HomeMy WebLinkAboutBLDCI-17-00280-05 • ommonwealth of Massachusetts
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City\Town of
111
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: HABILITATION ASSISTANCE CORP. BLDCI-17-000280-05
Trade Name: HABILITATION ASSISTANCE
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
7 LONG POND DR 07/02/2022
SOUTH YARMOUTH, MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
01st Floor 160 1-4 Institutional DayCare(More than
1-45) Administration-63
persons
1st floor-160 persons:
Allowable Education&Institutional
Occupant Load Total persons per the
BOH-160
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 7.--/: 727
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Building Commissioner Inspection
Signature of Municipal Signature of Municipal Date of
Building Commissioner /t Issuance .7117Z
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TOWN OF YARMOUTH
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M BUILDING DEPARTMENT
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;' zt ^ 1146 Route 28, South Yarmouth, MA 02664 508-398-2 ft €tO OI V E D
APPLICATION FOR CERTIFICATE OF INSPECTION JUL 26 2021
BUILDING DEPARTMENT
June 1, 2021 PAYABLE UPON RECEIPT By -- -
(X ) Fee Required$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: L1-3 LoC R r i ct Ut- 'm
Name of Premises: -c 3 \ }"&c O QSS l b nc LL Tel: d O B 7(p 7 7 C�
Purpose for which permit is used:Cc'c ���<(,A L �*-� ASP
License(s) or Permit(s) required for the premises by other governmental agencies: e a Sf vNS Ct1on
License or Permit Agency
( LDCI -11
cccO 2- O-- 6 q
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Certificate to be issued to Hab t l t} -1 On C S3[ nC t, Tel: 66 S 1(0 0 q 7 7 0
Address: y.3 ( r S _ S "-1 os r m oa�1•. 1.•--r(Ck
Owner of Record of Building
Address
Present Holder of Certificate
plCD,Tarn d'fief-°r
natu e of pe son to whom rile
Certificate is issued or his agent
Date
u
Email Address: S\OkA e—Cp h�3,e o �'_F n-1L LC
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# 1566C,/--/7 O-D
07/02/2021-07/02/2022