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BLDCI-17-003192-02 c The Commonwealth of Massachusetts ttwF=Or til _:y � City\Town of Fla YARMOUTH • 44,11 11. New and Renewal Certificate of Inspection In accordance with 780 CMR,Chapter 1 (The Eighth Edition of the Massachusetts State Building Code)and Chapter 304 of the Acts of 2004(an Act to further enhance fire and life safety),this certificate of inspection is issued to the premise or structure or part thereof as herein identified. Identify Name of Establishment Certificate No. Issued to Business Name:M.A.A.M.CORP. BLOCI-17-003192-02 Trade Name:LONGFELLOWS PUB Identify property address including street number,name,city or town and county Certificate Expiration Located at 182 OLD TOWNHOUSE RD 12/31/2019 SOUTH YARMOUTH,MA 02664 Use Group Floor Occupancy Use Group Classifications(s) Other A-2 01st Floor 66 A-2 Nightdub/Restauran1/Bar/Banquet Hail 20-Bar Stools 6-Standing Allowable 40-Main Dining Room 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 Philip Simonian III Name of Municipal Mark G lI Fire Chief Building Commissioner Th I ry �iection //p2t Signature of Municipal /� ��, Signature of Municipal / / Date of �+ Fire Chief 2/}1 !/ d� Building Commissioner i �' Issuance //,lfQ 't�q�' (/ G !/C2 1. `. ( v (fir Fee:$100.00 BLD Certoflnspection.rpt i > i'.,.°F...." TOWN OF YARMOUTH BUILDING ELECTRICAL GASY .r\ 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 PLUMBING 111 Telephone(508) 398-2231,Ext.1261 —Fax (508) 398-0836 SIGNS - ,. BUILDING DEPARTMENT Inspection and License Report bate // - Address /6'a ('4 rizedriich C/r Business NameACV 5 Cont 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: Egress Emergency egress signage Location ❑Emergency egress lighting Location Q Maintenance ofexits Location ❑Guards/handrails Location • Zoning ❑Signs Location ❑ Parking Location ❑ Other's Location Mechanical ❑ Combustion Air Location ❑Storage in Bola Room Location ❑Vents Location ❑Automatic door dosures on boiler room doors Location 0 Clothes dryer vents Location Other Location The State Building Code,Section 10013-Maintenance,provides that the owner as defined in Section 780 CMR shall be responsible for proper maintenance. In order to abate the above violation(s)von 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 annual inspection. o Make corrections within /0 days and contact this office for a follow-up inspection. Fr LocalOfficialInspecto IL IP a ' Received :• / ant . a a Tide / 7/J ! !t ^ ° GJi f Revised 2/8/13 °onmkt, , TOWN OF YARMOUTH y' BUILDING DEPARTMENT :e;"= % 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION October 3,2018 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: /6 Street and Number: d OhO 7711440#6 - ,e,1) Name of Premises: /YI MAM l ti C DBA �/ 6/tt o FT i61j5 50&"3 9Y-3663 Purpose for which permit is used: emso a11 J/ License(s) or Permit(s)required for the premis- • .u.• I governmental agencies: License or Permit R E C E 1 v Agency 00 " 2018 BUIID�N pEppRiMEN1 131 Certificate to be issued to / , c 205 / Tel: 6 37//6i / Address: /1 GM,i1/ Om Cl 0 , - 'Idle, M 0a&W Owner of gRecorddr,of Building , se /p Address 'a Oa 70 (/SC I1 50. Mine()7Z Present Holder of Certificate _11)//i i 00550 .A.42 . . - - /0-/3-IP Sig 47 re of person to whom Titlp �j,., f� Ce icate is issued or his agent - J Date Email Address: �K n , ,,0 //d/iv)9Z. Odin 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# �UDC1 -/7-07' 3 <Q2—o2„... 1/1/2019-12/31/2019 Ato CERTIFICATE OF LIABILITY INSURANCE DATE(1 M°°/Y Y" 10/18118 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER A.uN u61 NAME: Ray Travers Chagnon Oceanside Insurance Group Mo.;it 508-771.1880 I rife,Rot 508.775.1135 411 Route 28 West Yarmouth,MA 02673 • ADDRESS: raYeloceansldelnsurance.com INSURER(S)AFFORDING COVERAGE NAICS INSURER A: The Hartford Insurance INSURED • INSURER a: Scottsdale MAAM,Inc. INSURER Cr DBA Longfellow'Pub INSURER o: 182 Old Townhouse Rd Unit A South Yarmouth,MA 02664 INSURER E, INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW/THSTANDINGANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH This CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDR)ONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR auaeuoR POUCY EFF POUCY EXP LTR TYPE OF INSURANCE SOD MID POLICY NUMBER (MM,OD/YYYY) (MMIDDMYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE f 1,000,000 II D ‘E TU RENTED CLANS-MADE ©OCCUR PREMISES Ma occurrence) $ 100,000 MED (My one Person) $ 5,000 B _ Being issued 10/21118 10/21119 PERSONAL SADV INJURY _ f 1,000,000 GENLAGGREGATE UMITAPPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY❑JERGT ' I:1 LOC PRODUCTS-COMP/OP AGO $ 1,000,000 OTHER $ AUTOMOBILE LABILITY COMBINED SINGLE LIMIT f (Ea aaides° _ ANYAUTO BODILY INJURY(Par penes) S OWNED — SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per eoddeM) 7 HIRED NON-OWNED PROPERTY DANCE - AUTOS ONLY AUTOS ONLY TPN strident — f S UMBRELLA UAe _ OCCUR EACH OCCURRENCE $ _ EXCESS UAB CLANS-MADE AGGREGATE _ $ DED I RETENTIONS $ WORKERS COMPENSATION XI STATUTE I I0R AND EMPLOYERS LIABILITY Y/N ANY A OFFICERNE BER EXXCCLTUD�ECU7mlE l ELEACH $ 100,000 NIA OSWEC CB9655 02/23/18 02/23/19 . (Mandatory In NH) E.L.DISEASE•EA EMPLOYEE f 100,000 IlDESCRIPrypSa,RIPTON OFO TKXI OF OPERATIONS below E L.DISEASE•POLICY LNIT $ 500,000 Liquor Liability Occurrence 1,000,000 B Being Issued 10/19/18 10121/19 Aggregate 2,000,000 DESCRIPTOR OF OPERATORS/LOCATIONS I VEHICLES(ACORD 10t,ARSONS Remarks Schedule,may M mashed B mere specs le required) Year round pub,tavern Liquor Liability Included CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. Route 28 S.Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE Christian Barber, I 01988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2010/03) The ACORD name and logo are registered marks of ACORD