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Home My WebLink AboutBLDCI-18-001265-01 The Commonwealth of Massachusetts ,tits — A& City\Town of ror 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:FIRST CONGREGATIONAL CHURCH BLDCI-18-001265-01 Trade Name: PARISH HALUTHRIFT STORE Identify property address including street number,name,city or town and county Certificate Expiration Located at 329 ROUTE 6A 09/01/2019 YARMOUTH PORT,MA 02675 Use Group Floor Occupancy Use Group Other Classifications(s) A-3 Basement/Lower 415 A-3 Amusement/Church/Gym/Library/Museum 415 PERSONS Allowable Basement/Lower 193 A-3 Amusement/Church/Gym/Library/Museum 193 PERSONS Occupant Load 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 7:17 /� Building Commissioner 7 -"7 Inspection Signature of Municipal Signature of Municipal Date of Building Commissioner Issuance f/071 Fee:$5000— /oo.o BLD_Certoflnspection.rpt a.*--) Ro BTOWN OF YARMOUTH UILDING DEPARTMENT N`6),' .v 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION August 1, 2018 PAYABLE UPON RECEIPT (X) Fee Required .550,89 hip a ( ) 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: 32-`/ti\AAtO ctfET( *CM 0(411} Poe- Name of Premises: (2.-NCOp0(9-✓ a s((11• e PL.. � 2-( 4 s" l: g-3ttD�) Purpose for which permit is used: .—Th./2.14-- S"0e License(s) or Permit(s)required for the premises by other g vernmental agencies: License or Permit RECEIVED Agency AUG 15 2018 BUILDING /�By: .._. ------' Certificate to be issued to Mt2STCo, 6,4254 -`1c AcQ4j Tel: 6-Dg—a6.1-6972 Address: S/M c 45 r *Do't; Owner of Record of Building Address Present Holder of Certificate CP b 1 iscASct242 Signature of person to whom Title Certificate is issued or his agent '—&— IS Date Email Address: 0001 SCS C ALM CAST , NWT 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 ISS YOUR CERTIFICATE OF INSPECTION. Certificate of Inspection# ,jLDC. 9/10/2018-9/10/2019 00 X2'65-0J , t Church Mutual Insurance Company • NCCI CARRIER CODE NO. 16853 WC 00 00 01A WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE 1. The Insured: FIRST CONGREGATIONAL CHURCH OF YARMOUTH Policy No. 0187606 07-005235 Renewal of: 0187606 07-940073 Individual Partnership Mailing address:329 ROUTE 6A R Corporation or -- --- - -YARMOUTHPORT,—MA 02675 1517 See Schedule Federal Employers I.D.# Inter/Intrastate Risk I.D. # Other I.D.# Other workplaces not shown above:See Schedule Contact Phone Number 2.The policy period is from 12/23/2017 12:01 a.m.to 12/23/2018 12:01 a.m. standard time at the Insured's mailing address. 3. A.Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the 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 states designated in Item 3 .A. of the Information Page and ND, OH, WA, WY. D. This policy includes these endorsements and schedules: See Schedule 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 Rate Per Code Total Estimated $100 of Estimated Classification No. Annual Remuneration Remuneration Annual Premium See Item 4 . Extension WC 00 00 O1A Total Estimated Annual Premium$ 2, 021 Expense Constant$ 338 Taxes and Surcharges $ 103 Minimum Premium$. 281 (MA) 9101 Deposit Premium $ 2, 124 See Item 4 . Extension WC 00 00 O1A for the Taxes and Surcharges -for: MA Premium Adjustment Period: Annual Countersigned by: Servicing Office: Church Mutual Insurance Company Date: 10/20/2017 Producer: ANDERSON W. RYAN Church Copyright 1987 National Council on Compensation Insurance. Mutual • Original msuIAAAA cAAAAxr 4' . r s = Y`IN4c TOWN OF YARMOUTH of ly BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 August 1,2018 1s'. Congregational Church Thift Store/Hall 329 Route 6A Yarmouthport,Ma 02675 Re: Inspection Date: 9/10/2018-9/10/2019 Fee: 100.00 Pursuant to the provisions of the Massachusetts State Building Code 780 CMR, Section 110.7 and Table 110,you are required to apply for a Certificate of Inspection for the building located at 329 Route 6A,Yarmouthport,Ma 02675 ls`Congregational Church-Thrift Store/Hall. Please complete the enclosed application and return it with the appropriate fee payment to the Town of Yarmouth Building Department, 1146 Route 28,South Yarmouth,MA 02664. Checks should be made payable to the Town of Yarmouth. Please note that as of September 15,2008,a revised fee schedule has been instituted. The new fee schedule includes re-inspection fees. IMPORTANT: One (1) re-inspection to confirm the abatement of any violations listed during the initial inspection will be included in the initial fee if the abatement is completed during the time period(typically 10 days)listed on the Inspection Report. Additional re-inspections will cost$80 each, which is payable in advance of the re- inspections. Unless otherwise requested, inspections will be performed unannounced. Typically the following elements/systems are inspected: fire protection equipment, means of egress, including emergency lights, exit signs, egress doors&hardware, clear path of travel, adequate lighting and occupancy total. Also, the building shall be maintained and adequate housekeeping provided to insure public safety. Rooms such as basements and attics are included. Violation details will be provided in the form of a Violation Notice and may delay the issuance of your certificate and/or license, if applicable. Note: After receiving your application a minimum of 3 weeks' notice is require for an inspection. Finally, applications and fees must be received within ten(10)days of receipt of this letter. Failure to comply may jeopardize your license where applicable, and/or the occupancy of the building. Very truly yours, 0 Mark A Gry s ll AUG 6 2018 Building Commissioner 'aril