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Home My WebLink About8A and 8B Rental ApplicationsRENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARf,MENT 1 1 45 ROUIE 28, SOUTH YARMOUITI, MA 026649 E] RENEWAL f] NEWAPPUCANON PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026 APPLICATION PROCESS SUBMITTING THE APPLICAIION DOES NOI AUTOMATICALLY ESUE A RENTAL CERTIFICATE. A BEV.IEwPROCESS FOLLOWS; wHICH INCLUDES:o VERIFICATION OF ASSESSOR RECORDSo SEPflC SYSTEM CHECK o NUMBER OF LEGAL BEDROOMS. VlEw OF PREVIOUS INSPECTIONS OCCUPANCY LIMITS DEIERMINED BYo SEPTIC SYSTEM CAPACITYr NUI\4BER OF LEGAL BEDROOMS WHY THIS MAITERS: THESE MEASURES PROTECT DRINKNA WATER AND AQUIFERS, ESPECIALLY AS THE TOWN TRANSITIONS TO A FWURE SEWFR SYSIEM SMOKE AND CARBON MONOXIDE DETECTORS AS PART OF YOUR COMPLIANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING: ALLSMOKE DETECTORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES ALL UNITS HAVE BEEN TESTEDAND ARE IN PROPER WORKING CONDITION ALL UNITS ARE LESS THAN lOYEARSOLD I OWNER CERTIFICATION REOUIRED I CERTIFY THAT I HAVE COMPLEIED THE ABOVE REQUIREMENTS OWNER INITIALS Smoke Detector Location Reouirements - Yarmouth. MA - copy avaitabte at Buitding Department FEES (PER uNn) SHORT.TERM / WEEKLY RENTALS RENTALS OF 3 7 oAvS OR LESS I NSP ECf IO N S REQU IRED YEARLY $180 ANNUALLY LONG-TERI'4 / YEAR.ROUND RENTALS $80 ANNUALLY PubucHcalth IMPORTANT RENTAL CERTIFICATE NONCE IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATEwlTHIN 30 DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT IMMEDIATELY UNTIL YPIJ.RECEIVE THE CERTIEICATE, YOUR PROPERW IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY RESULT IN FINES AND PENALTIES. A NON-REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED AN ADDMONAL FEE OF ilOO PER UNIT/RENTAL IS REQUIRED FOR SHORT-IERM RENIALS PER BUILDING CODE RENTAL CERTIFICATES EXPIRE ON DECEMBER 315T OF EACH YEAR MAIL OR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTMENT: 1145 ROUTE 28, SOUTH YARMOUTH, MA 02664 TO REGISTER ONLINE AND PAYVIA CREDIT CARD, VISITIffiUTH HEALTH DEPARTMENT WEBSITE: DUPLEVMULThFAMILY RENTALS - REFUSE DISPOSAL RESPONSIBILTTY OWNER INITIALS PHONE # OR EMAILwlLL NOT BE PROCESSEDINCOMPLETE FORMS WITHOUT A VALI RENTAL INFORMANON Jo1atg rH )rlRENTAL PROPERTY ADDRESS o,NO PROPERW OWNER NAME PROPERW OWNER MAILING ADDRESS,I h 7O t\/ u l.HAve t4A 0 PROPERry OWNER PHONE #6f7-?60.-r/ rpREQUIREO 7 &/- z,P v- o7/s ALTERNATIVE PHONE # IF APPLICABLE VERBU4H @ GttATL, Cc^4EPROPERry OWNER EMAIL ADDRESS AGENTOWNER'S REPRESENTATIVE/RE IF APPLICABLE REPRESENTATIVE PHONE * REQUIRED REPRESENTATIVE EMAIL AODRESS REQUIRED ko*n-ra*"rraoR-RouND trsH.RT-TERMMEEKL' RENIAL PERIOD TRASH REMOVAL BY ! OWNER /tE*ort REMAL OF: J,Cor.. ,|NUMBER OF UNITS FOR RENT: tr DUPLEX OCONDO tr APARTMENT trROOM ACKNOWLEDGMENT STATEMENT ereby acknowledge that I have thoroughty reviewed and am futty Iamitiar with the fottowing regutations: Town of Yamouth Chaptor 108 - Rontat Houslng Bytaw, Town of Yarmouth Chapter 1(t4 - Anti-Noise Eytaw, Town of yamouth short-Torm Rentat Bytaw (if appLicsbte), Massachusotts state Sanitarycode, chapter lt -Minimum standards of Fhnass for Human Habitation These documents are avaitabte for reference on the official Town 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 I cease rentingthe property. Failure to do so may resutt in the imposition of fines and/orfees. th qUESnONS: Phone #: 508-398-2231 Ex. 1 mait: rniederberger@yarmouth.ma.us APPLICANT SIGNATURE DATE ln accordance with 105 CMR 410.550, and o(copt 83 provided ln 105 CttlR 410,560(C) (for BULK ttems) , the owner of any residence containing tYUo o. mors dwelling unlts, I ]oomlng houso, homotoss shelter, or manufucturad housing communlty, shelt bo r6sponsibt6 for and paytor the finat cotLcdon and uttimate dkposal o rsfuse. I, THE OWNER, CERTIFYTHAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS,IS IN COMPLIANCE wTH MA STATE SANtTARy CODE 105 CMR410.560 (C) AND 105 CMR 410.560 (4)(E). REQUIRED PAID PICK-UP TRASH COMPAI.IY NAME: ? 7ho$: 9 Pubuc Ileafthtr RENEWAI C] NEW APruCATION PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026 IMPORTANT RENTAL CERfl FICATE NOTICE IF YOU DO NOT RECEME YOUR REITIAL CERTIFICATE WITHIN 30 DAYS OFAPPLYING, CONTACT THE HEALTH DEPARIMENT IM14EDIATELY UNILYOU RECE]VE THE CERTIFICATE, YOUR PROPERiYIS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY RESULT IN FINESAND PENALTIES. APPLICATION PROCESS SUBMITNNG THE APPLICATION DOES NOT AUTOMATICALLY ISS,IJE A RENIAL CERTIFICATE. A REVIEW PROCESS FOLLOWS, WHICH INCLUDES: . VERIFICATION OF ASSESSOR RECORDS. SEPnC SYSTEM CHECK. NUMBER OF LEGAL BEDROOMS . VIEW OF PRMOUS INSPECIIONS OCCUPANCY LIMITS DETERMINED BY. SEPTIC SYSTEM CAPACITY . NUMBER OF LEGAL BEDROOI.4S WHY THIS MANERS:THESE MEASURES PROTECT DRINKING WATER AND AQUIFERS, ESPECIALLYAS THE TOWN TRANSITIONSTO A FUTURE SEWER SYSTEM. SMOKE AND CARBON MONOXIDE DETECTORS AS PART OFYOUR COMPUANCE RESPONSIBILITIES, PLEASE ENSURE THE FOLLOWING:. ALL SMOKE DETECTORS & CARBON MONOXIDE DEIECTORS HAVE FRESH BATTERIES . ALL UNITS HAVE BEEN TESTED AND ARE IN PROPER WORKING CONDITION. ALL UNITS ARE LESS THAN 1O YEARS OLD OWNER CERTIFICATION REqUIRED I CERTIFYTHAT I HAVE COMPLEIEDTHEABOVE REQUIREMENTS OWNER INITIALS - Smoke Detector Location Reouirements - Yarmouth. MA -copy avaitable at Buitding Department FEES (PER UNTT} SHORT-TERM / WEEKLY RENTALS RENIATS OF3' DAYS OR TESS I N S P E CT IO N S REQU I R E D Y EARLY $180 ANNUALLY LONG.TERM / YEAR-ROUND RENTALS $80 ANNUALLY A NON.REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED AN ADDINONAL FEE OF $IOO PER UNIT/RENIAL IS REQUIRED FOR SHORT.IERM RENTALS PER BUILDING CODE RENTAL CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR MAIL OR DROP OFF CHECK TOTHEYARMOUTH HEATTH DEPARTMENT: 1145 ROUTE 28, SOUTH YARMOUTH, MA 02664 ro REGTSTERoNlr"t^"" "''^"it"?'.tffi;l',tJl]iliJ3}"),?i,H1lt"urH HEALTH DEPARTMENTwEBSTTE: RENTAL REGISTRATION APPLICATION 2026 TOWN OFYARMOUTH HEALTH DEPARTMENT 1146 ROUTE 28, SOUIH YARMOUTH, MA 02564 DUPLEX/MULTI.FAMILY RENTAIIi. REFUSE DISFOSAL RESPONSIBILITY ln accordance with 105 CMR 410.560,8nd sxcspt 83 providod ln 105 CMR 410.56O(Cl (ror BUIX itams) , the ownsr of any r€sidence cortaining tro or mors dryelllng unlE, I roomlng house, homoloss sholt6r, or msnutacturud houging communtly, shau be rosponslbto for and pay tor the llnat colloction and ultimato disposal of rofuso. RENTAL INFORMANON INCOMPLETE FORMS WIHOLTT A VALID PHONA# OR EMAILWLL NO-T BE PROCESSED B B Jqln,s P*ru STkkNy,,rH AARENTAL PROPERTY ADDRESS ev.vsHttV,v AveBau t<H /3G S7 sPROPERW OWNER MAILING ADDRESS 6(z -760-e /r.p PROPERry OWNER PHONE # REQUIRED 78/-o7 /9 ALTERNATIVE PHONE # IFAPPLICAELE E / s -t A veRB,otL(/ @ Gtvl r c, c oLl PROPERry OWNER EMAIL ADDRESS REQUIRED OWNER'S REPRESENTATIVURENTAL AGENT IF APPLICABLE REPRESENTATIVE PHONE * REQUIRED &touc-renurwlR-RouND trsHoRT-TERM,.vvEEKLy RENTAL PERIOD TRASH REMOVAL BY tr OWNER PAID PICK-UP TRASH COMPANY NAME #.*o*, ddoraa o orrrEx trcoNDo trA'ARTMENT trRooM NUMBER oF uNrrs FoR REN' I RENTAL OF: ACKNOWLEDGMENT STATEMENT I hereby acknowl,edge that I have thoroughty reviewed and am futty famitiar with the fottowing reguLations: Town ol Yamouth Chaptor 108 - Rentat HoGlnE Bytaw, Town ol Yarmouth Chsptsr 104 - Anti-Noiso By'aw, Town ot Yarmouth Short-Torm Roraal Bytaw (if appticabte), Massachusatts Stato Sanitary Code, Chaptar ll- Minimum Standards ol Fhnsss lor Human Hsbitation These documents are avaitabte for reference on the otficiat Town ofYarmouth website and may atso be obtained upon request from the Yarmouth Heatth Departrnent. Furthermore, I understand thst I am required to notify the Heatth Department in writing wheo lcease rentingthe property. Faiture to do so may resutt in the imposition of fines and/orfees. OUESTIONS: Phone #: 508-398-'l 240, Emait: rniederberger(dyarmouth.ma.us APPLICANT SIGNATURE DATE I, THE OWNER, CERTIFYTHAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UNITS, IS IN COMPLIANCE wTH MA STATE SAN tTARy CODE't0s CMR 410.s50 (C) AND 105 CMR 410.s60 (4)(E). OWNER IN]TIA|.rS - PROPERTY OWNER NAME REPRESEI{IATIVE EMAIL ADDRESS REQUIRED _Uz*a6