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Home My WebLink AboutRental ApplicationDUPLEVMULTI-FAMILY RENTALS . REFUSE DISPOSAL RESPONSIBILITY I, THE OWNER, CERTIFY THAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE wtTH MA STATE SANTTARY CODE lOs CMR 410.s60 (C) AND 10s CMR 410.560 (4)(E). OWNER INITIALS 4R- RENTAL INFORMANON INCOMPLETE FORMS W|THOUT A VALID PHONE # OR EMAILW|LL NOT BE PROCESSED RENTAL PROPERry ADDRESS4lo sfat.r..An- PROPERTY OWNER NAME A \r'tu..;-o- fZe-^cn PROPERTY OWNER I.4AILING ADDRESS PROPERTY OWNER PHONE # REQUTRED 5 Dg 3=2- 11. l-+ ALTERNATIVE PHONE # IF APPLICABLE PROPERry OWNER EMAIL ADDRESS "o''"'a\-lS-:..r.- \2 3 .r @rr,.4 "^J c-s* OWNER'S REPRESENTATIVE/RENTAL AGENT IF APPLICABLE REPRESENTATIVE PHONE # REQUIRED REPRESENTATME EMAIL ADDRESS REQUIRED RENTAL PERIOD: tr LoNG-TERM^/EAR-Rou ND 4as-nonr-reRvrweerrv TRASH REMOVAL BY "t-owr.ren ] TENANT PAID PICK-UP TRASH COMPANY NAI.4E RENTAL OF: WOUSC tr DUPLEX DCONDO N APARTi.4ENT CROOM NUMBER OF UNITS FOR RENT: / ACKNOWLEDGMENT STATEMENT I hereby acknowtedge that I have thoroughty reviewed and am futtyfamitiar with the fottowing regutations: Town ofYarmouth Chapter 108 - Rentat Housing Bytaw, Town ofYarmouth Chapter 104 -Anti-Noise Bytaw, Town ofyarmouth Short'Term Rental Bytaw (if appticable), Massachusetts State Sanitary Cods, Chapter ll - Minimum Standards of Fitness for Human Habitation These documents are availabte for reference on the otficiatTown of Yarmouth website and may also be obtained upon request from the Yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heal.th Department in writing when I cease renting the property. Failure to do so may resutt in the imposition of fines and/or tees. QIJEITIONS: Phone #: 508-398-2231 Ex. 1240, Emait: rnjederLerger@yarmquth.ma.us APPLICANT SIGNATURE DATE ln accordance with 105 CMR410.560, and except as provided in 105 CMR410.560(C) (for BULx items), the owner ofany residence containingtwo or more dwelting units, a rooming house, homeless shelter, or manutacturod housing community, shalt be responsibts for and pay tor lhe finat qoltoction and ultimate disposal. of refuse. RENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARTMENT 1146 ROUTE 28, SOUTH YARMOUTH, MA 026549 Public Healthf] RENEWAL E] NEW APPLICATION PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026 IMPORTANT RENTAL CERTIFICATE NOTICE IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 3O DAYS OF APPLYING, CONTACITHE HEALTH DEPARTMENT IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH T4AY RESULT IN FINES AND PENALTIES. APPLICATION PROCESS SUBMITTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH INCLUDES: o VERIFICATION OF ASSESSOR RECORDS . SEPTIC SYSTEM CHECK r NUMBER OF LEGAL BEDROOMS . VIEW OF PREVIOUS INSPECTIONS OCCUPANCY LIMITS DETERMINED BY: . SEPTIC SYSTEM CAPACIW. NUI4BER OF LEGAL BEDROOMS WHYTHIS MATTERS: IHESE MEASURES PROTECT DRINKINGWATER AND AQUIFERS, ESPECIALLY AS THE TOWN IMNS/I/ONS TO A FUTURE SEWER SYSIEM. SMOKE AND CARBON MONOXIDE DETECTORS AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING: . ALLSMOKE DETECTORS & CARBON MONOXIOE DETECTORS HAVE FRESH BATTERIES. ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDtTloN . ALL UNITS ARE LESS THAN 1O YEARS OLD Smoke Detector LocationAcsu[enoclls Ylrmguti-l{A - copy avaitabte at Buitding Department OWNER CERTIFICATION REQUIRED I CERTIFY THAT I HAVE COMPLETED THE ABOVE REQUIREMENTS FEES PER UNIT) UALNN$SHORT.TERM / WEEKLY RENTALS RENTATS OF 3 1 DAYS OR LESS INSPECr/ONS EEQU I R ED Y E A8 LY $80 ANNUALLY LONG-TERM / YEAR-ROUND RENTALS OWNER INITIALS -- A NON-REFUNOABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED AN ADDITIONAL FEE OF 31OO PER UNIT/RENTAL IS REQUIRED FOR SHORT-TERM RENTALS PER BUILDING CODE RENTAL CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR MAIL oR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT: 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664 TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISITTHE TOWN OF YARMOUTH HEALTH DEPARTI'4ENT WEBSITE: https:lwwwJarmouth.ma.us/127lllcaltb