HomeMy WebLinkAboutUnit9RentalAppRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
1146 ROUIE 28, SOUTH YARMOUIH, MA026649
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tr NEW APruCATION
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PLEASE REGISTER YOUR RENTAL PROPERW NO LATER THAN APRIL 1, 2026
APPLICATION PROCESS
SUBMTTflNG THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICAIE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:. VERIFICATION OF ASSESSOR RECORDS
. SEPTIC SYSTEM CHECK
. NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY. SEPTIC SYSTEM CAPACIry. NUMBER OF LEGAL BEDROOMS
WHY THIS MATTERS: THESE MEASURES PROTEC| DRINKINGWATER AND AQUIFERS, ESPECIALLY AS fHE TOWN
TRANSMONS TO A FUTURE SEli,lER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:
o A[r SMOKE DEIECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIESo ALL UNITS HAVE BEEN TESTED ANO ARE lN PROPER WORKING CONDflON
. ALL UNITSARE LESS IHAN lOYEARSOLD
OWNER CERTIFICATION REQUIRED
ICERTIFYTHAT I HAVE COMPLETEDTHE ABOVE REQUIREMENTS
OWNER INITIALS
Smoke Detector Location Reouirements -Yarmouth. MA -copy avaitabte at Buitding Department
FEES (PER UNIT)
SHORT.TERM / WEEKLY RENTALS
FE /TALS OF 3
'
DAYS OR LESS
I NSPECI]ONSBEOIJIBEDIEABU
$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/REMTAL IS REQUIRED FOR SHORT.TERM RENTALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31SI OF EACH YEAR
MAIL OR DROP OFF CHECK TOTHE YARMOUTH HEALTH DEPARTMENT:1146 ROUTE 28, SOUTH YARMOUTII, MA02664
TO REGETER ONLINE ANO PAY VIA CREDIT CARD, VISITTHE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSI-TE:
https://www.yarmouth.ma.us/1 27lHealth
IMFORTANT RENTAL CERTIRCATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OFAPPLYING, CONTACTTHE HEALTH DEPARTMENT
IMMEDIATELY UNTILYOU RECEIVE THE CERTIFICATE, YOUR PROPERTY IS CONSIDERED NOT CERTIFIED FOR RENTAI- WHICH MAY
RESULT IN FINES AND PENALTIES.
DUPLEVMULTI.FAMILY RENTALS - REFUSE DISPOSAL RESPONSIBIUTY
ln accordance with I05 CMR 410.560,8nd excspt as provided in I 05 Ct{R 410.560(C) (lor BU1K items} , the owner of any residence
conta ining tyvo or mora dwotling unlts, a rooming house, homsless shelt€r, or manufactuted housing communlty, shall be
rasponsibteror 8nd paylor ths finatcol.lection and ultimate disposat of rstuse.
I, THE OWNER, CERTIFYTHAT MY RENTAL PROPERW, WHICH CONTAINS TWO OR MORE DWELUNG UNTTS,IS IN COMPLIANCE
wTH MA STATE SANTTARY CODE los CMR 410.560 (C) AND lOs CMR410.560 (4XE).
AtowNER tNtrli[Ls Pi L '
RENTAL INFORHATION
INCOMPLETE FORMS WTHOT'T A VAUD PHONE # OR EMAILWLL NOT BE PROCESSED
RET.ITAL PROPERTY ADDRESSd o5 Ht LiQit"t cRau-teL<- RPto + ?
PROPERTY OWNER NAME cpr"do n-t,l*tO^n/ 4olla-B
PROPERry OWNER MAILING ADDRESS30 Fit tmone Rr> 6rctl-r laRuout-na
PROPERW OWNER PHONE #
REQUIRED '?n1- 48+.0qtr?
ALTERNATIVE PHONE #
IF APPLICABLE 1+1-49) pfas-
PROPEFIY OWNER EMAIL ADDRESS
REQUTRED C1 l,t/ K /-l O €L/4 gN CotLl
OWNER'S REPRESENTATIVE/RENTAL AGENT
IFAPPLICABLE Fan
REPRESENIAIIVE PHONE #
REeUIRED ,v A.
REPRESENTATIVE EMAIL ADDRESS
REQUIRED M'e
RENTAL PERIOD:
X lonc-renvryeaR-RouND tr SHORT-TERMA/VEEKLY
TRASH REMOVAL BY
$owrlER tr TENANT
PAID PICK.UP TRASH COMPANY NAME: NI(i|'ET
REMAL OF:
o HousE tr DUpLo< ficoHoo D AeABTMENT oRooM
NUMBER OF UNlTS FOR RENT:
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughly reviewed and am futty famitiar with the fottowing regutations:
Town ot Yamouth Chaptor 1 08 - Rontal Ho$ing 8ylew, Toryn of Yamouth Chaptor I 04 - Arti-Noiss Bytaw, Tos,n of Y.mouth
Short-Torm Rantal Bylaw (if appticabte), MassachuseiG Stato Sanitary Cod6, Chsptsr ll - Minlmum Standards of Fitness for Human
Habitation
These documents are avaitsble for reference on the otficialTown 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 lcease
rentingthe property. Failureto do so may resutt in the imposition offines snd/or fees.
APPLICAM SIGNATURE ^-Cl
r.{_ &3-gG
QUESTIONS: Phone #: 508-398-2231 Ex. 1240, Emai[: rniederberger(ayarmouth.ma.us
C"v*e""^DATE