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Home My WebLink AboutBDLCI-16-003134 The Com ►o wealth of Massachusetts w r, (Jity\Town of YARMOUTH T. ihr r /• LIl- 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: BLDCI-16-003134 Trade Name: Flax Pond Recreation Area Identify property address including street number, name,city or town and county Certificate Expiration Located at 31 DUPONT AVE 11/04/2022 SOUTH YARMOUTH, MA 02664 Use Group Floor Occupancy Use Group Other Classifications(s) A-3 01st Floor 206 A-3 Amusement/Church/Gym/Library/Museum CHAIRS ONLY cost Floor 96 A-3 Amusement/Church/Gym/Library/Museum TABLES&CHAIRS Allowable Occupant Load 01st Floor 289 A-3 Amusement/Church/Gym/Library/Museum STANDING 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 �� Building Commissioner Inspection Signature of Municipal Signature of Municipal ate of Building Commissioner Issuance [0/240 r�,� wI Fee: $0.00 BLD Certoflnspection.rpt - }°=-�; h TO N OF YARMOUTH o. - ,� BUI DING DEPARTMENT " " " 1 1146 Route 28, Sou h Yarmouth, MA 02664 508-398-2231 ext. 1260 � :tc+ APPLICATION FOR CERTIFICATE OF INSPECTION October 1,2021 PAYABLE UPON RECEIPT ( ) Fee Required (X) 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: 31 Dupont Avenue Flax Pond Recreation Area - Lorusso Lodge Name of Premises: Town of Yarmouth - Recreation Dept. Tel: 508 398-2231 X-1520 Purpose for which permit is used: Assembly Space License(s)or Permit(s)required for the premises by other governmental agencies: RECEIVED License or Permit Agency OCT 06 2021 Entertainment License/Sundays Commonwealth of MA BUILDING DEPAR NT Entertainment License/Weekdays Town of Yarmouth-clerks By. Camp I icense/SummPr 2021 Town of Yarmouth-health Certificate to be issued toTown of Yarmouth Recreation Department Tel: 508 398-2231 X-1520 Address: 424 Route 28, West Yarmouth, MA 02673 Owner of Record of Building Town of Yarmouth Address 1146 Route 28, South Yarmouth, MA 02664 Present Holder of Certificate Town of Yarmouth Recreation Department X4 (�� Aimee Howell I Recreation Director Signature of person to whom Title Certificate is issued or his agent October 5, 2021 Date Email Address: recreation@yarmouth.ma.us Instructions: Make check payable to: Town of Yarmouth 1146 Route 28, South Yarmouth,MA 02664 , Return this application to: Building Inspector's Office 1 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# 11/23/2021-11/23/2022 !, 'A 4 # • 0411C1)10 FIRE EQUIPMENT INVOICE i N c 0 RP OR Ai E o j INVOICE#: SIN127590 Protechrr3 New England.Because so much Is at cfake. _ INVOICE MEDFORD • AGAWAM • HYANNIS • SMITHFIEtD • MANCHESTER 02/03/2021 DATE: Phone:508-775-3473 Fax.508-775-6110 DUE DATE: 03/05/2021 www.feinewenRland.com hyaservice@feinewengland.com BILLING ADDRESS: SHIPPING ADDRESS: YARMOUTH RECREATION DEPARTMENT YARMOUTH RECREATION DEPA 424 ROUTE 28 424 ROUTE 28 WEST YARMOUTH, MA 02673 WEST YARMOUTH, MA 02673 WORK PERFORMED Ext.inspec CUSTOMER REFERENCE : WORK ORDER NUMBER PURCHASE ORDER WORK COMPLETED ON YARRECDEP WO-00190454 T&M ( 02/03/2021 PRODUCT NAME DESCRIPTION QUANTITY= UNIT PRICE NET VALUE I Manufacturer's 2.5%Tariff Manufacturer's 2.5%Tariff Surcharge 1.00 $0.35 $0.35 Surcharge Portable Fire Extinguisher 1-Annual-626A-Extinguisher Inspection 1.00 $0.00 $0.00 Labor Labor 1.00 $42.00 $42.00 Inspection of Fire Extinguishers Inspection of Fire Extinguishers 7.00 $6.00 $42.00 Pull Tamper Seals Pull Tamper Seals 7.00 $2.00 $14.00 NET TOTAL: $98.35 TAX TOTAL: $0.00 INVOICE TOTAL: $98.35 OUTSTANDING TOTAL: $98.35 fL, , Flex REMIT TO:FIRE EQUIPMENT INC•PO BOX 423•READING,MA 01867-0623 INVOICE 40 FIRE EQUIPMENT INCORPORATED INVOICE#: SIN127590 Protecting New England.Because so much is at stake. INVOICE MEDFORD • AGAWAM • HYANNIS • SMITHFIELD • MANCHESTER 02/03/2021 HATE: Phone:508-775-3473 Fax:508-775-6110 DUE DATE: 03/05/2021 www.feinewengland.com hyaservice@feinewengland.corn BILLING ADDRESS: SHIPPING ADDRESS: YARMOUTH RECREATION DEPARTMENT YARMOUTH RECREATION DEPA 424 ROUTE 28 424 ROUTE 28 WEST YARMOUTH,MA 02673 WEST YARMOUTH, MA 02673 PEFRFO Ext.inspec CUSTOMER REFERENCE WORK ORDER NUMBER PURCHASE ORDER - WORK COMPLETED ON YARRECDEP WO-00190454 T&M 02/03/2021 PRODUCT NAME DESCRIPTION QUANTITY UNIT PRICE NET VALUE Manufacturer's 2.5%Tariff Manufacturer's 2.5%Tariff Surcharge 1.00 $0.35 $0.35 Surcharge Portable Fire Extinguisher 1-Annual-626A-Extinguisher Inspection 1.00 $0.00 $0.00 Labor Labor 1.00 $42.00 $42.00 Inspection of Fire Extinguishers Inspection of Fire Extinguishers 7.00 $6.00 $42.00 Pull Tamper Seals Pull Tamper Seals 7.00 $2.00 $14.00 NET TOTAL: $98.35 TAX TOTAL: $0.00 INVOICE TOTAL: $98.35 OUTSTANDING TOTAL: $98.35 n� REMIT TO:FIRE EQUIPMENT INC•PO BOX 423•READING,MA 01867-0623