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Home My WebLink About12 Highland St ApplicationRENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARTMENT 1146 ROUTE 28, SOUTH YARMOUTH, MA 026649 JAN n7 2026 >d.nrn o. PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026 f] NEW APPIJCANON IMPORTANT RENTAL CERTIFICATE NOTICE IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WIIHIN 3O DAYS OFAPPLYING, CONTACIIHE HEALTH DEPARTT4ENT IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH PlAY RESULT IN FINES AND PENALTIES. APPLICATION PROCESS OCCUPANCY LIMITS DETERMINED BYo SEPTIC SYSTEM CAPACIry . NUMBER OF LEGAL BEDROOMS WHY THIS MATTERS: IHESE MEASURES P ROTECT DRINKING WATER AND AQUIFERS, ESPECTALLY AS rHE TOWN TRANSITIONS TO 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 TESTED AND ARE lN PROPER WORKING CONDITION . ALL UNITS ARE LESS THAN 1O YEARS OLD OWNEH CERTIFICATION R€QUIRED I CERTIFY THAT I HAVE COMPLETED THE OVE REQUIREMENTS OWNER INITIALS Smoke Detector Location Requirements - Yarmou - copy avaitabte at BuiLding Department FEES PER U $180 ANNUALLYSHORT.TERM / WEEKLY RENTALS RENTALS OF 31 DAYS OR LESS /NSPECIIO,ryS fiEQ U I R E D Y E A R LY $80 ANNUALLY LONG-TERM / YEAR-ROUND RENTALS A NON-REFUNDABLE APPLICATION FEE OF 380 PER UNIT/RENTAL IS REQUIRED AN ADDITIONAL FEE OF $1OO PER UNIT/RENTAL IS REQUIRED FOR SHORT'TERM RENTALS PER BUILDING CODE RENTAL CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR MAIL oR DRoP oFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT : 1.I46 ROUTE 28, SOUTH YARMOUTH' MA 02664 TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OFYARMOUTH HEALTH DEPARTMENT WEBSITE: hltll s: //w!vw almouth.!tra.u s/1 2ZlH eatth ftrblic Healtn SUBMITTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH INCLUDES:r VERIFICATION OF ASSESSOR RECORDSo SEPTIC SYSTEM CHECK . NUMBER OF LEGAL BEDROOMS . VIEW OF PREVIOUS INSPECTIONS DUPLEX/MULTIFAMILY RENTALS - REFUSE DISPOSAL RESPONSIBILIW ln accordance with 105 CMR 410.560, and except as provided in 105 CMR410.560(C) (tor BULK items), the ownerof any residence containing two or more dwetling units, a rooming house, homeless shelter, or manufactured housing community, shall be responsibte tor and payfor the finaI cottection and ultimate disposal of refuse. I, THE OWNER, CERTIFY THAT MY RENTAL PROPERry WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE wlTH PlA STATE SANTTARY CODE r 0s CMR 410.560 (C) AND 105 CMR 410.560 {4}(E}. OWNER INITIALS RENTAL INFORMATION INCOMPLETE FORMSWITHOUT AVALID PHONE # OR EMAIL WILL NOT BE PROCESSED RENTAL PROPERTY ADDRESS/2 Hic*lA,to 5r /L6r Y/+</oaTH ./r4 5tSz73 PROPERry OWNER NAME Artrtt't' Cr<- bOPeT<--- PROPERry OWNER I'4AILING ADDRESSn O, 80X /A6 g /47A//,u/5, /04. 0,260/ PROPERTY OWNER PHONE # REQUIRED ({De) 3s)- fi{a arr6rulrtvE pHoNe + II- APPL}CABLE PROPERry OWNER EMAIL ADDRESS REQUIRED C,\Qecotrne€ /J3 e Aor. to,*- OWNER'S REPRESENTATIVE/RENTAL AGENI t! At'PLIC/\BLE REPRESENTATIVE PHONE #REQUTRED -_../ REPRESENTATIVE EMAIL ADDRESSREQIJIRED - -- RENTAL PERIOD: ! LoNG-TERM/vEAR-RouND r$onr-renvnrveerrv TRASH REI.4OVAL BY:7OWNER tr TENANT PAID PICK.UP TRASH COI'4PANY NAME /' OUSE trDUPLEX DCONDO trAPARTMENT D ROOI'4 NUI'-lBER OF UNITS FOR RENT I I hereby acknowtedge that I have thoroughty reviewed and am futty Iamitiar with the fottowing reguLations: Town ofyarmouth Chapter 1OB - Rentat Housing Bylaw, Town of Yarmouth Chapter 104 -Anti-Noise Bylaw, Town of Yarmouth Short-Term Rentat Bylaw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness for Human Habitation These documents are avaitable for relerence on the officiatTown ofYarmouth website and mayatso be obtained upon request from the yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heatth Department in writing when I cease renting the property. Faiture to do so may resutt in the imposition of fines and/or fees. QUESTIONS: Phone #:.508-39a-2231 T240, Emait: rniederberge(@yarmouth,ma.us (DArE t /r /uzT/APPLICANT SIGNATURE -4 RENTAL OF: ACKNOWLEDGMENT STATEMENT