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HomeMy WebLinkAboutBCOI-24-5- a> O LO 0 es (I) 4-- N O (o N '0 L Z p a) 'a R N k _ca) a)W U ao U v ? o 0y c co �� O 00 s• c N O o CD •C (I)co O d (I) C C.) aas ) m as G) 'D O N a) 3 O X -O .2 4- C-)Li Q 7l. O C.)H N al a as N 0, N c = Zi N o :o e O N 7 cnON NON NON .C .aO� O N C01 .c — . .z � .5,� U h 4 v 2 c o' L c (B c �, a) N = C O U C O U O O U O 0 V CO0. y C V (0 0 U fa c9 co C '6 cn (3 (� 0 ..C-) w N .O y 0.2 co. 8 .0 .c • .0 m N +� w , t 'O 2 U .c-O 2 U _c -oN U 0 0 C L. = L_ co E a' a- a) F � I- a) y •w •f p U V'-, — O To, 0 O O cn U O co cq O v) (5 o a v ` O aa) t am v d aas a� a'o 't 40 40 4) ~ L 3 H M ,_ u) C ` '� i w O N V .0 w V ~ L O M L O N M L O 43 o Dcb M N flup o N Oc p b E 03I O O O co O O f k,,,, S O � _ co W —' � cv_) � c -CQ) C� � 2o hpW cm3 II— ail c N >- s `m �' E _ Z N V = 7 C C E m d p (n Z G O V N ._ co m a a) fA o (n (n U L . m _a 0 O 0 h O O .a O o U co •() L O O _• a O 0 CZ v CO ~ b Q c c a) O O O a) 'p 6- a) h c9 E co2 4? N Z U U)c.) ..� ,a'". >' a) w -0 co c Ca C - ,i a) a) N L ` O. ` (n U V O O p C CO 1 a) LL I y Niii N I-- -2 co _cco O O O N JO U .� .(22 c as Syr 'C c asu) m o a) CO C O U C (a G. L • a) d (ii 0 O c a ii 3 O (o `—° v m — U a U V C W J Q. 0 r-- al a c co 2 am 3 CU L O m Q I— C m is '(I).0 E c N (B O)L Z "coU ° YAR TOWN OF YARMOUTH — BUILDING DEPARTMENT MATTACM CSC/� 'Ae 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION January 1, 2024 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 located at the following address: Street and Number: ` . Name of Premises: A,A.e,e,e;tr-j- ®1f i' / Tel: Sac)/-, 4e),iG') Purpose for which permit is used: MR M; r ion ©c c/''n,G y i' /d u>4i7I LGI�P 1j( License(s) or Permit(s)required for the premises by other governmental agencies:License or Permit Agency M� V" (� fie4/Tfi_ siv6 f e c7io* _ 3-6 cP T ye f- Certificate to be issued to / t.la-"d L.,d e/ Address: �J' rVfG' /Rv,�del: i- ✓ Read S� rapAla t'ttj, Au 0 2-6 6 q Owner of Record of Building kzpa,,a r'd 4y B/' n'14 SDA'/G .Y`G s Address n/�1�„ 5 Aa°4 d Sc�. �r,//1r�c�T ime v 666 U.9fildPresent Holder of Certificate hienvith dley P /v/G�Sevvi 7/Z0 T vs��e RECEIV FD ignature of person to whom Title Certificate is issued or his agent JAN 9 2024 ��; Date BUILDING DEPARTMENT By Email Address: At i jQ/✓�©/� Gi;/cOMG,�57,A/e 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# 02/24/2024-02/24/2025 6r A��4 �� /'� C-d/1 4A 'y ,ovMey