HomeMy WebLinkAboutBCOI-23-1814 2025 The Commonwealth of Massachusetts
* Town of o:
,� YARMOUTH .0 y
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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
Trade Name: GYM/CLASSROOM/CAFETERIA BCOI-23-1814
Identify property address including street number, name, city or town, and county Certificate Expiration
Located at 276 Station Ave
South Yarmouth, Ma 02664 December 31,2025
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) 01 st 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 Grylls °Da f Inspection I /I o DA
Commissioner / I
Signature of Municipal Fire Signature of Municipal Building `(...._ , Date of Issuance
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Chief Commissioner
/ o YAK TOWN OF YARMOUTH
Office of the Building Commissioner
1146 Route 28, South Yarmouth, MA 02664
-4 , 508-398-2231 ext. 1260 Fax 508-398-0836
- MATTACHEESE
C°�''1'ORATE)\b /
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-named premises located at the following address:
Street and Number: .2 -2 4- 'ST-Art/31,- A v4-
Name of Premises: 5 1 j fl DU•A IJ j..)lit__ 1.41-i I.f.j✓t'kitAl Tel: ,S a s`- ZL O - b-"G
Purpose for which permit is used: O ✓('
License(s)or Permit(s)required for the premises by other iovernmental agencies: R E C
EIVPD
License or Permit Agency
NOV 0 8 2024
BUILDING DEPARTMENT
Certificate to be issued to 1T►nJ A -ut/4 d Lt Tel: - ? By
t�wa<a''� .r"eg �o ___----
Address: .216 ST4ITliwi A 1'I�vt- S rv{- yp/ulovH, IflA . 0.2L4 V
Owner of Record of Building - -¢ e.•o 'D�skn
Address S►Afur1 A✓ai( ' S jrvik y.ifi ratk. jA . 41,46 y
Present Holder of Certificate
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Si ature of person to whom Title
Certificate is issued or his agent /...0 y
Date
Email Address: f-A v ' - k(2 .rrIA. .✓S
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# 3 —' Z
oct-„ /,),
12/31/2024-12/31/2025I 't