HomeMy WebLinkAboutBLDCI-17-000190-02 The Commonwealth of Massachusetts
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'= 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:TOWN OF YARMOUTH BLDCI-17-000190-02
Trade Name: HEARING ROOM
Identify property address including street number, name,city or town and county Certificate Expiration
Located at
1146 ROUTE 28 07/10/2023
SOUTH YARMOUTH, MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s) 3 ^.m::Jem iC „n ; r /Museum 130 PERSONS
A-3 u i si Row 130 ent h..._h.Gy.r. b.ary.
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 ( l
Building Commissioner Inspection —k� U�d�
Signature of Municipal Signature of MunicipalJ Date of
Building Commissioner Issuance LZ 2�
1� ee: S0.00
BLD Certoflnspection.rpt
TOWN OF YARMOUTH
BUILDING DEPARTMENT
��MATTAtsr 1 146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
June 1, 2022 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: /i�l o Ro o M Z8 , S, Li .t yA-201 o(1 1-f
Name of Premises: TowN OF Y4 4oLi N/1 a-Pg-iNC /ZOOM Tel: 508-398-ZZ31
Purpose for which permit is used: RECEIVE Di
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency LJUN 092022
BUILDING DEPARTMENT
By: -
Certificate to be issued to Tel:
Address:
Owner of Record of Building
Address
Present Holder of Certificate
Torn.o ik,tti`�St
Signature of person to who Title
Certificate is issued or his agent G 9
Dat
Email Address: ruAlr A-.ct\Ci`);" yacMo. \, t"Iic-� . 05
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#
07/10/2022-07/10/2023