HomeMy WebLinkAboutBCOI-23-1813 2025 The Commonwealth of Massachusetts
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Town of O�. `moo,
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'aji YARMOUTH
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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: Margaret E. Small Elementary School
Trade Name: GYM/CLASSROOMS/CAFETERIA BCOI 23 1813
Identify property address including street number, name, city or town,and county Certificate Expiration
Located at 400 HIGGINS CROWELL RD
WEST YARMOUTH, MA 02673 December 31, 2025
Floor Occupancy_ Use Group Other
Use Group Classification(s) 01st Floor 172 A-3 Lecture halls,dance halls, 172-CAFETERIA 172-GYMNASIUM
churches and places of religious 20-CLASSROOM, LIBRARY VISUAL
Allowable Occupant Load worship,recreational centers, AID ROOMS
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 ry s Date of Inspection {{
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Commissioner Th i I Hp �'`�J
Signature of Municipal Fire Signature of Municipal BuildingC
Chief Commissioner , /'� Date of Issuance `1 15/2 r—
,(YA TOWN OF YARMOUTH 01
r�.1 Office of the Building Commissioner
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1146 Route 28, South Yarmouth, MA 02664
508-398-2231 ext. 1260 Fax 508-398-0836
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\� MATLA I aE ;
C°RpORATE'D,b�pl'
"`` — -- APPLICATION FOR CERTIFICATE OF INSPECTION
November 01, 2024 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-namedn premises located at the following address:
Stet and Numbgr: H 1-10 (-�i ®q i Y1 _ __ _
Name of Premises: MQY9Uert f e E Sma( ( EJCh'1erl+Uru, Tel: 5 0 e- •i 11'9I9I t5
Purpose for which permit is used: O C L P p u G 1
License(s)or Permit(s)required for the premises by other governmental agencies:
RECEIVED
License or Permit Agency
NOV 0 8 2024
BUILDING DEPARTMENT
Certificate to be issued to Ili A>Z S U�^' • S non lI Tel: o i- • 7 7¢ ' 7 ---'--
Address: Li(-(.o R ►Sg%.3S C.me.w - 2p
Owner of Record of Building "1>4,+...s • 4•14. *r t•i. afttoka'a-\ Sc.►ti.v t( T>vt +-&tT
Address 2. Ili s T irri b a A✓4. . S eu-i i. YA It.rn p,•tlN m . a -c. c.y
Present Holder of Certificate
. -Y `7" irut c.#eN.__ o z�! f J
re Signa of person to whom Title
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Certificate is issued or his agent l/,r"/Z..y
Date
Email Address-. r.Qv(..4 se_ n y. t'Li-3 tn+1ti- k 12.•1+44 .--uS
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#
12/31/2024-12/31/2025 Kb/--tl 3-A--/) /2/1.3
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