HomeMy WebLinkAboutRental Application 2026RENTAL REGISTRATION APPLICATION 2026
TOWN OFYABMOUTH HEALTH DEPARTMENT
I I 46 ROUTE 2E, SOUTH YARMOUTH, MA 026A4
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He8lth Depa'trDert
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E] EENEWA!
O NEw APTCATIoN
Public Health
PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026
IHPORTANT RENTAL CERtrIFICAIE NONCE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICAIE WITHIN 30 DAYS OF APPLYING, CONTACTTHE HEALTH DEPARTMENT
IMMEDIATELY. UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAI- WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMITNNG THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:o VERIFICATION OF ASSESSOR BECOBDSo SEPTIC SYSTEM CHECK. NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCYLIMITS
DETERMINED BY
o SEPTIC SYSTEM CAPACITY
o NUMBER OF LEGAL BEDROOMS
WHY THls MATTERS: rHESE
^TE4SURES
PROTECT DRINKING WATER AND AQUIFERS, ESPECTALLY AS THE TOWN
T&ANSIflONS IO A FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
OWNER CERTIFICATION REQUIRED
I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
Smoke Detector Location Requirements - Yarmouth. MA- copy avail,abte at Buitding Depsrtment
FEES PER UN
SHORT.TERM / WEEKLY RENTALS
RENTALS OF 31 DA}'IS OR I.ESS
INSPECNON.S REQ U I RE D YEARLI
$180 ANNUALLY
LONG.TERM / YEAR.ROUND RENTALS $80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF SBO PER UNITi RENTAL IS REQUIRED
AN ADOMO AI. FEE OF $1(xt PER UNIT/RENTAL IS REQUIRED FOR SHORI'I.IERM RENTTALS PER BUII.DING CODE
RENTAL CERTIFICAIES EXPIRE ON DECEMBER 31s' OF EACH YEAR
MAIL oR DROP OFF CHECK TO THE YARMOUIH HEALTH DEPABTI.IENI : 1 146 RoUIE 28, SOUTII YARMOUIH, MA 02664
TO REGETER ONLINE AND PAY VI,A CREDIT CARD, VISITTHE TOWN OFYARMOUTH HEALTH DEPARTMENT WEBSITE:
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOwlNG:r ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERTESo ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WOBKING COND|T|ON. ALL UNITSARE LESS THAN 1O YEARS OLD
OWNER
DUPLEVMULTI.FAMILY RENTALS. REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR 410.560, and except as providod in 105 cMR 410.560(C) (for BUtK itams) , the own€r of arry residence
contalnlng tYYo or morr dwEung unftr, a roomrng hous6, homoto33 str€[cr, or manrr?EctunBo housrng communny, sna6 iercaponslblo for and payforthefinal coltrction and ultimate dkposal o, refuro.
wTH MA STATE SAN|TARY CODE 105 CMR 410.560 (C) AND t05 CMR 410.560 (4)(E).
.)WNFR IN
RENTAL INFORMATION
INCOMPLETE FORMS WTHOUT A VALID PHONE #OR EMAIL WLL NOT BE PHOULSSIIJ
RENTAL PROPERTY ADDRESS6g €-
PROPERTY OWNER NAME ButLzr-Jd tf r,,r, O
0263{
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PROPERTY OWNER MAILING ADDRESS
REQUIRED
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PROPERTY OWNER PHONE #ALTERNATIVE PHONE #
1F APPLICABLE
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PROPEBTY OWNER EMAIL ADDRESS
REQUIRED el-er6
OWNER'S REPRESENTAIIVE/RE
IF APPLICABLE
AGENT
REPRESENTAIIVE PHONE #
REQUIRLD c | -t€/Ln.r.*I - [6nq -rett6 $nt
i4
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
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RENTAL PERIOD:
TRASH REMOVAL BY
PAID PICK.UP IRASH COMPANY NAME:-)
/owNen orENANr
tr HousE dounrx tr coNDo uApARTMENT trRooM
RENTAL OF
NUMBER OF UNITS FOR RENT: Z_
ACKNOWLEDGMENT STATEMENT
These documents are avaitabte for reference on the officiat Town of Yarmouth wobsite and may atso be obtained upon request from theYarmouth Health Departrnent. Furthermore, I understand that I am required to notify the Heatth Deparunent in writing when I ceaserenting the property. Faiture to do so may resutt in the imposition offinss and/orteos.
Habitation
s;Town Yermouth Town Ya Town Ya
hIere that hI VCabyacknowtedge reviewed am famitiarthoroughty with fothettowitutty onngregutatiof081RontalChapterofHousingouthrmcIBytaw1o4Anti-Noisehapte ofBylaw rmouthShortTermntaIRecabteMassachu(ifBytaw ptiap Statoaetts San),Code Mintmitaryum StandChaptorards Firofness uma nforH
oUESnONS: Phone #: 508-398-2231 Ex.1240, Emait: rniederberger(oyarmouth.ma.us
APPLICANT SIGNATURE DATE 5 -6'26
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