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HomeMy WebLinkAboutCI-23-005564 2024 o c iO „ i.O `c. d W Op cT ' hCbb \LL I ' co w. UV Q co V C.) r = O 0 Q C O N d V . C COv Cr) O. - O �*. O H 'C n-2 CON N a) UI MJ2Z � .G Q O c O 0 CO N td - U w Q 7i c w��+ 3 °t. 'a c CI too c c.) F. 't •-, !S A O Fwmilvi O !........-! g (..) 5 H m Q 6 111 I . 2 t — m CI 41 � ilw C U a) E Ili y = IX = N a V ©y ICI ICae I Z H c (D >- 8 2 p O O O Fil = d a+ ) N L. E10 wO � d N C� 0 N O . 0 . 'O O o c v aod m co . v' - Z _) m Cos) ro 7 d2 iZS ll 15 z a a g coc o U Q. a •b cu 4. co a 0 ' '� �' m a .n ti U N N y4; a N •O f . O •� U N CO O n Ci _O t�q zs N H U ' LL N .I. y w O w alO cd y U t t. C.� d O Niti 4 ii poilito; o w co 3 w 13 1... (.) T.' 0 1 .5 o w 0. .-, I1: "hea*". g ca o �1r 6.) 0 O 3 I�II���� �tiA V co a) c6 E c $Aji 1#�11,0* ' c F co co Z fn 1146 Route 28, South Yarmouth, NIA 02664 508-398-2231 e:" t, 1260 APPLICATION FOR CERTIFICATE OF INSPECTION April 1, 2023 PAYABLE UPON RECEIPT (X) Fee Required $205.00 ( ) 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: 3`5 5 jl Name of Premises: 3tC ( 4tO Tel: 5-0mf-ei Purpose for which permit is used: 1 License(s) or Permit(s) required for the prem. es b ther governmental agencies: V License or Permit Agency APR 06 2023 BUILDING DEPARTMENT ay n Certificate to be issued to ^ L . 1 ' 32 RI Address: , =MN _ f/ • f/I ►n G // Owner of Record of Building, " Address / 2j 5 t�(/7 0/1 1 ►� Present Holder of Certificate P G/�/Y1/!11 a1�1 gnature of person to whom Title rtificate is issued or his agent Date Email.Address: 1E4 ' e CO ' e S Ct° nlcu . COY 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# 05/02/2023-05/02/2024