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Home My WebLink AboutBLDCI-17-002911-02 The Commonwealth of Massachusetts � =airs City\Town of Witir — 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:GERARDI'S CAFE,INC. BLDCI-17-002911-02 Trade Name:GERARDI'S CAFE . Identify property address including street number,name,city or town and county Certificate Expiration Located at 902 ROUTE 28 12/31/2019 SOUTH YARMOUTH, MA 02664 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 57 A-2 Nightclub/Restaurant/Bar/Banquet Hall 57 Persons- Tables/Chairs/Booths Allowable 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 Ill Name of Municipal Mark Grylls Date of (/ Fire Chief Building Commissioner Ispection Signature of Municipal Signature of Municipal Date of • Fire Chief A.<I Building Commissioner - i/ �� ' ssuance Fee:$100.00 • BLD_Certofinspection.rpt I ;'4 ,, °F 49. TOWN O F YARMOUTH BUILDING ELECTRICAL GAS '~ y�.,�ra 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 "'IN _' PLUMBING Telephone(508)398-2231,Ext.1261 —Fax (508) 398-0836 SIGNS BUILDING DEPARTMENT Inspection and License Report �O/G�-r // /�� Address Q 9Date y� /� tc � Business Name �E.C'.�� / �?/cL� 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 Boar 'of Health rules,the following violation(s)were observed: Egtai U Emergency egress signage Location / i ` • U Emergency egress lighting Location /� .j I]Maintenance oferits Location0 f/ iT 6 - o Guards/handrails Location V ,Zoning ❑Signs Location • ❑ Parking Location ❑ Other Location Mechanical ❑ Combustion Air Location ❑Storage in Boiler Room Location ❑Vents Location ❑Automatic door closures ort boiler room doors Location ❑ Clothes dryer vents Location • qtr Location V 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 violations)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 an ual inspection. o Make corrections within /0 days and contact this office for a follow-up inspection. Jnh1O&idal/L tai„ i ii IS IMP A e \---.)Received By Title DNA),),/ti j Revised2/8/13 ' Rio TOWN OF YARMOUTH y' BUILDING DEPARTMENT RECEIVED ' • 1146 Route 28, South Yarmouth, MA 02664 508-398-22 1 xt 0 �.�'"��.� �; N'� 06 2018 BUILDING DEPARTMENT 7PPLICATICERTI ATE OF INSPECTION By: October 3,2d18 �e W1 l L '-" 4a 12 I3 PAYABLE UPON RECEIPT / , I I (X) Fee Required $100.00 ✓ CLQ,,, a ( ) No Fee Required In accordance with the provisions o e 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: gel/ Rode_ 25 1 Name of Premises: e r/t I S ed I n e • Tel: 34i1/3 11 0 t\ 60\11Purpose for which permit is used: tau at WI- n. qt‘ License(s) or Permit(s)required for the premises by other governmental agencies: n 1 License or Permit Agency Certificate to be,jssued to DI Yb �FZGYL61 / Tel: Sol? 07 (0 a,to__n.jj Address: X' L Pon a-n ' gas me, 07414/ Owner of Record of Building 1e jC 3�aL j e-1Zcrn'/ Address /I Present Holder of Certificate• 'b/ e1Q (i t ra rvi' IJ ® .t. 01441M- Signature of person to whom Title I Certificate is issued or his agent MdI 1 I(- Date Email Address: cY1 e hC.-MAUL COW) 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# cf,�-9'i�_o . 1/1/2019-12/31/2019 WORKERS COMPENSATION ANU tMPLUTttCSUAtWWLI T INSURANCE POLICY INFORMATION PAGE ,IN,Sl7REfi: POLICY NO: WE077044A NORFOLK & DEDHAM MOTDAL FIRE INSURANCE COMPANY 222 ALES STREET ENDORSEMENT EFF05/19/2018 ! DEDHA.M4, MA 02026 NCCI Company No: 21059 Account No: FEIN: 04-3519092 ITEM 1. NAMED INSURED AND MAILING ADDRESS: AGENT NAME AND ADDRESS: CEP..SRDI'S CAFE, INC. DBA GERARDI'S CAFE NUMBER ONE INS AGCY, INC 902 ROUTE 28 C/O PIKE INSURANCE SOUTH YARMOUTH, MA 02664 AGENCY, INC PO`BOX 2743 ORLEANS, .MA 02653 AGENT NO.: 20001222 LEGAL ENTITY: CORPORATION OTHER WORKPLACES NOT SHOWN ABOVE: (See Workers Compensation Classification Schedule) ITEM 2. POLICY PERIOD:From: 05/19/2018 To: '05/19/2019 Effective 12:01 A.M.Standard Time at the Insured's mailing address. ITEM 3. COVERAGE: 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 fisted in Item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident BodityInjury try Disease: S 500,000 porcyliimit Bodiy Injury by Disease: S 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states,if any,listed here: SEE'ENDORSEMENT 14C 20 03 '06 8 D. This Policy includes these Endorsements and Schedules: See Schedule of Forms and Endorsements. ITEM 4. PREMIUM:The premium for this Polcy Ni!be determined by our Manuals of Rules,Classifications.Rates and Rating Rens. All information required on the Workers Compensation Classification Schedule is subject to verification and change by audit. Total Estimated Minimum Premium: S 217 Annual Premium; $ 2,547 Audi Period:ANNUAL Additional 1 Return Premium: $ 404 ADDITIONAL Comments: CHANCE PAYROLL PER AUDIT Issued At Date:06/25/2018 Countersigned by WC 0000 01 A Copyright 191:7 National Council on Compensation Msunnce ..arenfreel