HomeMy WebLinkAbout2026 Application 2RENTAL REGISTRATION APPLICATION 2026
TOWN OF YARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664
Rrblic HealtliifRENEwAL
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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 PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL. WHICH MAY
RESULI IN FINES AND PENALTIES
APPLICATION PROCESS
ITTING THEAPPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
VERIFICATION OF ASSESSOR RECORDS
SEPTIC SYSTEM CHECK
NUIVIBER OF LEGAL BEDROOMS
VIEW OF PREVIOUS INSPECTIONS
INCLUDES
SUBM
OCCUPANCY LIMITS
DETERMINED BYI. SEPTIC SYSTEM CAPACITY. NUI'IBER OF LEGAL BEDRooMS
wHY THls MATTERS: THEsE MEASURES pRorEcr DRINKtNG 4ATER AND AeutFERs, EspEctALLy AsrHE fowN
TRANSITIONS TO A FUTURE SEWER SYSIEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:. ALL SMOKE DETECTORS & CARBON MONOXTDE DETECTORS HAVE FRESH BATTERTES. ALt UNITS HAVE BEEN TESTED ANDARE tN pROpER WORKING CONDtTtON. ALL UNITS ARE LESS THAN 1O YEARS OLD
Smoke Detector Location Requirements _yarmouth. MA_copy avaitable at BUitding Department
OWNER CERTIFICATION REQUIRED
I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENIS
OWNERINITIALS R.O.
FEES (PER UNIT
SHORT.TERM / WEEKTY RENTALS
FENIATS OF37 DAYS OB LESS
/NSPFCI/ONS FEQUIRED YEARLY
$180 ANNUALLY
LONG.TERM / YEAR.ROUND RENTALS $BO ANNUALLY
A NON.REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIREDAN ADDITIONAL FEE OF $1OO PER UNIT/RENTAL IS REQUIRED FORSHORT-TERM RENTALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEM BER 31ST OF EACH YEARMAIL OR DROP OFF CHECKTo THE YARMoUTH HEALTH DEPARTMENT i 1146 ROUTE 28, SOUTH yARMOUTH, MA 02664TO REGISTER ONLINE AND PAYVIA CREDITCARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
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DUPLEx,/MULTI.FAMILY RENTALS. REFUSE OISPOSAL RESPONSIBILIW
ln accordance with 105 CMR 4'10.560, and except as provided in 105 CMR 410.560(C) (for BULK items) , the owner of any residence
containing two or mora dwelting units, a rooming housa, hometess shelter, or manufactured housing community, shatt be
responsible for and pay for ths tinat cottection and uttlmato dlsposal of refuso.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS. IS IN COMPLIANCE
wlTH MA STATE SANTTARY CODE 10s CMR 410.s60 {C) AND 10s CMR 410.560 (4)(E).
oWNER INITIALS R A
RENTAL INFORMATION
INCON4PLETE FORMS WITHOUT A VALID PHONE # OR EMAIL WILL NOT BE PROCESSED
RENTAL PROPERIY ADDRESS?AA o 5P., V/ gs{ /a/'rru}th, YYIA o aq 73
PROPERTY OWNER NAME
(n LLC
PR o PERTY OWNER l"lA L NG DDR
t'7 Rabbrt La ne, A'/annis 1 (v)A o 21a61n'tgMa wI
PRoPERTY owNER pHoNE #
REeU,RED OOg -a?1-5?.7r1 ALTERNATIVE PHONE #
IFAPPLICABLE
PROPERTY OWNER EMAIT ADDRESS
REQUIRED ra,\ph di rno ni,e@ 1 crL.oo . c.orn
OWNER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE Ralptr );Hon |C,Vqquq ( r
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATIVE EMAIL ADDRESS
REQUIRED ra.t phdCm on l-c @ laho o' c o n4
RENTAL PERIOD
BLONG-TERM/YEAR.ROUND tr SFIORT-TE RM/WE E KLY
TRASH REMOVAL BY:
RHOUSE trDUPLEX trCONDO E APARTMENT trROOM
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughly reviewed and am fuLly tamitiar with the fottowing regutations:
Town of Yarmouth Chapter 108 - Rentat Housing Bytaw, Town ol Yarmouth Chapter 104 - Anti-Noise Byl,aw, Town of Yarmouth
Shon-Term Rentat Bytaw (ii appticable), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness tor Human
Habitation
These documents are avaitabte for reference on the otficiat Town of Yarmouth website and may atso be obtained upon request trom the
Yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heatth Department in writing when I c ease
renting the property. Faiture to do so may result in the imposition of fines and/or tees.
QUESTIONS: Phone #: 508-398-2231 Ex. 1240, Emait: rniederberger@yarmouth.ma.us
APPI ICANT SIGNATI IRF DATF
I
I
56$- 2V't-5114
PAID PICK.UP TRASH COMPANY NAME:
RENTAL OF:
:OWNER ETENANT
NUMBER OF UNITS FOR RENT: I