HomeMy WebLinkAbout54 Forest Road rental application-2025Application for 2O25 Rental Registration
Application
TOWN OF YARMOUTH
Health Department
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664
Telephone: (508) 398 - 2231, ext. l24l
Fax: [508) 760 - 3472
E-Mail: sprovos@yarmouth.ma.us
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A ,-oo.arr,, Notice (PLEASE READ CAREFULLY):
Ifyou do not receive your rental certificate within 30 days of sending in 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.
Submifting 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 subiect to
adiustment based on the criteria mentioned above.
HEALTIT t
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 l0years old: Pleose initiot lrp,
Contact the Building Department regarding qu€stions on typ€ and Iocahon prror to furchasrng.
See Reverse Side ------------------------------------)
. A rurrefundable application fee of $8O per unit/rentalis 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.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 (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: Tovvn of Yarmouth Health Department.
Please Print Clearly
Alt elds are re uired! lncom lete rms without a valid hone # or will not rocessed
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5"*h ur,n*"4, /u10" 6atb/
Rental Property Address:
Year-Round/Lon gtur^ V/
Weekly/Short Term fless than 31 days) _
Rental Period
Trash Removal by
Tenan XOwner
Paid Pick Up
Iex Condo Aoartmfi)t Room
Rental of
elyi Du pHous
'Wii:-Mailins Address:
,15[ Brr^SA
W^14-. /,L, olus3
\pswe<n
IrequiredJ Primary Phone Number
l-331-qto-rt#
Alternate Phone Numtler [required)E-mail Address;
d"nf ^'J5g of q"^i(''"'
Owner's Representative/RentalAgent/ VR BO, Del Mar, Vacasa, We
Need a Vacation, Other
(required) Primary Phone
Number:(required)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 (where
applicable), and the Massachusetts State Srnitary Code, Chapter ll{Minimum Standards ofFitness for Humarr
Habitation). These documents are available for reference on the Town's website and may also be obtained upon
request from the Yarmouth Health Department.
purthermore, 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.
6 t
Reised:70/23/2024
Rental Property Information