HomeMy WebLinkAboutBCOI-23-1795 2024 C L U
O
O
Z Lo O `a
d - k `- a) as M
R M W i , 0 Ni
O fa c p
pN 0 nn..
a. a) - p "p4) CO
.0c ~ � C)
O M00 � 'V U
C)
U) 0 Cl)
C 7
C o 0 U p o
vi 'al C ' a. -
Q.
0 N c �, a) ca
O ' CL°)i of
a t p U .i C N
Cu C) 2 alo 0
C Z _c •C .y a) N
w
3 C C O . s p
O m .
O ... co
4 0 0 o N D a Q-
CO v dam .`-° OCR
Q. v cv
.0 (A C p -0 ti .i Q ur a) w \ *+'
co .s2 mm ED- O ZQ p CD ,``�
0 0 W cao c Q ~ O C O
o Q 3 C, N z .a > ii RI ,z' U a)
E C I� w a C Q.
E c c To-
o _ 7 H O N O CI O CO p C)
a) Cu o a m � a 2 .o L, o
t 3 a) u) $ 7) a)•�
I— Z a) -0 in L. EE = E
o a)
Q. = � « ca o mo
U O r c � ZO U)O
co O.
i5 .a a) C
m y j L
Cu o C
7
U
0 o ) NI- 2
a) LL O = C) . ..of/
`,
7 co L 'Q Q
a � 'IS O Ca) cr
0 ° Cl) - C
O C
asw w. W
Cl) CCI
+' V , c Cl)
0 Cu O O
N
Ca4-
IF) I1
5 d C
3 .V.). VC v p — QU
a) Cu
jill
O C •
UJ
CU '9
ii>
D 1
= Oc
wo NrBU V) QHDi(
Z (n 0
•Ylftit TOWN OF YARMOUTH
° BUILDING DEPARTMENT
�M4A�TTACH ss`.Y 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
IJ\�9o011.t[o�c
APPLICATION FOR CERTIFICATE OF INSPECTION
November 3, 2023 2nd Notice PAYABLE UPON RECEIPT
(X) Fee Required 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:
Street and Number: .y 'J(,)ki �;j - ,( t t - 1.
Name of Premises: et.O.Tb O C Lb Tel: 50,6 (oci 4, 4,0-0
Purpose for which permit is used: ?ps^ .-a & t. J-((Lj r(11)
License(s) or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency NOV 16 2023
B C)I�JC i ! ARTf44ENT
By
A,
Certificate to be issued to Tel: 5° - (P8 42) 'V
1G °)v
Address: 3 3 V i��i�$ Aa,„ -1,._ Ck t �- S- `�ce r�...�t. 4. M P.- 0)(o�o Li
Owner of Record of Building ,�
Address
Present Holder of Certificate Si 6 ,,,,,
p , LE I Ma,,, o
rtr
Si re of person to whom Title
erti icate is issued or his agent 1 t .. 11
Date
Email Address: lnf p e c.ectdolCetpiLCcA.C60"-
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 CA OT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection # cU� 3-/75-
12/31/2023-12/3 1/2024