HomeMy WebLinkAbout503 Route 28 22 Rental Application 2026RENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1,146 ROUTE 28, SOUTH YARMOUTH, MA 026649
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D NEW APPIJCAITON
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PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026
IMPORTANT RENTAL CERIIFICAIE NONCE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE W]TH IN 30 DAYS OFAPPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY. UNTIL YOU RECEME THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINESAND PENALTIES.
APPLICATION PROCESS
OCCUPANCY LIMITS
DETERMINED BY. SEPTIC SYSTEM CAPACTY. NUMBER OF LEGAL BEDROOMS
WHY rHlS MAITERS: THESE MEASURES PROTECTDRINKING WATER AND AQUIFERS, ESP EC IALLY AS THE TOWN
TRANSITIONSTO A FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:. ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES. ALL UNfTS HAVE BEEN TESTED AND ARE IN PROPER WORKING CONDITION. ALL UNTTS ARE LESSTHAN lOYEARSOLD
OWNER CERTIFICATION REQ!'I8ED
ICERTIFY THAT I HAVE COMPLETEDTHE ABOVE REQUIREMENTS
OWNER lNlTliALS i r ,
FEES (PER UNTT)
SHORT-TERM / WEEKLY RENTALS
RENIAIS OF 3
'
DA}{S OR LESS
blsP EcTto N s BEQU tREp yEAEU
$180 ANNUALLY
LONG-TERM / YEAR-ROUNO RENTALS $80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADD]TIONAL FEE OF IlOO PER UNIT/RENTAL IS REQUIRED FORSHORT.TERM RENTALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31SI OF EACH YEAR
MAIL OR DROP OFF CHECI( TO THE YARMOUIH HEALIH DEPARTMENT: 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664
TO REGISTER ONLINE AND PAY V'A CREDIT CARD, VISITTHE TOWN OF YARMOUTH HEALTH DEPARTMENT WEESITE:
https://wwwyarmouth.ma.us/ l 2ZHeallh
rtaltlr Doartrnent
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SUBMI'TTINGTHE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WH ICH
INCLIJDES:
r VERIFICATION OF ASSESSOR RECORDSo SEPTIC SYSTEM CHECKo NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
Smoke Detector Location Reouirements -Yarmouth. MA - copy avaitabte at Buitding Department
RENTALS REFUSE DISPOSAL RESPONSIBIUTY
ln accordance with 1O5 CHR 4f 0.560, and cxccB.s provid.d ln 1O5 CMR /tl0.56O(C) (tor Bfrlx lbm3) , the owncr of any rssidence
containing trvo or mor6 dry€lllng unats, s rooming hou3€, homotals rholtsr, or manuf8ctured hou3in8 community, thall bc
rospomlbb for and pay lor tho ffnal collccdon and ultimete dllPolel of rsfus..
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wtrH MA STATE SANITARY CODE 105 CMR 410.s60 (C) AND 105 CMR 410.s60 (4)(E).
RENTALINFORMANON
INCOMPLETE FORMS WITHOUT AVALID PHONE # OR EMAILWLL NOT SE PROCESSED
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PROPERTY OWNER NAME
Deni--r- -l>c-n\] Ci,-
PROPERTY OWNER MAIUNG ADDRESS
i-D!vc.i. L-r'r $r,LZrrrl:, P>M )
PROPERry OWNER PHONE#
REQUIRED ')( Y"')L'i (c
Adenue.?23Dqv"po, I L/-n-)
PROPERTY OWNER EMAIL ADDRESS
OWNER'S REPRESEMATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATTVE EMAIL ADDRESS
REQUIRED
{sxorr-reRNrweerrv
RENTAL PERIOD:
D LONG.TERM/YEAR-ROUND
TRASH REMOVAL BY
{owlren C TENANT
PAID PICK-UP TRASH COMPANY NAME:
tr HousE tr DUpLEx (coNoo o AeARTMENT trRooM
RENTAL OF
NUMBER OF UNITS FOR RENT:i
ACKNOWLEDGMENT SIATEMENT
I hereby acknowtedge that I have thoroughly revi€wed and am tutty tamitiar with the fotLowing regutations:
Town ot Yarmouth Chsptar I 08 - Rentet Housing Bytaw, Town of Yamouth Chsptsr 1 04 - Anti-Noise Bytaw, Town of Yarmouth
Short-Tsm Rental Bytaw (if appLicabte), Ma$achusetts Steta S.nitary Code, Chapt6r ll - Minimum Standerds ot Fltncas ior Human
Habit tion
These documents are avaitabte for reference on the officiatTown of Yarmouth website and may also be obtained upon request from the
Yarmouth HeaLth Department. Furthermore, I understand that lam required to notify the Heatth Departtnent in wftingwhen lcease
renting the property. Faiture to do so may resutt in the imposition offnes end/or fees.
oUESTIONS: Phone #: 508-398-2231 Ex. 1240, EmaiL miede[belge!@afioouLma.us
APPTICANT SIGNATURE DATE
N.N
OWNER INITIALS
RENTAL PROPERry ADDRESS
IIALTERNATTVE PHoNE #
I
r eeetrceatt
REQUIRED
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