HomeMy WebLinkAboutCI 24-85CITY/TOWN OF YARMOUTH
In accordance with the Massachusetts State Building Code, Section Z08.15, this
CERTIFICATE OF INSPECTION
LOUIS
is issued to ......................................... COLUMBO
-.,
County of.. BARris� 4$....Comnonwealth of Massachusetts.
number of persons:
BY STORY
Story. "Capacity• .. Story Capacity ..
The means of egress are sufficient for the following
Story Capacity .. Story Capacity
. i BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly •. Place of Assembly
or Structure Capacity : Location :: or Structure : Capacity : Location
USE GROUP A-3 73 PERSONS 1st. FLOOR •• '
CLASS 4-B
#24 FEBRUARY 16. 1986
Certificate Number Dare Certificate Issued Atte Certificate Expires Building Official
The buildi,ng.official shalt be notified within (Z0) days of any changes in the above information.
Y Tfrttfg that I have
inspected
the.C91ffEE•SHOP.0
...:........:.•....
known as.•BASS•RIVER,GOLF,FOURSF,,,
HIGH BANK EGAD
located at. ..........................
TOWN...... of...
in the.....
S017{i, Y0V917K................... .
-.,
County of.. BARris� 4$....Comnonwealth of Massachusetts.
number of persons:
BY STORY
Story. "Capacity• .. Story Capacity ..
The means of egress are sufficient for the following
Story Capacity .. Story Capacity
. i 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
#24 FEBRUARY 16. 1986
Certificate Number Dare Certificate Issued Atte Certificate Expires Building Official
The buildi,ng.official shalt be notified within (Z0) days of any changes in the above information.
ODIC INSM'TION RE ORT
Instructions: wnis zom in to oe completea sawn Lime a perioaie 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 oertifieate. Any changes since the
last inspection tre to be added to the file card of the premises. This form
should be filed by street address.
Street and Number HIGH BANK ROAD, S.Y.
Name of Premises BASS RIVER GOLF COURSE - COFFEE SHOP
Certificate to be Issued to
Address
Owner of Record of Building
Address TOWN OF YARMOUTH
Purpose for Which Premises
Use Group Classirication or Premises A-
Chanaes Since Last Inspection (Required on File Car
1.
2.
5.
6.
Date Order Issued
Order Issued To
Address
Date V iolation(a) Corrected
Rebarks
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.
Certificate Number - 1985.
Date Certificate Issued
Date Certificate Expires
Recommended Next Periodic Inspection Date
FORK SBCC-4-7h
l.Jr!:in: ,-T.assAc-ilss,•rs
'-outh
0= Yan1
� `z asap L _ ICATION FOR CERTIFICATE OF I?.'S?SCTIO:7
;ate 1/.30/85 (XX) Fee Required (Amount)$40.00
( ) No Fee Required
In accordance with the erovisions of the Massachusetts State 3u'-ld=r.,;
Code, Section 108,15, ! a_ply for a Certificate of Inspection for
the below -named premises located at the following address:
Street and Number HIGH BANK ROAD, SOUTH YARMOUTH, MASS 02664
Name of Premises BASS RIVER GOLF COURSE -COFFEE SHOP
Purpose for Which Premises is Used COFFEE SHOP
License(s) or Permit(s) 3ecuired for the Premises by Other Governmental
Agencies:
License or Permit - Agency
Certificate to be issued to 1/XC2Y roto ".ao
-Address — —
owner of Record of Building—�l (ewy of Uel ovr>'i
Address------- - - —
Na_e of Present Holder of Certificate
Name of gent, if any — --.--
ST
IGNAURE CO PERSON TO.WH0:•1 _ TITLE
-CERTIFICATE IS ISSUED OR HIS ,I
AUTHORIZED AGENT --------------
DATE
INSTRUCTIONS:
1) Make 'check payable to: � TO. -21 Or YAR-'Gi -- --------�---- -----
2)'. Return this aDDli.cation with your check to: SU110ING INSFECTOR'S DEP.�`,'Ti,EiJT
SO.. YAr;.UUTH, is h55. li21
PLEASE NOTE-
-1) Application -form with accomnvnying fee must be submitted !for each uu_lc-
ing or structure.or part thereof to be certified. _
'2) I,pD)-1 C:'_tlOn and fee be received before t'h-_` .ce--L iiic to :i I
3) The building �:i,c��� X11 q1_ no,iti,ld j" C. •. -..
1
.,�•:.-:1;.':-riIE if _/y Ex