HomeMy WebLinkAbout22 Berry Ave Rental Application 2026RENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664
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PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2025
IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 3O DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT
I14MEDIATELY UNTIL YOU REGEIVE THE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMITTING THE APPLICATION OOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUOES:
o VERIFICATION OF ASSESSOR RECORDS
. SEPTIC SYSTEM CHECK
o NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY:. SEPTIC SYSTEM CAPACITY
r NUMBER OF LEGAT BEDROOMS
WHY THIS MATTERS; IHESE MEASURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLY AS THE TOWN
TRANSITIONS TO A FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:
. ALLSMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIESo ALL UNI'IS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDITION
. ALL UNITS ARE LESSTHAN 1O YEARS OLD
I CERIIFY THAT I HAVE COMPLET HE ABOVE REQUIREMENTS
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FEES R UNIT)
SHORT-TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS OR LESS
/NSPECI/QNS 8f QU I RE D Y EABLY
$180 ANNUALLY
LONG-TERM / YEAR.ROUND RENTALS S8O ANNUALLY
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OWNER CERTIFICATION LEQUISEQ
OWNER INITIALS
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADD]TIONAL FEE OF $1OO PER UNIT/RENTAL IS REQUIRED FOR SHORT-TERM RENTALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR
MAll- OR DROP OFF CHECK TO THE YARMOUTH HEALTH OEPARTMENT: t 146 ROUTE 28, SOUTH YARMOUTH, MA 02664
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENI WEBSITE:
DUPLEX/MULTI-FAMILY RENTALS. REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 410.560(C) (tor BULK items) , the owner of any residence
containingtwo or more dw€llingunits, a rooming houss, homeless sheltor, or manufactured housing community, shsll bc
responsible for and pay forthe final collection and ultimate disposal of refuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
R s60 (c) AND 1os CMR 410.s60 (4)(F)
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OWNER INITIA
RENTAL INFORMATION
INCOMPLETE FORMS wlTHOUT A VALID PHONE # OR EMAILWlLL NOT BE PROCESSED
RENTAL PROPERTY ADDRESS
PROPERTY OWNER NAME
PROPERry OWNER I.4AlIIfiG ADDRESS f - -
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ALTERNATIVE PHONE #
IF APPLICABLE
PROPERTY OWNER PHONE #
/ut? -n7'hYr'S-REQUIREO
C,.^tZfp8r,m/.<stPROPERTY OWNER EMAIL ADDRESS
REQUIRED
VE/RENTAL AGENTOWNER'S REPRESE
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
RENTAL PERIOD:
SHORT-TERM/!VEEKLYtr LONG-TERMryEAR-ROUND
TRASH REMOVAL BY:6^r tr TENANT
PAID PICK.UP TRASH COMPANY NAME
aforra oort.'Ex .coNDo ! A,ARTMENT trRooM
RENTAL OF
NUMBER OF UNITS FOR RENT:
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am futly
Town of Yarmouth Chapter 108 - Rental Housing Bytaw, Town ofYarmouth c
Short-T€rm Rontat Bytaw (if appticabLe), Massachusetts State Sanitsry Code, Chapter ll - Minimum Standards of Fitnoss for Human
Hsbitation
These documents are avaitabte for reference on the otliciat Town ot Yarmouth website and may atso be obtained upon request from the
Yarmouth Health Department. Furthermore, I understand that I am required to notify the Heatth Department in writingwhen I cease
renting the property. Faiture to do so may resutt in the imposition ot fines and/or lees'
famitiar with the fot(owing regutations:
hapter 104 - Anti-Noise Bylaw, Town ofYarmouth
QUEST]ONS:Pho
APPLICANT SIGNATURE
#: 508-398-2231 Ex. I240, Emait: rniedsb€rger@yarrtrouth ma-us
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WITH MA STATE SANITARY CODE 105
IF APPLICABLE