HomeMy WebLinkAboutRental Application 2026hblicEeal6D RENEWAI.
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PLEASE REGISTER YOUR RENTAL PROPERW NO LATER THAN APRIL 1 , 2026
IMFORTANT RENTAL CERTIFICATE NONCE
IF YOU DO NOI RECEIVE YOUR RENTAL CERIIFICATE WIIHIN 30 DAYS OFAPPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY UNTIL YOU RECEIVE THE CERTIFICATE, YOUR PROPERry B CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
APPLICATION PROCESS
SUBMITTING THE APPLICATION DOES NOT AUTOMANCALLY ISSUE A RENTAL CERNFICATE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:. VERIFICATION OF ASSESSOR RECORDS. SEPnC SYSTEM CHECK. NUMBER OF LEGAL BEDROOMS. VIEW OF PRMOUS INSPECTIONS
OCCUPANCY LIMITS
DETERMINED BY. SEPnC SYSTEM CAPACITY. NUMBER OF LEGAL BEDROOMS
WHY THIS MAITERSi IHESE ME4SURES PROTEC| DRINKING WA|ER AND AQUIFERS, ESPECIALLY AS THE TOWN
TRANSffIONS TO A FUTURE SEWER SYSIEM.
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIBILIIIES, PLEASE ENSURE THE FOLLOWNG:. ALL SMOKE DETECTORS & CARBON MONOXIDE DETECIORS HAVE FRESH BATTERIES. ALL UNITS HAVE BEEN TESTEO ANO ARE IN PROPER WORKING CONDIION. ALL UNITS ARE LESS THAN lOYEARSOLD
Smoke Detector Location Bequirements -Yarmouth. MA- copy avaitabte at Buitding Department
OWNER INITIALS
OWNER CERTIFICATION REQUIRED
ICERTIFYTHAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
FEES UNIT)
SHORT.TERM / WEEKLY RENTALS
RENTATS OF 3 7 oAyS OR t ESS
INSP ECTIO N S REOU IRED YE ARLY
$180 ANNUALLY
LONG.TER14 / 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.TERM RENTALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR
MAIL OR DROP OFF CHECK TO THE YARMOUTH HEALTH DEPARTHENT:1146 ROUTE 28, SOUTH yARMOUTH, MA 02664
TO REGISTER ONLINE AND PAY VIA CREDIT CARD, VISITIHE TOWN OF YARMOUTH HEALTH DEPARTMENT WEBS]TE:
hups;//ww!vyarmouth.ma
RENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
r 146 ROUTE 28, SOUTH YARMOUTH, MA 026649
kr
DUPI"EX/MUL'11-FAMILY RENrAI-S - REFUSE DlSPtosAL RESPoNStilffii .lt '
ln accordance with 105 CMR 410.560, and o)(c€pt 83 provided in 105 CMR 41O.560(C) (tor BUIK ltEms) , the ownar of any residence
containingturo or mors drrglling untts, a rooming housa, homeless shetter, or menulecturcd housing communlty, shal,l bo
rBponsibte for 8nd paytor the finatcollsction and ultimato disposal ot retuso.
I, THE OWNER, CERTIFYTHAT MY REMIAL PROPERTY, WHICH CONTAINS TWO OR MORE DWELLING UN]TS,IS IN COMPLIANCE
wTH MA STATE SANTARY CODE 10s CMR 410.s60 (C) AND 10s CMR 410.s60 (4)(E).
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RENTAL INFOR ANON
INCOMPLETE FORMS WITHOUT A VALID PHONE # OR EMAILWLL NOT BE PROCESSED
Ir
RENTAL PROPERry
(
ESS
PROPERTY OWNER NAME
N
MAILING ADDRESSPROPERry
Cr \
(n e'*'\2-EIFAPPL
HONE #
qt
PROPERTY OWNER PHONE #'+zzf C xren)o3 LREQUIRED
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OWNER'S REPRESENTATIVE/RENTAL AGENT
IF APPLICABLE
REPRESENTATIVE PHONE *
REQUIRED
REPRESENTANVE EMAIL ADDRESS
REQUIRED
&do*r-r.r"*..*.,tr LONG-TERM/YEAR.ROUND
TRASH REMOVAL BV
PAID PICK.UP TRASH COMPANY NAME As,kh oNN
OWNER tr TENANT
RENTAL OF:
UPLEX trCONDO D APARTMENT trROOMtua
tr HOUSE
ACKNOWLEDGMENT STATEMENT
I hereby acknowtedge that I have thoroughty reviewed and am futtyfami
Town ol yamouth Chaptu I 08 - Rantat Housing Bykw, Town of Yarmouth Chaptor 1 04 - Attti-Noiso Byt8w, Town of Ysrmouth
Shon-T.rm Rontst Bylaw (if appticabte), Massachusstts Stat6 Sanitary Codo, Chaptor ll- Minlmum Stsndards of Fhn6ss lor Human
Habitation
These documents are avsitabte for reference on the otficiatTown ofYarmouth website and may atso be obtained upon request from the
yarmouth Heatth Department. Furthermore, I understand that I am required to notifythe Health Department in writingwhen I cease
rentingthe property. Faiture to do so may resutt in the imposition of fines and/or fees.
tiar with the fottowing regutations:
QUESnONS: Phone #: 508-398-223t Ex. 1240, Emait: rniederberger(ayarmouth ma us
DATE b
9\
)I]O HTV3H
OWNER INITIALS
["1 K,',th,a.*J
PROPERry OWNER EMAIL ADDRESS
REQUIRED
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RENTAL PERIOD:
NUMBER OF UNITS FOR RENT:
APPLICANT SIGNATURE