HomeMy WebLinkAbout88 Poinsetta Dr 2026 ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02664
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PLEASE REGISTER YOUR RENTAL PROPERW NO LATER THAN APRIL 1, 2026
IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY UNIIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
SUBMITTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:. VERIFICATION OFASSESSOR RECORDSo SEPTIC SYSTEM CHECK. NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
APPLICATION PROCESS
OCCUPANCY LIMITS
DETERMINED BYo SEPTIC SYSTEM CAPACIWI NUMBER OF LEGAL BEDROOMS
WHY THB MATTERS; IHESE MEASURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLY AS THE TOWN
rRANS/r/ONS TOA FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:o ALLSMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIESo ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDITION. ALL UNITS ARE IESS THAN 'I O YEARS OLD
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I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
OWNER INITIALS
Smoke Detector Location Bequiremeds:Yarmou![!A - copy availabte at Buitding Department
FEES (PER UNIT)
SHORT.TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS ORTESS
INSPECZONS REQU IR E D YE AR LY
$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 BUILDING CODE
RENTAL cERTIFIoATES ExPIRE oN DEcEI,4BER 31sT oF EAcH YEARMAIL OR DROP OFF CHECK To THE YARMoUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUTH yARMOUTH, MA 02664TO REGISTER ONLINEAND PAY VIA CREDIT CARD, VISITTHE TOWN OFYARMOUTH HEALTH DEPARTMENT WEBSITE:httpsi/lw\ulvJarmouth.ma.us/127lH ea tti
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DUPLEVMULTI-FAMILY RENTALS - REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR410.560, and except as provided in 105 CMR410.550(C) (for BULK ilems) , the owner of any residence
containingtwo or more dwetting units, a rooming house, homeless shelter, or manufactured housing community, shatt be
responsibte for and pay for the final cottection and uttimate disposal ot refuse.
I, THE OWNER, CERTIFYTHAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wlTH MA STATE SANITARY CODE 105 CMR 410 60 (c) AND 10s CMR 410.s60 (4)(E).
OWNER INITIALS
RENTAL INFORMATION
INCOI.4PLETE FORI'4S WITHOUT A VALID PHONE # OR EMAIL WILL NOT BE PROCESSED
PROPERTY ADDRESSf g toq/qg1Tt/]-
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PROPERTY OWNER NAIVE,/#
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PROPERry OWNER PHONE #
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PROPERTY OWNER EMAIL ADDRESS
REQUIRED
OWNER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
l}LONG-TERM/YEAR-ROUND D SH O RT-TERI'4/lVEE KLY
RENTAL PERIOD
PA|D PrcK-uP TRASH CoMPANY NAME bl)Orue€-
TRASH REI4OVAL BY
tr OWNER BTENANT
RENTAL OF:
NUMBER OF UNIIS FOR RENI:
EITIOUSE trDUPLEX DCONDO trAPARTMENT trROOM
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am futty famitiar with the fottowing regutations:
Town ofYarmouth Chapter 108 - Rental Housing Bytaw, Town ofYarmouth Chapter 104 -Anti-Noise Bylaw, Town ofYarmouth
Short-Term Rentat Bytaw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness for Human
Habitation
These documents are avaitabte for reference on the officiat Town ol Yarmouth website and may atso be obtained upon request from the
yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Health Department in writing when I cease
renting the property. Faiture to do so may resutt in the imposition oI fines and/or fees.
QtlESIIQl{S: Phone #: 508-398-2231 Ex. 1240, Ema11' t61s6eL[erger@yarmouthoa'us
APPLICANT SIGNATURE DATE 3 F.Paa
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ALTERNATIVE PHONE #
IF APPLICABLE