HomeMy WebLinkAboutBLDCI-23-004463 The Commonwealth of Massachusetts City\Town of
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, YARMOUTH
s.
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New and Renewal Certificate of Inspection
In accordance with 780 CMR,Chapter 1 (The Eighth Edition of the Massachusetts State Building Code)and Chapter 304 of the Acts of 2004(an Act to further
enhance fire and life safety),this certificate of inspection is issued to the premise or structure or part thereof as herein identified.
Identify Name of Establishment Certificate No.
Issued to
Business Name:The Pancake Man BLDCI-23-004463
Trade Name:The Pancake Man
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
952 ROUTE 28 11/30/2023
SOUTH YARMOUTH,MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-2 01st Floor 185 A-2 Nightclub/Restaurant/Bar/Banquet Hall 185 Person
Allowable
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 -AIM+ Name of Municipal 4Mark Grylls Date of �+�
Fire Chief BuildingCommissioner ��GC.3
‘,,.yt r - Inspection
Signature of Municipal Signature of Municipal ` / Date of
Fire Chief Building Commissioner Issuance /G iz3,
_._ _ ,
Fee:$150.00
BLD_Certofl nspection.rpt
BUILDING DEPARTMENT
1146 Route 28, South Yarmouth, MA 02664
508-398-2231 ext. 1260 Fax 508-398-0836
LICENSE INSPECTION APPROVAL LOG - 2023
NAME: The Pancake Man ADDRESS: 952 Route 28
This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your
building/premises. When all signatures are obtained, this log shall be presented to the License &
Permits office and/or the Health Department in order to obtain your license. Licenses will be
withheld until all inspectors have signed.
Building Commissioner Rep. Date Comments Approved for
License 7 Issuance No
7-/Y71
Fire Department Rep. Date Comments Approved for
License Issuance
�- s
l j X Yes [7 No
L �
Board of Health Rep. Date Comments Approved for
License Issuance
I] Yes ❑ No
Plumbing/Gas Inspector Date Comments Approved for
License Issuance
H Yes J No
Electrical Inspector Date Comments Approved for
License Issuance
❑ Yes [; No
Taxes Paid [_1 Yes ❑ No
Rev.Sept.2003
-W1a TOWN OF YARMOUTH
•
BUILDING- DEPARTMENT
�a• �HXTT/r.Ln •SC:/��
� t 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
RECEIVED
APPLICATION FOR CERTIFICATE OF INSPECTION
FEB 0 9 2023
February 1, 2023 PAYABLE UPON REC fLqING DEPARTMENT
(X) Fee quired $150 00
( ) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code, Section 110.7, I hereby apply for a
Certificate of Inspection for the below-named premises located at the following address:lo
Street and Number: b e,`Ali- ° 5
�� Tel:A ,2 '1) e - 3 'TgJ a1r3 ;—
Name of Premises: �CUIC
Purpose for which permit is used: L`a--rAq tl4 t) 1
License(s)or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
Sep s -70a1 4,11 AL/0 Nat, S>?,� rc-ren,..J
Fo aci S p('J)G r5 e c n M) 1 (-j p/4-2 0 OIL r4.44-(4
Certificate10 be issued to 11- MA L, ,,r e Tel: '1(b-S ei C S 3 Z
Address: "1,�� I� `d S� g11d A2 mbiA'114 r,6
Owner of Record of Building Q.5 VAa �
( u � 1 e-� �,,� ) Yb
Address �� .(31s `) S ?,'1 1 \A G �► p " ✓`✓�� / rh C) L`ri ley 2417
Present older of Certificate I h c 19.,4 .G P, v` i
Signa erson to whom Titl
Certificate is issued or his agent 3
Da
Email Address:MA GC'i$ it�j pGp, �'V`A , 0j vV
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 C NOT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection# .`t T(O 3
04/01/2023-11/30/2023