HomeMy WebLinkAboutBLDCI-16-007018-05 S;;;;,\ f—Ill'he Commonwealth of Massachusetts
h it 5 City\Town of
YARMOUTHY
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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: ROBERT LAVERY BLDCI-16-007018-05
Trade Name:THE VILLAGE INN CAPE COD
Identify property address including street number, name,city or town and county Certificate Expiration
Located at
92 ROUTE 6A 07/16/2022
YARMOUTH PORT, MA 02675
Use Group Floor Occupancy Use Group Other
Classifications(s)
R-1 01st Floor 2 R-1 Hotel/Motel/Boarding House/Transient 2 BEDROOMS
Allowable 02nd Floor 8 R-1 Hotel/Motel/Boarding House/Transient 8 BEDROOMS
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 G Date of / � '
Building Commissioner Inspection b
Signature of Municipal Signature of Municipal Date of
Building Commissioner1 ;.n Issuance 2,/
U Oee:$100.00
BLD_Certofl nspection.rpt
t'°6ff0f`94k
k y TOWN OF YARMOUTH.
50 _ -0-zy3 if BUILDING DEPARTMENT
1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 126(1
APPLICATION FOR CERTIFICATE OF INSPECTION
June 1, 2021 PAYABLE UPON RECEIPT
(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:
n
Street and Number: ( lo
� it-OU f e C'1�1
Name of Premises: I t e U I Gal(: I Yki N Tel: ‘Z gi
Purpose for which permit is used: Lob&i li&
License(s) or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency
RFC
Certificate to be issued to Ru31u IA - 1 Tel: -502 342
Address: '\2 U 2021
Owner of Record of Building aji,C-Ki 4 C cAi
l�, BCJIL` I '` I�
Address ��- �ale E Xt t1. k`fl-moo '{16t Yo(� ----- -- --- .�
Present Holder of Certificate 17 01,t vV LA '-'"
Si " ature of person to m Title
Certificate is issued o s agent
Date
Email Address: 'LIMA lVV iji W")) 6-41414.,
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#
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