HomeMy WebLinkAboutBCOI-23-1814 2026 g - TOWN OF YARMOUTH
�,� .} � �. Office of the Building Commissioner
,,# ` ; , 1146 Route 28, South Yarmouth, MA 02664
,0 �� ,��` 508-398-2231 ext. 1260 Fax 508-398-0836
MATTAEHEESE
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APPLICATION FOR CERTIFICATE OF INSPECTION
November 1, 2025 PAYABLE UPON RECEIPT
( ) Fee Required$100.00
( 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: 2.9 co 51(AT'Orl Alit--
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Name of Premises: 3 a ri on 4 V eli at. l I e a'lc_{'i(i' t1-1 5 t " - 7 b 0- S )
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Purpose for which permit is used: £(�UC6,T1 Un
License(s)or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency
Certificate to N ssued to D Li $ Tel: _ SO 3(J Z-7 k 7
Address: GG 0 � (',t-1 0-Y) e _ S(r){---1,, 4 a v-TYl U7{-(,.,
Owner of Record of Building
Address
Present Holder of Certificate DV t2.5 I)
� (Icc Foci I � {z'e�
Sin so + om Title
Ce i icate is issu + or his agent l l I 13 (2'S
Date
Email Address U( 5 D-]-0 10(161 . (l I2 (-'3'1t�wS € r �._ ..:__ _-_._ -
J NOV 17 2025
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-23-1814
12/31/2025-12/31/2026
The Commonwealth of Massachusetts
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Town of z o
YARMOUTH
Nc�OR ATE bAv
INew 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 BCOI 23 1814
Trade Name: GYM/CLASSROOM/CAFETERIA
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, 2026
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) 01st 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 G _Date of Inspection - I��Commissioner Z
Signature of Municipal Fire Signature of Municipal Building Date of Issuance 'tb(Z/Y/Z/
Chief Commissioner