HomeMy WebLinkAbout54 Wimbledon Rental App@
b\00 RENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARf,MENT
1146 ROUIE 28, SOUTH YARMOUTH, MA 02664
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E] RENEWAL
tr NEWAPruCANON
9
RECEIVED
APR 23 20?6
HEALTH orpt
PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026
IMPORf,ANT RENIAL CEFTIHCATE NOTICE
IFYOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WITHIN 30 DAYS OFAPPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry lS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINESAND PENALTIES.
APPLICATION PROCESS
SUBMTTTING THE APPLICATION DOES NOT AUTOMATICALLY ISSUE A RENTAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:
o VERIFICATION OF ASSESSOR RECORDS
. SEPTIC SYSTEM CHECK
. NUMBER OF LEGAL BEDROOMS
. VIEWOF PREVIOUS INSPECTIONS
DETERMINED BY
o SEPTIC SYSTEM CAPACITY
o NUMBER OF LEGAL BEDROOMS
WHY THIS MATTERSi IHESE MEASURES PROTECT DRINKING WAiER AND AQUIFERS, ESPECIALLY AS fHE TOWN
TRANSITIONS TO A FWURE SEI4/ER SYSTEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OFYOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWNG:
o ALL SMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES. ALL UNITS HAVE BEEN TESTED ANO ARE lN PROPER WORKING CONDITION
. ALL UNITSARE LESS THAN 1O YEARS OLD
OWNER CERTIFICATION REQUIREO
ICERTIFYTHAT I HAVE COMPLETED THE ABPVE REQUIREMENTS
11,
OWNER INITIAI.S H V
Smoke Detector Location Requirements -Yarmouth. MA -copy avaitabte at Buitding Department
FEES (PER UNTT)
SHORT.TERM / WEEKLY RENTALS
RE /rArS OF 3 ' DAyS OR LESS
I N SP E CT I O N S REO U I R E D Y E ARLY
$180 ANNUALLY
LONG.TERM / YEAR-ROUND RENTALS
$80 ANNUALLY
A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDITIONAL FEE OF $1OO PER UN]T/RENTAL 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, SOUIH YARMOUTH, MA 02664
TO REGISTER ONLINE AND PAYVIA CREDIT GARD, VISITTHE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBSITE:
httos://wwwyarmouth.ma.us/1 27lHeatth
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PublicHcalth
OCCUPANCY LIMITS
DUPLEVMULTI.FAMILY RENTAUi. REFUSE DISPOSAL RESFONSIBIUTY
ln accordance with 105 CMR410.560,8nd €xc€pt 8s providod ln 105 CMR 410.560(C) (for BU]I( it ms), the owner of any residence
containing turo or mors d\.6tllng unlts, a rcomlng houss, homolass sholt6r, or manufrctursd housing communlty, shalt bs
rasponslblo ior and pay ior the ffnal cotlection and [ltimate disposal of rofuso.
I, THE OWNER, CERTIFY THAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE
wtTH MA STATE SANtTARy CODE .t05 CMR 410.s60 (C)AND 105 CMR 410.s60 (4)(E).
RENTAL INFORMANON
INCOMPLETE FORMS WTHOUT AVALID PHONE # OR EMAILwlLL NOT BE PROCESSED
\sr-Q\-a0ss $ynue . \^1. KrvusJR-r, ftu o16r
RENTAL PROPERry ADDRESS
Aux C , \)rc-$,=PROPERTY OWNER NAME
5q u)\Lr.gt-e)c1.: f$etirs \t.t, \\t-".&, Un or"-7
PROPERTY OWNER MAILING ADDRESS
:
PROPERTY OWNER PHONE #
2o3*3\t.1 -6\o?
ALTERNATIVE PHONE #
IF APPLICABLE ^-/ft
Gnq.c'.rtcevrl z1-p $-vvwn-' c ow-t
PROPERTY OWNER EMAIL ADDRESS
REQUIRED
OWNER'S REPRESENTATIVVRENTAL AGENT
IF APPLICABLE
n-'/ n
REPRESENTATIVE EMAIL ADDRESS
REQUIRED /fi
M6HoRr-reRurweerrv
RENTAL PERIOO:
tr LONG.TERM/YEAR-ROU ND
TRASH REMOVAL BY d6**.*tr TENANT
PAID PICK-UP TRASH COMPANY NAME:
drortt D DUpLEx trcoNDo tr A'ARTMENT trRooM
NUMBER OF UNITS FOR RENT:
RENTAL OF:
I hereby acknowtedge that I have thoroughty reviewed and am futty famitiar with the fotlowing regutations:
Town of Yamouth Chaptor I 08 - Ront8l HoBing Bytaw, fown ot Ysmouth Chafior 1 04 - Anti-Nolsc Bytaw, Town ol Ya.mouth
Short-T.rm Rorltat Bytsw (if appticabte), Massachusotts Stato Senltary Cods, Chaptor ll - Minlmum Standards ot F'ltnoss tor Human
Habkation
These documents are available for reference on the official Town ofYarmouth webshe and may atso be obtaioed upon request from the
Yarmouth Heatth Department. Furthermore, lunderstand that lam required to notify the Heatth Department in writing when lcease
rentingth€ property. Faiture to do so may resutt in the impositon offines and/orfees.
QUESTIONS: Phone #: 5 2231 Ex.rniederberger@yarmouth.ma.us
APPLICANT SIGNATURE
240,
DATE 76
OWNER INITIALS
5
REQUIRED
/h
REPRESENTATIVE PHONE #
REQUIRED
ACKNOWLEDGME].IT STATEMENT
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