HomeMy WebLinkAboutCI 131-98C11Ijr of Anosttr4ulul#o
CITY/TOWN OF YARMOUTH
In accordance with the Massachusetts State Building Code, Section 108.15, this
CERTIFICATE OF INSPECTION
THOMASB. KELLY .................
...............................
is issued to ...............................................
.
1 t .... known as.. ,BASS RIVER. GOLF COURSE
1 Tertiflj that I have inspected the...... SNACK.BAR...... • , . , , ................
HIGH BANK ROAD SOUTH YARMOUTH.........._.
located at.... ...............in the.. T��.....of..................
.....................
BARNSTABLE
County of.................Commonwealth of Massachusetts. The means of egress are sufficient for the following
number of persons:
The building official shaZZ be notified within (10) days of any changes in the above information.
BY STORY
Story Capacity
.. Story Capacity
.. Story
Capacity
.. Story Capacity
..
•
•• BY PLACE OF ASSEMBLY
OR STRUCTURE
Place of Assembly
Location
.. Place
:: or
of Assembly
Structure
Capacity Location
or Structure
Capacity
USE GROUP A-3
:73 PERSONS: IST FLOOR
CLASS 5-B
:
.
•FEBRUARY
A•
`6
18. 1999
#131,
to �
Aate C rtificate Issued
Date Certificate Expires
icial
iZdi.ng Official
b
Certificate Numer
The building official shaZZ be notified within (10) days of any changes in the above information.
PERIODIC INSPECTION REPORT
INSTRUCTIONS: THIS FORM IS TO BE COMPLETED EACH TIME A PERIODIC INSPECTION IS MADE. AT p
THE TIME THAT A NEW CERTIFICATE IS ISSUED. A RECEIPT INDICATES THAT A FEE HAS BEEN PAID
WILL BE ATTACHED TO THIS FORM OR THIS FORM WILL BE STAMPED "PAID" PRIOR TO ISSUING THE
CERTIFICATE. ANY CHANGES SINCE THE LAST INSPECTION ARE TO BE ADDED TO THE FILE CARD OF
THE PREMISES. THIS SHOULD BE FILED BY STREET ADDRESS.
STREET AND NUMBER: HIGH BANK ROAD, SOUTH YARMOUTH
NAME OF PREMISES: BASS RTVRR GOT,F COURSF
CERTIFICATE TO BE ISSUED TO: THOMAS B. KELLY
ADDRESS:
OWNER OF RECORD OF BUILDING: TOWN OF YARMOUTH
ADDRESS:
PURPOSE FOR WHICH PREMISES ARE USED: SNACK BAR
USE GROUP CLASSIFICATION OF PREMISES: A -
CHANGES SINCE LAST INSPECTION (REQUIRED ON FILE CARD):
1.
2.
3.
4.
5.
DATE: ORDER ISSUED:
ORDER ISSUED TO:
ADDRESS:
DATE VIOLATION (S) CORRECTED:
I HAVE THIS DAY INSPECTED THE ABOVE DESCRIBED PREMISES, AND THE SAME CONFORMS TO THE PERTINENT
REQUIREMENTS OF THE MASSACHUSETTS STATE BUILDING CODE AND THE RULES AND REGULATIONS
PURSUANT THERETO.
6 1 "7
DATE
CERTIFICATE NUMBER: #131
DATE ISSUED
DATE EXPIRES: FEBRUARY 18, 1999
RECOMMENDED NEXT INSPECTION DATE:
BUILDING OFFICIAL
COMMONWEALTH OF MASSACHUSETTS
/ City/Town of YARMOUTH
APPLICATION FOR CERTIFICATE OF INSPECTION
Date MAY 22, 1998 (DUPLICATE
MAY 2 81998
CERTIFICATE EXPIRED FEBRUARY 18, 19
UPON RECEIPT
Fee Required $ 40.00
) NO Fee Required
In accordance with the provisions of the Massachusetts State
Building Code, Sec. 108,15, I hereby apply for a Certificate of
Inspection for the below -named premises located at the following
address:
Street and Number 62 HIGHBANK ROAD, SOUTH YARMOUTH, MA
Name of Premises BASS RIVER GOLF COURSE SNACK BARTpT._
Purpose for which premises is used S"Arx RAR
License (s) or Permits (s) required for the presises by other govermental
Agencies:
License or Permit Agency
Certificate to be issued to
Address:
Owner of Record of Building—Jp101t
Address & (� =1 66& r—T—l\V
Present Holder of Certificate 7—b
Signature of -Person t�whom Certifi-
cate is issued or his agent
C
Title
at
iga �
**********************************************************************************
Instructions: :Sake Check Payable to
Town of Yarmouth
1146 Route 28 S. Yarmouth, Ma 02664
Return this application to BUILDING INSPECTORS OFFICE
Please note:
Application form with accompaning fee must be submitted for each building or
structure or part thereof to be certified.
,application and fee must be received before the certificate will be ussued.
The building offical shall be notified within ten (10) days ofany change it
the above information./ PLEASE SEND US A COPY OF YOUR
/�
Carcificata +/ / WORKER'S COMPENSATION INSURANCE
/ FORM WITH THIS APPLICATION OR WE CANNOT
ISSUE YOUR CERTIFICATE OF INSPECTION.