HomeMy WebLinkAboutBLDCI-16-005164-05 The ommonwealth of Massachusetts *'
n 1 t City\Town of
> YARMOUTH
..
g
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 Motel BLDCI-16-005164-05
Trade Name:Swaminaraya, LLC
Identify property address including street number, name,city or town and county Certificate Expiration
Located at 03/21/2023
891 ROUTE 28
SOUTH YARMOUTH, MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
R-1 01st Floor 10 R-1 Hotel/Motel/Boarding House/Transient 10 Units-Bld. 1
Managers Apartment&
Office
Allowable 01st Floor 10 R-1 Hotel/Motel/Boarding House/Transient 10 units-bld.2
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 or
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 Gryl Date of l_
Building Commissioner Inspection
Signature of Municipal Signature of Municipal / Date of
Building Commissioner Issuance 1!t / L
'Fee:$160.00
BLD Certoflnspection.rpt
-f� AR, TOWN OF YARMOUTH
(tt` ; .y BUILDING DEPARTMENT
"" "" s` �� 1146 Route 28, South Yarmouth, MA 02664 508-398-/2R EcCitEM V E D
FEB 14 2022
APPLICATION FOR CERTIFICATE OF INSPECTION
BUILDING DEPARTMENT
February 1,2022 PAYABLE UPON RECET -T---
(X)Fee Required$160.00
( ) 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: '/' / -, ie. M AWN ,S t- . 50 V T H J pr (_p4 ii 1i71-t- IAA , v 61
(36575 R=UCl2 M0iI L-
Name of Premises: pogo SwAM s/VIv/ZA71tIV LLC• Tel: SOS --3 9 o' -2 ', YV
Purpose for which permit is used: /i4 0 G1-
License(s)or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency
/
Certificate to be issued to 1IO r11 NM A g A ,_ Tel: 31 e -- 4 W
Address: v4 I iq.,E- 2�• Avant'. .6. .S 01,1I* yAle41( t)714. ( i R • D 2 6‘4
Owner of Record of Building MA f--I ENJ�/z-R a , 6 H R .Q . k 0 k: fl- 1✓l• Q f-IR-
Address (q/ / -.�. .ZF'. Sp (I -r' -f 'ffR rvl0t)7Pf. MA . O-? 66.4
Present Holder of Certificate M Ali c-:"WD�R— .1 pc o/Z 13et77-7'1
)n ®r(c')( R . L t -r_42/V
Signature of person to whom Title
Certificate is issued or his agent .2.T q-- .20 . Z.
Date
Email Address:
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 CANNA SOT, ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection# . .-vim/—/&D- 3"/“/_,OS-
03/21/2022-03/21/2023