HomeMy WebLinkAboutBLDCI-17-000431-03 The Commonwealth of Massachusetts
City\Town of
__14 a s YARMOUTH
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: CAPE COD& ISLAND ASSOCIATION OF REALTORS BLDCI-17-000431-03
Trade Name: CAPE COD&ISLAND ASSOCIATION OF REALTORS
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
22 MID-TECH DR 08/18/2021
WEST YARMOUTH, MA 02673
1 -
Use Group Floor Occupancy Use Group Other
Classifications(s)
01st Floor 170 A-3 Amusement/Church/Gym/Library/Museum Meeting Room 1 -
A-3
Concentrated-170
01st Floor 80 R-3 Single Family/Duplex Residence/Child Care 5 or Less/Congregate Living 'Meeting Room 2-
Allowable
Unconcentrated(table&
Occupant Load chairs)80
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
Signature of Municipal Signature of Municipal Date of
Building Commissioner Issuance
•A 1NSPzar/ '2
Cd 7 t7 D Fee:$100.00
C
BLD Certoflnspection.rpt
6oaR, l
�� TOWN OF YARMOUTH
oIv/i4 Y BUILDING DEPARTMENT
,MAT� s 1.146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
sue'. E D
J ZQ21 , PPLICATION FOR CERTIFICATE OF INSPECTION
J lut11,L202-4 DEPARTMENT PAYABLE UPON RECEIPT
Y (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: (-:,��� M, A Z:C.,
Name of Premises: a C -- / /1 c c f ' t,'���'ti t i`` ) r� C.)U, �'> Tel j ( ,
•
Purpose for which permit is used:
License(s) or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency
Certificate to be issued to f -.;� 1 A e_. r ' �' -.� !_ "'
�}-- Tel(:�U,� r,:, � . J�vu
Address: v a tut. c.�-cU )r,vz L1 c r m.: I\n.( . v :7 s'
Owner of Record of Building -' 1"- i!k., A.- (stt�4; {A{,;;;":c` ,,,,, 17 �,
Address 'L l\A I A,�t\,, '\�r: .,-t. ,t,)P� yr,,,, ,,,,-, „ IVFICA oDA.,)-is
Present Holder of Certificate
A ,
Si ature of person to whom Title
ertificate is issued or his agent -7 /+i ,:2�> /
Da
Email Address: C 6� ,�'o-r,, (�CI,-:�.2�(;. 0,0,�.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 CANNOT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection# 13Ct/07/—Opt,934))
08/18/2021-08/ 2
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