HomeMy WebLinkAboutRental Applications{i*:i.i;,;;,-.J
2025 Rental Registration Application
lmportant Notice (PLEASE READ CAREFULLY):
lfyou do not receive your rental certit'icate within 30 days ofsenriing in your application, please contact our
ubmitting the registration application does not complete the process or guarantee the automatic issuance of
rental certificate. Your application will undergo a ireview process, which includes verification of assessors'
ecords, 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
[or preserving our water resources- Previous occupancy determinations may be subiect to
adiustment based on the criteria mentioned above.
Ia
. .{ rrnrefundable applicatic n fee of $8O per unit/rental is required
. Rental Certificates expire on December 31'r, 2025.
. To register online and pay via credit card, visit the Torvn of Yarmouth Health Department
your application oniine. Alier" completing the initial steps, make your check payable to the Town of
Yarnro'"rth, and be sure to inclucle your BHR number (rvhich will be provided during the online
application process) and youi" rental address. Make a note in the notes section that you will be
sending a check. Mail the check to the address above.
lf NOT registering online, please make checks payable to: Town of Yarmouth and mail
completed application (on reverse side) & payment to: Torvn ofYarmouth Health Department.
rvebsite: https://wlvw.$armouth.ma.us1l27/Health lf
See Reverse Side )
you prefer to pay by check, you may begin
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors,/Carbon
Monoxide Detectors and verified that they are less than 10 years old: Please initiat I
Conlact rhe BurldinB Dcprrtment r€garding questions on t-vp€ and location prior to purchrsing
TOWN OF YARMOUTH
Herlth Department
I IJ.6 ROLITE 2E, SOUTH YARMOUTH
MASSACHT]SETTS 02664
Telephone (50t) 398-2231, ext. 1240
Far (508) 76O-3t72
E-m ai I : mdale)-@ya rmouth. ma. us
office immediately! Please be aware that untilyou receive a rental certiticate from the Health Department, your
property is being rented without a val:d certificate, which may result in fines and other penalties.
Please Print Clearly
Rental Propertr llliormation
t
Rental Property Address:
5- Cl'^r!,."-<
ii Yr^(,^^or1L
A"{-
^1 +
01615
Rental Period:
ear-Round/Long Tu.r" f/i
eekly/Shon Term (less than 3l days) _
Trash Removal by
wner 'fenant X H ouse_ lluplexx Condo_ ,^partnlent Room_
roperty Owner Full Name
5^rob 8",(.)
required) Enrire Mailing AddressI eqx - i.{
\rinn'S fu +, "lA e2-$-1*
(r'et1rr ilcd) Primary Phone Number
e8 2z\ YgCIz
(required) E-
lnruJ €toQ1att,loz"':
Alternate Phone N unlber mail Adclress
ttt.-,1,r{ Kj<
epres
BO, DAgen
Need
e sr ne tatiVE ne ta
M reR c il
a o h
RepresenEdve's Primary Phone
Number:Reprcser)rJrivc's I1-mail Address
Habitation). These documents are available for reference o!t the 'Iown's website and may also be ot tained uponrequest from the Yarmouth Health Department.
Fur(4lermore, I understand I must notify the Health Department in writing when I am no longer renting theproPerty, or I may be subiect to fines & fees.
t
Sr Date:-
fb
h b cil okr')de e that ah TC e dv na ad funl fa Itl I'ht ht Teo fo l'l tr uo htv s hCa er r u0p
R n it H sLI l1 B l:l hCa r 40 I]t N SC B h 1'e op on Yf fit onturh hS r1o I Dlt'Rv tall ts a h revcbiinattdhJ\1 c uhsett tas e Sal)p tat c do hCa r l\1 II uItl m S nt.l adrd fo t.p n Ses r uH nt
Revi /26 /2024
Rental of:
r_Vacation,
wi i
I
)t
Please Print Clearly
Rental Property Information
All fields are required! Forms without a volid phone #, oddress, or e-mail oddress will not be processed.
Rental Property Address:
7 C["?51,i,-( A^"{-
u-Jr^f,."a,(L , 4koeelj
Rental Period:
ear-Round /Lons Term X
eekly/Shon Term (less than 31 days] _
Trash Removal by
ner House_ Duplexx Condo_ Apartment_ Room_
Rental ofl
S^t"b )vu:41
roperty Owner Full Name:required) Entire Mailing Address
fueo1.'q
\ann,'S ,Par{n& oz4-t-
(requ ired) Primary Phone Number
eg 22\ \gvz
Alternate Phone Number:(required)E-mail Address:
jnKnc)e,,eY^"1'/ot'-
A" 1t(, Kj<
Owner
Agent/
Need a
epres
BO, D
S ne ti R t)e
e aMrR eaasalc
Ca ti,l Do o h f
Representative's Primary Phone
Nunrber:
-laY f lo 6976
am fully familiar with the Town of Yarmouth's Chapter 10B
Bylaw, the Town of Yarmouth Short-Term Rental Bylaw fwhere
ry Code, Chapter ll (Minimum Standards ofFitness for Human
Habitation). These documents are available for reference on the Town's website and may also be obtained uponrequest from the Yarmouth Health Department.
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.
Si Date:_
I hereby acknowledge that I have reviewed and
Rental Housing Bylaw, Chapter 104 Anti-Noise
applicable), and the Massachusetts State Sanita
Revis /26/2024
IAN 0 n 2025
'l'enant X
Representative's E-mail Address: