HomeMy WebLinkAboutBLDCI-16-001516-06 The Common a h of Massachusetts
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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:SUNFLOWER SCHOOL BLDCI-16-001516-06
Trade Name: SUNFLOWER SCHOOL
Identify property address including street number, name,city or town and county Certificate Expiration
Located at
923 ROUTE 6A UNIT F 07/01/2023
YARMOUTH PORT, MA 02675
Use Group Floor Occupancy Use Group Other
Classifications(s)
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 Schoo(,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 Grylls Date of
Building Commissioner Inspection
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Signature of Municipal Signature of Municipal Date of
Building Commissioner y Issuance 7/ ez,
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Fee:;100.00
B LD_Certofi n spection.rpt
TOWN OF YARMOUTH 4-46 366°
\c' BUILDING DEPARTMENT
1146 Route 28, South Yarmouth MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
June 1, 2022 PAYABLE UPON RECEIPT
(X) Fee Required$100.00
( ) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code, Section 110.7, I hereby apply for a
Certificate of Inspection for the below-named premises located at the followinngg address:
Street and Number: Ci023 �v� c 14 C u f1►�' 1��tJ! rt
Name of Premises: CJu,r.410(4e,' 5J) T ei: 4
Purpose for which permit is used: CLE%1)cQGccart C&r k/
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
-!D 5 I6)a 1 1 \ . Q\ l G-1 CaA0-1-)0,, 1- �✓ l
Certificate to be issued to Gu,,c to kt./ Sao) Tel: - 362 -54? 1-tvECEIVED
Address: Clot 3 JUL 07 2022 120 �� , Un)i G- , '/c,rrruv.1-L k 1 'f(lfl Ord')$-
Owner of Record of Building L.1,,z_k. 'R�11 -'-
Address C1 Li �)stc-rc C�r��.) y v WO JUL
Holder of Certificate th ,1=lo�1�/ �c ) _
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By
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Sig nature o' .- so to whom Title
Certificate :. •. . • .tent 7/0 /g
Date
Email Address: ,,r, r, aer -on[..ol2 _ 60r0
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# [k//(p-e)0, .(7,6. t —(7 So
07/01/2022-07/01/2023