HomeMy WebLinkAboutBLDCI-17-000937-06 The Commonwealth of Massachusetts
_ City\Town of
Entilm"' = YARMOUTH
New and Renewal Certificate of Inspection
In accordance with the Massachusetts State Building Code,Section 110.7
Identify Name of Establishment Certificate No.
Issued to
Business Name:DENNIS-YARMOUTH REGIONAL HIGH SCHOOL BLDCI-17-000937-06
Trade Name:CLASSROOM/GYMNASIUM/AUDITORIUM/CAFETERIA
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
210 STATION AVE 12/31/2023
SOUTH YARMOUTH,MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-3 01st Floor 1300 A-3 Amusement/Church/Gym/Library/Museum 489-AUDITORIUM
250-STAGE
Allowable 325-LARGE
Occupant Load CAFETERIA
1300-CLASSROOMS
150-SMALL
CAFETERIA
1286-UPPER GYM
1288-LOWER GYM
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 life safety features. This certificate shall be framed behind glass and/or laminated and posted in a conspicuous place within the space as directed
by the undersigned.Failure to pose or tampering with the contents of the certificate is strictly prohibited.
Name of Municipal Name of Municipal Mark Grylls Date of
Building Commissioner Inspection
Signature of Municipal Signature of Municipal Date of
Building Commissioner Issuance
F :$0.00
BLD_Certoflnspection. t
i.4.r. \%'''...
i I
a\ci
/6:74
Mz!!.-, nCCS 8 South 'Yarmouth, MA 02664 08--398- 23I el t C I V
APPLICATION FOR CERTIFICATE OF INSPECTION NOV 2 1 2022
November 1, 2022 PAYABLE UPON RECEIPT BUILDING DEPARTMENT
( ) Fee Requ relt: _ ------
(X) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code, Section 1 l 0.7, I hereby apply for a
Certificate of Inspection for the below-named premises located at the following address:
Street and Number: fb S-1 ie 74 I = A.) A// . '"v L-
Name of Premises:
/2 1 Sib 1 / 5 ( Cr.. ' / Tel: cog —3 9, J 6 µ'
Purpose for which permit is used: 42. ci t' c, " ( "D~'
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
.
Certificate to be issued to &•. `t�P,)4 i, . Tel: ,570 er- .:? r— 7 7 C
E
Address: ,. / 1' . 7"/ I-t I, /Q a 4,z,
Owner of Record of Building 41. i' ( D6`M 5 a rill,/ ►,d A.-01 fr
'' r col, in .... «f ill, A A .
6.2 f `/
Address � � � t�� �°�� u � �. � ,�r� r�
Present Holder of Certificate
<::::: lie' /
7:1 C ' e 1*1, j ,91,frls, 1 L /4 —
Sig a of person to whom Title
Certificate is issued or his agent / r'/,/ -
Date
Email Address: // Y cL ..ri- c c t, - it.. 5 .,),.%." t . k. 1 . . , q/9 17>
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 #
12/31/2022-12/31/2023