HomeMy WebLinkAboutBCOI-23-1814 2024 The Commonwealth of Massachusetts ,fo) ..
Town of z� YAK
YARMOUTH 3i ►• �
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New and Renewal Certification of Inspection
In accordance with the Massachusetts State Building Code, Section 110.7
Identify Name of Establishment Certificate No.
Issued to Business Name: Station Ave Elementary School BCOI-23-1814
Trade Name: GYM/CLASSROOM/CAFETERIA
Identify property address including street number, name, city or town, and county Certificate Expiration
Located at 276 Station Ave December 31, 2024
South Yarmouth, Ma 02664
Floor Occupancy_ Use Group Other
01 st Floor 363 A-3 Lecture halls,dance halls, CAFETERIA-363 PERSONS
churches and places of religious
worship,recreational centers,
terminals,etc.
Use Group Classification(s) 01st Floor 958 A-3 Lecture halls,dance halls, GYMNASIUM-958 PERSONS
churches and places of religious
Allowable Occupant Load worship, recreational centers,
terminals,etc.
01 st Floor 964 A-3 Lecture halls,dance halls, 23 CLASSROOMS-964 PERSONS
churches and places of religious
worship, recreational centers,
terminals,etc.
This certificate of inspection is hereby issued by the undersigned to certify that the premise, structure, or portion thereof as herein specified has been inspected for
general fire and line safety features. This certificate shall be framed behind clear glass and/or laminated and posted in a conspicuous place within the space as directed
by the undersigned. Failure to post or tampering with the contents of the certificate is strictly prohibited.
Name of Municipal Chief Name of Municipal Building Mark II ate of Inspection J3J/Z ry p
Signature of Municipal Fire Signature of Municipal Building
Chief Commissioner Date of
Issuance ` / c11/i1j
;YA�% TOWN OF YARMOUTH
90(
0 $; BUILDING DEPARTMENT
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'-:�,A"*"- .* c a, 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 (pi,
APPLICATION FOR CERTIFICATE OF INSPECTION
November 1, 2023 PAYABLE UPON RECEIPT
( ) Fee Required
(X) 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: 2 I(o ` }c14-1 of A u- -
Name of Premises:5171 1Dr') Ave_ E>le.YYI eA 1 fa rit Tel: _ O T -ROO E C £ I V
FD
Purpose for which permit is used: 1 G1 W c C441 Qr i
License(s)or Permit(s) required for the premises by other governmental agencies: DEC 0 7 2023
License or Permit Agency BUILDING DEPARTMENT
By.
Certificate to b issued to 4CA,A1kOn U G . Tel: -5600
Address: Z1 L �i 'O( Pcutinix, L
Owner of ReAord of Biuilolin,g hn1'S ' ya((Y' j) cov tI G ADCSC►Ct✓
Address 2,1 p £ C. 60 A.hUC., ,GUU�'4 �'-
nY '1
Present Holder of Certificate
i'itecAz517e i G`1,'k,°ems
Signature of person to whom Title
Certificate is issued or his agent 12-'-t- 23
"�,, Date
rQ,'1,�(�r i Email Address: .4c S e ]�y - rej Ion _111'L,1. m ra. U S
Instructions: Make check payable to: Town of Yarmouth
1146 Route 28, South Yarmouth, MA 02664 4
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 T ISSUE YOUR ERTIFICATE OF INSPECTION.
Certificate of Inspection# � /
12/31/2023-12/31/2024