?t7l? molb)
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mary onerequre um er ternate Phone Num ri
E-.-/)-60 r3 ( req u ired) E-mail Address:r(Ass QLreq'fthz
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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 notify the Health Department in writing when I am no longer renting theproperty, or I may be subject to fines & fees.
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,laN 0I 2025
HEAI-TH DEPI,
Revised: 11.024
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