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Home My WebLink About16 Echo Road Rental Application 20269 R$licH€8lthf] RENEWAI. f] NEWAPPLICATION PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026 APPLICATION PROCESS OCCUPANCY LIMITS DETERMINED BY. SEPTIC SYSTEM CAPACIryo NUMBER OF LEGAL BEDROOMS wHYTH\S MATTERS: IHESE MEASURES PROTECT DRTNKNOWATER AND AQU|FERS, ESPECTALLY AS THE |OWN TRANSITIONS TO A FUTURE SEWER SYSTEM. SMOKE AND CARBON MONOXIDE DETECTORS AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG: r ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES . ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONOITION . ALL UNITS ARE LESSTHAN lOYEARSOLD OWNER CERTIFICATION BEQUIBED I CERTIFY THAT I HAVE COMP TH REQUIREMENTS OWNER INITIALS a-^L6 r\ar6^i^r I ^^-+i^^ O -copy avaitabte at Buitding Department FEES (PER UNIT) SHORT-TERM / WEEKLY RENTALS RENTALS OF 3 ' DAYS OR LESS I N S P EQII O N S REO U I RE D YE A RLY $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 BUII.DING COOE RENTAL CERTIFICATES EXPIRE ON DECEMBER 315T OF EACH YEAR MAIL OR DROP OFF CHECK TOTHE YARMOUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664 TO REGISIER ONLINE AND PAY VIA CREDIT CARD, VISITTHE TOWN OF YARMOUTH HEATTH DEPARTMENT WEBSITE: https:/1wuryryartr|0ulh. ma.uslL27lHealth RENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARTMENT ,I146 ROUTE 28, SOUTH YARMOUTH, MA 02664 IMPORTANT RENTAL CERTIFICATE NOTICE IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACTTHE HEALTH DEPARTMENT IMI.4EDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY RESULT IN FINES AND PENALTIES. SUBMITTINGTHE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH INCLUDES: o VERIFICATION OF ASSESSoR RECORDS o SEPTIC SYSTEM CHECK O NUI4BER OF LEGAL BEDROOI'4S . VIEW OF PREVIOUS INSPECTIONS DUPLEx,/MULTI.FAMILY RENTALS - REFUSE DISPOSAL RESPONSIBILITY ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 410.560(C) (for BULK items) , the owner oI any residence containingtwo or more dwelling units, a rooming house, homeless shetter, or manulactured housing community, shatl be rgsponsible for and pay for the tinal cotlection and ultimale disposal of refuse. I, THE OWNER, CERTIFYTHAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE wTH MA STATE SANTTARY CODE 10s CMR410.560 (C)AND 10s CMR410.550 (4)(E). RENTAL INFORMATION INCOMPLETE FORMS wlTHOUT A VALID PHONE # OR EMAILWLL NOT BE PROCESSED RENTALPR.PERTlT'k,le w, lA|.<r:/n rn n, i'h NAMEf,r r( L6F4F7oPRONER '*o"*7ry88?)'i.^W w, Vflfw1, PROPERTY OWNER PHONE # REeUIRED EgZ Z:g ??og ALTERNATIVE PHONE # IF APPLICABLE F,pb/c G mrA2<-o tlzl ,4r2 I PROPERTY OWNER EI.4AIL ADDRESS REQUIRED OWNER'S REPRESE IF APPLICABLE TAL AGENT REPRESENTATIVE PHONE # REPRESENTATIVE EMAIL ADDRESS LONG.TERI'4/YEAR.ROUND trSHORT-TERM/vVEEKLY RENTAL PERIOD TRASH REMOVAL BY: tr OWNER NANT RENTAL OF tr HOUSE DUPLEX trCONDO tr APARTMENT trROOM ACKNOWLEDGMENT STATEMENT I hereby acknowledge that I have thoroughly reviewed and am futty famitiar with the fottowing regutations: Town of Yarmouth Chapter 108 - Rentat Housing Byl,aw, Town ol Yarmouth Chapter 104 -Anti-Noise Bytaw, Town of Yarmouth Short-Term Rental Bytaw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards o, Fitness for Human Habhation These documents are avaitable for reference on the officiatTown of Yarmouth website and mayatso be obtained upon request from the Yarmouth Health Department. Furthermore, I understand that I am required to notifythe Heatth Department in writingwhen I cease rentingthe property. Faiture to do so may resutt in the imposition offines and/or fees. QIJESTIONS #: 508-398-223'l Ex. 1240, Emait: rniederberger@yarmoulth-malrs APPLICANT SIGNATURE DATE Z OWNER INITIALS REQUIRED REQUIRED PAID PICK.UPTRASH COMPANY NAME: NUMBER OF UNITS FOR RENT: -