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Home My WebLink About31 Pond Street 31A Application 2026{;$:+9 Public HeattiJ *.n.*o,- f] NEW APPUCATION PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026 IMPORTANT RENTAL CERTIFICATE NOTICE IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OF APPLYING, CONTACTTHE HEALTH DEPARTMENT IMMEDIATELY UNIILYOU RECEIVETHE CERTIFICATE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAL,WHICH MAY RESULT IN FINES AND PENALTIES. APPLICATION PROCESS SUBMITTINGTHE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH INCLUDES:. VERIFICATION OF ASSESSOR RECORDS r SEPTIC SYSTEM CHECK. NUMBER OF LEGAL BEDROOMS . VIEW OF PREVIOUS INSPECTIONS OCCUPANCY LIMITS DETERMINED BY. SEPTIC SYSTEM CAPACIry. NUMBER OF LEGAL BEDROOMS WHYTHTS MATTERSj rHESE MEASURES PROTECT DRINKINGWATER AND AQUIFERS, ESPECTALLY ASTHE TOWN TRANSITIONSTO A FUTURE SEWER SYSTEM. SMOKE AND CARBON MONOXIDE DEIECTORS AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:. ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERTES ./. ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKTNG CONDIT|ON /o ALL UNITS ARE LESS THAN 1O YEARS OLDr' Smoke Dgtectol LgcatiotrlReouirements - ygmeutthrMA - copy avaitabte at Buitding Department OWNER CERTIFICATION BEqUAEP ICERTIFYTHAT I HAVE COMPLETEO THE ABOVE REQUIREMENTS FEES (PER UNIT) SHORT-TERM / WEEKLY RENTALS RENTAIS OF 3 ' DATS OR LESS INSPECI/ONiREQ U I BED Y E A8 LY $180 ANNUALLY $80 ANNUALLY A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIREDAN ADDITIONAL FEE OF$.tOO PER UN]T/RENTAL IS REQUIRED FOR SHORT.TERM RENTALS PER BUILDING CODERENTAL CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEARMAIL OR DRoP oFF cHEcKTo It{E YARMoUTH HEALTH DEPARTMENT: 1146 ROUTE 28, souT}t yARMoUTH, MA 02664TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE: ulh.ma,uslUZHeatth RENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARTMENT 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664 OWNER INITIALS LONG-TERM / YEAR-ROUND RENTALS ln accordance with | 05 CMR 410.560, and excspt as provided in 105 CMR 4l0.560(C) (for BULK items) , the owner of any residence containing two or more dweLting units, a rooming houso, hometess shelter, or manufactured housing community, shatt be responsible for and pay for the fin8[ collection and ultimate disposat of rsluse. I, THE OWNER, CERTIFY THAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE wTH MA STATE SANTTARY CODE 105 CMR 410.s60 (C) AND 105 CMR 410.s60 (4)(E). OWNER INITIALS QIJESIIOi{S: Ph 8-2291 Ex. 1 240, EmaiL rDiedelberger@yaJ[IlguthJtraJJS RENTAL INFORMANON INCOMPLETE FORMS WITHOUT A VALID PHONE # OR EMAILWLL NOT BE PROCESSED 3l A PonJ Strcct, South Yormouth, MA ozblc\ RENTAL PROPERTY ADDRESS PROPERTY OWNER NAME lsobctto Mcrino PROPERry OWNER I.4AILING ADDRESS 3lF Poi/ Slr:cl , Sou{h Yarnouth, MA 015lDt PROPERry OWNER PHONE # REQUTRED GOC. Zrb. Dr5i ALTERNATIVE PHONE # IF APPLICABLE PROPERry OWNER EMAIL ADDRESS OWNER'S REPRESENTATIVE/RENTAL AGENT IF APPLICABLE REPRESENTATIVE PHONE * REQUIRED REPRESENTATIVE EMAIL ADDRESS REQUIRED RENTAL PERIOD: TRASH REMOVALBY d OWNER PAID PICK-UP TRASH COMPANY NAME: Erothcr's Dispcol D TENANT dHouse n oupt-Ex D coNDo TApARTMENT trRooMRENTAL OF: INUMBER OF UNITS FOR RENT ACKNOWLEDGMENT STATEMENT (ir rontat S:het ttowifodnmafamtialIeweda regungthatavehothfuttyrocaowledknheughvlegeby uthTofarmohac104otarmouthBylawustTpter08RentatHo1rmouthBylawfolangChapteforNCSSHumanndrdsaFitofMnmumStaChaSaStatenitateMassachusettspterCode,a b ryticaeTRetmtnta)Short-ppBytaw APPLICANT SIGNATURE DATE 9.lql,,|^ DUPLEVMULTI-FAMILY RENTALS - REFUSE DISPOSAL RESPONSIBILIW REQUTRED iaymorinoo f Stctal G) gmall.com dloruo-renurvEeR-RouND trsHoRT-rERt4rlvEEKLy Habitation These documents are avaitabLe for reference on the ofticiatTown ofYarmouth website and may atso be obtained upon requestfrom the Yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heatth Department in writingwhen I cease rentingthe property, Faitule to do so may resutt in the imposition ot fines and/orfees' with Anti-NoiseTown