HomeMy WebLinkAbout94 WIlfin 2026 ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
.I145 ROUTE 28, SOUTH YARMOUTH, MA 02664
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O RENEWAT
O NEw APTCATIoN
PLEASE REGISTER YOUR RENTAL PROPERTY NO I.AIER THAN APRIL 1, 2026
IMPORIANT RENTAL C ERITI FICAIE NONCE
IF YOU DO NOT RECEIVE YOUR RENTAL CEFITIFICATE WTIHIN 30 DAYS OFAPPLYING, CONTACTTHE HEALTH DEPARTMENT
IMMEDIATELY. UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry ls CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINESAND PENALTIES.
APPLICATION PROCESS
SUBMITTING IHE APPLICATION DOES NOT AUTOMAIICALLY LSSUE A RENTAL CEFITIFICATE. A REVIEW PROCESS FOLLOWS, WHTCH
INCLUOES:
. VERIFICATION OF ASSESSOR RECORDS. SEPIC SYSIEM CHECK
o NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY:. SEPTIC SYSTEM CAPACIW. NUMBER OF LEGAL BEDROOMS
WHYTHIS MATTERS: IHESE MEASURES PROTECT DRINKING WAIER ANDAQUIFERS, ESPECIALLY AS THE TOWN
IRANSITIONS fO A FU|URE SEI,YEF SYSIEM
SMOKE AND CARBON MONOXIOE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:. ALL SMOKE DETECTORS & CARBON MONOXIDE DEIECTORS HAVE FRESH BATTERTESo ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDIT|ON. ALL UNITS ARE LESS TTTAN 10 YEARS OLD
- copy avarlable at Buitding Department
OWNER ININALS
OWNER CERTIFICATION REQUIRED
ICERNFYTHAT IHAVE COMPLETED THE ABOVE REQUIREMENTS
FEES (PER UN
SHORT.TERM / WEEKLY RENTATS
RENTALS OF 31 DAYS OR TESS
/NSPECTiONS REQUI R E D YEA RLY
$180 ANNUALLY
$80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDMONAL FEE OF$1OO PER UNI/RENTAL IS REQUIRED FOR SHORI.IERM RETTALS PER BUILDING CODERENTAL CERTIFICATES EXPIRE ON DECEMBER 315T OF EACH YEARMAIL OR DROP OFF CHECX TO THE YARMOUTH HEAIIH DEPARIMEI{T: l l rt6 ROUIE 23, SOUTH yARMOUTH, MA 02664TO REGISIER ONLINE AND PAY VIA CRED]TCARD, VISITTHE TOWN OFYARMOUTH HEALTH DEPARTMENT WEBSITE:
armouth.ma.us/1 2ZHeatthhtt
,T\S
LONG-TERM / YEAR.ROUND RENTALS
DUPLEVMULTI.FAHILY RENTALS. REFUSE DISPOSAL RESPC'NSIBILITY
ln accordance with 105 CmR 410.560, and except as provided in 105 CHR 410.560(C) (tor BULK items) , the owner ot any residence
containingtwo or more dwetlingunits, a roomin8 house, homeless shGltar, or manufactured housing community, shatl be
responsible for and pay tor th€ final collection and ultimate disposal of refuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERry WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wTH MA STATE SANTTARY CODE lOs CMR 410.s60 (C) AND 10s CMR 410.560 (4)(E).
RENTAL PROPERry ADDRESS-- 4,i ii rui r ii ^ ?ood- , 6 o u\0, 'for uou-Q
J-(a\<vr S, I(t,Jqu..h,a Sol{t) A.tPROPERry OWNER NAME \o
Ll)laro(, rl(Vl onl?PROPERry OWNER MAILING ADDRESS;)
PROPERW OWNER PHONE #
soY 3?7 -1 88c1REQUIRED
zc7- 6 8 Y5ffi{o8
/aLtERttlttvE pHoNE *
IF APPLICABLE
PROPERTY OWNER EMAIL ADDRESS
REeU:RED 1Kt r_o AeA R_0 gwe"t\. O O n
(\o w<
OWNER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTAIIVE PHONE f
REQUIRED nana-
REPRESENTATIVE EMAIL ADDRESS
REQUIRED n Dy\e-
#o*r-rr^r-rr*,-,RENTAL PERIOD:
tr LONG.TERM/YEAR.ROUND
O OWNER
Aalsu t
TRASH REMOVAL BY:
tr TENANT
PAID PICK.UP TRASH COMPANY NAME
{rour, tr DUpLEx ocoNDo tr A'ARTMENT ERooM
RENTAL OF
NUMBER OF UNITS FOR RENT:I
ACKNOWLEDGMET{T SIATEMENT
I hereby acknowtedge that I have thoroughty reviewed aod am tuttyfamitiar with the fottowing regutations:
Town of Yarmouth Chapter 'l08 - Rantal Housing Bytaw Town of Yarmouth Chapter 'l04 - Anti-Noise Bytavv, Town ot Yarmouth
Short-Term Rental Bytaw (if appticabte), MassachusetB State SanitaryCode, Chapter ll - Minimum Standards of Fitness lor Human
Habitation
These documents are available for relerence on the officialTown of Yarmouth \,t/ebsite and may also be obtained upon request from the
Yarmouth Health Department. Furthermore, I understand that I am required to notify the Heatth Department in wliting when I cease
rentingthe property. Faitureto do so may resutt in the impositon olfines and/orfees.
QUESTIO NS: Phone #:508-39A-2231 Ex- 12rO, EmaiL rniederberger@yarmouth. ma.us
a{rIAPPLICANT SIGNATURE DATE
ab
OWNER INMALS
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RENTAL INFORMATION
INCOMPLETE FORMSWTTHOUT AVAUD PHONE f OR EMAILWlLL NOT BE PROCESSED