HomeMy WebLinkAboutBLDCI-22-007495 The o monwealth of Massachusetts
I i ir
City\Town of
' YARMOUTH
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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:West Yarmouth Congregation Church BLDCI-22-007495
Trade Name:West Yarmouth Congregational Church
Identify property address including street number, name,city or town and county Certificate Expiration
Located at
383 ROUTE 28 5/1/2023
WEST YARMOUTH, MA 02673
rUse Group - Floor Occupancy Use Group Other
Classifications(s)
A-3 01st Floor 210 A-3 Amusement/Church/Gym/Library/Museum 210 Persons
Allowable Other 40 A-3 Amusement/Church/Gym/Library/Museum Balcony
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 Inspection
-
Signature of Municipal Signature of Municipal L.—_-- - Date of ��f
Building Commissioner (.:L".46,01t: �' Issuance yj,V
Fee: $50.00
• B LDCertofl nspection.rpt
\0 TOWN OF YARMOUTH
,a BUILDING DEPARTMENT
;S���MATTACt. _t,_a '� 1146 Route 28, South Yarmouth CIA 02664 508-39 -
APPLICATION FOR CERTIFICATE OF INSPECTIO JUN 27 2022
April 1, 2022 PAYABLE UPON RECEI IBUILDING DEPARTMENT
(X) uire .
( ) 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: 13$3 �r� oZ 7 63, QY`
/
Name of Premises: WI . • O l„ • eh v/^c_k�k Tel: $r_ 7 75 -O 9i
n
Purpose for which permit is used: ehU t-0 f * 1" Sdhp
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
5/10/4
Certificate to be issued to A) y C C Tel: <5Q 8- 7 Y5 - 9'
Address: 3& k4- 2t
Owner of Record of Building
Address 00 3 Rr� 02�,/ cJ Q�•,✓� .
Present Holder of Certificate
/4C/cie 6"/,0 elA't (-76/
re of pe son to w om Title
C ificate is issued or his agent 6 - /1/-
Date
Email Address: 07)1'7 @Xn-Tj:74 (p I,•7
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.
7 rh4 shoe Aacs no em//o yees•
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# / ' ��
05/01/2022-05/01/2023 -0574