HomeMy WebLinkAbout12 Brattle 2026 Rental ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664
,: I C
"..i,;,;:r hrbHcllcalth! RENEWAL
E] NEWAPPLICATION
PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026
IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOI RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACITHE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEME THE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMTTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:
o VERIFICATION OF ASSESSOR RECORDS
. SEPTIC SYSTEM CHECK
. NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BYo SEPTIC SYSTEM CAPACIryr NUMBER OF LEGAL BEDROOMS
WHY IHIS MATTERSj rHESE MEASURES PROTECT DRINKtNG WATER AND AQUtFERS, ESPECIALLYAS THE TOWN
TRANSITIONS TO A FUfURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:
o ALLSMOKE DEIECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES
o ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDITION
. ALL UNIS ARE LESSTHAN 10 YEARS OLD
OWNER CERTIFICATION REQUIRED
ICERTIFYTHAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
A.BOWNER INITIALS
Smoke Deteator Lolatroniequirements - Yarmouth, MA - copy avaitabte at BuiLding Depanment
FEES (PER UNIT}
SHORT-TERI.4 / WEEKLY RENTALS
RENIAIS OF31 DATS OF IESS
i A/SPEC I/ONS REQUIRED YEARLY
$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/RENTAL 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 : 1'146 ROUTE 28, SOUTH YARMOUTH, MA 02664
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSI-TE;
httpsr/lyw\ry.yarrLouth, maxsll 27]Hcalth
DUPLEVMULTI-FAMILY RENTALS. REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 4'10.560(C) (tor BULK items) , the owner of any residence
containingtwo or more dwetLing units, a rooming house, homeless shetter, or manufuctured housing community, shatt be
responsibtefor and payforthe finat cottection and uttimate disposal oI r€fuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wTH MA STATE SANTTARY CODE r05 CMR 410.560 (C) AND 10s CMR410.s60 (4)(E).
OWNER INITIALS
RENTAL INFORMATION
INCOMPLETE FORMS WITHOUT A VALID PHONE # OR EMAILWlLL NOT BE PROCESSED
/Z e ro // /e iAr,Yo- "/*.,"-"//L
Oro./
e- .S\.i oo/L', Pot
PROPERry OWNER
a( r'rt
s/,t"/
,/r/ /".fuf/"uZrPROrfN.a^t-7'1 O,'1.9\
OWNER I'4AILING ADDRESS
LLC
pRdpeRry ownen prbne f
508-77G >/3{REQUIRED 5o?- 3a2- 32+?
aLtenNltlve pxoty'+
IFAPPLICABLE
,gloslJogL 6-q?s l"l na<,(. z **1
PROPERTY OWNER EMAIL ADDRESS
REQUIRED
cl*h)v &./ t,/.luoWNER,S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATIVE PHONE #
REQUIRED 5.8- 674- 68V{
REPRESENTATME EMAIL ADDRESS
REQUIRED
c\O-
At-oruc-renurvelR-RouND trsHoRT-TERMMEEKLy
RENTAL PERIOD:
TRASH REMOVAL BY:
tr OWNER
PAID PICK.UP TRASH COMPANY NAME:
dirousr troupLEX trcoNDo tr AeARTMENT trRooM
NUMBER OF UNITS FOR RENT:
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am tutty famitiar with the fottowing Iegulations:
Town ot Yarmouth Chapter 108 - Rentat Housing Bylaw, Town ol Yarmouth Chaptor 104-Anti-Noise Byt8w, Town ofYarmouth
Short-Term Rentat Bytaw (if appticabte), Massachusetts Slate Sanitary Code, Chapt8r ll - Minimum Stendards ot Fitness for Human
Habitation
These documents are availabte tor reference on the otficiatTown of Yarmouth website and may also be obtained upon request from the
Yarmouth Heatth Department. Furthermore, I understand that lam requiredto notifythe Heatth Department in writingwhen lcease
renting the property. Failure to do so may resutt in the imposation of fines and/or fees.
QUESIIQiLS: Phone #: 508-398-2231 Ex. 1 240, Emait: rniederbe8er@Jarmquti.rtra.us
APPLICANT SIGNATURE ,/?,*, z/Z /sez
RENTAL PROPERTY ADDRESS
flrerurur
RENTAL OF:
L>