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Home My WebLink AboutRental Applications!,J 2025 Rental Registration Application Important Notice (PLEASE READ CAREFULLY): lfyou do not receive your rental certificate within 30 days ofsending 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 dggg..l!gl! 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 ofbedrooms and previous inspections. *An inspection may be required as part of this process, Ia Smoke Detectors and Carbon Monoxide Detectors are Requiredl Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors/Cafbon Monoxide Detectors and verified that they are less than 10 years old: Pleose initial E/ll Contact the Building Department regarding questions on type and location prior to purchasin& ht!Ds: l/www.varmouth.ma.us/DocumentCenler / Vre!r / I l22l /rrr{,ke-(lere( l{I -kx.rtion . A ncrrrefundable application fee of $8O per unit/rental is required. . Rental Certificates expire on December 37.t,2025. . To register online and pay via credit card, visit the Town of Yarmouth Health Department website: https://www.varmouth.ma.us/ 12 7/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 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 side,) & payment to: Town of Yarmouth Health Department. See Reverse Side ) TOWN OF YARMOUTH Health Department I I46 ROT]TE 28, SOT'TH VARMOTITH MASSACHI.JSETTS 02664 Telephone (508) 398-22Jt, exl. 1240 Fax (50E) 760-3172 E-mail : md aleyadya rmou th. n! a.u s 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 adlustment based on the criteria mentioned above. ) z0?5 Please Print Clearly Rental Property Information All lialrls Ltre required! l-ornis v'iLht)tll utttlil phone #, .rddi-e-{-J, or e,-rrrrr r/ rrrlrlr or Ll tll ttot ltt processetl Rental Property Address i8 A Lrtt,au p)Rental Period: Year-Round/Long t"r* / Weekly/Short Term (less than 31 days) _ Owner- Tenan Paid Pick Uo: Trash Removal by Rental ol */,House_ Duple ondo_ Apartment_ Room_ Property Owner Full Name: E l/ r(rPn Nrxoouc,h (r'equ ired) Entire Mailing Addr l0 .!til,/t;s 3/'/ 0. lo,Lou4h, xP ollzT ESS (required) Primary Phone Number: 5or 77/-tjfl/ Alternate Phone Number:(required)E-mail Address: e ..tne -)onn a4ua)/( Owner's Representative/Rental Agent/ VRBO, Del Mar, Vacasa, WeNeed 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 of Yarmouth's Chapter 108 Rental Housing Bylaw, Chapter 104 Anti-Noise Bylaw, the Town ofYarmouth Short-Term Rental Bylaw [whereapplicable), and the Massachusetts State Sanitary Code, Chapter II (Minimum Standards of Fitness for Human Habitation).'l hese documents are available for reference on the Town's website and may also be obtained upon request from the Yarmouth Health Department. si Dnte f Reisedt 17 /26 /2024 az-"'-- 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. C,2025 Rental Registration Application TOWN OF YARMOUTH Health Department I I46 ROUTE 2E, SOI]TH YARMOUTH MASSACHTISETTS 02664 Telephone (5O8) 398-223t, ext. 1240 Fax (5O8) 760-3472 E-mail: mdalev(avarmouth-ma.us Important Notice (PLEASE READ CAREFULLY): Ifyou do not receive your rental cer ncate within 30 days ofccndincin your application-please contact our office immediately! 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. $ubmitting the registration application 4gg!!g! complete the process or guarantee the automatic issuance of h rental certificate. Your application will undergo a *review process, which includes verification of assessors' [ecords, septic system, the number ofbedrooms and previous inspections. 'An inspection nray be required as p.rrt 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 Requiredl Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors/Cabon Monoxide Detectors and verified that they are less than 10 years old: Pleqse initial l4l Contactthe Buildin8 Department regarding questions on tyPe and location prior to purchasin& armouth-ma.us/Documentcenter/View/ 1 122 1/Smoke-detector'location . A rurrefundable application fee of $80 per unit/rental is required. . Rental Certificates expire on December 3l'r,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 processJ 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 side) & payment to: Town of Yarmouth Health Department. See Reverse Side ) Ji\i; ,: J ,/0?5 Please Print Clearly Rental Property lnformation [*tl''u g1) ,t htr\\4 qt All fields are required! lncomplete Iorms without q valid phone i, oddress, or e-moil uddress wlll notprocessed. Rental Property Address: l{ g Lztcua-P.L Weekly/Short Term 0ess than 31 days) _ Rental Period: Year- Round/Long Term Trash Removal by ..un^r, / Paid Pick Uo: Owner_House_ Duplex1,ondo_ Apartment_ Room_ roperty Owner Full Name (required) Entire Mailing Address: I o Jraq re,'t Bl 'd o{,ya/^ro*h, MP oJl73 (required) Primary Phone Num-Eer fu(77i-t33& Alternate Phone Number (required)E-mail Address: ecs mc n) oq.oea ma il . co"y. d Owner's Representative/Rental Agent/ VRBO, Del Mar, Vacasa, W Need a Vacation, Other_ Cape Rcal17 sionn Ho/o,, e Representative's Primary Phone Number: sc8 TTfggto Representative's E-mdil Address horonthe " o*"or-t. ,rt at I have reviewed and am fully familiar with the Town of yarmouth, apter 104 Anti-Noise Bylaw, the Town of yarmouth Short-Term Rental Bylaw (where achusetts State Sanitary Code, Chapter ll (Minimum Standards ofFitness for HumanHabitation). 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 notit, the Health Department in writing when I am no longer renting theproperty, or I may be subject to fines & fees. I hereby acknowledge th s Chapter 108Rental Housing Bylaw, Ch applicableJ, and the Mass Revi,sed,: 17 /26/2024 CV Rental oi Eltuwra-- l'kn)on4o---