HomeMy WebLinkAbout2026 Rental Applicationto I1AR 1
,I 2026
HEALTH 1-r,'tr RENEWAL
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IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 3O DAYS OF APPLYING, CONTACI THE HEALTH DEPARTMENI
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMITTING THE APPLICAIION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:
o VERIFICATION OF ASSESSOR RECORDS
o SEPIIC SYSTEM CHECK
o NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY:e SEPTIC SYSTEM CAPACIW
r NUMBER OF LEGAL BEDROOMS
WHYTHTS MATTERS: THESE MEASURES PROTECT DRINKINGWATER AND AQUIFERS, ESPECTALLY ASTHE TOWN
IEANS/flONS IO A FU|URE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
ASPARTOFYOURCOMPLIANCERESPONSIBILITIES,PLEASEENSURETHEFOLLOWING:
o ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES
o ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDITION
. ALL UNITS ARE LESSTHAN 1O YEARS OLD
smoke Detector Location Requirements - Yarmouth. MA - copy avaiLabte at Buitding Department
OWNER INITIALS
OWNER CERTIFICATION REOUIRED
I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
FEES (PER UN
$180 ANNUALLYSHORT.TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS OR LESS
i NSPECr1OIVSfEOU/8 ED YEABLY
$80 ANNUALLY
LONG-TERI''1 / YEAR-ROUND RENTALS
A NON-REFUNDABLE APPL|CATION FIE OF $80 PER UNIi'Ifi'IiTAL iS REQUIRED
AN ADDITIONAL FEE OF 31OO 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 CHECKTO THE YARMOUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUTH YARMOUTH' MA 02664
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
RENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664
R_r-'
PLEASE REGISTER YOUR RENTAL PROPERW NO LATER THAN APRIL 1, 2026
DUPLEV LY REFUSE RESPONSIBI UTYNTALSDISPOSALRELTI-FAMIMU
tn accordance with ,tOS CMR 410.560, and except as provided in 105 CMR 4lO.56O(C) (for BULK items) , the owner ol any residence
containingtwo or more dwell,ing units, a rooming house, homeless shelter, or manufactured houslng community, shall be
responsible for and payforthe tinal collgction and uttimate disposat of refuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPEf;TY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wlTH MA STATE SANITARY CODE 105 CMR 410.560 (C) AND',l05 CMR 410.s60 (4)(E)'
PzOWNER INITIALS
AVALID PHONE # OR EMAILWILL NOT BE PROCESSEDINCOMPLETE FORMS WITHOUT
RENTAL INFORMATION
RENTAL PROPERTY ADDRESS
PROPERTY OWNER NAME
LLC
M u7lrtl
PROPERTY OWNER MAILING ADDRESS
ALTE ATIVE PHONE #
IF APPLICABLE
PROPERTY OWNER PHONE #
REQUTRED I )y _ A)O 5331
PROPERTY
REQUIRED fz,++,
SSEENERI'4 ADDRLOW
n (C SLL
OWNER'S RE RESE NTATIVE/R E NTAL AG E NT
IF APPLICABLE
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
RENTAL PERIOD:
SHORT-TERM/WEEKLYtr LONG -TERI"1/YEAR.ROU N D
PAID PICK.UP TRASH COMPANY NAME tVc,t,aS t'/ D,t)
dowruEn tr TENANT
RENTAL OF:
C DUPLEX trCONDO tr APARTMENT CROOM
NUMBER OF UNITS FOR RENT
Knousr
REPRESENTATIVE PHONE #
REQUIRED
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am futty famitiar with the lottowing regutations
Town of Yarmouth Chapter 108 - Rentat Housing Bytaw, Town ofYarmouth Chapter 104 - Anti-Noise Bylaw, Town of Yarmouth
Short-Term RentaL Bytaw (iI appticabte), Massac husetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness for Human
Habitation
These documents are avaitabte for reference on the otficiatTown ofYarmouth websiteand mayatso be obtained upon requestfrom the
yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heatth Depanment in writing when I cease
renting the property. Faiture to do so may resutt in the imposition of lines and/or fees.
QUESTIONS: Phone #: 508-398-2231 Ex l240, Emait: rniederberger@yarmouth'ma'us
APPLICANT SIGNATURE DATE I
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TRASH REMOVAL BY:
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