HomeMy WebLinkAbout56 Mercury 2026 ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
11/rS ROUTE 28, SOUTH YARMOUTH, MA 02664
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PLEASE REGISTER YOUR RENTAL PROPERry NO LATER THAN APRIL 1, 2026
APPLICATION PROCESS
SUBMTTflNGTHE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:
. VERIFICATION OF ASSESSOR RECORDS
o SEPTIC SYSIEM cHEcK
. NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY. SEPTIC SYSIEM CAPACrYo NUMBER OF LEGAL BEDROOMS
WHYTHIS MATTERS: THESE MEASURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLY AS THE TOWN
TRANSITIONS TO A FUTURE SEWERSYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:
o ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES
. ALL UNITS HAVE BEEN TESTED AND ARE IN PROPER WORKING CONDITION
. ALL UNITSARE LESSTHAN lOYEARSOLD
OWNER CERTIFICATION REQUIBED
I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
OWNER INITIALS ck
Smoke Detector tgcatonlequirements: Yarmolth, MA - copy avaitabLe at Buitding Depanment
FEES (PER UNIT)
SHORT-TERM / WEEKLY RENTALS
RENTALS OF 31 DAYS OR LESS
I N S P E CTI O N 5 RE qU R E D YE A R LY
$180 ANNUALLY
LONG-TERM / YEAR-RoUND RENTALS l/,/'$80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDMONAL FEE OF ilOO PER UNIT/RENTAL IS REQUIRED FOR SHORT.IERM RENTALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31SI OF EACH YEARMAIL OR DROP OFF CHECKTOTHE YARHOUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664TO REGISIER ONLINEAND PAY VIA CREDITCARD, VISITTHE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
rmouth.ma-us/1 27lHeattfrh
Public Healtn
IMFOKTANT RENTAL CEHNFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE W]THIN 30 OAYS OF APPLYING, CONTACTTHE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINESAND PENALTIES.
DUPLEVMULTFFAHILY RENTALS - REFUSE DISPOSAL RESPONSIBIUTY
ln accordance with 105 CMR 410.560, and except as provided in 105 CMR 410.560(C) (for BULK itemsl , the owner of any residence
containingtwo or more dtyelling units, a rooming house, homsless she(ter, or manufactursd housing community, shall h
responsible for and payforthe final cotlection and uttimate disposal ot refuse.
I, THE OWNER, CERTTFY THAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wrrH MA srATE SANTTARY CODE t 0s CMR 410.560 (C) AND 10s CMR 410.560 (4XE).
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RENTAL INFORMATION
INCOMPLETE FORMS WITHOUTAVALID PHONE # OR EMAILwlLL NOT BE PROCESSED
RENTAL PROPERry ADDRESS5L lhorc, rv br. 5o'4^ Vaamoc:il
e-/r, ?uoLPROPERry OWNER NAME
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ffit1 Dr:th'&{ k4, ghorra, M* )toc.R MAILING ADDRESSPROPERry
ALTERNATIVE PHONF #
IF APPLICABLE
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OWNER'S REPRESENTATIV ENTAL
PROPERTY OWNER EMAIL ADDRESS
IF APPLICABLE
REeUIRED ODi 4
REPRESENTATIVE EMAIL ADDRESSni'ouiato / /p
{loruo-renurvrnR-RouND trsHoRT-IERM/wEEKLy
RENTAL PERIOD
IRASH REMOVAL BY p6wl,ren DTENANT
trHOUSE FoUPLEX DCONDO DAPARTMENT trROOM
NUMBER oF uNrrs roR ReNt 4
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am fuLtyfamitiar with the fottowing regul.ations:
Town of Yatmouth Chapter 108 - Rontal. Housing Bylaw, Town of Yarmouth Chapte. 104 - Anti-Noise Bt aw, Town ot Yarmouth
Short-Term Rentat Bytaw (if appticabte), MassachusetG Stats Sanhary Code, Chapter ll - Minimum Standards o, Fitness for Human
Habitation
These documents are available for reference on the officiatTown ofYarmouth website and may atso be obtained upon request from the
Yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heatth Department in writing when I cease
rentingthe property. Failure to do so may result in the imposition ofrines and/orfees.
QUESJIONS: Phone #: 508-398-2231 Ex. 1240, EmaiL rniederberger@yarmouth.ma.us
APPLICANT SIGNATURE o[r-oare J zn>L
REPRESENTATIVE PHONE f
REQUIRED tl/A
pAtD ptcK-Up TRASH coMpANy NAME: frnAZo a fuia,a"l b.
RENTAL OF:
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