HomeMy WebLinkAbout2026 Rental Application9
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PLEASE REGISTER YOUR RENTAL PROPERW NO LATER THAN APRIL 1, 2026
IMPORTANT RENTAL CERf,IFICATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WTHIN 30 DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY UNTILYOU RECEIVE THE CERTIFICATE, YOUR PROPERry E CONSIDERED NOT CERTIFIED FOR RENIAL WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMIIflNGTHE APPLICATION DOES NOT AUTOMA]ICALLY ISSUE A RENTAL CERNFICATE. A REV|EW PROCESS FOLLOWS, WHICH
INCLUDES:o VERIFICATION OF ASSESSOR RECORDS. SEPTIC S\6IEM CHECKr NUMBER OF LEGAL BEDROOMS. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DEIERMINED BYo SEPTIC SYSTEM CAPACITYI NUMBER OF LEGAL BEDROOMS
WHY THIS MATTERS: rHESE MEASURES PROTEC| DRINKING WA\ER AND AQUIFERS, ESPECIALLY ASTHE |OWN
IRANSMONS TO A FWURE SEWER SYSIEM
AS PART OFYOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:o ALL SMOKE DEIECTORS & CARBON MONOXIDE DEIECTORS HAVE FRESH BATTERIES. ALL UNITS HAVE BEEN TESTED ANO ARE lN PROPER WORKING CONDflON
. ALL UNITS ARE LESS THAN lOYEARSOLD
OWNER INITIALS Df7
Smoke Detector Location Requirements -Yarmouth. MA-copy avaitabte at Euitding Department
FEES uNn)
$180 ANNUALLY
LONG.TERM / YEAR-ROUND RENTALS $80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDMONAL FEE OF$1OO PER UNIT/RENTAL IS REQUIRED FOR SHORT.IERM RENTALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR
MAIL OR DROP OFF CHECK TO THEYARMOUTH HEALIH DEPARTMENT:1146 ROUTE 28, SOUTH YARMOUI}I, MA 02664
TO REGISIER ONLINE AND PAY VIA CREDII CARD, VISIT THE TOWN OF YARMOUTH HEALTH DEPARIMENT WEBSITE:
https://www.varmouth.ma,us/1 27lHealth
RENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1 1 46 ROUTE 28, SOUTH YARMOUTH, MA 02664
SMOKE AND CARBON MONOXIDE DETECTORS
OWNER CERTIFICATION BEOUIRED
ICERTIFYTHAT IHAVE COMPLETED THE ABOVE REQUIREMENTS
SHORT-TERM / WEEKLY RENTALS
RENIALS OF 3 , D/AYS OR IESS
I NSPECf IO NS REQU I RED YEARLY
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DUPI"EVMULTI.FAMILY RENTAITS - REFUSE DISFOSAL RESPONS]BIUTY
ln accordance with 105 CMR 410.560, and arcopt as provided in 105 CMR410.560(C) (tor BULK itams) , the ownsr of any resid€nce
conteining two or mol€ drYolllng unttt, a roomlng house, homaless sholtol, or manufactuad hoBlng communtty, ahall bo
r€sponsiblo toa a nd pay tor th€ ffnal cotloction end ultimato dlsposal ol rofuso.
I, THE OWNER, CERTIFYTHAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wtTH MA STATE SANtTARy CODE 10s CMR 410.560 (C) AND 10s CMR 410.s60 (4)(E).
OWNER INITIALS cq
RENTAL INFORHANON
INCOMPLETE FORMS WITHOI'T A VAUD PHONE # OR EMAILWLL NOT BE PROCESSED
I BAz4I/FC*D <J V,+fula.n* fuar 036 zs
RENTAL PROPERTY ADDRESS
Da ibii,o B*o ua Cozprxru RoQt,use.o - E&opNPROPERry OWNER NAME
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OWNER MAILING AODRESS
17+ - Sl2'fls 3o
PROPERTY OWNER PHONE #
REQUIRED q/6 //co
ALTERNATIVE PHONE #
IFAPPLICABLE
REQUTRED 7 7+ da rnkn@ qrrza, / -c ooe dD.. 4o//a.nrob,n-s"n
PROPERry OWNER EI'4AIL ADDRESS
61€ Orrta,(A
owNER's REPREsErutarwnevreL aUEut
IF APPLICABLE
REPRESENTATIVE PHONE #
REQUIRED
BtoNG-rERM/vEAR-RouND g3uont-renurweexLv
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TRASH REMOVAL BY
PAID PICK-UP TRASH COMPANY NAME
Iz,owrurn D TENANT
y'House tr DUpLEx ocoNDo tr AeARTMEM trRooM
REMAL OF:
NUMBER OF UNITS FOR RENT
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am futty famitiar with the fotlowing regutations:
Torvn of Yamol,th Chsptrr 108 - Rontal Houlna Bytaw, Town ot Ysmouth Chapter 104 - Ant-Noisc Bylaw, Town of Ylrmouth
Short-Ts]m Ront8L Bytaw (if sppticabte), Massachusetts State Sanitary Codo, Chapter ll- Mlnimum Standards ol Fitness tor Human
Habitation
These documents are avaitabte for reference on the officiat Town ol Yarmouth website snd may atso be obtoined upon request from the
Yarmouth Heatth Department. Furthermore, I understand that I am required to notify the Heatth Department in w ting when l cease
renting the property. Failure to do so may result in the imposition offines and/or fees.
APPLICANT SIGNATURE in)..------.')DATE
1
I
REPRESENTAIIVE EMAIL ADDRESS
REQUIRED
RENTAL PERIOD:
QUESnONS: Phone #: 508-398-2231 Ex. 1240, Emai[: rniederberger@yarmouth.ma.us
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