HomeMy WebLinkAboutCI 8-88- CITY/TOWN OF YARMOUTII
In accordance with the Massachusetts State Building Code, Section 108.15, this
w
CERTIFICATE OF INSPECTION
is issued to ....LOUIS COLUMBO .......................................................................
TPiYIf lj that I have inspected the. COFFEE, SHOP ... . . . . . . . ....... . k,t� as. BASS .RIVER, GOLF, COURSE
HIGH BANK ROAD TOWN. SOUTH YARMOUTH
located at.................................:......an the ..... -.......of. ...................................
..
BARNSSTABLE
County of....... ..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 .4-B
#8FEBRUARY 18, 1989
Certificate Number DatelCertfificate Issued Date Certificate Expires Building Official
The building official shall be notified within (ZO) days of any changes in the above information.
PERIODIC INSPECTION REPORT
Instructions: This form is to be completed each time a
inspection is made. At the time that a new certificate
indicating that the fee has been paid will be attached t
will be stamped "PAID" prior to issuing the certificate.
last inspection are to be added to the file card of the
should be filed by street address.
Street and number: High Bank RoaD, South Yarmouth
Name of premises: High Bank Golf Course, Coffee Shop
Certificate to Issued to: Louis Columbo
Address:
Owner of Record of Building: Town of Yarmouth
Address:
Purpose for which premises are used: coffee shop
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:
periodic ,
is issued, a recAipt
o this form or this for
Any changes since the
premises. This form
I have this day inspected the above described premises, and the same conforms
to the pertinent requirments of the Massachusetts State Building Code and the
rules and regulations pursuant thereto.
DATE
Certificate Number #8
Date Issued
Date Expires
Recommended next inspection date
jlo::r
BUILDING OFFICIAL
Date 1/14/88
CWCXON"e7EALTH OF KXSSACHUSETTS
City/Town of YAR.�fOUTH
APPIO 5901 C
ICATE OF INSPECTION
(x ) 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 :lumber High Bank Road, South'Yarmouth
Name of Premises Bass River Golf Course
Purpose for which premises is used Coffee Shop
License (s) or Permits (s) required for the presises by other govermental
Agencies:
License or Permit Agency
U D
Certificate to be i sue to C /JAL
Address: l
Owner of Record of Bu lding tG / 6 U
Address
Present Holder of Certificate
Signa ure of Person to whom Certifi- Title ro
cate is issued or his agent
Date
Instructions: Make 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.
Certificate # S) R �)