HomeMy WebLinkAboutCI 2936-11r\
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The Commonwealth of Massachusetts
City\Town of
New and Renewal Certificate of Inspection
In accordance with 780 CMR, Chapter 1(77ze Sixth Edition of the Massachusetts State Building Code) and Chapter 304 of the Acts of 2004 (an Act to
further enhance fire and life safety), this certificate of inspection is issued to the premise or structure or part thereof as herein identified.
Idents Name of Establishment
Cert�te No.
Issued to
GRILLE AT BASS RIVER
2936
BASS RIVER GOLF COURSE
Identify property address including street number, name, city or town and county
Certificate Expiration
Located at
62 HIGHBANK ROAD
DECEMBER 31, 2011
SOUTH YARMOUTH, MA 02664
Basement
First Floor
Second Floor
Third Floor
Fourth Floor
Other
Use Group
78 INSIDE
Classification(s)
112 OUTSIDE —
A-3
TOTAL 190
With
TOTAL WITH
Allowable
entertainment:
ENTERTAINMENT:
Occupant Load
50 INSIDE
172 PERSONS
112 OUTSIDE -
This certificate of inspection is hereby issued by the undersigned to certify that the premise, structure or portion thereof as herein specified has been inspected for general
fire and life safety features. This certificate shall be framed behind clear glass and\or laminated and posted in a conspicuous place within the space as
directed by the undersigned. Failure to post or tampering with the contents of the certificate is strictly prohibited.
Name of Municipal
MICHAEL A. WALKER
Name of Local
ANDRE AULT
Date of
Fire Chief
Building Inspector
Inspection
Signature of Municipal
Signature of Local
Date of
Fire Chief
Building Inspector
Issuance
TOWN OF YARMOUTH
0 y BUILDING DEPARTMENT
1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 12
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FONRECEIPT
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APPLICATION FOR CERTIFICATE OF INSPECTION
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Date: February 28, 2011 PAYABLE
)Fee Required—�
( X ) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code, Section 106.5, I hereby apply for a
Certificate of Inspection for the below -named premises located at the following address:
Street and Number:
Name of Premises:17.055 ll, (�O(F(v cL15. _ "J e Tel//PAS✓ v �g 967�
Purpose for which permit is used: 9-eSTouiJ-w%
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
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Certificate to be issued tooum OF )4wWT Rf- Tel:
Address: IIV(e Qf 21r Srwrt, Y i*war4_ 41/, ezzq
Owner of Record of Building e V OF ll�r► rN,if1l.
Address ny(- 2T 2$ 5k+
Present Holder of Certificate yah -%em rEj
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Signature of person to who Title
Certificate is issued or his agent 3 AY i CA 20
Date
Instructions: Make check payable to:
Return this application to:
Town of Yarmouth
1146 Route 28, South Yarmouth, MA 02664
Building Inspector's Office
Please note: Application form with accompanying fee must be submitted for each building or structure or part
thereof to be certified. Application must be received before the certificate will be issued. The building official shall
be notified within ten (10) days of any change in the above information.
PLEASE SEND US A COPY OF YOUR WORKER'S COMPENSATION INSURANCE FORM WITH THIS
APPLICATIO— NNOT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate #
Certificate Dates: 04101/11 — 04/01/12