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Home My WebLink About54 Starbuck Lane 2026 ApplicationRENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARTMENT 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664 {ffi,-9"t n:rewru- tr NEwAPPLIoATIoN PLEASE REGISTER YOUR RENTAL PROPERW NO LATER THAN APRIL 1, 2026 IMPORTANT RENTAL CERTIFICATE NOTICE IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 3O DAYS OF APPLYING, CONTACTTHE HEALTH DEPARIMENT IMMEDIATELY. UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERIIFIED FOR RENTAL, WHICH MAY RESULT IN FINES AND PENALTIES. APPLICATION PROCESS SUBMITTING THE APPLICATION DOES NOT AUTOII'IATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH INCLUDES:o VERIFICATION OFASSESSOR RECORDSI SEPTIC SYSTEM CHECKo NUMBER OF LEGAL BEDROOMS . VIEW OF PREVIOUS INSPECTIONS OCCUPANCY LIMITS DETERMINED BYo SEPTIC SYSTEM CAPACIry. NUMBER OF LEGAL BEDROOMS WHY fHtS MATTERS: rHESE MEASURES PROTECT DRtNKtNG WA|ER AND AQUIFERS, ESPECIALLY ASTHE TOWN TRANSITIONS TO A FUTURE SEWER SYSIEM, SMOKE AND CARBON MONOXIDE DETECTORS AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:. ALL SMOKE DETECTORS & CARBON MONOXIOE DETECTORS HAVE FRESH BATTERIES. ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDITION. ALL UNITSARE LESS THAN 1O YEARS OLD OWNER CERNFICATION REQUIRED I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS OWNER INITIALS Smoke Detector Location Requiremenls =-Yarmoqth,l{A - copy avaitabte at Buil.ding Department FEES (PER UNIT) SHORT-TERM /WEEKLY RENIALS RENTALS OF 31 DAYS OR IESS /NS?EC ZONS REQ U I R E D Y E N1 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 CERIIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR MAIL OR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664 TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARIMENT WEBSITE: httlBs:,us/l2Zlbleatth Y* DUPLEVMULTI.FAMILY RENTALS. REFUSE DISPOSAL RESPONSIBILITY ln accordance with 105 CMR410.560, and except as provided in 105 CMR410.560(C) (for BULK items), the owner of any residence containing two ot more dweLting units, a rooming house, homeless shelter, or manufactured housing community, shalt be responsibte for and payfor the finat collection and uttimate disposat of refuse. I, THE OWNER, CERTIFY THAT MY RENTAL PROPER|TY, WHICH CONTAINS TWO OR MORE OWELLING UNITS, IS IN COMPLIANCE wlTH MA STATE SANITARY CODE 10s CMR410.s60 (C) AND 10s CMR410.s60 (4)(E). OWNER INITIALS RENTAL INFORMATION INCOMPLETE FORMS WITHOT.IT AVALID PHONE # OR EMAILWLL NOT BE PROCESSED tJ/e.z4'7{RENTAL PROPERTY ADDRESS/q--(7 ?0a PROPERry OWNER NAME- -J-o/z// i+UoNey /qcf .{/*oza3VPROPERTY OWNER I.4AILING ADDRESS o e*/o1r PROPERTY OWNER PHONE # REQUTRED 564Vr4 Loov OWNER'S REPRESENTATIVE/RENIAL AGENT IF APPLICABLE REPRESENTATIVE PHONE # REQUIRED REPRESENTATIVE EMAIL ADDRESS REQUIRED ETONG-TERM/YEAR-ROUND !SHORT-TERM/lVEEKLY RENTAL PERIOD TRASH REI'lOVAL BY PAID PICK-UP TRASH COMPANY NAME |U,U / eTicygq- tr OWNER D(ENANT RENTAL OF: NUMBER OF UNITS FOR RENI 7_.-- ACKNOWLEDGMENT STATEMENT I hereby acknowtedge that I have thoroughty reviewed and am futty famitiar with the foltowing reguLations: Town ofYarmouth Chapter l Os - Rentat Housing Bytaw, Town ofYarmouth Chapter 104 -Anti-Noise Bytaw, Town otYarmouth Short-Term Rentat Bytaw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fitness for Human Habitation These documents are avaitabtefor reference on the officialTown ofYarmouth website and may atso be obtained upon request from the yarmouth Heatth Department. Furthermore, I understand that lam required to notifythe Health Department in writingwhen lcease renting the property. Faiture to do so may resutt in the imposition of fines and/or fees. QUESTf ot{s: Phone #: 508-398-2231 Ex' 1240' Emait: rniederbergpr@yarmouth'ma us APPLICANT SIGNATURE DATE t> t*zl- ALTERNATIVE PHONE # IF APPLICABLE PROPERry OWNER EMAILADDRESS REQUIRED trHOUSE F.DUPLEX trCONDO tr APARTMENT trROOM