HomeMy WebLinkAbout132_134 West Yarmouth Road';ffi,-9"
f] RENEWAL
D NEWAPPLICATION
PLEASE REGISTER YOUR RENTAL PROPERTY 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
II.4MEDIATELY 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 INSPECIIONS
OCCUPANCY LIMITS
DETERMINED BY. SEPTIC SYSTET'4 CAPACIryo NUMBER OF TEGAL BEDROOMS
WHYTHB MATTERS: IHESE MEASURES PROTEC| DNNKING WATER AND AQUIFERS, ESPECIALLYASTHE |OWN
TRANSITIONS fO A FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:. ALL SMOKE DETECTORS & CARBON MONOXIDE DETECIORS HAVE FRESH BATTERIES
. ALLUN]TS HAVE BEEN TESTEO AND ARE lN PROPER WORKING CONDITION
. ALL UNTTS ARE LESS THAN lOYEARSOLD
9m!kc Dctecto( Llcation Requircrtrelts Yatrmouth-MA - copy avaatabLe at Buitding Department
OWNER INITIALS
OWNER CERTIFICATION BEQUIRED
I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
FEES (PER UN
SHORT-TERI.4 / WEEKLY RENTALS
RENTALS OF 31 DAYS OR LESS
[vsPEcrloNs 8EQUL&ED YEARLY
$180 ANNUALLY
LONG-TERM / YEAR-ROUND RENTALS $80 ANNUALLY
AT
ITlRENTAL -TE RENTA
NTA ICATE
YA LTH YARM
YARM ALTH PART
A oNN EFUR DABN EL PAPLtc ON FEE Fo P$80 RE IS ER U R DEaADANDtTtAONFLEEOF001P$ER NU IS RED FORREQUI SHO RT MR PELS BUR LDING CODERELCEsrRTEXSPERNoEDcEMBERFoHEACMAILoDRPROFoCHFECKETHRMOUTHHEADEPARTMNET11642sOUTH8,OUTH o2MA664oTREGIRSTENoNLIANEDREcDTCADRISTITEHTooHUTHEDEMENTEITEBShup7LHc!tlh
RENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1.I46 ROUTE 28, SOUTH YARMOUTH, MA 02664
UNIT/RENTAL
31 YEARTOROUTE
PAY VIA OF
DUPLEVMULTI-FAMILY RENTALS . REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 410.560(C) (ror BULX items) , the owner of any residence
containingtwo or more dwetling qnits, a rooming house, homeless shelter, or manufactured housing community, shalt be
responsible for and payforthe final cotlection and ultimate disposat of retuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wrTH MA STATE SANTTARY CODE r05 CMR410.560 (C) AND 105 CMR410.560 (4)(E).
OWNER INITIALS
RENTAL INFORMATION
INCOMPLEIE FORMS WTHOUTAVALID PHONE # OR EMAILWlLL NOT BE PROCESSED
flZ - 17 ? r-J. /p;,-r--d-A74 H,uj, y'prrnt=-^.-. 6RENTAL PROPERTY ADDRESS
PROPERTYOWNER NAI.4EMu,o //_-Lq-
Za?- Z a,e-4+t-rt'1at-L cJ, 6,+..NJC-4{LE Vaa- g'Z{( N
PROPERry OWNER I'4AILING ADDRESS
PROPERTY OWNER PHONE #
nrQuaro ljgT f'2J 6b?-2-
ALTERNATIVE PHONE #
IF APPLICABLE
PROPERTY OWNER EMAIL ADDRESS / t
REQU iRED /L.: <l -
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OWN ER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
A*n-rt*rrEAR-RouND trsHoRT-TERMAvEEKLy
TRASH REMOVAL BY
tr OWNER
PAID PICK-UP TRASH COMPANY NAME:
Ty'rer'rar.r
PLEX DCONDO tr APARTMENT trROOM
NUMBER OF UNITS FOR RENT
tr HOUSE
ACKNOWLEDGMENT STATEMENT
Thesedocumentsareavaitabteforre'erenceontheofficiatTownotYarmoUthWebsiteandmayalsobeobtain
yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heatth Department
rentingthe property' Faiture to do so may resutt in the imposition offines and/orlees'
Habitation
Mini
th ttowifo n Lat nstofumlatimlawithdnaacregudthatavehthorouItvteacknowteheghlydgeby of rmoqtha104TofarmouthBytawn08RentatousHhca1ofrmouthEapterT numarHfondStardsFitnessofrummSanitacsauhsettsChapteCode,a bte Mas ryifeTRermntal)Short-ppLica(
ed upon request trom the
in writing when lcease
QUESIIONS:398-2231 Ex. 1 240, Emait: rnredelberger@yarmoutLma-usPhone li 50
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RENTAL PERIOD:
RENTAL OF:
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II TownAnti-NoiseChapterBytaw,
StateBytaw
APPLICANT SIGNATURE //'L