HomeMy WebLinkAboutRental Application*2OZS Rental Registration Application
TOWN OF YARN{OUTH
Health Department
I Id6 ROI'TE 28. SOLITH YARMOLITH
MASSACHUSETTS 02664
'l'elephone (5O8) 398-2231, ext. I 240
Fax (508) 760-3472
E-mail: md aley@ya rmo u th. ma. us
Important Notice (PLEASE READ CAREFULLY):
If you do not receive your rental certificate within 30 days of sending in your application, please contact our
office immediatelyl Please be aware that until you 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 does not 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 rnay 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 Detector rbo nS
Monoxide Detectors and verified that they are less than 10 years old: Please initial
Contact the Building Department regard ing q uestions on type and location prior to purchasin&
httDs://www.yarmouth,ma.us/DocumentCenter/Vrew/ I I 221 /Smoke-detecror-lo.arron
A rurrefundable application fee of $8O per unit/rental is required.
Rental Certificates expire on December 3l't,2025.
To register online and pay via credit card, visit the Town of Yarmouth Health Department
website: https://www.y armouth.ma.us/ 127 /Health lf you prefer to pay by check, you may begin
your application online. After completing the initial steps, make your check payable to the Town of
Yarmouth, and be sure to include your BHR number fwhich will be provided during the online
application process) and your rental address. Make a note in the notes section that you will be
sending a check. Mail the check to the address above.
If N0T registering online, please make checks payable to: Town of Yarmouth and mail
completed application (on reverse side, & payment to: Town ofYarmouth Health Department.
See Reverse Side )
Please Print Clearly
Rental Property ln fornration
Rental Property Address:
C,rey G d\
(wra. o-206{
Ll s'l
4o'
d lnc\oq)
r"t o ,^$r.
Rental Period:
Year- Round/Long Ter^ yL
Weekly/Short Term (less than 31 days)
-Trash Renroval by
Owner 'l'enant_
paiaprcruu O4r6Sf P\<gos".\
Rental of:
HouseYDuplex- Condo- Apartment- Room-
Property Owner Full Name:
Po\.'. c,.^ fno.^\tot'
(rcquired) Entire Mailing Address
\4 Cr.a.rv',od D<
5o. Oatrr.9 (\ct ozl"6o
(requ iretl ) Primary Phone Number
5oB z3) loz5
(required)E-mail Address:'f\-ro,+ t\o.r co.la}. ,^.ltio .', O
c" c-' co g,\ - cr e-t
Owner's Representative/RentalAgent/ VRBO, Del Mar, Vacasa, We
Need a Vacation, 0ther
Representative's Primary Phone
Number:Representative's E-mail Address
I hereby acknowledge that I have reviewed and am fully familiar with the Town ofYarmouth's Chapter 108
Rental Housing Bylaw, Chapter 104 Anti-Noise Bylaw, the Town ofYarmouth Short-Term Rental Bylaw (where
applicable), and the Massachusetts State Sanitary Code, Chapter II [Minimum Standards of Fitness 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 notify the Health Department in writing when I am no longer renting the
property, or I may be subject to fines & fees.
Sisn QAU ru/A t-1-z{Date
Reisedt 17 /26/2024
Alternate Phone Numtrer:
5os zzs 8339
1 3 2C25