HomeMy WebLinkAboutCI-16-1516-03 The Commonwealth of Massachusetts I
i,_7 w t City\Town of "'
• ` �_ YARMOUTH
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
Business Name: SUNFLOWER SCHOOL BLDCI-16-001516-03
Trade Name: SUNFLOWER SCHOOL Bld.2 Unit F
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
923 ROUTE 6A UNIT F 07/01/2020
YARMOUTH PORT, MA 02675
Use Group Floor Occupancy Use Group
Classifications(s) Other
E E 01st Floor 19 E Educational School to 12th Grade/Child Care(More than
5) from 2.9 years&older
Allowable 01st Floor 13 E Educational School to 12th Grade/Child Care(More than 5) from 2.9 years&older
Occupant Load
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 pose or tampering with the contents of the certificate is strictly prohibited
Name of Municipal Name of Municipal Mark G I
ry Date of
Building Commissioner Inspection 4045 s3,
Signature of Municipal Signature of Municipal ` Date of
Building Commissioner Issuance$(2r4
// 7/
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Fee:$100.00
B LD_Certofl nspection.rpt
UM!'"
.Y4k TOWN OF YARMOUTH
t,ein e., a
° BUILDING DEPARTMENT
1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
June 11,2019 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 following address:
Street and Number: 9023 9,1,, (i, lti'mocc,ic
Name of Premises: �j'An F(o‘U c/ 641N00 Tel: -31,2- S43 l ev F. 113
Purpose for which permit is used: at tWcgj't Gw+g ear L'rY.se,Gh1-10 ! Cecl-t./
License(s)or Permit(s)required for the premises by other governmental akencies:
License or Permit Agency
9 033gl a. 40cf1'. o F Leveti La1.44 .1° Coore
Certificate to be issued to 5tArd {r. �/1 I Tel: 605�-36�.-6t+2,C1 ¢�L, ) 3
Address: qaa Qpw, �, fc,,r .14. A- 01A Oa.4,7 c
Owner of Record of Building
Address Cab �v1'i(9A 1P4ce s 1Ylir
Present Holder of Certificate Gjt,,n frIavdc♦
•��./ 01.114
Signatur: a on to whom Title
Certificate is issued or his agent "? 16lg)) 1
Dat
Email Address: yc,r, Svinciout,et'1ar.„612, , Cohn
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# p6/5,1 6-0
7/1/2019-7/1/2020