HomeMy WebLinkAbout25 Butler 2026 ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUIH, MA 02664
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Public Health
PLEASE REGISTER YOUR RENTAL PROPERTY NO LATERTHAN APRIL 1, 2026
IMPOKTANT RENTAL CERMFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WrTHIN 30 DAYS OF APPLYING, COMACT THE HEALTH DEPARTMENT
IMMEDIATELY. UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
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tr NEW APPLICATION
APPLICATION PROCESS
SUBMTTflNG THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES;
o VERIFICATION OF ASSESSOR RECORDS
. SEPTIC SYSTEM CHECK
o NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY:
. SEPIIC SYSTEM CAPACITY
o NUMBER OF LEGAL BEOROOMS
WHY THIS MATTERS: THESE MEASURES PROIECT DRINKING WA|ER 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 FOLLOWNG:
o ALLSMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES
. ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDIflON
. ALL UNITSARE LESS THAN 1O YEARS OLD
Smoke Detec&r LoeatiolRequlemeds - Ya rmouth,ItA - copy avaitabte at Buitding Department
ckOWNER INITIALS
FEES (PER UNIT)
SHORT-TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS OR LESS
/rySPEE I/OA]S REQUIRED YEARLY
$180 ANNUALLY
LONG-TERM / YEAR ROUND RENTALS $80 ANNUALLYt/
A NON-REFUNDAELE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDMONAL FEE OF $1OO PER UNTT/RENrAL IS REQUIRED FOR SHOR|I-IERM RENTATS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31SI OF EACH YEAR
MAIL OR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT: 1145 ROUIE 28, SOUIH YARHOUTH, MA 0266/r
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISITTHE TOWN OFYARMOUTH HEALTH DEPARTMENT WEBSITE:
hftps://wwryv sl127 /Hcalth
OWNER CERTIFICATION REQUIRED
I CERIIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
DUPLEVMULTI.FAMILY RENTALS - REFUSE DISPOSAL RESPONSIBIUTY
ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 410.560(C) (for BULK items) , the owner of any residence
containingtryo or more dry€lling units, a rooming house, homeless shelter, or manufactured hoEing community, shalt be
responsibL€ forand pay for the final collection and uttimate disposat ot refuse.
I, THE OWNER, CERTIFYTHAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wTH MA STATE SANTTARY CODE lOs CMR 410.560 (C) AND 105 CMR 410.560 (4XE).
OWNER INITIALS
RENTAL INFORMANON
INCOMPLETE FORMSWTHOUT AVALID PHONE # OR EMAILWlLL NOT BE PROCESSED
RENTAL PROPERTYADDRESS- - 25 bulfu ftvL , vl6r \s'rao "fl"
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PROPERTY OWNER EI.4AIL ADDRESS
REQUTRED OO;/:/4 nal
REPRESENTATIVE PHONE *
REQUIRED tf/4
REPRESENTATIVE EMAIL ADDR
REQUIRED
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Xt-or',ro-renvrveAR-RouND o sHoRT-TERM/wEEKLy
RENTAL PERIOD:
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TRASH REMOVAL BY Vowrurn Ir TENANT
FQUPLEX tr CONDO trAPARTMENT trROOM
RENTAL OF
rJ HOUSE
NUMBER OF UNITS FOR RENT L
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am tuttyfamitiar with the fottowing regulations:
Town ot Yarmouth Chaptar log - Rontal Housing Bytaw, Town of Yarmouth Chapter I 04 -Anti-Noise Bt^aw, Town of yarmouth
Short-Term Rentat Bytaw (if appticabte), MassachusetG Stats Sanhary Code, Chapter ll - Minimum Standards of Fhness for Human
Habit8tion
These documents are avaitable for reference on the officiat Town olYarmouth website and may atso be obtained upon request trom the
Yarmouth Heatth Department. Furthermore, I understand that I am required to notitythe Heatth Department in writingwhen I cease
rentingthe property. Failure to do so may resutt in the imposition offines and/or fees.
QUESIIQNS: Phone #: 508-398-2231 Ex. j 240, EmaiL miedqrbcrger@yarmouth.ma-us
APPLICANT SIGNATURE t t-.3 2.o L4
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owNER's REpREsENrerrvErnrrutnr ridenr
PAID PICK-UP IRASH COMPANY NAME:
DATE