HomeMy WebLinkAboutBldci-16-00416-03 The Commonwealth of Massachusetts
City\Town of
ff[ ' YARMOUTH r" %111
i-1
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: MCDONALD'S RESTAURANT OF SOUTH YARMOUTH BLDCI-16-004164-03
Trade Name: MCDONALD'S HAMBURG RESTAURANT
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
1060 ROUTE 28 02/24/2021
SOUTH YARMOUTH, MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-3 01st Floor 73 A-3 Amusement/Church/Gym/Library/Museum 73 PERSONS
Allowable
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 Grylls Date of �_/� ot�
Building Commissioner Inspection
Signature of Municipal Signature of Municipal Date of
Building Commissioner Issuance Z . ZO 70
Fee:$100.00
B LD_Certofi nspection.rpt
•
o;Y R TOWN OF YARMOUTH
k.o ~ ' -� BUILDING DEPARTMENT
,` 4, 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
January 6,2020 PAYABLE UPON RECEIPT
(X) Fee Required 100.00
( ) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code,Section 110.7,I hereby apply for a
Certificate of Inspection for the below-named premises located at the following address:
Street and Number: /0(00 it (Re
Name of Premises: 111C n na)J is Tel: See 02360.196
Purpose for which permit is used: / 8)- 1-,d R rs1.u
License(s)or Permit(s)required for the premises by other governmental agencies:
License or Permit RECEIVED Agency
JAN 2 •P 2020
BUILDIN ' U ARTMENT
Certificate to be issued to ypp Tel; ,236-3.194
Address: DLLINr 3 3 W -get7cli }n14- 002a5lx,
Owner of Record of Building 1 rp, Le . evt es.
y,Address , ,z aS a oe L.
Present Holder of Certificate
Signature of person to whom Title
Certificate is issued or his agent /'-jam --
Date
Email Address: e/Yer.nna► , fl&Mr 'v) b e 'n14 6l4—L
Instructions: Make check payable to: Town of Yarmouth
1146 Route 28, South Yarmouth,MA 02664
Return this application to: Building Inspector's Office
Please note: Application form with accompanying fee must be submitted for each building or structure or part thereof
to be certified. Application must be received before the certificate will be issued. The building official shall be
notified within ten(10)days of any change in the above information.
PLEASE SEND US A COPY OF YOUR WORKER'S COMPENSATION INSURANCE FORM WITH THIS
APPLICATION OR WE CANNOT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection tt$LD- j6(1) i ,c'i—6.3
2/24/2020-2/24/2021
e6ed xed dH Wd90:ZO OW? E 6 Uef