test Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.SHORT TERM RENTAL STREET ADDRESS *Street address of STR as listed in Town recordsSTR Type *Non-owner Occupied; Non owner occupied; A dwelling that is not occupied by an operator/owner, operator/owner adjacentPartially Exempt; A STR property which meets the requirements of Operator/Owner Occupied STR, Operator/Owner Adjacent STR or Resident Operator/Owner Non-adjacent STR.Owner Name *FirstLastMailing AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAs listed in Town Collector records.PhoneEmail *Operator Name / Emergency Contact *FirstLastOperator name and contact information for emergency contact.Phone *24hour emergency phone contactEmail *Operator contact emailBooking Agent / Operator Agent *FirstLastPlatform / Business AgentMA DOR Registration Number *Registration number from MA DOR registration certificateHealth and Safety Compliance *Applicants shall attest under penalties of perjury that a dwelling unit or bedroom offered for STR shall comply with all state and local requirements for health and safety and the Standards of Fitness for Human Habitation as stated in the Massachusetts State Sanitary Code-Chapter ii-105 CMR 410.000Smoke and Carbon Monoxide (CO)Detection *Smoke and CO detection complianceAttest to smoke and CO detection complianceFire Extinguisher Compliance *A fire extinguisher mounted in (or near) kitchens used for the STR in a clearly visible location, or if the unit offers no kitchen, a fire extinguisher will be mounted in a location easily accessible to occupants.Number of Bedrooms *The number of bedrooms / sleeping areas advertised.Number of Bedrooms *Attest to the number of bedrooms / sleeping areas advertised for STR matches BOH records on file for the property listedWater Test Report Click or drag a file to this area to upload. Well water used for drinking or cooking (potable) purposes must be tested prior to initial registration and every subsequent 5 years for attachment to the registration form to ensure that it is safe to use for personal consumption.Parking SpacesNumber of off-street spaces providedClick to Submit Form
