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HomeMy WebLinkAboutBCOI-23-1726 2024 o / \ k co e \ \ a \ f E2 b. " U �� t 03 6 v >, G E 3 / ± f t q � il \ae \ j \ a « // fa 2 ° C4 / f/ q \ CL \ c § » S 7E \ / CO as p0f 22 % > % _ �k\ • -0 ] ) iU - ,—0 k/ ( E t $ k0 2 � k �.E 0co = 0. k / / � # -, / / k \ /2 / \ r as 1,F j ;wfl $ ° $ 2f � � / k / § \ � m o 2 / 2 f ai\ / < . � 2 a = E ■ _ O ■ _ _ § % e \ o © � 5 = � q = m � . . Milli 55 � gym ® co % / � kk \ � cn\ g\ ■ O ® � � � � 2 z k / � o >>> _ @ c § $ / \ z \ / k f 13 2E k' 03 E § \ E / 13 dk 0k \ - § \ � E � o & 2 0 . C) 0C / k CD \ k / k \ •CD .0 �ca � � \ \ ( k ■ m a) Q Z & m f § EECE o a) / / ] / /j o K a ® C �k \ 3 C \ -- & � � \ co ƒ _oƒ a) / o ® 2I- _c Q � § 5 a $ a _ o , § / co c / I k Ea m 2 k k : 2 e £ \ _ 5 p 2 CA S ® = \ 0. % = a $ _ _ 0 6 o o. f / % \ . � a .0 e r \ k <4 4, • / k § / \ © - E ■ 2 # 2 ` as ( k} a ® z eo °-oFI''Ak , TOWN OF YARMOUTH 4 - \ t'''',1 BUILDING DEPARTMENT 5' ° -.. 1146 Route 28, South A arrnouth, MA 02664 508-398-2231 ext. 1260 RECEIVED APPLICATION FOR CERTIFICATE OF INSPECTION JUN 20 2023 June 1, 2023 PAYABLE UPON RECEIPT (X) Feie Required$'100'.06M 'JT ( ) No"Fee-Requ'ite. In accordance with - : s . . e•, e - assachusetts State Building Code, Section 110.7, I herebyapply for a Certificate of Inspection for the below-named premises located at the following address: pp y Street and Number: V / &/ �! S' - So /4,-,,,,,, Name of Premises;, , L ritia. i'` ff o) , hi Ale/IQ db.. f— Tel: --CV - 2 g - , & e4✓off_ Purpose for which permit is used: s f S h . p iee✓re . ►mot,/, ,,,,s C; c✓/m,ys L/e 5 e'.s License(s) or Permit(s)required for the premises by other governme tal age ies: License or Permit Agency L SAD Se,,j!-A 6(/AiO., -h Q\5 Certificate to be issued to �f) , "-se Li ,4t f--A.)6 I C It,,,-0 . Tel: S-v 3 71- 5 yr 2 Address: ?a 0/1 Al4 in ,61-, 5 p/y//4,,e,),,et--' Owner of Record of Buildi�u 3 toe 5 SUc Arno✓,��t raw, JO /1.1c Address1�3 ''' 6 q Old ,/1 ath. si. 5'6 . g it/to C Present Holder of Certificate y;( (.‘elf(C*,. Si re of person to whom Title ificate is issued or his agent Date Email Address: 5y1)44 6- 5GGv c- - J,�,/ ,.� ve f GG �' 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# ' ' --7724 , 07/28/2023-07/28/2024