HomeMy WebLinkAboutCI-16-1518-02 he Commonwealth of Massachusetts
tR _ 1 City\Town of
a4 )= 1re. YARMOUTH
•
44,-L,. New and Renewal Certificate of Inspection
In accordance with the Massachusetts State Building Code, Section 110.7
Identify Name of Establishment Certificate No.
Issued to ri�uu-iauui5is ul
Business Name: SUM-LOWER SCHOOL
Trade Name:SUNFLOWER SCHOOL
Identify property address Including street number, name,city or town and county Certificate Expiration
Located at 071(12019923 ROUTE 6A BLD. 3 UNITS I,J. K
YARMOUTH PORT, MA 02675
Use Group Floor Occupancy Use Group Other .
Classification(s)
14 01st Floor 20 1-4 Institutional Day Care(More than 5) toddlers and preschool(18
mos.-7 yri.)
Allowable 01st Floor 9 1-4 Institutional Day Care(More than 5) toddlers(18 months-2.9
Occupant Load yrs.)
This certificate of inspection is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for general
fire and life safety features. This certificate shall be framed behind glass and\or laminated and posted in a conspicuous place within the space as directed by the
undersigned. Failure to post or tampering with the contents of the certificate is strictly prohibited.
Name of Municipal Name of Municipal Mark Gryils Date of �D
^
Building Commissioner Inspection 37.
/�8
Signature of Municipal Signature of Municipal Date of
Building Commissioner , ,4009:,/ Issuance /2°Z/V,
CI
Fee:$100.00
BLD_Certofl nspection.rpt
617+Zt
6,117:91.)�o TOWN OF YARMOUTH
BUILDING DEPARTMENT
�.. 11.46 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
June 5, 2018 PAYABLE UPON RECEIPT
(X) Fee Required 100.00
( ) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code, Section 110.7, I hereby apply for a
Certificate of Inspection for the below-named premises located at the
ttfollowing
�address: Q
Street and Number: °a3 4nc 6 Pt Un A. L,�) , k / & atria 3
Name of Premises: anQ c,w-ce____,G ) Tel: W. •„5489 e4. J13
Purpose for which permit is used: 6 t I PlAce Cann V+c
License(s)or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
am i a I ba x.04 &A CcL. ca$2Cc.ct
Certificate to be issued to 4, , . ..... Tel: 501-34:12 543°1 6,(4• I )'3
Address: C1 9,.% ?mate\'.e A \-- pima in A • owl c
Owner of Record of :uilding a - _ a-
Address c1. if-2._ _ ., r 4 W; +� RECEIVED
Present Holder of Certificate ....
SEP 28 2018
0
Signa. -efpersont. horn Title BUILDING DEPARTMENT
C-mile i '- • or his agent ciAlAV
Date
Email Address: 6cs.nQ G, a t3,✓On CAt.(nit`
Instructions: Make check payable to: Town of Yarmouth
1146 Route 28, South Yarmouth,MA 02664
Return this application to: Building Inspector's Office
Please note: Application form with accompanying fee must be submitted for each building or structure or part thereof
to be certified. Application must be received before the certificate will be issued. The building official shall be
notified within ten(10)days of any change in the above information.
PLEASE SEND US A COPY OF YOUR WORKER'S COMPENSATION INSURANCE FORM WITH THIS
APPLICATION OR WE CANNOT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection#'ZjlJCi -A., - 04-44---02,
7/1/2048-7/1/2019 Cc,//—07.