HomeMy WebLinkAbout2026 Rental ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUTE 28, SOUTH YARMOUTH, MA 026649
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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, CONTACTTHE HEALTH DEPARTT4ENT
IMT4EDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH I4AY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMITTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:r VERIFICAIION OF ASSESSOR RECORDSo SEPTIC SYSTEM CHECK. NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY:r SEPTIC SYSTEM CAPACIry. NUMBER OF LEGAL BEDROOf4S
WHY THIS MATTERS: THESE MEASIJRES PROTECT DRINKING WA\ER AND AQUIFERS, ESPECIALLYAS THE TOWN
TRANSITIONSTO A FUTURE SEWER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:
. ALL SMOKE DETECTORS & CARBON I'4ONOXIDE DETECTORS HAVE FRESH BATTERIES
. ALL UNITS HAVE BEEN TESTEDANDARE lN PROPER WORKING CONDITION
. ALL UNITS ARE LESSTHAN 1O YEARS OLD
Smoke Detector Location Requirements -Yarmouth. MA -copy avaitabte at Buitding Department
OWNER INITIALS
OWNER CERTIFICATION REOUIRED
ICERTIFYTHAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
FEES PER UNIT)
$180 ANNUALLYSHORT-TERM / WEEKLY RENTALS
RENTALS OF 3 ' DAYS OR LESS
/NSPECZO&SAEOU I RE D YEABU
$80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDITIONAL FEE OF $1OO 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, VISIT THE TOWN OF YARMOUTH HEALTH OEPARTMENT WEBSITE:
th.ma.us/127lHealth
LONG-TERI.,1 / YEAR-ROUND RENTALS
DUPLEVMULTI-FAMILY RENTALS. REFUSE DISPOSAL RESPONSIBILITY
ln accordance with 105 CMR410.560, and except as provided in 105 CMR410.550(C) (forBULKitems), the ownerofany residence
containingtwo or more dwelting units, a rooming house, home[ess shelter, or manufactured housing community, shatl be
responsibte for and pay for the finat cottection and uttimate disposat of refuse.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wtTH MA STATE SANTTARY CODE 10s CMR 41O.s6O (C) AND 10s CMR 410.560 (4XE).
QUESIIONS: Phone #: 508-398-2231 Ex. 1240, Emait: rniederberger@yarmouth.ma.us
RENTAL INFORMATION
INCOMPLETE FORMS WTHOUTA VALID PHONE # OR EMAILWILL NOT BE PROCESSED
RENTALPR.PER*ADDRESS3 / fe. House <./ S. Ya r.noot/ p/A
/noa.r, "/ b ,(y'- 4e noz/PROPERTY OWNER NAME
zz 2ez6 /l-.4?g/zr/rL 6rzythlPROPERTY OWNER MAILING ADDRESS
(9oS)277-7o76PROPERTY OWNER PHONE #
REQUIRED
ALTERNATIVE PHONE #
IF APPLICABLE
PROPERry OWNER EMAIL ADDRESS
REQUTRED y'...12. A nazf @ t"/"., C-a 41
OWN ER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
,.
REPRESENTATIVE PHONE #
REQUIRED
REPRESENTATIVE EMAIL ADDRESS
REQUIRED
RENTAL PERIOD
tr LONG.TERT4/YEAR-ROUND ORT.TERI4/VVEEKLY
TRASH REI"IOVAL BY:
PAID PICK.UPTRASH COMPANY NAME
Xnouse trDUpLEx trcoNDo TAeARTMENT trRooM
RENTAL OF:
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ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughly reviewed and am futty famitiar with the fottowing regutations:
Town of Yarmouth Chapter 108 - Rentat Housing ByLaw, Town of Yarmouth Chapter 104 -Anti-Noise Bylaw, Town ofyarmouth
Short-Term Rentat Bytaw (if appticabte), Massachusetts State Sanitary Code, Chapter ll - Minimum Standards of Fhness for Human
Habitation
These documents are avaitabte for reference on the officiaI Town of Yarmouth website and may atso be obtained upon request from the
Yarmouth Heatth Department. Furthermore, I understand that I am required to notity the Heatth Department in writing when I cease
rentingthe property. Faitureto do so mayresutt in the imposition offines and/orfees.
APPLICANT SIGNATURE
OWNER INITIALS
/owNen tr TENANT
NUMBER OF UNITS FOR RENT:
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