HomeMy WebLinkAboutBldci-16-004746-05 The Comm alth 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: HALLET FAMILY TRUST BLDCI-16-004746-05
Trade Name: HALLET FAMILY TRUST-FUNERAL HOME
Identify property address including street number, name, city or town and county Certificate Expiration
Located at
273 STATION AVE 02/25/2023
SOUTH YARMOUTH, MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-3 01st Floor 140 A-3 Amusement/Church/Gym/Library/Museum 140 PERSONS
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 Building Commissioner / Inspection a/el -- 011.
Signature of Municipal Signature of Municipal Date of
Building Commissioner Issuance g /, 4Z
Fee:$100.00
BLD Certoflnspection.rpt
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TOWN OF YARMOUTH
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Q, „ ft .;a BUILDING DEPARTMENT
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AP IFICATE OF INSPECTION
REC_ EIV
January 1, 2022 Lig PAYABLE UPON RECEIPT
28 20 2 (X)Fee Required$100.00
t51) ( ) No Fee Required
BUILDING DEPARTMENT
In accordance with the provisio 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: 273 S tat ion Ave.
Name of Premises: Hallett Funeral Home Tel: 508-398-2285
Purpose for which permit is used: Funeral Home
License(s)or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency
Certificate to be issued to Hallett Funera i Aome Tel: 508-398-2285
Address: 273 Station Ave. , South Yarmouth, MA 02664
Owner of Record of Building Hallett Family Holdings LLC
Address 273 Station Ave. . South Yarmouth, MA 02664
Present Holder of Certificate same
C---- . ,W)6(4 President
Signature of person to whom Title
Certificate is issued or his agent January 25, 2022
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 CANNOT,� ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection# 8, / /(p-t)tymv-1:25--
02/25/2022-02/25/2023
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