HomeMy WebLinkAbout54 Mercury 2026 Application1*.n.,ro,-f] NEW APPLICATION
RENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 2A, SOUTH YARMOUTH, MA 02664
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PLEASE REGISTER YOUR RENTAL PROPERTY NO LATERTHAN APRIL 1, 2026
SUBMTTNNG THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:
o VERIFICATION OF ASSESSOR RECORDS
o SEPTIC SYSTEM CHECK
e NUMBER OF LEGAL BEDROOMS
. VlEw oF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BYo SEPTIC SYSTEM CAPACIY. NUMBER OF LEGAL BEDROOMS
wHY THts MATTERS: IHESE MEASURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLY AS THE roWN
TRANSITIONS TO A FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:. ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIESo ALL UNTTS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDITION. ALL UNITSARE LESS THAN 10 YEARS OLD
OWNER CERTIFICATION REQUIRED
ICERIIFYTHAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
OWNERINMA6 C(
Smoke Detector Location Requirements - Yarmouth, MA- copy avaitable at Bui(ding Department
FEES (PER UN
SHORT.TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS OR TESS
I N SP ECTI O N S REQA I B E A YE A RLY
$180 ANNUALLY
LONG-TERM / YEAR-ROUND RENTALS u,/
A NON-REFUNDAELE APPLICATION FEE OF $80 PER UNtT/RENTAL IS REQUIRED
AN ADDMONAL FEE OF $1OO PER UNIT/RENTAL IS REQUIRED FOR SHORf,.IERM RENTA1S PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31SI OF EACH YEAR
MAlt OR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUrH YARMOUTH, MA 02664
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISITTHE TOWN OF YARMOUTH H EALTH DEPARTMENT WEBSIIE:
/www.yarmouth.ma .usl1 27 l1ea\h
IMPORTANT RENTAL CERTIFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CEBTIFICATE WTTHIN 30 DAYS OF APPLYING, CONTACTTHE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
$80 ANNUALLY
DUPLEVMULTI-FAMILY RENTALS. REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 410.560(c) (tor BULK items) , the owner of any residence
containingtwo ormore dlyelling units, a rooming house, homeless shelter, or manufacturad housing community, shall be
responsible forand payforthelinal coltection and ultimate disposat ot refuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wTH MA STATE SANITARY CODE't05 CMR 410.s60 (C) AND 1Os CMR 4.!0.550 (4)(E).
OWNER INITIALS CK
RENTAL lNFORMANON
INCOMPLETE FORMS wlTHOUTAVALID PHONE # OB EMAIL WILL NOT BE PROCESSED
,+ llAenrat ba Seutl-. Yn mr*tLRENTAL PROPERry ADDRESS
PROPERTY OWNER NAME I
PROPERTY OWNER I.4AILING ADDRESSt? |ekfrp* Rd,SL-","n,tvla 0 zo67
pRopeRry owNdf, pnorue *
78r-363- 6z-11REQUIRED
ALTERNATIVE PHONE #
IFAPPLICABLE 1
i O 4ma,(, an
PROPERry OWNTR EI.4AIL ADDRFSS
REQUIRED DO LC
N/A
owN ER's REpRESENrnrverREfi rer loerl-
IF APPLICABLE
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REPRESENTATIVE PHONE #
REQUIRED
{/rtREPRESENTATIVE EMAIL ADDRESS
REQUIRED
RENTAL PERIOD:
tr SHORT-TERM^lvEEKLY
pArD ptcK-up rRAsH coMpANy NAME , rttn azo n
TRASH REMOVAL BY
()
Xowrurn tr TENANT
Dr
fouerex trcoNDo tr AeARTMENT trRooM
RENTAL OF:
tr HOUSE
NUMBER OF UNITS FOR RENT:L
ACKNOWLEDGMENT STATEMENT
These documents are avaitable for reference on the officiatrown ofYarmouth website and may atso be obtained upon request from theYarmouth Heatth Depanment. Furthermore, lunderstand that lam required to notify the Heatth Department in writingwhen lceaserentingthe property. Faiture to do so may resutt in the imposition offines and/orfees.
I hereby acknowtedge that I have thoroughly reviewed and am ful
Town ofYarmouth Chapter 108 - Rental Housing Bytaw, Town of yarmouth
Short-Term Rental. Byl,aw (if appticabte), Massachusetts State Sanitary Code,
Habitation
QUEStrONS: Phone #: 508-398-2231 Ex. 1240, EmaiL rnied€rberger@yarmoutb.ma.us
ty famitiar with the fottowing regutations:
Chapter 104-Anti-Noise Bylaw, Town of yarmouth
Chapter ll - Minimum Standards ot Fitness for Human
APPLICANT SIGNATURE frrL DATE 7 t1 ZICZL
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