HomeMy WebLinkAboutCI 120-93Mit (bututuumaWl of Mumu lluuu#g
CITY/TONN OF YARMOUTH
In accordance with the Massachusetts State Building Code, Section 108.15, this
CERTIFICATE OF INSPECTION
.
is issued to ....................... T!IOMAS B. KELLY, & . MICHAEL _ BEAN
.................................. 0 ....... ......................... . . . .
SNACK BAR BASS RIVER GOLF COURSE
�P1'tlfl� that I have Inspected the.................................knoras as...........................
located at..........:. HIGH, BANK ROAD ................ in the.. TOS ..... of ....., • SOUTH.YARMOUTH
......
....................
County of...94WATUW.Commonwealth of Massachusetts.
number of persons:
The means of egress are sufficient for the following
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:IST FLOOR
CLASS 5—B
#120 -7 FEBRUARY 18, 1994
Certificate Number Nt-e Certificate Xa8ued Acte Certificate Erpsrea Pli,
Ing OfflczaZ
The building official shalt 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 the time that a new certificate is issued, a receipt indicating
that the 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 form
should..be filed by street address.
Street and number: HIGH BANK ROAD, SOUTH YARMOUTH, MA
Name of Premises: BASS RIVER GOLF COURSE -
Certificate to be Issued to: THOMAS B. KELLY/MICHAEL BEAN
Address: 12 MORNING DRIVE, SOUTH YARMOUTH, MA
Owner of Record of Building: TOWN SNACK BAR
Address:
Purpose for which premises are used: SNACK RAR
Use Group Classification of Premises: A-3
Changes since last inspection (Required on File Card)
1.
2.
3.
4.
5.
Date Order Issued:
Order Issued to:
Address:
Date violation(s) corrected:
Remarks:
I have this day inspected the above described premises, and the same conforms
to the pertinent requirements of the Massachsuetts State Building Code and
the rules and regulations pursuant thereto.
(,4:z
DATE
Certificate Number #120
Date Issued
Date Expires FEBRUARY 28, 1994
Recommended next inspection date
Q:A✓�
BUILDING OFFICIAL
Date
COMMONWEALTH OF MASSACHUSETTS
• City/Town of YARMOUTH
APPLICATION FOR CERTIFICATE OF INSPECTION
MAY 1 8
41--
In actor ce wi pr
Building Code, Sec. I er
Inspection for the below -name
address: 'I
Street and ;Number 'NKA
PAYABLE UPON RECEIPT
( ee Required $ kj6l�
( ) NO Fee Required
'sions of the Massachusetts State
by apply for a Certificate of
mises located at the following
Name of Premises VP�
Purpose for which premises is used 'Q0,0
License (s) or Permits (s) required for the presises by other govermental
Agencies:
License or Permit Agency
Certificate
Address:
Owner
Address Lz
Present Holder o
Certificate,(
�1�-� � Gcc,1L,.�C •
Signature of Person to whom Certifi— Title
tate is issued or his agent
ate
Instructions: :take 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 _
1� �� WORKER'S COMPENSATION INSURANCE
Car tificate r1 1 FORM WITH THIS APPLICATION OR WE CANNOT
ISSUE YOUR CERTIFICATE OF INSPECTION.