The URL can be used to link to this page

Home My WebLink AboutBLDCI-23-000766 The Comm ealth of Massachusetts r,I.,. - i ty\Town of MOW III YARMOUTH �`!vr 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: First Congregational Church of Yarmouth BLDCI-23-000766 Trade Name: First Congregational Church of Yarmouth Identify property address including street number, name, city or town and county Certificate Expiration Located at 9/1/2023 329 ROUTE 6A YARMOUTH PORT, MA 02675 Use Group Floor Occupancy Use Group Other Classifications(s) Basement/Lower 415 A-3 Amusement/Church/Gym/Library/Museum 415 PERSONS A-3 Basement/Lower 193 _ A-3 Amusement/Church/Gym/Library/Museum 193 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 Building Commissioner '7 Inspection Signature of Municipal Signature of Municipal ^sj Date of Building Commissioner Issuance ,40 L Fee: $100.00 BLD Certoflnspection.rpt TOWN OF YARMOUTH -tfttit,;oc. BUILDING DEPARTMENT ' y$ _ _ 3 �' EIVED t,a.a,,,,toyc,- 1146 Route 28, South Yarmouth, MA 02664 5(18 398 22_ A 0 022 APPLICATION FOR CERTIFICATE OF INSPECTION - -LW BUIL ING DEPARTMENT [3 : August 1, 2022 PAYABLE UPON RECE ' ______ (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: 3 act Ma (N St i '(C &O 4 Pc)rt.- 1--rest- CovtL cc tlot Q- c kw Name of Premises: OF" [ccrMOt2* Tel: 5tq Z &- 36a- 6c(77 Purpose for which permit is used: License(s) or Permit(s) required for the premises by other governmental agencies: License or Permit Agency Certificate to be issued to C(AcAJtf t F �CthcLo t24L Tel: SZA - 36a- £ri-17 Address: Owner of Record of Building Address Present Holder of Certificate C i dlPtcNts-6(c . Signature of person tow om Title Certificate is issued or his agent cbr--7- aa- Date Email Address: 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# B L'cJ-23—tLb7(o(a 09/01/2022-09/01/2023 • '‘441' �� The Comm ealth of Massachusetts 1 n it (dty\Town of , YARMOUTH ID I , =/ New and Renewal Certificate of Inspection In accordance with the Massachusetts State Building Code, Section 110.7 Issued to Identify Name of Establishment Certificate No. Business Name: First Congregational Church of Yarmouth BLDCI-23-000766 Trade Name: First Congregational Church of Yarmouth Identify property address including street number, name,city or town and county Certificate Expiration Located at 329 ROUTE 6A 9/1/2023 YARMOUTH PORT, MA 02675 • Use Group Floor Occupancy Use Group Other Classifications(s) Basement/Lower 415 A-3 Amusement/Church/Gym/Library/Museum 415 PERSONS A-3 Basement/Lower 193 _ A-3 Amusement/Church/Gym/Library/Museum 193 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 w_ Building Commissioner --' Inspection 4AA Signature of Municipal Signature of Municipal 0 Date of Building Commissioner Issuance 7/1/0t Fee: $100.00 BLD Certoflnspection.rpt • Church Mutual Insurance Company, S.I. NCCI CARRIER CODE NO. 16853 WC 00 00 01A WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE 0 8 1. The Insured: FIRST CONGREGATIONAL CHURCH Policy No. 0187606 07-302281 OF YARMOUTH Renewal of: 0187606 07-170554 Individual Partnership Mailing address: 329 ROUTE 6A X Corporation or YARMOUTH PORT, MA 02675-1817 Federal Employers I.D.# See Schedule Inter/Intrastate Risk I.D. # Other I.D. # Other workplaces not shown above: See Schedule Contact Phone Number 2. The policy period is from 12/2 3/2 0 21 12:01 a.m. to 12/2 3/2 0 2 2 12:01 a.m. standard time at the Insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are:Bodily Injury by Accident $ 500, 000 each accident Bodily Injury by Disease $ 500, 000 policy limit Bodily Injury by Disease $ 500, 000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All states except states designated in Item 3 .A. of the Information Page and ND, OH, WA, WY. D. This policy includes these endorsements and schedules: See Schedule 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rate Per Code Total Estimated $100 of Estimated Classification No. Annual Remuneration Remuneration Annual Premium See Item 4 . Extension WC 00 00 O1A Total Estimated Annual Premium$ 1, 9 5 0 Expense Constant$ 3 3 8 Taxes and Surcharges $ 72 Minimum Premium $ 288 (MA) 9101 Deposit Premium $ 2, 022 See Item 4 . Extension WC 00 00 O1A for the Taxes and Surcharges for: MA Premium Adjustment Period: Annual Countersigned by: Servicing Office: Church Mutual Insurance Company, S. I . Date: 10/29/2021 Producer: ALEX PEREZ Church Mutual Copyright 1987 National Council on Compensation Insurance. Oriainal INSURANCE' Y :qA TOWN OF YARMOUTH 5o: -,�� BUILDING DEPARTMENT 'y x�" 1146 Route 28, South Yarmouth, MA 02664 508-398-223 E I V E D it JO A22 APPLICATION FOR CERTIFICATE OF INSPECTION BUIL ING DEPARTMENT 3 August 1, 2022 PAYABLE UPON RECE (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: 3 act Ma (N *ANK.0 Po rt- f S`t- COS rc tic Ckw'CI%� Name of Premises: DF ycAr-MOL-N4\ Tel: 5-V&- 36a -- (fly(77 Purpose for which permit is used: License(s) or Permit(s) required for the premises by other governmental agencies: License or Permit Agency Certificate to be issued toCLIWRAJ �0.1>A (14-(.1 Tel: SEA - 36a- 6q17 Address: Owner of Record of Building Address Present Holder of Certificate CO kit( s - Signature of person tow om Title Certificate is issued or his agent '-7- 2�01— Date Email Address: 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# BC.,C1-23-0C7(0(p 09/01/2022-09/01/2023