HomeMy WebLinkAboutRental Application!o 2025 Rental Registration Application
TOWN OF YARMOLTTH
Health Department
I I.16 ROTITE 2E, SOTITH YARMOTITH
MASSACHUSETTS 02664
Telephone (5O8) 398-223f, exr. l24O
Fax (508) 760-3472
E-nrail: md aley@va rmou th. m a. u s
Important Notice (PLEASE READ CAREFULLY):
Ifyou do not receive your rental certificate within 30 days of sending in your application, please contact our
office immediately! 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 dggglgl! 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
adrustment based on the criteria mentioned above.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detector S Carbon
Monoxide Detectors and verified that they are less than 10 years old: Please initiol
Contact the Building Department regard ing questions on type and location prior to purchasinB.
httl,s://www.varmouth.ma.us/Docu m e ntCenter /View / 1 I 2 2 I / s moke-detector-location
A rntrefundable application fee of $8O per unit/rental is required.
Rental Certificates expire on December 3l't,2025.
To register online and pay via credit card, visit the Town ofYarmouth Health Department
website: h s:armouth.ma.us t27 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 processJ and your rental address. Make a note in the notes section thatyou 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 )
Ia
Please Print Clearly
Rental Property Information
tlll lields Ltre rlquircd! Ii)nus \r,itllout a velkl pllonr fl, olL!rcss, or e'nrrri/ orl/r lrs * ill not he processecl
Rental Properqr Address:
ZSq Dood Rcl
9o, ../ar rno - t\r lY\ ot
oz6b\
Rental Period:
ear-Round/Long T .r^ -/
eekly/Short Term (less than 31 days) _
Trash Removal bv
wner Tenan plex_ Condo_ Apartment_ Room_LH orse
roperty Owner Full Name:
Q+.. 10. noo,^\to....
required) Entire Mailing Address:
\4 4<ccnrrt, c,.J D(
4c. De'''"ris 0Ar. o26tO
(r'equired) Primary Phone Numberi
5og z 3) togS
Alternate Phone Number:
gos 3sc €339
(required) E-mail Address:
cre^[ too co..s+(6<-+\b c\
O corncagt- cret
eAg
Ne
e sf n a VC Re tall
nt e aMr asca
ed a cati no he ro
Representahve's Primary Phone
Number:Representative's E-mail Address
ereby acknowledge that I have reviewed and am fully familiar with the Town of Yarmouth's Chapter 108
Rental Housing Bylaw, Chapter 104 Anti-Noise Bylaw, the Town ofYarmouth Short-Term Rental Bylaw fwhereapplicable), and the Massachusetts State Sanitary Code, Chapter Il (Minimum Standards ofFitness for Human
Habitation). These documents are available for reference on the Town's website and may also be obtained upon
request from the Yarmouth Health Department.
Furthermore, I understand I must noti8/ the Health Department in writing when I am no longer renting the
property, or I may be subject to fines & fees.
Si Date i "1- 25[, lhril,r-
th
Reised: 11,/26/2024
Rental ol
IAN 13?