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HomeMy WebLinkAboutBLDCI-16-003260-02 4 The Commonwealth of Massachusetts t et City\Town of _ YARMOUTH 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:INAHO JAPANESE RESTAURANT BLDCI-16-003260-02 Trade Name: INAHO JAPANESE RESTAURANT • Identify property address including street number,name,city or town and county Certificate Expiration Located at 157 ROUTE 6A _ 12/31/2019 • YARMOUTH PORT,MA 02675 Use Group Floor Occupancy Use Group • - Other Classifications(s) A-2 01st Floor 64 A-2 Nightclub/Restaurant/Bar/Banquet Hall 12 Persons-Counter 22 Persons-Booths 30 Persons-West Allowable - Room-Tables&Chairs Occupant Load 01st Floor 16 A-2 Nightclub/Restaurant/Bar/Banquet Hall - 16 Persons-East Room-Tables&Chairs 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 Ill Name of Municipal Mark Grylls Date of // n Fire Chief B Building Commissioner ,Inspection -7C Signature of Municipal >/ // J Signature of Municipal / Date of Fire Chieffir �/ 0}/�///�Building Commissioner •7` '/� Issuance /2 a Fee:$100.00 • • _ BLD_Certoflnspection.rpt si Y"R TOWN OF YARMOUTH -,. °' BUILDING DEPARTMENT 4. '- ` 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-namedpremisespremises located at the following address:(s / Street and Number: �5 i /f I/ U I'i . �y T` pato 7-5 Name of Premises: y(1/4.)/1.1-10 SA?A c 5& '£S'7 . Tel: _d .3402 5—ot?- Purpose for which permit is used Ej T j}U P 413-7— _Q Jt C E V E License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency NOV 07 2018 BUIL% p•p • ii yy_ By _. A tOCg Certificate to be issu d to ;Witt 7-0L hest R e.5+. Tel: .�0?-3(v.1- S )- _ Address: /$7 kie i , , pmn /�r 4 Do?G 9S Owner of Record 6f t uilding A, _ - Address 1.- -, La u •er�� a •lk !lh i _ Present Holder of Certificate 1ignature o person to whom Title Certificate is issued or his agent ,/// 14)0/7 II / LDate Email Address: a/(YA Wa/ana e/6m Ca 571. V)PI 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 YO�C RTIFICATE OF INSPECTION. Certificate of Inspection# ,BLDCZ - /‘- a 4a--o?. 1/1/2019-12/31/2019 ACCPRO CERTIFICATE OF LIABILITY INSURANCE DA's'""°°""" 11/0712018 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 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 CONTACT NAME: PHONE FAX Automatic Data Processing Insurance Agency,Inc. a- cNs.E)Ry (MC,No): 1 Adp Boulevard ADDRESS: Roseland,NJ 07068 • INSURER(S)AFFORDING COVERAGE NAICS INSURER A: EmpWyen PmMTM insurance Company 10346 INSURED INSURERS: INAHO JAPANESE RESTAURANT INSURER C: 157 RTE 6A Yarmouthport,MA 02675 INSURER o: INSURER!: _ INSURER F: _ COVERAGES CERTIFICATE NUMBER: 1020552 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.NOTWITHSTANDING ANY 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 CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDO � POLICY EXP UNITS (POUCY (POLIC YEXP COMMERCIAL GENERAL LABILITY EACH OCCURRENCE S DAMAGE TO RENTED CLAIMS-MADE ❑OCCUR PREMISES(Ea occurrence) f MED EXP(Any one parson) f PERSONAL f ADV INJURY f _ GEN'L AGGREGATE UMITAPPLIES PER: GENERAL AGGREGATE RPOUCY[J n LOC PRODUCTS•COMP/OP AGO f OTHER: f AUTOMOBILE LIABILITY COMBINED SIO`!UNIT f (Ea mordent) ANY AUTO BODILY INJURY(Per parson) f ALL OWNED SCHEDULED BODILY INJURY(Pet accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE f AUTOS (Per accident) f UMBRELLA UAB OCCUR EACH OCCURRENCE f EXCESS UAB CLAIMS-MADE AGGREGATE $ - DED RETENTIONS f WORKERS COMPENSATION X NATUTE OTH- ER AND EMPLOYERS'LWBIUIY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 A (Mandatory UMEMB REXCLUDED? ❑Y NIA N EIG248569801 05/0212016 05/02/2019 1,000,000 (Myyesst.,dtory In NH) E.L DISEASE EA EMPLOYEE $ DESCRIPTION OF OPERATIONS!Now E.L DISEASE•POLICY UNIT S under 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES(ACORD 101,Additional Remarks Schedule,may he washed a mon space I.required) 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. 1146 Ma-28 South Yarmouth,MA 02664 AURIORDED REPRESENTATIVE te-y)a-.)/L.. A- A©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 4 w • ,. ? 'F tTOWN OF YARMOUTH ELECTING ELECTRICALGAS. 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 �I Telephone(508)398-2231,Ext.1261 —Fax(508) 398-0836 PLUMBING SIGNS - '. BUILDING DEPARTMENT Inspection and License ReportDa/�7�/ Bu Address /1,07 /core 6se //—,Oti 7-/6Business Name _....77149/76 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: ,Egress ❑ Emergenryegress signage Location r ❑Emergenryegress lighting Location /1/1 � • ID of exits Location /� (J(/ V ❑ Guards/handrails Location J ain ❑ Signs Location ❑ Parking Location ❑ Other Location. Meehan/cal ❑Combustion Air Location StorageinBoilerRoom Location ❑Vents Location ❑Automatic door closures on boiler room doors Location ❑ Clothes dryer vents location Qtgr 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. in order to abate the above violation(s)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 annual inspection. o Make corrections within ... days and contact this office for a follow-up inspection. Local Official/Inspecmr 3/419 4' Received By 4t4 114C tat Title Revised 2/8/13