HomeMy WebLinkAbout56 Starbuck Lane 2026 ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1 146 ROUTE 28, SOUTH YARMOUTH, MA 02564
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PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026
IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOI RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACT THE HEALIH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERIIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMITTING THE APPLICATION DOES NOT AUTOMAIICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:o VERIFICATIoN OF ASSESSOR RECORDSo SEPTIC SYSTEM CHECK
o NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BYo SEPTIC SYSTEM CAPACIry
o NUMBER OF LEGAL BEDROOMS
WHYTHIS MATTERS; IHESE ME SURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLY AS THE TOWN
rMNS/7ONS TOA FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:o ALLSMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES. ALL UNITS HAVE BEEN TESTED AND ARE lN PROPERWORKING CONDITION
. ALL UNITS ARE LESS THAN .I O YEARS OLD
OWNER CERTIFICATION REQUIRED
I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
OWNER INITIALS
Smoke Detector Location Requlremenls- Yarmouth, MA - copy avaitabte at Buitding Department
FEES (PER UNIT)
SHORT.TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS OR LESS
/MSPFCr/ONS FEQU I RE D Y EABLY
$180 ANNUALLY
LONG-IERM / YEAR-ROUND RENIALS $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 CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR
MAIL OR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT: 1145 ROUTE 28, SOUTH YARMOUTH, MA 02564
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
htt!si//wwwlarmouth. ma.us/'1 22Health
DUPLEVMULTI-FAMILY RENTALS - REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR 41O.560, and except as provided in 105 CMR 410.560(C) (tor BULK items) , the owner of any residence
containingtwo or more dwelling units, a rooming house, homeless shelter, or manufactured housing community, sha(l be
responsiblefor and payforthefinal coltection and uttimate disposatof refuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wTH MA STATE SANITARY CODE 10s CMR 410.s60 (C) AND 10s CMR 410.560 (4)(E).
OWNER INITIALS
RENTAL INFoRI'lATloN
INCOMPLETE FORMS WITHOI'I A VALID PHONE # OR EMAILWlLL NOT BE PROCESSED
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PROPERTY OWNER NAME
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PROPERry OWNER MAILING ADDRESSpe-€a*p.7y DP.zr9 Pot-T- //// o269
PROPERTY OWNER PHONE #
REQUtREDfo€ 4?( Zoa't-
ALTERNATIVE PHONE #
IF APPLICABLE
OWNER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
RENTAL PERIOD
gLONG-TERM/YEAR.ROUND trSHORT.TERM/VVEEKLY
TRASH REMOVAL BY:
tr OWNER E4ENANT
PA|D PrcK-UPTRASH CoMPANY NAME, gVtttP gn Lf-tL
RENTAL OF:
trHOUSE FDUPLEX DCONDO trAPARTMENT trROOM
NUMBER OF UNITS FOR RENT:
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am futty famitiar with the fottowing regutations:
Town ofYarmouth Chapter 108 - Rentat Housing Bylaw, Town ofYarmouth Chapter 104- Anti-Noise Bylaw, Town ofYarmouth
Short-Term Rental Bytaw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness for Human
Habitation
These documents are avaitable for rererence on the ofriciat Town of Yarmouth website and may atso be obtained upon request from the
Yarmouth Heatth Department. Furthermore, lunderstand that lam required to notifythe Heatth Department in writingwhen lcease
renting the property. Faiture to do so may resutt in the imposition of fines and/or fees.
QUESTIONS: Phone #: 508-398-2231 Ex.1240, Emait: rniederberger@yarmouth.ma.us
APPLICANT SIGNATURE
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DATE **ze
RENTAL PROPERTY ADDRESS4ro 9{clbcLClt- 2P
PROPERTY OWNER EMAIL ADDRESS
REQUIRED