HomeMy WebLinkAbout24 Capt Besse Road 2026 ApplicationRENTAL REGISTR.ATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
I146 ROUTE 28, SOUTH YARMOUTH, MA 02664
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PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026
APPLICATION PROCESS
SUBMITTING THE APPLICATION OOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, wljICH
INCLUDES:. VERIFICATION OF ASSESSOR RECORDSo SEPTIC SYSTEM CHECKo NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY
o SEPTIC SYSTEM CAPACIryo NUt"IBER OF LEGAL BEDROOMS
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:o ALLSMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIESe ALLUNITS HAVE BEEN TESTED AND ARE IN PROPER WORKING CONDITION. ALL UNITS ARE LESS THAN 1O YEARS OLD
OWNER CERTIFICATION REQUIRED
I CERTIFY THAT I HAVE COMPLETED E ABOVE REQUIREMENTS
OWNER INITIALS
Smoke Detector Localionlequiremcnls-Yarrrrolth-l4A - copy avaitabte at Buitding D€partment
FEES (PER UNIT)
SHORT-TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS OR IESS
/NSPEC ]'IONS REQUIRED YEABLY
$180 ANNUALLY
LONG.TERM / YEAR-ROUND RENTALS $80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADOITIONAL FEE OF $1OO PER UNIT/RENTAL IS REQUIRED FOR SHORT-TERM RENTALS PER BUITDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31sr OF EACH YEAR
MAIL OR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUfH YARMOUTH, MA 02664
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTN4ENT WEBSITE:
https;/1v!vwJarmorJth.ma,us/1 2TlHealth
IMPORXANT RENTAL CERTIFTCATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 3O DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT
IN4MEDIATELY. UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
WHY THls MATTERS: THESE MEASURES PROTECT DRINKING WATER ANO AQUIFERS, ESPECIALLY ASfHE TOWN
IBANSIIIONS IO A FUIURE SEYYES SYSIEM.
DUPLEVMULTI-FAMILY RENTALS. REFUSE DISPOSAL RESPONSIBILIW
ln accordance with 105 CMR 410,560, and except as provid6d in 105 CMR 410.560(C) (for BULK ltems) , the owner of any residence
containingtwo or moro dwotting unlts, a roomlng houss, homeless sholter, or manutsctursd housing community, shslt bg
relponsibb for 8nd pay for the finel. col.bction and ultimate disposaI of refuss.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wTH MA STATE SANTTARY CODE 10s CMR410.560 (C)AND 10s CMR 410.s60 (4)(E).
RENTAL INFORMATION
INCOMPLETE FORMSWITHOUT AVALID PHONE # OR EMAILWILL NOT BE PROCESSED
RENTAL PROPERry ADDRESS
f4n€3 A- F.$-l b,.eS/^)PROPERTY OWNER NAME
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PROPERTY OWNER PHONE #
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ALTERNATIVE PHONE #
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PROPERTY OWNER EMAIL ADDRESS
REQUIRED
OWNER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
{or.ro-renvnEAR-RouND trsHoRT-TERM/vvEEKLy
BENTAL PERIOD:
TRASH REMOVAL BY:
tr OWNER NANT
PAID PICK-UP TRASH COMPANY NAME:X,
RENTAL OF
D DUPLEX DCONDO tr APARTMENT IIROOM
NUMBER OF UNITS FOR RENT
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am futty tamitiar with the tottowing regutations:
Town of Yarmouth Chept6r 108 - Rentat Housing Byt8w, Town of Yermouth Chaptor 104 - Antl-Noise Bytaw, Town of Yarmouth
Short-Torm Rental, Bylaw (if appticabte), Massachus6tts Stato Sanitary Codc, Chapt6r ll - Mlnlmum Stsndard3 of Fltn6ss for Human
Habltation
These documents are avaitabte for reference on the official Town of Yarmouth website and may atso be obtained upon request from the
Yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heatth Department in writing when I cease
rentingthe property. Faitureto do so mayresutt in the imposition ottines and/orfees.
QUESTIONS: Phone #: 508-398-2231 Ex. 1240, Emait: rniederbelger@yarrnouth.ma.us
APPLICANT SIGNATURE DATE
OWNER INITIALS
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