The URL can be used to link to this page

Home My WebLink AboutApplicationsRENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARTMENT 1146 ROUTE 28, SOUTTI YARMOUTH, MA 02664 {.,*+ , :.:,;r.' 9 /% D RENEWAL tr NEWAPPLICATION hrblic Health PLEASE REGISIERYOUR RENTAL PROPERTY NO LATERTHAN APRIL 1,2026 IMPORTANT RENTAL CERTIFICATE NOTICE IF YOU DO NOT RECEIVE YOUR RENIAL CERTIFICATE WIIHIN 3O DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH I4AY RESULT IN FINES AND PENALTIES. APPLICATION PROCESS SUBMITTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH INCLUDES: o VERIFICATION OF ASSESSOR RECORDSI SEPTIC SYSTEM CHECK . NUMBER OF LEGAL BEDROOMS . VIEW OF PREVIOUS INSPECTIONS OCCUPANCY LIMITS DETERMINED BY o SEPTIC SYSIEM CAPACITY o NUMBER OF LEGAL BEDROOMS WHYTHIS MATTERS: THESE MEASURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLY AS THE TOWN IMNS/flONS TOA FUTURE SEWER SYSTEM. SMOXE AND CARBON MONOXIDE DETECTORS AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING: o 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 OWNER CERTIFICATION REQUIRED I CERTIFY THAT I HAVE COI.4PLETED THE ABOVE REQUIREMENIS OWNER INITIALS Smoke Detector Location Requirements - Yarmouth, MA - copy avaitabte at Buitding Department SHORT-TERM / WEEKLY RENTALS RENTALS OF 31 DAYS ORTESS/SE/SONAL RENTALS /NSPECIiONS REQU I RE D YEARLY $180 ANNUALLY LONG.TERM / YEAR-ROUND RENTALS $80 ANNUALLY A NON.REFUNDABLE APPLICATION FEE OF $80 PER UNITi RENTAL IS REQUIRED AN ADDITIONAL FEE OF $1OO PER UNIT/RENTAI.IS REQUIRED FOR SHORT.TERM RENTALS PER BUILDING CODE RENTAL CERTIFICATES EXPIRE ON DECEMBER 31SI OF EACH YEAR MAIL OR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUTH YARMOUIII, MA 02664 TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISITTHE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE: hft p$//wlrywyarmouth-ma.!s1127lllealth t,l FEES (PER UNIT) DUPLEVMULN-FAMILY RENTALS - REFUSE DISPOSAL RESPONSIBIUry ln accordance with | 05 CMR 410.560, and except as provided in 105 CMR 4'l 0.560(C) (for BULK items) , the owner of any residence containingtwo or more dweUing units, a rooming house, homeless shelter, or manufactured housing community, shatt be responsibte for and payforthe finat collection and u[timate disposal of refuse. I, THE OWNER, CERTIFY THAT MY RENTAL PROPERry WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE wTH MA STATE SANITARY CODE 10s CMR 410.560 (C) AND 10s CMR 410.560 (4XE). OWNER INITIALS 5g RENTAL INFORMATION INCOMPLEIE FORMS WTHOUTA VALID PHONE # OR EMAILWLL NOT BE PROCESSED RENTAL PROPERry ADDRESS \12- A +'b frAyuteut ST PROPERTY OWNER NAMEsus4N S7/N9ON PROPERry OWNER MAILING ADDRESS+ HA,HPN RD hnaa/zl HA b2 t"Ll 5 PROPERTY OWNER PHONE # REQUIRED 5o8- 737-23f3 ALTERNATIVE PHONE # IF APPLICABLE PROPERTY OWNER EI.4AIL ADDRESS REQUIRED su-*:t a4i nson @ qrn ai l, cam OWNER'S BEPRESENTATIVE/RENTAL AGENT tF APPu)ABLE p/n REPRESENTATIVE PHONE # REQUIRED //n REPRESENIATIVE EMAI/L AP REQUTRED p/r/DRESS RENTAL PERIOD:(ao*o-ra*rrraAR-RouND usHoRr-rERM/wEEKLy y'owr.ren Corp171 tr TENANT PAID PICK-UP TRASH COMPANY NAI'4E RENTAL OF trHOUSE tr DUPLEX tr CONDO APARTMENT I] ROOM ACKNOWLEDGMENT STATEMENT I hereby acknowtedge that I have thoroughty reviewed and am futty famil.iar with the fottowing regutations: Town ofYarmouth Chapter 108 - Rentat Housing Bytaw, Town ofYarmouth Chapter 104 - Anti-Noise Bylaw, Town of Yarmouth Shon-Term Rental Bytaw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness for Human Habitation These documents are avaitabte for reference on the officiat Town of Yarmouth website and may atso be obtained upon request from the Yarmouth HeaLth Department. Furthermore, I understand that I am required to notify the Heatth Department in writing when I cease renting the property. Failure to do so may resutt in the imposition of fines and/or fees. QUESI|OIIS: Phone #:508-398'2231 Ex.1240, Emait: rn iederberger@yarmouth.ma.us APPLICANT SIGNATURE DATE /-7.2b NUI.4BER OF UNITS FOR RENT: TRASH REMOVAL BY: RENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARTMENT ,I145 ROUTE 28, SOUTH YARMOUTH, MA 026 tAN n a 10?69 Heaftb PLIASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026 IMPORTANT RENTAL CERTIFICATE NOTICE IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACTTHE HEALTH DEPARTI'4ENT I14MEDIATELY. UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERW IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY RESULT IN FINES AND PENALTIES. APPLICATTON PROCESS SUBMITTING THE APPLICAIION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH INCLUDES: o VERIFICATION OF ASSESSOR RECORDS o SEPTIC SYSTEM CHECK o NUMBER OF LEGAL BEDROOMS . VIEW OF PREVIOUS INSPECTIONS LIMITS DETERMINED BY:o SEPTIC SYSTEM CAPACITY o NUMBER OF LEGAL BEDROOMS WHYTHIS MATTERS: THESE MEASURES PROTECT DRINKING WATER AND AQU|FERS, ESPECIALLY AS THE TOWN rRANS/7ONS IO A FUTURE SEWER SYSTEM. SMOKE AND CARBON MONOXIDE DETECTORS AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING o ALLSMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES o ALL UNITS HAVE BEEN TESTED AND ARE IN PROPER WORKING CONDITION . ALL UNITS ARE LESSTHAN lOYEARSOLD OWNER INITIALS Smoke Detector Location Requirements - Yarmouth, MA - copy available at Building Department FEES (PER UNIT) SHORT-TERM /WEEKLY RENTALS RENTALS OF 31 DAYS OR LESS /SEASONAL RENTALS INSPECflONS REQUIRED YEARLY $180 ANNUALLY LONG-TERM / YEAR-ROUND RENTALS A NON.REFUNDABLE APPLICATION FEE OF $80 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: 1145 RoUTE 28, soUTH YARMoUTH, MA 02664 TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTI'4ENT WEBSITE: hitps://wwrarya rm outlt m a. u sll2 T/ H e3t!h f] RENEWAL f] NEWAPPLICATION OWNER CERTIFICATION REQUTRED I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS $80 ANNUALLY DUPL.EX/MULTI-FAMILY RENTAIS - REFUSE DISPOSAL RESPONSIBILITY ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 41O.56O(C) (for BULK items) , the owner of any residence containingtwo or more dwetling units, a rooming house, homeless shelter, or manufactured housing community, shau be responsible for and payforthe finat coltection and uttimate disposaI of refuse. I, THE OWNER, CERTIFY THAT MY RENTAL PROPERry WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE wtTH MA STATE SAN|TARY CODE 105 CMR 410.s60 (C) AND 105 CMR 410.560 (4)(E). OWNER INITIALS A3 RENTAL INFORMATION INCOMPLETE FORMS WITHOUT A VALID PHONE # OR EMAIL WILL NOT BE PROCESSED RENTAL PROPERry ADDRESSt30 -BA{VlElrj sr PROPERry OWNER NAME srs^b{ gTtNSbN PROPERTY OWNER MAILING ADDRESS H A&ltztAl f4 oTlPq{ PROPERW OWNER PHONE # REQUTRED g'og- 7 g7- zfrz ALTERNAIIVE PHONE # IF APPLICABLE PROPERTY OWNER EMAIL ADDRESS REQUIRED <;uSaztcsl\n Son @ 3 rna-t I . An OWNER'S REPRESENTATIVE/RENTAL AGENT IF APPLICABLE //ft REPRESENTATIVE PHONE # REQUIRED y'/1 REPRESENTATIVE EMAIL ADDRESSREeUIRED t h RENTAL PERIOD: dlouo-renvrveaR-RouND trsHoRT-TERM/vvEEKLy TRASH REI.4OVAL BY: E6wruen CerF/*) tr TENANT PAID PICK-UP TRASH COMPANY NAI"IE: ACKNOWLEDGMENT STATEMENT I hereby acknowtedge that I have thoroughty reviewed and am futLyfamitiar with the foltowing regutations: Town ofYarmouth Chapter 108 - Rentat Housing Bytaw, Town of Yarmouth Chapter 104 -Anti-Noise Bytaw, Town ofYarmouth Short-Term Rental Bytaw (if applicabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Filness for Human Habitation These documents are avaitabte for reference on the officiatTown of Yarmouth website and may also be obtained upon request from the Yarmouth Heatth Department. Furthermore, lunderstand that lam required to notifythe Heatth Department in writingwhen lcease renting the property. Failure to do so may resutt in the imposition of fines and/or fees. QUESTIONS: Phone #: 508-398-2231 Ex.1240, Emai[: rniederberger@yarmouth.ma.us APPLICANT SIGNATURE DATE /7L 4 AAgttPA (D RENTAL OF: trHousE u DUpLEx trcoNDo ,6eeaRtuetr nnoou NUMBER OF UNITS FOR RENT: