HomeMy WebLinkAboutBCOI-24-59 Y � TOWN OF YARMOUTH
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„ o Office of the Building Commissioner s 4-7,7
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4 �i 1146 Route 28, South Yarmouth, MA 026 4
- y r 508-398-2231 ext. 1260 Fax 508-398-083 MAR 0 5 2026
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APPLICATION FOR CERTIFICATE OF INSPECTION r wu,
March 1, 2026 PAYABLE UPON RECEIPT
(X) Fee Required$100.00
( ) 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°► I s1 r\ci_
Name of Premises: E) tAQ LX,Akr Crkte Room' Tel: S0e)-398 - 88
Purpose for which permit is used: �\•,,' P-P. M,A
License(s)or Permit(s) required for the pres by other governmental agencies:
License or Permit Agency
Certificate to be issued to 6(u i � V 2ur-1- Tel: S'68-3,210-1ZQ a
Address: do,1 1/4/ 1 Sl-,r,, ur
Owner of Record of Building E.os 14o<pii-o,\'kl
Address aG\ l 50, 5ho-2 p c
Present Holder of Certificate
PIG-in
S' f person t om Title
ertific e is issued or his agent 3/5]2(a
- 1 Date
Email Address: �S c,4v@ 1 QU3a\u '25v/IS,CoM
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 chan:e in the above information.
PLEASE-SEND , A .. 4,- ', t 'ecc r F * ,.
Certificate of Inspection#_BCOI-24-59_
04/01/2026-04/01/2027