The URL can be used to link to this page

Home My WebLink AboutBLDCI-17-000431-02 -w • The Commonwealth of Massachusetts 'i=.;:ill 6 • City\Town of _u t=‘� YARMOUTH New and Renewal Certificate of Inspection In accordance with the Massachusetts State Building Code,Section 110.7 Identify Name of Establishment Certificate No. Issued to Business Name:CAPE COD&ISLAND ASSOCIATION OF REALTORS BLDCI-17-000431-02 Trade Name:CAPE COD&ISLAND ASSOCIATION OF REALTORS Identify property address including street number,name,city or town and county Certificate Expiration Located at 22 MID-TECH DR 08/18/2019 WEST YARMOUTH,MA 02673 Use Group Floor Occupancy Use Group Other Classifications(s) A-3 01st Floor 170 A-3 Amusement/Church/Gym/Library/Museum Meeting Room 1- Concentrated-170 Allowable 01st Floor 80 A-3 Amusement/ChurcwGymQLibrary/Museum Meeting Room 2- Occupant Load Unconcentrated(table& chairs)80 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 life safety features. This certificate shall be framed behind glass and/or laminated and posted in a conspicuous place within the space as directed by the undersigned. Failure to pose or tampering with the contents of the certificate is strictly prohibited Name of Municipal Name of Municipal Mark Grylls Date of SR^ /` aQ Building Commissioner Inspection Signature of Municipal Signature of Municipal / ate of • Building Commissioner Issuance I ///^��, J /i Fee:$100.00 BLD Certoflnspection.rpt k TOWN OF YARMOUTH t0tectyI BUILDING DEPARTMENT ` 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION July 1,2018 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: Da MID TrCH D .1 V E Name of Premises: ee R O FFICB Lb Tel: SOB - 951- y30-0 Purpose for which permit is used: OF-F I CE License(s) or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be issued to ey n Tel: 5 03 - 95 ]-4300 Address: 22MOD nett Dr'1teK. W•yRiRMO&Tt-1 (vtA- n2f0t Owner of Record of Building Q,CI4Ofa-`type cod I tS1onc1-s AAscciall on 0C eeoctits) Address 22 M Ito Tr '( Tit-t -Delve.. Y fleMO�dT�-} Present Holder of Certificate CC f 4 0R. C. E. O . Invoice No. Si a ture of person to whom Title Certificate is issued or his agent1 1 r—rAccount No.: Amount: Date 540(_400 igfie S 0 Email Address: 240 I .-O - —s 0 Instructions: Make check payable to: Town of Yarmouth Total: --1-0-C11-- 1146 Route 28, South Yarmouth, MA 02664 Return this application to: Building Inspector's Office Approved: Entered: __ 5 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# QL,Jk'1-/7 erim/'O 8/18/2018-8/18/2019 !icy Provisions: WC 00 00 00 C) I //INFORMATION PAGE WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TWIN CITY FIRE INSURANCE COMPANY P INSURER; it L. ONE HARTFORD PLAZA, HARTFORD, CONNECTICUT 06155 I w., ! NCCI Company Number: 14974 THE �' Company Code: 7 HARTFORD,ti • fi/d/ Suffix LARS RENEWAL POLICY NUMBER: 08 WEC NJ2677 13 Previous Policy Number: 08 WEC NJ2677 HOUSING CODE: DW 1. Named Insured and Mailing Address: CAPE COD & ISLANDS ASSOCIATIONOF (No., Street,Town, State, Zip Code) REALTORS, INC. 22 MID TECH DRIVE FEIN Number: 042315153 WEST YARMOUTH, MA 02673 State Identification Number(s): UIN: The Named Insured Is: CORPORATION Business of Named Insured: REAL ESTATE AGENCIES Other workplaces not shown above: 22 MID TECH DRIVE WEST YARMOUTH MA 02673 2. Policy Period: From 11/30/17 To 11/30/18 12:01 a.m., Standard time at the insured's mailing address. Producers Name: DOWLING & O'NEIL INS AGENCY/PHS 301 WOODS PARK DRIVE • CLINTON, NY 13323 ' • Producer's Code: 088233 Issuing Office: THE HARTFORD 301 WOODS PARK DRIVE CLINTON NY 13323 (866) 467-8730 Total Estimated Annual Premium: $1,081 Deposit Premium: Policy Minimum Premium: $231 MA (INCLUDES INCREASED LIMIT MIN. PREM.) Audit Period: ANNUAL Installment Term: The policy is not binding unless countersigned by our authorized representative. Countersigned by (Sean or C "'L`t 10/14/17 Authorized Representative Date Form WC 00 00 01 A (1) Printed in U.S.A. Page 1 (Continued on next page) Process Date: 10/14/17 Policy Expiration Date: 11/30/18 • sr •r INFORMATION PAGE (Continued) Policy Number: 08 WEC NJ2677 3.A. Workers Compensation Insurance: Part one of the policy applies to the Workers Compensation Law of states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $500,000 each accident Bodily Injury by Disease $500,000 policy limit Bodily injury by Disease $500,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT ND, OH, WA, WY, US TERRITORIES, AND STATES DESIGNATED IN ITEM 3.A. OF THE INFORMATION PAGE. D. This policy Includes these endorsements and schedule: WC 00 04 03 WC 00 04 22B WC 20 03 03D WC 99 03 OOD WC 00 04 14 WC 20 03 01 WC 20 03 02A WC 20 04 01 WC 20 04 05 WC 20 06 O1A 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below Is subject to verification and change by audit. Premium Basis Classifications Total Estimated Rates Per Estimated Code Number and Annual $100 of Annual Description Remuneration Remuneration Premium 8810 786,600 .07 551 CLERICAL OFFICE EMPLOYEES NOC INCREASED LIMITS PART TWO (9807) 1.00 PERCENT 6 TO EQUAL INCREASED LIMITS MINIMUM PREMIUM (9848) 44 TOTAL PREMIUM SUBJECT TO EXPERIENCE MODIFICATION 601 MA - MERIT RATING CREDIT (9885) .950 PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION 571 TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 571 EXPENSE CONSTANT (0900) 250 MASSACHUSETTS DIA ASSESSMENT 4.560 PERCENT 24 TERRORISM (9740) 786,600 .030 236 TOTAL ESTIMATED ANNUAL PREMIUM 1,081 Total Estimated Annual Premium: $1,081 Deposit Premium: Policy Minimum Premium: $231 MA (INCLUDES INCREASED LIMIT MIN. PREM.) Interstate/intrastate Identification Number: / 000101853 NAICS: Labor Contractors Policy Number: SIC: 6531 UIN: NO. OF EMP: 000011 Form WC 00 00 01 A (1) Printed in U.S.A. Page 2 Prdcess Date: 10/14/17 Policy Expiration Date: 11/30/18 Ii TOWN O F YARMOUTH BUILDING ELECTRICAL • F GAS •:r•ik/E 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 -111 Telephone(508) 398-2231.Ext.1261 —Fax (508) 398-0836 PLUMBING SIGNS BUILDING DEPARTMENT Inspection and License Report Date 7- i?7 J �.'U Address C9 �.G-T�L/7 /_ Business Name CCC 6)255 Xcg/y-cr4e Contact Phone During the Annual Inspection of your premises,performed in accordance with the provisions of Section 110.7 of 780 CMR(Massachusetts State Building Code),the Board of Selectmen,and/or the Board of Health rules,the following violation(s)were observed: Egrat ❑Es signage Location ❑ Emergencyegresslighting Location Cr 1 D Maintenance of exits Location `` IDGuards/handrails Location Zoning S\Yi • ❑ Signs Location ❑Parking Location ❑ Other Location Mechanical ❑CombusdonAir Location ❑Storage in Boiler Room Location ❑Vents Location ❑Automatic door closures on boiler room doors Location ❑ Clothes dryer vents Location Other Location The State Building Code,Section 1001.3-Maintenance,provides that the owner as defined in Section 780 CMR shall be responsible for proper maintenance. Jn order to abate the above violation/0 you must: o Make corrections immediately and contact this office for a follow-up inspection. o Make corrections prior to opening and contact this office for a follow-up inspection. o Make corrections prior to your next a ual inspection. o Make corrections within Iv days and contact this office for a follow-up inspection. Local Officialllnspector 'PAM -Z�f k • -;:(11":'"1`1,4- . _ / Received By ,1.` ``1,4-(`'ti'\ —�� e Tide v Revised 2/8/13