HomeMy WebLinkAboutRental application,o 2OZS Rental Registration Application
TOWN OF YARMOLI TH
Health Department
I I.16 ROT]TE 28, SOTJTH YARMOUT}I
MASSACHI-ISETTS 02664
Telephone (5O8) 398-2231, ext. 1240
Fax (508) 76O-j172
E-mail : mdaleyadyarmouth. m a. 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 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 does not complete the process or guarantee the automatic issuance of
a rental certificate. Your application will undergo a *review process, which includes verification of assessors'
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 sublect to
adiustment based on the criteria mentioned above.
Io
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectorsl$ar-bon
Monoxide Detectors and verified that they are less than 10 years old: Pleose initial ( Nl
Contact the Building Department regarding q uestio ns on type and location prior to purchasing
hti Is. // w w w.yal n to ulii.nia.ir s/ Dot-u nr e r r iCelltc t Nicw i t iZZi iSmoke- d etec(r-iocau on
. A rnrrefundable application fee of $8O per unit/rental is required.
. Rental Certificates expire on December 31x,2025.
. To register online and pay via credit card, visit the Town of Yarmouth Health Department
website: https://www.yarmouth.ma.us/ 127lHealth 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 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 NOT registering online, please make checks payable to: Town of Yarmouth and mail
completed application (on reverse sideJ & paymentto: Town of Yarmouth Health Department.
See Reverse Side )
Please Print Clearly
Rental Propertv lnformation
Rental Property Address:
q6q oo' t\ai'r 5\
So . f*; mo '^*\"r (6a azbr.4
Rental Period:
Year-Round,/Long f.r^ Y/
Weekly/Short Term (less than 31 days) _
Trash Removal bv
Owner_
Paid Pick Up:
Rental of:
Houru/oupt., Condo Apartment Room-
Property Owner Full Name:
pe\.. t^.l. fho,-t*on
(required) Entire Mailing Address
19, (,rccnv,cr-r D(
6o. ()c-..nis $aq o Z LioO
(required) Primary Phone Number:
50a z3-7 loAS
Alternate Phone Number:
5oS 355 a33a
(req u i red) E-mai I Address:
ty.io u\ \o.\ co ".,
g{<c\ iscr
Co (.^Lot5\.- ...' Lt
;
Owner's Representative/RentalAgent/ VRBO, Del Mar, Vacasa, We
Need a Vacation, Other_
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 1OB
Rental Housing Bylaw, Chapter 104 Anti-Noise Bylaw, the Town of Yarmouth 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.
Si ,u h) (n'tIL Date: I 1-25
Reised:11/26/2024
'tarrurr, \/
13?