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HomeMy WebLinkAboutCI-23-005564 (2023) to 0 0 0 +. N Z ci in ` co otS m M 0 0. N 01 !s0 O w N T `. . 1, N t� N 0 0 7 -6 'd 03 _ 15 O. • 0 0 C: O O `� l0 O 0 O C.) m d • • e ¢' C1 0 A W O N . QI 0 O 0 0 0 0 d 7 O •�' L M J 2 Z A- p ,tom J 0 2 m a N m 0 C 0 y O V �01 y cl r.. .5 pr -0 ii CA bl G� �p C '� 9 i.1 V U q ~ 44 C E CD z' "E. a C 6 ti CO CI 3 .0 :: .kN (/I h.l r.' 0 0 0 CS 0 O C O 5 Fi W O O t O -0 U 0 O E N c°p' G z N = "B 14 4 O O 6 0 fi c m ce Q c .E V 8a °..0 0 44.1 i�l w ° w ± m g o m a� el w w oo wo _Z c a.c '� 0 >y cti z E c } o c° ao eo o o ksy\ Eg (0 d cl,N C M O 0 .a a a) c6r1L-Ni A., 0I— fn O ui a $ 0 E co in CO cd 1� m • N c. tv CO o v b `: A. Z 0 & -d (1) f p a a C ai ,� a w 0 0 0 b m O U y 0) •0 C (0 '" 7 b G) a) a) 4, o y . LL •o43 a z 'LT. y ..0 . , N 7 O O Nea y CO E 44 es ii. Iv ea Cd a) a c m 0 U To 1v 3 �y R U' v ' 3 cal t °q)i •v • c co v o E. 4 Iii13 ice, iiel-1111 fa 10 C c . 3IIADC'ggi K '2 U o O 7 1INII �_ 0 10 # 4��1 r Z . i •: TOWN OF YARMOUTH ' log .f3 BUILDING DEPARTMENT ' Mai ' :,agi��%`� 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 f 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: i 35 O'2AL-4 k\UY 0nu Name of Premises: d5.9._ c .. Tel ,S-- `a 7e � Purpose for which permit is used: ? W1 .�-,,eA License(s) or Permit(s)required for 1 ' RECEIVED q t he prem es b ther governmental agencies:License or Permit Agency B[ APRO62OjJ DING DEPARTM Certificate to be issued to Address: -- � , TA 1: l35 3�01A, . il't0'}i,‘-Q an '' , o t.: _'. 0 '. KA 010 10 mg. 0,( f.19 Owner of Record_of Buildin_ , g i / ; ,. Cr Address / C �'1'� Present Holder of Certificate ,(k_ gnature of person to whom rtificate is issued or his agent Title f Date Email Address: o\c ' eG S ((JI e C O&c,v0 S ' 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# 05/02/20 -05/02/20 073