HomeMy WebLinkAbout31_33 Courtland Way 2026 ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
.I146 ROUTE 28, SOUTH YARMOUTH, MA 026549
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PLEASE REGISTER YOUR RENTAL PROPERry NO LATER THAN APRIL 1, 2026
IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACTTHE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMITTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES;
. VERIFICATION OF ASSESSOR RECORDS
. SEPTIC SYSTEM CHECK
. NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY. SEPTIC SYSTEM CAPACIry. NUMBER OF LEGAL BEDROOMS
WHYTHIS MATTERSj rHESE MEASURES PROTECT DRINKINGWATER 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 BATTERIES. ALL UNTTS HAVE BEEN TESTED AND ARE IN PROPER WORKING CONDITION
. ALL UNITS ARE LESSTHAN 1O YEARS OLD
Smakelclestqloqati!LRlsulremeds_Yimoulh, MA- copy avaitabte at Buitding Department
OWNER INITIALS
OWNER CERTIFICATION BEQUIRED
ICERTIFYTHAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
R UN|T)FEES
SHORT-TERM /WEEKLY RENTALS
RENIATS OF37 DAYS OR IESS
INSPECI/ONS EEQ U] RE D Y E A R LY
S180 ANNUALLY
LONG.TERM / YEAR.ROUND RENIALS $80 ANNUALLY
A NON.REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIREDAN ADDITIONAL FEE OF $1OO PER UNIT/RENTAL IS REQUIRED FOR SHORT-TERM RENTALS PER EUILDING CODERENTAL CERTIFICATES 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 ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
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f] RENEWAL
tr NEWAPPLICATION
DUPLEx,/MULTI-FAMILY RENTALS . REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 4'10.560(C) (for BULK items) , the owner of any residence
containingtwo or more dwel[ingunits, a rooming house, homeless shelter, or manufactured housing community, shatt be
responsibte lor and pay forthe finsl collection and ultimate disposaI of retuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINSTWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wtrH MA srATE SANtTARy CODE lOs CMR410.560 (C) AND 105 CMR410.560 (4)(E).
OWNER INITIALS
RENTAL INFORMAIION
INCOMPLETE FORMS WTHOUT A VALID PHONE # OR EMAILWILL NOT BE PROCESSED
RENTAL PROPERTY ADDRESS
-De.o,-, r€PROPERTY OWNER NAI4E
'ZAT Cc: M-a?r'trr--r-t Cnl cL , K*.r-". ( -/ 41t tE- r"r.*- o2-66 (1PROPERTY OWNER MAILING ADDRESS
PROPERTY OWNER PHONE #S;a srs 4?7-REQUIRED
ALTERNATIVE PHONE #
IF APPLICABLE
PROPERW OWNER EMAIL ADDRESS /
REQUTRED dl.ru; r.l _ h.rtg g- -€-oc! 1t/c-'^l es fc-t"t - <-',^'-L-1
OWNER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
D(e{G-TERM/vEAR-RouND trsHoRT-TERMMEEKLy
RENTAL PERIOD:
TRASH REMOVAL BY
N OWNER
PAID PICK.UP TRASH COMPANY NAME:
6sNlrlr
o uousEl(uptEx o coNDo tr AeARTMENT tr RooM
RENTAL OF:
z-NUMBER OF UNITS FOR RENT:
ACKNOWLEDGMENT STATEMENT
Habitation
These documents are avaikbre for refelence on the oflicialTown of Yarmouth website and may also be obtained upon request from the
yarmouth Heatth Department. Furthermore, I understand that lam required to notifythe Heatth Department in writingwhen lcease
rentlngthe property. Faiture to do so may resutt in the imposition offines and/orfees'
ty
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OUESTIONS. Phone #: 508-398-2231 Ex. 1240, Emait: rniederbergel@!?rmouti'ma'!LS
APPLICANT SIGNATURE /,{/,'r t-DATE s/n/rzk