HomeMy WebLinkAbout2026 Rental ApplicationRENTAL REGISTRATION APPLICATION 2026
TOWN OFYARMOUTH HEALTH DEPARTMENT
.I145 ROUTE 28, SOUTH YARMOUTH, MA 026649
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tr NEW APruCAIION
PLEASE REGISTER YOUR RENTAL PROPERTY NO LATER THAN APRIL 1, 2026
IMPORTANTT RENTAL CERTIF]CATE NOTICE
IF YOU DO NOT RECEIVE YOUR RENTAL CERTIFICATE WTHIN 30 DAYS OF APPLYING, CONTACT THE HEALTH DEPARTMENT
IMMEDIATELY UNTILYOU RECEIVE THE CERTIFICAIE, YOUR PROPERry IS CONSIDERED NOT CERTIFIED FOR RENTAL, WHICH MAY
RESULT IN FINES AND PENALTIES.
SUBMTNINGTHE APPLICATION DOES NOT AUTOMANCALLY ISSUE A RENTAL CERNFrcAIE. A REVIEW PROCESS FOLLOWS, WHICH
INCLUDES:
o VERIFICATION OF ASSESSOR RECORDS
e SEPNC SYSTEM CHECK
e NUMBER OF LEGAL BEDROOMS
. VIEW OF PREVIOUS INSPECTIONS
SMOKE AND CARBON MONOXIDE DETECTORS
AS PART OF YOUR COMPLIANCE RESPONSIEILITIES, PLEASE ENSURE THE FOLLOWING:. ALLSMoKE DETECIORS & CARBON MONOXIDE DETECTORS HAVE FRESH BATTERIES. ALL UNITS HAVE BEEN TESTED AND ARE lN PROPER WORKING CONDITION. ALL UNITS ARE LESS THAN lOYEARSOLD
Srnoke Detector Location Requirements - Yarmouth. MA -copy avaitabte at Buitding Department
OWNER INITIALS
OWNER CERTIFICATION REOUIRED
ICERNFYIHAT I HAVE COMPLETED THE ABOVE REQUIREMENTS
FEES uNn)
SHORT.TERM / WEEKLY RENTALS
RENTATS OF 3 ' OAYS OR LESS
INSP ECTIO NS REOU IRED YEARLY
$180 ANNUALLY
LONG-TERM / YEAR-ROUND RENTALS $80 ANNUALLY
APPLICATION PROCESS
OCCUPANCY LIMITS
OETERMINEO BY. SEPTIC SYSTEM CAPACIryo NUMBER OF LEGAL BEDROOMS
wHY THIS MAITERS: rHESF MEASURES PROTECT DR|NKING WA|ER AND AQUIFERS, ESPECTALLY AS THE TOWN
TR,ANSIIIONS fO A FU|URE SEWER SYSTEM.
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A NON.REFUNDABLE APPLICATION FEE OF $80 PER UNIT/RENTAL IS REQUIRED
AN ADDITIONAL FEE OF $1OO PER UNIT/RENTAL IS REQUIRED FOR SHORT-IERM REMIALS PER BUILDING CODE
RENTAL CERTIFICATES EXPIRE ON DECEMBER 31ST OF EACH YEAR
MAIL OR DROP OFF CHECK TO THE YARMOUTH HEALTH OEPARTMENT: | 146 ROUTE 28, SOUTH YARMOUTH, MA 02664TO REGISTER ONLINE AND PAYVIA CREDIT CARD, VISITTHE TOWN OF YARMOUTH HEALTH DEPARTMENI WEBSITE:
DUPIEX/MULTI-FAMILY RENTALS - REFUSE D|SPTOSAL RESFONSTBTUW
In accordance with 105 CMR 410.560, and oxcept ss providod in 105 CMR 41O.S6O(C) (tor BULK itrsms) , the ovvn€r of eny r€sidence
containing tvvo or mol€ duotling units, I roomlnf housa, homalosg shelt6r, or manutacturcd housing communlty, shrll b6
rasponsiblo for and pay tor tho ffnat coltection and ultimate dLposaL of rsftrsa.
I, THE OWNER, CERTIFYTHAT MY RENTAL PROPERTY, WHICH CONTAINS TWO OR MORE OWELLING UNITS, IS IN COMPLIANCE
wTH MA STATE SAN|TARY COOE 10s CMR 410.s50 (C)AND 1Os CMR 410.560 (4)(E).
OVYNER lNlTlAUi . ')J7rh
RENTALINFORHATION
INCOMPLETE FORMS WIHOIJI A VALID PHONE # OR EMAILWLL NOT BE PROCESSED
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RENTAL PROPERW ADORESS
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PROPERry OWNER NAME
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IPRoPERT owNER MetLnc aoo'Agss3Le u)s
PROPERTY OWNER PHONE #
REQUTRED < ^<1ql 5)Vb
ALTERNATIVE PHONE #
IF APPLICABLE
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SENTATIVE/E R AGENT
PROPERW OWNER EMAIL ADDRESS
REQUIRED ona
OWNER'S REPR
IF APPLICABLE
REPRESENIATME PHONE #
REQUIRED
REPRESENIATIVE EMAIL ADDRESS
REQUIRED
--fiiono-renvrveAR-RouND usHoRT-TERM/wEEKLy
RENTAL PERIOD:
TRASH REMOVAL BY
PAID PICK.UP IRASH COMPANY NAME
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RENTAL OF
NUMBER OF UNITS FOR RENT:
ACKNOWLEDGM E NT STATEM ENT
I hereby acknowtedge that I have thoroughty reviewed and am futty famitiar with the fottowing regutations:
Town of Ysrmouth Ch8pt r I 08 - Refitat Housing B! sw, Town ol Yamouth Chaptor 1 04 - Anti-Noisa Bytaq fown ot Yamouth
Short-T.rm Rental, Bytew (if appticabte), Massaclrusatts Strto SanltaryCodo, Chaptsr ll-Minimum Standards of Fitnoss for Human
Habitation
These documents are avaitablefor reference on the otficial Town of Yatmouth website and may atso be obtained upon request from the
Yarmouth Heatth Department. Furthermore, lunderstand that I 8m required to notify the Heatth Department in writingwhen lcease
rentingthe property. Fai(ure to do so may resutt in the imposition of fines and/or fees.
QUESnONS: Phone #: 508-398-2231 Ex. 1240, Emait: rniederberger@yarmouth.ma.us
APPLICANT SIGNATURE DATE 5-/a'aaaA
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