HomeMy WebLinkAboutBLDCI-22-004820 (2) \ The Commonwealth of Massachusetts
1 ,.L4` .tri City\Town of
, s YARMOUTH
i.
New and Renewal Certificate of Inspection _--Y'
In accordance with the Massachusetts State Building Code, Section 110.7
Identify Name of Establishment Certificate No.
Issued to
Business Name: HOLIDAY VAC CONDO ASSOC INC BLDCI-22-004820
Trade Name: HOLIDAY VAC CONDO ASSOC INC
Identify property address including street number, name,city or town and county Certificate Expiration
Located at
488 ROUTE 28 03/09/2023
WEST YARMOUTH, MA 02673
Use Group Floor Occupancy Use Group Other
Classifications(s)
R-1 Other 11 R-1 Hotel/Motel/Boarding House/Transient BLD. 1 (11 Units)
R-1 Hotel/Motel/BoardingHouse/Transient
Allowable Other 14 BLD.2(14 Units)
Occupant Load
Other 10 R-1 HoteVMotel/Boarding House/Transient BLD.(10 Units)
Other 7 R-1 Hotel/Motel/Boarding House/Transient BLD.4(Units)
1 Story Storage
Building/former 2
car-garage
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 VA-72 2
Signature of Municipal Signature of Municipal Date of
Building Commissioner Issuance q/fl41.
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BLD Certoflnspection.rpt
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,,'Y4. TOWN OF YARMOUTH
O, ',i. pi, BUILDING DEPARTMENT �_
m w 1146 Route 28, South Yarmouth, M. A 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
February 1, 2022 PAYABLE UPON RECEIPT
(X) Fee Required $196.00
( • ) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code, Section 110.7, I hereby apply for a
Certificate of Inspection for the below-named premises located at the following address: 7,y_3togca005
Street and Number: / r8 o`U -- 2$ 1,) - ycLf')1o,m„ Ma Q z(;7�% R FE C F 4� E 0
it
Name of Premises: Mc tCA,cL9 \jO c -ion Celrx& ,n;ury? Tel: 5O ' '? ?5 act ti
. MAR 1 202
2 _..�1
, Purpose for which permit is used: L i GLns�S
License(s) or Permit(s) required for the premises by other governmental agencies: BUILDING UEHARTMENT
By. _
License or Permit Agency
Certificate to be issued to ok ieka-4 V A.c a -on C d onnwv,,, ,Tel: 506 Z 15-D' 11
Address: - % lezo 2% w.VO,r m Ou -t- MA 02(, ?3
Owner of Record of Building Ool<&c y VAce ar) 1J.-,moo 4ns#
Address q S lLo►-k_ a% L<,, y Cox,,, ,.K„ Ma eaV?3
Present Holder of Certificate A-to t vka.,9 V0.c ej Ai on C'�nclor iti noc1jy' ' Y-01 +
1.----___ Pro P4,347 /1/(a —
Signatur f person to whom Title
Certificate is issued or his agent Zg Z Z
Da
Email Address: \/ ti.r hPUci.aMVa-C Corr`
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#
03/09/2022-03/09/2023
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