HomeMy WebLinkAboutRental Application)o
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 g!ry]! complete the process or guarantee the automatic issuance of
rental certificate. Your application will undergo a *review process, which includes verification ofassessors'
cords, 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.
Ia
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors
Monoxide Detectors and verified that they are less than 10 y
Contact the Building Depanment reSardintquestions on typ€ and location priorto purchas
h nDs: / /ww\{.varmo uth.ma. us / Do(u m e ntL e nter /V iew / I I 2 2 I /Smoke-detectorlocau o n
ears old:
. A rurrefundable application fee of $80 per unit/rental is required.
. Rental Certificates expire on December 31.'1,2025.
. To register 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 of
Yarmouth, and be sure to include your BHR number (which will be provided duringthe 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 beginarmouth.ma.us/ 127 /Health lf
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website: https://www.v
2025 Rental Registration Application
TOWN OF YARMOUTH
Health Department
I I46 ROTITE 28, SOITTH YARMOI,ITH
MASSACH LISETTS 02664
Telephone (508) 398-22J l. e\t. I 240
Fax (508) 760-3472
E-mail: mdaleyava rmouth. ma. us
Please Print Clearly
Rental Property Information
All fields are required ! lncomplete forms without o volid phone #, address, or e-moil address will notprocessed.
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Rental Property Address:U",g5/
eekly/Short Term (less than 3'1. daysl _
Rental Period:
ear-Round/Long Term
Trash Removal by:
er House- Duplex- Condoldpan-ent- Room-_/
Rental ot
W'e-a u rkn-lvebroe o r Fu Nprty
CZ d required) Entire Mailing Address:8/ aVerzns i<d,io**L' Dervati-1,'77 P 'oA66a
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requrre onermary un)er ternate Pho ne Number:Address:86ne,'1, u'z'tu/erNf
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Representative's Primary Phone
Number:
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Furthermore, I understand I must notiry the Health Department in writing when I am no longer renting theproperty, or I may be subject to fines & fees.
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Revised: 11 024
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(required)E-mail
Representative's E-mail Address:
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