HomeMy WebLinkAboutCI 19-960l p Tainittanwralt4 of Massttdaurtts
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' CITY/TOWN OF YARMOUTH
In accordance with the Massachusetts State Building Code, Section 108.15, this
CERTIFICATE OF INSPECTION
is issued to ....... THOMAS B. KELLY & MICHAEL BEAN
1 !tt t........................................................................ ...............
1 Y1Pl�ii1, that I have inspected the...... , SNACK. BAR , , .......... • , known as.. BASS RIVER GOLF COURSE
.......................
located at......... HIGH .BANK. RQ AD.............. in the.. TOWN .....of....... AQVTH .YARMOUTH.............
County of.. BARNSIABLE ..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 �•
#19 FEBRUARY 18, 1997
Certificate Number Date C rti i ate Issued Date Certificate Expires uilding Official
The building official shall be notified within (10) days of any changes in the above information.
CTION REPORT
Instructions: This form is to be completed each time a periodic-inspe�.
is made. At the time that a nese certificate is issued, a receipt indict:
that the fee has been paid will'be attached to this form or this form w_
be stamped "PAID" prior to issuing the certificate. -Any changes since t
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,. MA. 02664•
Name of Premises: BASS RIVER GOLF COURSE
Certificate to be Issued to: THOMAS B. KELLY/MICHAEL BEAN
Address:
Owner of Record of Building: TOWN OF YARMOUTH
Address:
Purpose for which premises are used: SNACK BAR
Use Group Classification of Premises: A_3
Changes since last inspection (Required on File Card)
1.
2.
3.-
4.
5.
Date Or=e= Issued:
rder Issued to:
Address:
Date violation(s) corrected:
Remarks:
have t -his day inspected the above described premises, and the same ccnf-
o the pertinent requirements of the Massac.1-isuetts State Building Code ar.t
he rules and regulations pursuant thereto.
DATE
ertificate Number #19
ate Issued'
ate Expires FEBRUARY 18, 1997
ecommended next inspection date
_�i1,PCf11s1
BUILDING OFFICIAL
N
COMMONWEALTH OF MASSACHUSETTS
JCity/Town of YARMOUTH
APPLICATION FOR CERTIFICATE
CERTIFICATE EXPIRES FEBRUARY 18, 1996
Date FEBRUARY 13, 1996
0
INSP'EC`T JP
--4-0.00
( ) 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 0266644 C
Name of Premises BASS RIVER GOLF COURSE SNACK BAR TFT. _
Purpose for which premises is used SNACK BAR
License (s) or Permits (s) required for the presises by other govermental
Agencies:
License or Permit Agency
Certificate to be issued to 10105 3 k
Address: /.x arcgr3'f'o? (', l\ .5
l�frcff►fu � �s9K/mrr '3/ 11 /da,6
Owner of Record of Building YIlf;r oa7ll
Address
Present Holder of Certificate 61f'9t6 /}S &136//,r
Signature of erson to/whom Certifi- Title
cate is issued or his agent
ate
**********************************************************************************
Instructions: :fake 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 in
the above information. PLEASE SEND US A COPY OF YOUR
WORKER'S COMPENSATION INSURANCE
Certificate J 19 -9(o FORM WITH THIS APPLICATION OR -WE CANNOT
ISSUE YOUR CERTIFICATE OF INSPECTION.