HomeMy WebLinkAboutRental Application2025 Rental Registration Application
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors/Carbon
Monoxide Detectors and verified that they are less than 10 years old: Pleose initial
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A rnrrefundable 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
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 NOT registering online, please make checks payable to: Town ofYarmouth and mail
completed application (on reverse side, & payment to: Town of Yarmouth Health Department.
See Reverse Side
you prefer to pay by check, you may beginarmouth.ma.us/ lZ7 /Health lt
)
website: https://www.v
TOWN OF YARMOUTH
Health Department
I t{6 ROUTE 28, S()ITTH YARMOITTII
M ASSA(]II I.ISETTS 0266.I
Telephone (508) 398-2231, ext. l2,lO
Fax (50E) 760-3172
E-nlail: mdaleyaa'1'armoulh.ma.us
lmportant Notice (PtEASE READ CAREFULLTI:
Ifyou do not receive your rental certificate within 30 days of sending in your application, please contact our
ffice immediatelyl Please be aware that untilyou receive a rental certificate from the Health Department, your
roperty is being rented without a valid certificate, which may result in fines and other penalties.
ubmitting the registration application {ggg3g1! complete the process or guarantee the automatic issuance of
rental certificate. Your application will undergo a *review process, which includes verification of assessors'
ecords, 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.
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PIease Print Clearly
Rental Property Information
All felds are required! lncomplete forms without a valid phone i, acldress, or e-mail address will notprocessed.
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Rental Property Address:Rental Period:
ear-Round/Long Term _
eekly/Short Term (less than Zl days) /
Trash Removal by
Iter Tenant-House- Duplex_ Condo_ Apartment_ Room
Rental of
Atlat^,1(o1
roperty Owner Full Name
Conlo n
(required) Entire Mailing Address
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Yatmorfl', fn,f,Mrt ozb'l{
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require flmary one unl Alternate Phone Number:
5;08, 2Z(- 8zob
(req u i red ) E- mail Address
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Representative's Primary Phone
Number:
viewed and am fully familiar with the Town of Yarmouth's Chapter 1OB
Anti-Noise Bylaw, the Town ofYarmouth Shon-Term Rental Bylaw (where
applicable), and the Massachusefts State Sanitary Code, Chapter Il (Minimum Standards ofl.itness 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 notify the Health Department in writing when I am no longer renting theproperty, or I may be subject to fines & fees.
3-2o-2{h1',ob-
I hereby acknowledge that I have re
Rental Housing Bylaw, Chapter 104
Reised: 11,/26/2024
Representative's E-mail Address: