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HomeMy WebLinkAboutRental Application2025 Rental Registration Application Important Notice (PLEASE READ CAREFULLY): ecords, septic system, the number ofbedrooms and previous inspections *An inspection may be required as part ofthis process. fyou do not receive your rental certificate within 30 days ofsending in your application, please contact our ffice immediately! Please 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 penalhes. ubmitting the registration application dgg!4! complete the process or guarantee the automatic issuance of rental ce-rtificate. Your applicition will undergo a *review process, which includes verification ofassessors' 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. Io A rsrrefundable application fee of $80 per unit/rental is required' Rental Certificates expire on December 31't' 2025. To register online and pay via credit card, visit the Town of Yarmouth H ealth Department website, https://www.Yarmouth.rna.us/ 12 7 /Health If you prefer to pay by check' you may begin ,*.",,ffisteps,makeyourcheckpayabletotheTownof'y;;.;;ih, and be sure to include your BHR number [which will be provided during the online ,ppri*i"" process) and you.i"ni"l address. Make a note in the notes section that you will be ,"naing " check. Mail the check to the address above' If NOT registering online, please make checks payable to: Town ofYarmouth and mail ."..pi","t appliclation (on reverse sideJ & payment to: Town of Yarmouth Health Department' )See Reverse Side Smoke Detectors and Carbon Monoxide Detectors are Required! owners: I have ensured the batteries are changed, have tested ALL smoke Detectorslga Monoxide Detectors and verified that they are less than 10 yea rs o I cl: Conlact the Euilding Department regardingquestions on lyPe and location prior to purcha n hnos: / /www.yglqggh tt22r Ismoke-detectorlocation TOWN OF YARMOUTH Health Depa rtment I I46 ROI]TE 28, SOT'TH YARMOT]TH MASSA('HtTSETTS 02664 Telephone (50E) 398-2231. ext. l2'10 Fax (508) 760-3472 E-mail: mdalel-.@]..a rmouth.m..us Alllields ore required! Incom Please Print Clearly Property lnformadon t a vulitl phane b, address_ or r:-natl a Rental ddress will not processed /4a flitv. -1es: /D/z/Z Renta I Properry Address: eekly/Short Term (less than 31 days) _ Rental Period: ea r- Round/Long Term Tenantner Trash Removal by noy[r4lunrex- condo- Apartment- Room- Rental of 4/berzr /rtK.--, roperty Owner Full Name:2t P .)r-r'=T,,--/"4 //74 a^6 v6 (required)Entire Mailing Address: go*- ^&o- /? 7/ requrre mary one um cr ternate Ph one Number:(req u ired)E-mail Addressaflxn 1J'b AEt14,[, ?& wne S eresnta ep Re tanneRoBeDAEl\4 r al caNeeadaacotinthore 16q)27/ffio Representative s Primary PhoDe Number:Representative's E-mail Address /oarc4ta,ra/upl Iffi:il::? l:]i"J:ff:J,TJ;:::y,;.3; Heaith Department in writins when r am no ronser rentins the fa fo h ree a kcn o deby e atht ah e vlree ad dn n1a u m aI-v th rh e oT o Yf I-a otn u h Cs ah te 1r 80RtanHuospnBaCheTv140nNspeuatho't'n a mrovu h sh rt T Rrrn tlta Ba a hchae reenadhyleaMspP(ca LIh e sftsta Sea n ta Cod Ch al rry npte um Starn nd rda os F'f enss rHhahTtlosedeoCn1ucllsraaehfoeI'f e rcence n eh oT n bs te dn m a o bvreeus ,.i n()mfroq eth aYr pmuoItethet)i'l lltrt nc t.I') Revised: 11 024 REGTEuVED .hN 0I 2015 HEALTH DEPI of ).c,(Human obtainedth