HomeMy WebLinkAboutCI 423-00TOWN.OF YARMOUTH
In accordance with the Massachusetts State Building Code, Section 106.5, this
CERTIFICATE OF INSPECTION
is issued to ...... THOMAS . KELLY ...................................................... .
I Certify that I have inspected the SNACK BAR known as . BASS RIVER GOLF COURSE
located at 62 HIGHBANK ROAD in the TOWN o f SOUTH YARMOUTH
County of Barnstable, Commonwealth of Massachusetts. The means of egress are sufficient for the following
number of persons:
BY STORY
Story Capacity Story Capacity Story Capacity
Story Capacity
BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly Place of Assembly
or Structure Capacity Location or Structure Capacity Location
USE GROUP A - 3 :73 PERSONS 1ST FLOOR
CLASS 5-B
# 423 FEBRUARY 16, 2001
Certificate Number
Date Certificate Issued
Date Certificate Expires Building Official
The building official shall be notified within (10) days of any changes in the above information.
TOWN OF YARMOUTH
BUILDING DEPARTMENT
o
` MATi. I 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 260
11.V
/ I ,, APPLICATION FOR CERTIFICATE OF INSPECTION
Date:(AF6n,,
� � o�S� PAYABLE UPON RE
V ( ) Fee Required $ .
( ) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code, Section 108, 15, I hereby apply for a
Certificate of Inspection for the
lI below-namedpremises located at the following address:
Street and Number: too) �-1 1�'li L� nup4qgA
Name of Premises:4nno - IUi t n � K91, l ' i aNx, Te1:'_Q t ��
Purpose for which permit is used:
License(s) or Permit(s) required for the pr es by other governmental agencies:
I �
License or Permit Agency SEP 2 G 000
Ig
Certifica:
Address:
Owner o
Address
Present hoiaer of �,enmcaie
Signature of person to whom
Certificate is issued or his agent
Instructions: Make check payable to:
Return this application to:
Title
Date
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 APPLICATI N OR WE CANNOT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate # ;��
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