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Home My WebLink AboutBLDCI-18-006301-01 i • i oma ! The Commonwealth of Massachusetts • ( '� l E'' City\Town of • `. I_— YARMOUTH i New and Renewal Certificate of Inspection F- 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 ' 4 enhance fire and life safety),this certificate of inspection is issued to the premise or structure or part thereof as herein identified. i 1 Identify Name of Establishment Certificate No. 1 Issued to - 1 { Business Name:GRILL 43 BLDCI-18-006301-01 1 Trade Name:GRILL 43 Identify property address including street number,name,city or town and county Certificate Expiration 1 Located at 1 43 ROUTE 6A 12/31/2019. j 1 YARMOUTH PORT,MA 02675 1 Use Group Floor i Occupancy Use Group Other I Classifications(s) 01st Floor 78 A-2 Nightclub/Restaurant/Bar/Banquet Hall A-2 9 78 Persons - 02nd Floor j 18 A-2 Ni htdub/Restaurant/BarBa uet Hall 1 Allowable 9 nq 18 persons Occupant Load 1 Total seats:96 1 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 1I 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 1 by the undersigned. Failure to pose or tampering with the contents of the certificate is strictly prohibited 1 1 1 Name of Municipal Philip Simonian Ile Name of Municipal - Mark Grylls Date of ,e2.....3.7„6, , Fire Chief Building Commissioner Inspection ' Signature of Municipal a'// /I Signature of Municipal Dateto of Fire Chief Building Commissioner Issuance tis- ' Fee: j . 0 a ' j I)l BLD_Certoflnspection.rpt - +}gum v;� - mmr r<^"'nll-••• •r^fi w,p. .•.m^*• ,.-;`.�'. ° 'Y444, TOWN OF YARMOUTH 0 � -.t -- BUILDING DEPARTMENT e `3 rf 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 eat. 1260 RECEIVED APPL C• TION FOR CER I CATE OF INSPECTION NOV 07 2018 October 3,2018 PAYABLE UPON RECEIPT BUILDING DEPARTMENT (X) Fee Required $100.00 sy ( ) No Fee Required " "' In accordance with the provisions of the Massachusetts State Building Code, Section 110.7,I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number. its M l9t/w 5• fl- Y,qp w 01,4,1 P Od 675 Name of Premises: I/3 /ham/Q ac pfi4 ail 11 93 Tel: 5:Di' -?c5-5V51,0 Purpose for which permit is used: 1-011 SEatACe 1?-<5 9,,P License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency El( I Frtcoho L re) C/nt-f . a�j et4 rt{imstelt1--Fee s e2 rz Certificate to be issued to rri GG4p4 II /1i* Tel: SO$- ?S S-.5-9YD Address: U/3 AIA-rin 6 pi. +L v//-(i piO4- W f} Owner of Record of Building 2Q D COt-cv / Address TO 3.D-2vu'aie NMA t.724-3)- Present Ho •- •f Certificate .5 +•t .owI X11 0 Lvit.er_R /Off-' ` Signature of person to whom Title/ 1 Certificate is issued or his agent / 7/ic< Date tin _ . Email Address:----- ea/1- NU1_6:9-3t/40..1 C-61M 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 CANNOTn� ISSUE YOUR CERTIFICATE OF INSPECTION. Certificate of Inspection# l am- /g-cv 6Th/-0/ 1/1/2019-12/31/2019 ACO CERTIFICATE OF LIABILITY INSURANCE GATB(MM/DDmrr) L...---- _ _ —11ro2/zola—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(les)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 CONTACT David Crawford NAME: Eldredge&Lumpkin Insurance Agency,Inc. PHONELAN,No,ern: (508)945-0393 FAX No (508)945-4048 697 Main Street EkalciLe: david@elinsurance.com ADDRE INSURERS)AFFORDING COVERAGE NAIC e Chatham MA 02633MSURERA: Hartford Insurance Group 00914 INSURED INSURER B: 43 Main,LLC INSURER C: DBA Grille 43 INSURER D: 161 Church St. INSURER E: Harwich MA 02645 INSURER F: _ COVERAGES CERTIFICATE NUMBER: X 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 ADDLSUSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE NISEI MD POUCY NUMBER (MMIDDIYYYY) (MM/DDIYYYY) LIMITS X COMMERCIAL GENERAL LIABLRY EACH OCCURRENCE S 2.000'000 DAMAGE TORLNIED 1,000,000 CLAIMS-MADE IE OCCUR PREMISES(Ea occurrence)- $ X Products/Comp Ops MED EXP(Any one person) $ 5,000 A X Valet Parking 08SBAAA5928 01/30/2018 01/30/2019 PERSONAL 6ADV INJURY $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 4,000,000 POLICY El PRO- LDC 4,000,000 JECT PRODUCTS-COMP/OP AGO $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2.000,000 _ (Es ac idenn ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per ecddent) $ AUTOS ONLY AUTOS _ xHIRED X NON-OWNED PROPERTY DAMAGE S AUTOS ONLY AUTOS ONLY (Per acddent) E X UMBRELLA LIAS X OCCUR EACH OCCURRENCE _ S 1,000,000 — A EXCESS Las cLAMS+MADE 08SBAAA5928 01/30/2018 01/30/2019 AGGREGATE $ 1,000,000 DED XI RETENTION$ 10,000 $ WORKERS COMPENSATION PER UTE ETH AND EMPLOYERS'LIABILITY Y IN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER:MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ II yes,desuibe under DESCRIPTION OF OPERATIONS below • E.L.DISEASE•POLICY LIMIT $ Liquor Liability • A 08SBAAA5928 01/30/2018 01/30/2019 Each Common Cause 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached I mon specs Is required) Restaurant w/Liquor ' 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 Rte.28 AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 U'r/�l 5.41 J I . O 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD LDIN o,... q TOWN—O F YA R M O-U T H ELLEECCTRIICAL GAS 34' �1 ` - 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-44$1 PLUMBING �; I�.II Telephone(508) 398-2231,Ext.1261—Fax (508) 398-0836 SIGNS '-- BUILDING DEPARTMENT Inspection and License Repen Address V3 /Zct✓rt C Business / essName G/U /51 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: Eg.et,❑ • Aron 1 � /# tt/o sir k Emergency egress signage ,r ✓! T ` ❑ Emergency egret lighting Location v�J °rnir/t Si GS✓ $hC/t figs ❑Maintenance ofexits • Location ipsn -b I a9S1 '/ C Cit lr ❑Guards/handrails Location r onin ❑Signs Location • ❑Parking Location ❑ Outer Location Mechanical ❑ Combustion Air Location ❑StorageinBoilerRoom Location ❑Vents Location ❑Automadcdoordosures on boiler room doors Location ❑ Clothesdryer vents Location • Othe ---—Location— The Loation—The State Building Code,Section 1001.3-Maintenance,provides that the owner as defined In Section 780 CMR shall be responsible for proper maintenance. )n order to abate the above violation(s)you must- o Make corrections immediately and contact this office for a follow-up inspection. o Make corrections prior to opening and contact this office for a follow-up inspection. o Make corrections prior to your next annual inspection. o Make corrections within 7 days and contact this office for a follow-up inspection. Local Offidal/I ,... . . iii$ . e Received By - `/ Tide Revised 2/8/13