HomeMy WebLinkAbout16 Highland St ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664 ol ?'J26
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PLEASE REGISTER YOUR RENTAL PROPERW NO LATER THAN APRIL 1, 2026
IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 3O DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERW IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICAIION PROCESS
SUBMITTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:
. VERIFICATION OF ASSESSOR RECORDS
o SEPTIC SYSTEM CHECK
o NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECIIONS
DETERMINED BYo SEPTIC SYSTEM CAPACITY. NUMBER OF LEGAL BEDROOMS
WHY THIS MATTERS: IHESE MEASURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLY AS THE TOWN
rRANS/flONS TOA FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS pAnr oF ycuR coMPLtAt\rcr RaspoNct$rL,rirs. plrAs,: ,:fisuxr rarr roLlow$rG:r ALL SIvIOKE DETECTORS & CARBON lvONOxlDE DETECTORS HAVE FRESH BATTERIES
o ALLUNITS HAVE BEEN TESTEDANDARE lN PROPER WORKING CONDITION
. ALL UNITS ARE LESS THAN 1O YEARS OLD
I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
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OWNER INITIALS ,/ '< ) 1!r7_
Smoke Delector Loaation Requirements Ya!:mouth, MA - copy avaitable at Buitding Department
FEES (PERUNIT)
SHORT-TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS OR IESS
lrltsrltcllol\s ftQUl R r_ D Y €AR LY
$180 ANNUALLY
LONG-TERM / YEAR-ROUND RENTALS $80 ANNUALLY
'"-'I}ABL[ APPLICATIUN I-LL OI $80 PLR UNiUHLNIAL IS REOUIRED
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 : 1 146 ROUTE 28, SOUTH YARMOUTH, MA 02664
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
httpsil/www.yarmcuth.ma.us/1 27ll-{ealth
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OCCUPANCY LIMITS
DUPLEVMULTFFAMILY RENTALS - REFUSE DISPOSAL RESPONSIBILITY
tn accordance with 105 CMR 41O.560, and except as provided in 105 CMR 410.560(C) (for BULK items) , the owner oI any residence
containingtwo or more dwetting units, a rooming house, hometess shelter, or manufactured housing community, shatt be
responsible for and payforthe tinat cotlection and uttimate disposal of refuse.
I. THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wllH MA STATE SANITARY CODE 105 CMR 410.560 (Ci AND 105 CMR 410.560 (4){E).
OWNER INITIALS
RENTAL INFORMATION
INCOMPLETE FORMS WITHOUT A VALID PHONE # OR EMAIL WLL NOT BE PROCESSED
LU€S7 OU 2d,
RENTAL PROPERry ADDRESS
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PROPERTY OWNER NAME
Pa, Zov /JLP Av*ttrvrS 114 O26D(
ALTERNATIVE PHONE #
IF APPI ICAEI T
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OWNER'S REPRESENTATIVE/RENTAL AGENT
It: APPLTCABLE ,_-
REPRESENTATIVE PHONE #
REP RESE NTATIVE EI'4AI L ADD RESS
REQUIRED
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RENTAL PERIOD
NU[4BER OF UNITS FOR RENT
y'USE trDUPLEX trCONDO tr APARTMENT trROOM
TRASH REMOVAL BY:
PAID PICK-UP TRASH COMPANY NAI'4E
j6wNea tr TENANT
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughLy reviewed and am futty famitiar with the fottowing regutations:
Town ot Yarmouth Chapter 108 - Rentat Housing Bytaw, Town of Yarmouth Chapter 104 - Anti-Noise Bytaw, Town of Yarmouth
Shon-Term Rentat Bytaw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness tor Human
Habitation
These documents are avaiLabte tor reference on the officiat Town ofYarmouth website and may atso be obtained upon requestfrom the
Yarmouth Heatth Department. Funhermore, I understand that I am required to notity the Heatth Department in writing when I cease
rentingthe property. Faiture to do so may resutt in the imposition offines and/or fees.
QUESIIOI{S: Phone #: 508-398-2231 Ex. 1240, Emait: rniederberger@Jarmouth.ma.us
APPLICANT SIGNATURE 1a re DATE u6
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PROPERry OWNER MAILING ADDRESS
RENTAL OF;
tr LONG-TERM/YEAR-ROUND
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