HomeMy WebLinkAboutRental Application2025 Rental Registration Application
TOWN OF YARMOUTH
Health Department
I I.16 ROTITE 28, SOUTH YARMOT]TH
MASSACHTTSETTS 0266,1
Telephone (508) 398-2231, ext. 1240
Fax (5O8) 760-3472
E-mail : mdaley(aya rmou th. ma. u s
Important Notice (PLEASE READ CAREFULLYJ:
lf you do not receive your rental certificate within 30 days of sending in your application, please contact our
pffice immediately! Please be aware that untilyou receive a rental certificate from the Health Department, your
properfy is beinB 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 ireview 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
adiustment based on the criteria mentioned above.
Smoke Detectors and Carbon Monoxide Detectors are Required!
Ovmers: I have ensured the batteries are changed, have tested ALL Smoke Detectorsfarbon
Monoxide Detectors and verified that they are less than 10 years old: Ptetse initiolflfuL--
Contactthe Building Department rega rd ing questions on rype and location prior to purchasing.
https://www.yarnmuth.ma.us/DocumentCenter /View/ I I 22 1/Smoke'det€ctork,catiorr
. A rsrrefundable application fee of $80 per unit/rental is required.
. Rental Certificates expire on December 37'r,2025.
. To register online and pay via credit card, visit the Town of Yarmouth Health Department
website: https://www.varmouth.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 ofYarmouthand mail
completed application (on reverse sideJ & payment to: Town of Yarmouth Health Department.
See Reverse Side -----------)
REGEiv
HEALIH DEIa
Please Print Clearly
Rental Property Information
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Rental Property Address:Rental Period:
Year-Round/Long term /-
Weekly/Short Term (less than 31 days) _
7 5it>rl
Owner_ Tenant_
Trash Removal by
2v'f<r-s''IL
HousedDuplex- Condo- Apartment- Room-
Rental of
(required) Entire Mailing Address: ?-{nfr*'u a-Atr< ( LW 4^61^'t!'
3,1 H alp L\f tur t#o tLD'
ltJfir1-r0111Y, ( 1 0t.l7o
Prooertv Owner Full Name:
Diwt' w-l fi'"q7fiN(" LA*"Lttvtd
(requilcd) Primary Phone Number:
)03 5t6 t',Ot{Alternate Phone Number:)oj 'tS'? LV6 (requ ired) E-mail Address
5f54 /4eVL'J.,w4 c,tcltril
Representative's Primary Phone
Number:
)ol ,lty Lcl,)g.
Representative's E-mail Address
Lst,,{>2-L 't'
Owner's Representative/Rental
Agent/ VRBO, Del Mar, Vacas4, we
Need a Vacation, OtheLryfr
I hereby 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 (where
applicable), and the Massachusetts State Sanitary Code, Chapter II (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 notify the Health Department in writinB when I am no longer renting the
property, or I may be subject to fines & fees.
Date:Si J
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Reised: '17 / 26 /2O24