HomeMy WebLinkAboutApplication 2026 RegistrationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664 UAIu n R 20?6
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Public Healthf] RENEWAL
E] NEW APPLICATION
PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026
APPLICATION PROGESS
SUBMITTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:
. VERIFICATION OFASSESSOR RECORDS. SEPTIC SYSTEM CHECK
o NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BV. SEPTIC SYSTEI.'l CAPACIry
. NUMBER OF LEGAL BEDROOMS
WHY THIS MATTERSi rHESE MEASURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLY AS THE TOWN
r&4NS/I/ONS TO A FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:r ALLSMOKE DETECTORS & CAREON MONOXIDE DETECIORS HAVE FRESH BATTERIES
o ALL UNITS HAVE BEEN TESTED AND ARE lN PROPERWORKING CONDITION
. ALL UNITS ARE LESS THAN lOYEARSOLD
OWNER CERTIFICATION REQUIRED
I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIRE14ENTS
OWNER INITIALS a/
Smqkelelector Location Requirements - Yarmouth. MA - copy avaitable at Buitding Department
)
FEES (PER UNIT)
SHORT.TERM / WEEKLY RENIALS
RENTALS OF 31 DAYS ORLESS
//VSPECZONS FEQUI RED ]EARLY
$180 ANNUALLY
LONG-TERM / YEAR-ROUND RENTALS $80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDITIONAL FEE OF $1OO PER UNIT/RENTAI- IS REQUIRED FOR SHORT.TERM RENTATS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEN4BER 31ST OF EACH YEAR
MAILOR DROP OFF CHECKTO THE YARMOUTH HEALTH DEPARTMENT:1146 ROUTE 28, SOUTH YARMOUTH, MA02664
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
httpsJ/wury,)Larmouth.ma.us/1 27lH€atth
IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY UNIIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY lS CONSIDERED NOI CERTIFIED FOR RENIAL, WHICH I'4AY
RESULT IN FINES AND PENALTIES.
DUPLEVMULTI-FAMILY RENTALS. REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR 41o.560, and except as provided in 105 CMR410.560(C) (for BULK items), the ownerof any residence
containing two or more dwetting units, a rooming house, hometess sheller, or manufactured housing community, shaU be
responsible for and pay for the finat cotlection and ultimate disposat of refuse.
t, THE OWNER, CERflFyTHAT My RENTAL PROPERW, WHrCH CONTATNSTWO OR MORE DWELLING UNITS, lS lN COMPLIANCE
wlIH MA SIATE SANITARY CODE 105 CMR 410.s60 (C) AND 105 CMR 410.s60 (4XE).
OWNER INITIALS N //I
RENTAL INFORMATION
INCOMPLETE FORMS WIIHOUT A VALID PHONE # OR EMAIL WILL NOT BE PROCESSED
RENTAL PROPERTY ADDRESS
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PROPERry OWNER NAMEa?ah,,rt'Jt,dr4 J
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frurTirtq /o,0 rnrl 477o.-3PROPERTY OWNER I.4AILING ADDRESS
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ALTERNATIVE PHONE #
IFAPPLI;ABLE 7 f/ . .55 )'6oa9PROPERTY OWNER PHONE #
REQUTRED / y/ r{/-3t/o
PROPERTY OWNER EMAILADDRESS ,
REOUIRED ----'r- , -J' .t(J.l //h -7f(e/Y)aP a Carn Ca 5 ( rl e-/-
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REQUTRED d a 7' 4a g-
REPRESENTATIVE PHONE #
OWNER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
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REPRESENTATIVE EMAIL ADDRESS
RENTAL PERIoD:/ )- t / st
o)G
REQUIRED 0
TRASH REMOVAL BY:
trowNER ofeNeNr
RENTAL OF:
CONDOtrHOUSE tr DUPLEX
NUMBER OF UNITS FOR RENT: /
tr APARTMENT ! ROOM
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am futty famitiar with the fottowing regulations:
Town ofYarmouth Chapter 108 - Rentat Housing Bytaw, Town ofYarmouth Chapter 104 -Anti-Noise ByLaw, Town ofYarmouth
Short-Term RentaI By]aw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness tor Human
Habitation
These documents are availab[e for reference on the officiat Town of Yarmouth website and may atso be obtained upon request from the
Yarmouth Heatth Department. Furthermore, lunderstand that lam required to notitythe Heatth Department in writingwhen lcease
renting the property. Faiture to do so may resutt in the imposition of fines and/or fees.
QUESIIQNS: Phone #:508-398-2231 Ex.1240, Email: miederberger@yarmouth.ma.us
APPLICANT SIGNATURE oerc / -rlC -)OS 6
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PAID PICK-UP TRASH COMPANY NAME: