HomeMy WebLinkAboutBLDC-22-004705 The monwealth 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 BLDCI-22-004705
Business Name: Evangelical Baptist Church
Trade Name: Evangelical Baptist Church
Identify property address including street number, name,city or town and county Certificate Expiration I
Located at 2/16/2023
1240 ROUTE 28
I SOUTH YARMOUTH, MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-3 01st Floor 260 A-3 Amusement/Church/Gym/Library/Museum Auditorium
02nd Floor 50 A-3 Amusement/Church/Gym/Library/Museum Gallery
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 U�_�7-
Building Commissioner ? Inspection / O�
Signature of Municipal Signature of Municipal
Date of
Building Commissioner ,A4_ __ Issuance
Fee: $50.00
BLD Certoflnspection.rpt
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c 44o TOWN OF YARMOUTH
LAj ) BUILDING DEPARTMENT
' 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
January 11, 2021 - PAYABLE UPON RECEIPT
(X ) Fee Required.50.00
( ) 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:
r• oR Veal-acZ 2' d S 77(;
Name of Premises: 05/4/ F�c,A./ g 5'7—CtfvRCkl Tel: 36
Purpose for which permit is used: ett+V fgC M
License(s) or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency RECEIVED
FEB 24 2022
BN�
''T-13ZR 1+U1 'C�-( By
Certificate ENT
Certificate to be issued to ' e Y' Tel: 3` 36 3 /
Address:f 2/AO ?out .2_1(
Owner of Record of Building ,/' 4c
Address
Present Holder of Certificate 51/27ti_ ,S' dOvt�
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Signature of per n to whom Title
Certificate is issued or his agent
Date
Email Address: CO COCO , C3,4( Cpsp.egC. ( ,SI LT ev icvu0, (vp)
3S:l/@)_ C 76- i C 0/1
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 CANNNQT,ISSaE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection# (,C, �'. (170.1 r
2/16/2021 —2/16/2022
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