HomeMy WebLinkAboutBLDCI-17-006088-05 ," The Commonw ,a th of Massachusetts
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5.— s.,G$ YARMOUTH
',A!.— . 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:PMB,INC. BLDCI-17-006068-05
Trade Name:VILLAGE GREEN MOTEL
Identify property address Including street number,name,city or town and county Certificate Expiration
Located at SEASIDE VILLAGE RD 0625/2022
SOUTH YARMOUTH,MA 02664
Use Group Floor Occupancy , Usti Group Other
Clasalficatlons(s) —
R-1 HoteVMolel/Boarding Hcuse transient 15 UNITS,OFFICE 8
R-1 Otsl Floor 15 LOBBY
02nd Floor 20 R-1 Hotet/Motel/Boarding House/Transient 20 UNITSAllowable
Occupant Load R-1 HoteVMotellBoerding Hwse/Translent COTTAGES 1-11
1 Other 20 INCLUDES 20
EFFICIENCY UNITS
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 IDnst of ectbn —�
Building Commissioner p
• Signature of Municipal / / Date of �/`
Signature of Municipal f T_ Issuances !C r �
Signing Commissioner
Fee:5235.00
BLD Certoflnepedion.rpt
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° TOWN OF YARMOUTH
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.� BUILDING DEPARTMENT
1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
•
APPLICATION FOR CERTIFICATE OF INSPECTION
May I,2021 PAYABLE UPON RECEIPT
(X)Fee Required$235.00
( ) 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: a 7 /&e \j// Z -/Qd
Name of Premises: Ll/I/��e. Gree4 inotivI Tel: �,?'ye et/4:' -'6
Purpose for which permit is used:
License(s)or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency
REcEIVIZ. D
MAY 182021
Certificate to be issued to eir-t-TerifoL f De 7 tel: eU Ala ror
Address: 32 SG(fce? 'i//a Ae•-•
Owner of Record of Building J,i/,///a f Oer/C/l!�
Address _vani/o A.� ab p/J'� /
Present Holder of Certificate iJ///t q 10 l / c /17t�t'J
Penigr—
Signature of o h m Title
Certificate i issued or his agent
Date
Email Address: t/re17 grivilail r
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# BCC.!-f--(xo Pic
6/28/2021-6/28/2022