HomeMy WebLinkAbout6 Chandler Grey 2026 ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALIH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 02564
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Rrbtic Healti
PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1 , 2026
IMFORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOT RECETVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACTTHE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERIIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
OCCUPANCY LIMITS
DEIERMINED BY:o SEPIIC SYSTEM CAPACrY. NUMBER OF LEGAL BEORoOMS
WHYTHIS MATTERS: THESE MEASURES PROTEC| DRINKING WATER AND AQUIFERS, ESPE9IALLY As THE T1WN
TRANSITIONS TO A FUTURE SEWER SYSTEM.
SMOKE AND CAREON MONOXIOE DETECTORS
copy avartabte at Buildrng Department
OWNER INITIALS
OWNER CERTIFICATION EEQUIRED
ICERTIFYTHAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
FEES (PER UN
SHORT-TERM / WEEKLY RENTALS
RENIALS OF 31 DAYS ORLESS
INSPLET ON5 EEqUI8ED YEABU
$180 ANNUALLY
LONG.TERM / YEAR-ROUND RENTALS $80 ANNUALLY
A NON.REFUNDABLE APPLICATION FEE OF S8O PER UNIT/RENTAL IS REQUIRED
AN ADDITIONAL FEE OF $1OO PER UNI/RENTAL IS REQUIRED FOR SHORT.IERM RENTALS PER BUILDING CODE
RENTAL CETTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEARMAIL OR DROP OFF CHECK TO THE YARMOUI}I HEALTH DEPARTMENT: 1 t46 ROUTE 28, SOUTH vARMOUTH, MA 0266/tTO RECISTER ONLINE AND PAY VIA CREDIT CARD, VISTT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:httos://wwwJarmouth.ma.us/l2T lYealth
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SUBMTTTINGTHE APPLICATION DOES NOT AUTOMATICALLY ISSU E A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:o VERIFICATION oF ASSESSOR RECORDS. SEPTIC SYSTEM CHECK. NUMBER OF LEGAL BEDROOMSo VIEW OF PREVIOUS INSPECIIONS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PL€ASE ENSURE THE FOLLOWING:. ALL SMOKE OETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERTESo ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKTNG CONDT-I|oN. ALL UNITS ARE LESSTHAN lOYEARSOLD
DUPIEVMULTI.FAMILY RENTAIS - REFUSE DISPOSAL RESPC'NSIBIUTY
E FORMSWTTHOUT AVALID PHONE f OR EMAILWILL NOT BE PROCESSEDINCOMPLEI
RENTAL INFORHANON
RENTAL PROPERTY AD
PROPERTY OWNER NAME
ER MAILING ADDRESSPROPERTY
ALTERNATIVE PHONE #
IF APPLICABLE .12L|-LU - D
OWNER PHONE #
7REQUIRED
PRO
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PROPERTY OWNER EMAIL ADDRESS
REQUIRED
OWNER'S REPR
IF APPLICABLE
NTATIVE/RENTAL AGENT
REPRESENTATIVE EMAIL ADDRESS
REQUIRED ...-_
giloruo-renuxraR-RouND trsHoRT-TERMllvEEKLY
RENTAL PERIOD:
TRASH REMOVAL BY:
DTENANTflowren
(-PAID PICK-UP TRASH COMPANY NAME: .A
RENTAL OF:
DHousE DDUPLEX trcoNDo l}lpantMEur caoon
NUMBER OF UNITS FOR RENT:
ACKNOWLEDGMENT STATEMENT
Habitatlon
These documents are avaitabte for r€ference on the officiatTown of Yarmouth website and may atso be obtained upon request trom the
yarmouth Heatth Department. Furthermore, I understand that I am required to notifythe Heatth Department in writing when I cease
rentingth€propsrty.Fa.turetodosomayresuttinth€impositionoffinesand/or'ees.
Town
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QUEsnoNs: Phone *: 508-398-223 1 Ex. 1 240, EmaiL rmedederger@varmosthma'us
APPLICANT SIGNATURE DATE o3 b
tn accordance with 105 CMR 410.560, and oxcopt as provlded in 105 CMR 410.580(Ct (for BUU( itemsl , the own rofanyresidenc€
containing two ot mora dwdlng units, a rooming housa, homctess 3hsltar, or mo dactuBd hoGing community, shalt bs
rasponsiblelor and pay for th6 final colloction ond ultimats disposat of rsfuse'
t, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPTIANCE
wrrH MA srATE SANITARY CODE 105 CMR 410'560 (C) AND 10s CMR 410.560 (4)(E).
OWNER IN]TIALS
-
REPRESENTATIVE PHONE #
REQUIRED
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