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HomeMy WebLinkAboutBLDCI-23-002936 The Commonwealth of Massachusetts 1 City\Town of mulibissiff • — 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: Town Of Yarmouth BLDCI-23-002936 Trade Name:Yarmouth Senior Center Identify property address including street number,name,city or town and county Certificate Expiration t Located at 528 FOREST RD 12/4/2023 • SOUTH YARMOUTH, MA 02664 Use Group Floor Occupancy Use Group Other Classifications(s) A-3 01 st Floor 430 A-3 Amusement/Church/Gym/Library/Museum 49 Person-Solarium 100 Person Front Allowable Ballroom \ Occupant Load 200 Person-Rear Ballroom MAXIMUM CAPACITY-430 PERSONS 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 n ection /�/3 ? Signature of Municipal Signature of Municipal ate of Building Commissioner Issuance /2 //2/121 ( Fee: $0.00 BLD_Certofl nspection.rpt °off YaR� . �Q TOWN OF YARMOUTH ' BUILDING DEPARTMENT , _ 1.146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 �`` m'" RECEIVED APPLICATION FOR CERTIFICATE OF INSPECTION 1 N0V 2 2 2022 ipcp November 1, 2022 PAYABLE UPON RECE P t ( ) Fee R q �NG U�HHRTMENT (X) No Fee equine In accordance with the provisions of the Massachusetts State Building Code, Section 110.7, I hereby apply for a Certificate of Inspection for the; s /below-named premises remises located at the following address: Street and Number: Lnf el 28 v . a).8017764 Ala- (1267. Name of Premises: Craa4/ dAkt Tel: 6'39 "7M, Purpose for whit permit is used: &YEW//[n/Ad& License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be iss ed t1_oi/ndd Ceo Tel: 5,0 3q i-74,Ai Address: .52B c 7 M. /yw 6 Z.3 Owner of Record of Buildmh �' // ax, 4 eitowcf..., Address '6 /f6 C, 4.,8 a iixp /yam. Oa,6V- Present Holder of Certificate / , ___,264*. Sig re of person to whom Title / Certificate is issued or his agent !``8/2 Date Email Address: a/[.[/ ,. i a.i 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# 6 CJld-cm- 931" 12/04/2022-12/04/2023