HomeMy WebLinkAboutBCOI-24-22 2027 f%S' Y4 ict TOWN OF YARMOUTH
�; Office of the Building Commissioner
1 I �' 1146 Route 28, South Yarmouth, MA 02664
y f 508-398-2231 ext. 1260 Fax 508-398-0836
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APPLICATION FOR CERTIFICATE OF INSPECTION
January 1, 2026 PAYABLE UPON RECEIPT
( X) Fee Required$130.00
( ) 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 tfor the below-named premises located at the following address:1 Street and Number: j 7 R I Z
Name of Premises: .J r J, . E, 'r+ N .) Tel: q.7? 3 , •L bZ(,;
Purpose for which permit is used:
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
LtC.eNi—e
Certificate to be issued to ,T �� S c 1N r4e1: RI B 3 6 1- 162 S"
Address:
I 3 KT
Owner of Record of Building
Address
Present Holder of Certificate
;on6�ignature of to whom Title
Certificate is issued or his agent ] ^-7 -7 6
cc Date
Email Address: C,I.K,01S IC o MAIL 3 CO " RECEIVED
JAN 07 2026
B U I I
LLL_ f
By
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# BCOI-24-22
02/17/2026-02/17/2027
The Commonwealth of Massachusetts
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Town of oY9 \.
YARMOUTH .i '0 �
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` '.cORPON ATEO`yA;
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: CJKOZ, LLC
Trade Name: The Escape Inn BCOI-24-22
Identify property address including street number, name, city or town, and county Certificate Expiration
Located at 1237 ROUTE 28 February 17, 2027
SOUTH YARMOUTH, MA 02664
Floor Occupancy_ Use Group Other
Use Group Classification(s) 01 st Floor 6 R-1 Hotels, motels,boarding houses, 6 Units&Office
etc.
Allowable Occupant Load 02nd Floor 7 R-1 Hotels, motels,boarding houses, 7 Units
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 Building
Name of Municipal Chief Commissioner Mark G s Date of Inspection ( '1 / 1,
Signature of Municipal Fire ' Signature of Municipal Building Date of Issuance /�/
Chief Commissioner