HomeMy WebLinkAboutBCOI-24-56 2026 �j� 'Y ' TOWN OF YA,RMOUTI-I R E C E D
f �, Office of the Iuilding Commissioner
tp ,` � APR 15 2025
,4 1146 Route 28, South Yarmouth, MA 026
S08-398-2231 ext, 1260 Fax 508-398-083I BUI
°. E T ENT
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APPLICATION FOR CERTIFICATE OF INSPECTION By
\pril 01,2025 PAYABLE UPON RECEIPT
( X ) Fee Required S208.00
) 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: 961 MA-28,South Yarmouth,MA
Name of Premises:—Harborside Suites Tel: (508)24-1444
Purpose for which permit is used: r—OCg,n1
License(s)or Pennit(s)required for the premises by other governmental agencies:
License or Permit Agency
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Certificate to be issued to rl ur h,r ',�Z S i,, Tel: �,,1 -),IL, - 141�1
Address: CV l fAl 4-�,Y , <,y fv,< 1i,,,----,,,t� jr, /-
Owner of Record of Building 11 ,,J,Th d in -'it 5 hah, L.L (-
Address 4-6 1- - L,,A L. y4,4 ,11lciv, 1 —*!_'o:•a , 1i',1t
Present Holder 4 f Certificate
Si:• o'person to whom Title
Cert is issued or his age it /71 /1/.j J
Date
Email Address: c,Iii
foi- .J J l t-a. . t-\V C-,0 (rr"1
Instructions: Make check payable to: Town of Yarmouth
1 146 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 INSPEC rION.
Certificate of Inspection t BCOI-24-56
05,15 2025-05<15'2026