HomeMy WebLinkAbout48_50 Ivanhoe Rd - ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1 146 ROUIE 28, SOUIH YARMOUTH, MA 02664I JAN n 7 20?8
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1r". ') et - Jx -r <-,:, . v-7 - c/U -{- ) -PLEASE REGISTER YOUR RENTAL PROPERW NO
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LATER THAN APRIL1,2026
f] NEWAPPLICAIION
IMPORTANT RENTAL CERXIFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
SUBM|rNNG THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:. VERIFICATIoN oF ASSESSOR RECORDS
. SEPTIC SYSTEM CHECK
e NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY:
. SEPTIC SYSTEM CAPACIWo NUMBER OF LEGAL BEDROOMS
WHYTHIS MATTERS: rHESE MEASURES PROTECT DRINKINGWATER AND AQUIFERS, ESPECTALLY ASTHE TOWN
rRAfiS/rONS IO A FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:
ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES
ALL UNITS HAVE BEEN TESTEO AND ARE IN PROPER WORKING CONDITION
ALL UNITS ARE LESS THAN 1O YEARS OLD
OWNER CERTIFICATION
I CERTIFY IHAT I HAVE COMPLETED REQUIREMENTS
OWNER INITIALS
Smoke Detector Location Re - copy avaitabte at Buitding Department
FEES (PER UNTT)
SHORT-TERM / WEEKLY RENIALS
RENTALS OF 31 DAyS OR LESS,/Sr4SOiVAt REM.ATS
INSP ECTIO NS REQU I RED YEARLY
$180 ANNUALLY
LONG-TERM / YEAR-ROUND RENTALS $80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDMONAL FEE OF $1OO PER UNIT/RENTAL IS REQUIRED FOR SHORT-TERH RENTALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31SI OF EACH YEAR
MAIL OR DROP OFF CHECK rO THE YARMOUTII HEALTH DEPARTMENT: 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664
TO REGISTER ONUNE AND PAY VIA CRED]T CARD, VISITTHE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
https://www.yarmouth.ma.us/1 27lH eatth
APPLICATION PROCESS
DUPLEVMULTI.FAMI LY RENTAE. REFUSE DISPOSAL RESPONSIBILITY
ln accordance with IO5 CMR.tl 0.560, and axcopt 6! provlded ln i05 CMR410.56O(CI (forBut(ttoms), the norofany rssidence
containing two or morc dwollllu unlE, a roomlng houre, homolo$ .h€l!or, or manufectrr€d housl( communlty, .hau bo
r€sponslbls lbr and pay for tho flnll oollcctlon rnd uhlmato dbpo.sl ot roftrlo.
t,THE OWNER, CEFflFy THAT MyRENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELIING UNITS,IS lN COMPUANCE
WITI MA STATE SANITARY CODE 105 CMR 410.560 (c) AND 105 CMR 410.s60 (4XE).
OWNER INITIALS
RENTAL INFORI{ANON
INCOMPLETE FORMSWTHOIIT A VAUD PHONE# OR EMAIL WLT NOT BE PROCESSED
L/,{-r 0 Luqnt oe
PROPERry OWNER NAMEGgD{LqL --T-(o , bo(g s
PROPERTY OWNER MAILING ADDRESS4l r:., ZA F-fop tt op-\ i;v*.:v yn ft
PROPERW OWNER PHONE #
REQUTRED La3 770 7635
ALTERNATTVE PHONE #
IF APPLICABLE
PROPERTY OWNER EMAIL ADORESS
REQUTRED Ge.o rL?{T.eao P-elq.i 2 Cancos* ,lo€f
OWNER'S REPRESENTATTVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATME PHONE #
REQUIRED
REPRESENTAITVE EMAIL ADDRESS
REQUIRED
RENTAL PERIOD:,/o*n-ra*r*^R-RouND trsH.RT-TERM/*EEKLy
TRASH REMOVAL BY #*o",tr OWNER
PAID PICK.UP TRASH COMPANY NAME:
RENTAL OF ,{urrr, trcoNDo trAPARTt'lENr oRoo,tr HOUSE
NUMBER OF UNITS FOR RENI
ACKNOWLEDGME]TT STATEMENT
I h€reby acknowlodge that I havethoroughty reviBwed and am futtylamitiar with the foltowing regutations:
Town ol Yarmouth Chapter 1 08 - Rontat HoBlng BylBw, Town ot Yarmouth ChaPter I 04 - Antl-Nolse Bytaw, Town ot Yarmouth
Short-Term Remal BytBw (ifappticabte), Massachusett3 Stato Sanltary Coda, ChaFtor ll - Mlnlmum Standards of Fhno3s forHuman
Habltatlon
These documents are availabte for referenc€ on the officiat Town ofYarmouth website and may also be obtained uPon request from the
yarmouth Heatth Department Furthermore, I understand that I am roquired to notify the Heatth Departrnent in writing when I cease
renting the property. Faiture to do so may result in the imposfion of fines and/orfees.
qUESTIONS: Pho 1 240, Emai[: rniederberger(ayarmouth.ma.us
APPLICANT SIGNATURE
#:50ti-1
DATE /e 5