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Application for 2O25 Rental Registration
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Fax: (508) 760 -3472
E-Mail: sprovos@yarmouth.ma.us
Important Notice (PLEASE READ CAREFULLY):
Ifyou do not receive your rental certificate within 30 days ofsending in your a e con ct our
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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 ofa
rental certificate. Your application will undergo a *review process, which includes verification of assessors'
records, septic system, the number of bedrooms and previous inspections.
tAn 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.
JUN 1 I 2025
E}LTH DEPT.H
Smoke Detectors and Carbon Monoxide Detectors are Required!
Owners: I have ensured the batteries are changed, have tested ALL Smoke Detectors,(Qarbon
Monoxide Detectors and verified that they are less than 10 years old: Please initial \NContacl the Building Depanmeni regarding questions on type and locatlon prior to purchasi"g. \N \,
httns://www.varmouth.ma.us/DocumentCenter/View/ t 122 I /Smoke-detector-locahon
. A rurrefundable application feeof $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/127/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 fwhich 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 appllcation fon reverse side) & payment to: Town of Yarmouth Health Department.
See Reverse Side - ----------)
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone: (508) 398 - 2231, ext. l24l
A elds are re
Please Print Clearly
Rental Property Information
uired! lncom lete rms without o valid hone # or will not rocessed.
Rental Period:
Year-Round/Long f .;\
Weekly/Short Term 0ess than 31 days)
-
Rental Property Address:
3os \sck- \srq.,), E\
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Condo
Rental of:
House_ Dupl Apartment_ Room_
Trash Removal by:
Owner ,"nr]\,
Paid Pick Up:
Mailing Address:
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(-.\t"o"..,^qr\scn Y\ C\-10\
Property Owner
Lc s\.-a.\.\\N\N ame:
\ss".L,*, Ns,", a Gvod, tu1
[requ iredJ Prinra ry Phone Number
5\\- \\\ 31r,(
Alternate Phone Number:
Sct- 1b\- 1-rr(
(required)E-mail AddressOwner's Representative/Rental
Agent/ VRBO, Del Mar, Vacasa, We
Need a Vacation, Other_
\qs, H.vor
(required) Primary Phone
Number:
5r:x-\\t- \sur
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 oIYarmouth Short-Term Rental Bylaw (where
applicable), and the Massachusetts State Sanitary Code, Chapter I I (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 notiry the Health Department in writing when I am no longer renting the
property, or I may be subject to fines & fees.
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Revise 70 /23 /2024
(required)E-mail Address: