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Home My WebLink AboutBLDCI-16-003278-02 F{+ Y 1 The Commonwealth of Massachusetts ' 1_: i_= City\Town of t ®iti =• 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:FOUR SEASONS TRATTORIA,INC. BLDCI-16-003278-02 Trade Name: FOUR SEASONS TRATTORIA Identify property address including street number,name,city or town and county Certificate Expiration Located at 1077 ROUTE 28 12/31/2019 SOUTH YARMOUTH,MA 02664 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 54 A-2 Nightclub/Restaurant/Bar/Banquet Hall Inside Allowable Other 16 A-2 Nightclub/Restaurant/Bar/Banquet Hall Outside Occupant Load OCCUPANCY LOAD SET BY HEALTH DEPARTMENT TOTAL PERSONS-70 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 4/�. /� Fire Chief Building Commissioner / ) Inspection Signature of Municipal /r ., Signature of Municipal "ir Date of Fire Chief ,/ /Se Building Commissioner Issuance ;Or Fee:$100.00 • BLD_Certoflnspection.rpt •p4• elk t � TOWN OF YARMOUTH I%It, BUILDING DEPARTMENT �.� a• :�3 1146Route 28, South Yarmouth,MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION October 3,2018 PAYABLE UPON RECEIPT (X) Fee Required $150.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 110.7,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Rc Street and Number: 10 71 Luke_ 9 22 YftY nr e tall Pt ft 0L s(c1, Name of Premises:A\ four qa.SO h L Tel: SbW 7a)O ((CD Purpose for which permit is used: '2G$ +I.U-Y'glet,\-- License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency /Certificate to be issued t OUr Jon-s % � (/3>ta.Tel: 09 -` bo ^Ego `c Address: (D77 IFAPc7 fctrtnotit h-ti Owner of Record of Building A c6`ty &itrt-/q Address Present Holder of Certificated< 3 Ur 4-'eve 4ct.at,- 1-44 ,` ® RECEIVED ij�r Aden_`_" S gna ' - of person to whom Title Certificate is issued or his agent NOV 15 2018 ll (S—17 Date BUILDING DEPARTMENT I Dy Email Address: 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 IS/SSUE Y UR CERTIFICATE OF INSPECTION. C Certificate of Inspection# # - ISO J �a '--QZ f 1/1/2019-12/31/2019 DATE. .A CORD' CERTIFICATE OFLIABILITY INSURANCELZ lsnol THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIt i 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: N the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WANED, 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 endortement(s). PRODUCER Phone; (978)651-9600 Fax (979)851-4848 CONTACT Kim Caron SULLIVAN INSURANCE AGENCY NAME` 885 MAIN STREET (ACNNO bit (978)475-0400 h4 Not (978)475-2171 ETEWKSBURY MA 01876 ADDRESS* INSURER(S)AFFORDING COVERAGE RAIL/ INSURER A : MA Retail Merchants Workers Comp Group • INSURED FOUR SEASONS TRATTORIA INC. INSURER e : . 1077 RTE 28 • INSURER : SOUTH YARMOUTH MA 02664 INSURER D: • INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 30546 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 ADM SUER POLICY EFF POLICY EMP ITR INSR TAM POLICY NUMBER IMMIOpM'YYI MMmDM'YYI LIMITS GENERAL UABMJTY._.. _ • EACH OCCURRENCE S '; COMMERCIAL GENERAL LtABIJTY DAMAGE TO RENTED S ICLAMS-LADE ❑OCCUR ASES�""""�i 4 MED.EXP(My one person) $ ICPERSONAL a AW INJURY S GENERAL AGGREGATE 5 • GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO S 7 POLICY[1 ECT El LOC S AUTOMOBILE LAMM COMBINED SINGLE LBMT Me am ANY AUTO _ 800IL4^MI $ —ALL OWNED 'SCHEDULED BODILY INJURY(Per person) S —AUTOS _AUTOS BODILY INJURY(Per accident) S HIRED AUTOS -OWNED _AUTOS PROP eeMAGE(par uket) (par . S UMBRELLA UM OCCUR EACH OCCURRENCE S EXCESS LUG CLAMS-SADE AGGREGATE S DED I RETENTIONS • S A MRKMID EMPLOYERV"LIAawTy 014005033240118 01/08/18 01/08/19 I TORYLIMve I I MM $ ANY PROPnETONPAmNsR cumE VIM E.L EACH ACCIDENT S 100,000 OFFICEAMEMBER EXCLUDEDi aalbe a .,uNIA E.L.DISEASE-EA EMPLOYEE S 100,000 DESCRIPTION OF OPERATIONS Oder E.L DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remade Schedule,it more space Is required) CERTIFICATE HOLDER CANCELLATION Town of Yarmouth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1146 Route 28 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN South Yarmouth,MA 02664 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPR ,E 1SE _NTATIVE (� /I Attention: l I / � y� ��33000JJJ \��JJJJJJ v ` Amy R.Jose ACORD 25(2010/05) ®1988- 10 ACORD ORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD d' `J �4 TOWN OF YARMOUTH BUILDING 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 PLUMBING 41 Telephone(508)398-2231,Ext.1261—Fax(508) 398-0836 SIGNS BUILDING DEPARTMENT Inspection and License Report p Due > a/-/8 ;Address /077 /��oiC .C5 Business Name / S9tS a7g/i� Conracr Phone ... Dating 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: ,Eg' ❑E ryLocation 75 7(C _, mergenegresssignage tion �ftt /!,(/hTC ❑Emergency egress lighting Location ❑Maintenanceofexits Location ❑Guards/handrails Location Zoning ❑Signs Location • ❑Parking Location ❑ Other Location ' • Mechanical ❑CombustionAir Location "�..„ ❑StorageinBoilerRoom Location ❑Vents Location ❑Automatic door closures on boiler room doors Location laer Clothes dryvents Location Qther Inrarion 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 7 days and contact this office for a follow-up inspection. Local Official/Inspector ,�0 �n //xi Received By /1oi I / Title Revised 2/8/13