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HomeMy WebLinkAboutBCOI-23-1793 2024 2 / � d ? \ \ a> V % o n \ % / co G \ f _ E 0 CO / ( k / 2 _c \ � . _ ' .c F. S 0 k ea \ k � C o a) G \ c § k c a \ f § 2 2 q 2 % a g / % E \ @ / § / % c k 5 a — 3 $ a ¢ ® c \ 2 CO 0 a & - , ._ CO () 4.0 2 a.0 J ) \ ka\ c ' . Z' 0 0 -o N '% $ ■ Q , ci ƒ /_ ) \ � a E $ = E ''') 0 0 ° © 2 -c m / k / \ � = � k / \ ( � q < 2as I 0 k / \ % / 2 �d / 47. O MCC 2 ® / 2 � } E /_ •C C 0 IC k % Ka2 / uas © ° £ % $ O CL 3 § f 2 7 ± $ m E Z $ ° 0 % f t• £ § $ § $ 0 6 in ® k Ill ,5 E cc $ k k = / ) 5 © / \ ) a)o CO \ \ _ o k \ }\ CO e o > g _ © 0 EEC o 0 -0 _0 zoi5 c >'/ / \ / : co t Ra ` a IS » � 0k o 4..... Cl) 8 ƒ _0/ 0 3 0 2 ) ( . ' o = ems k \ cn vg \ § % II 'l- a) � k Cl) 2 e � CO a .2 a g % $ } \ 2 ° 2 Sa = 0 = % 2 U U 0 E 7 \ \ S 2 0 g ° \ } / § 2 k8c ^To »I O t2\ a) LE o ih � %_ , , _, -"z ," -• ` 1146 Route 28, South 'ar nouth, �4' A 02664 5 8-39 -2231 ext, 1260 � R t f?'��� � i � Y APPLICATION FOR CERTIFICATE OF INSPECTION September 1, 2023 PAYABLE UPON RECEIPT (X) Fee Required $100.00 ( ) 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 ocated at the following address: Street and Number: .1-i Ri W ea y4rIiwktt 1t A• P ©4-73 Name of Premises: &I(.( StSh I Tel: Mg- a)-7 7 1s Purpose for which permit is used: License(s) or Permit(s) required for the premises by other governmental agencies: RECEIVED License or Permit Agency NOV 14 2-023--j BU L 14 TMENT By: Certificate to be issued to Sala St,(Sih t Tel: 50SP-p27-1 . 1 Address: 5 L�; ) U e q( �r;n M 1A 4 Ab?3 � I ()?..) Owner of Recordo Building F�ut 1in ('No /� Address /b aWJ er LN acunt e M ,A 0 .)2- f) l K Present Holder of Certificate , / r� `1)0 _Yt ( 4' 0 0 l COY Signature ofperson to whom g Title Certificate is issued or his agent 7 ((g (�23 rli Date Email Address: atiCl} ciOrl (1 b6yniai;L• Ctrr1'l 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 beore 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# Le.,0l-ci,3-K193 12/31/2023-12/31/2024