HomeMy WebLinkAboutBLDCI-22-006236 The Commonwealth of Massachusetts
City\Town of
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7�.Iss.,.-s—m
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: Bass River Lodge BLDCI-22-006236
Trade Name: Bass River Lodge
Identify property address including street number, name,city or town and county Certificate Expiration
Located at
28 PLEASANT ST 5/23/2023
SOUTH YARMOUTH, MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
R-1 01st Floor 1 R-1 Hotel/Motel/Boarding House/Transient
Allowable 02nd Floor 2 R-1 Hotel/Motel/Boarding House/Transient
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 G Date of
Building Commissioner / Inspection
Signature of Municipal Signature of Municipal Date of
Building Commissioner Issuance 0 G d
ee:$100.00
B LD_Certofl nspectio n.rpt
°oF�YaR�
i.4 ''� TOWN OF YARMOUTH
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• dot o `ei BUILDING DEPARTMENT
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g E F 16 RoC1E ®ate 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
APR 11 202tLICATION FOR CERTIFICATE OF INSPECTION
April 1, 2022BUILDING DEDEPARTMENT PAYABLE UPON RECEIPT
By.����4/'' t� (X)Fee Requir $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: il/g f S�j j//
Name of Premises: Aif5c/4.‘ a, / Cif `-e Tel: 5 - >z'r- vG
Purpose for which permit is used: fam e//'-e'f lir,1 �
License(s)or Permit(s)required for the pre ses by oilier governmental agencies:
License or Permit Agency
Certificate to be issued to er- T e 1: 9Q83 .j5-VQ
Address:
Owner of ecord of Building
Address , `it� .
Present Holder o Certificate Sifirs �i`i/g-, !B (Iye-
.0, cif __-- wfri,fe-re
Signature of p on to whom Title
Certificate is issued or his agent a�
Date
Email Address: lF)d:i7t�gfSs VP/��(- -1/ l,. CV/,
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# /l//1 6 LI ,d_2.2_...C(0<
05/23/2022-05/23/2023