HomeMy WebLinkAboutBLDCI-19-002913 . t
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The Commonwealth of Massachusetts
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r au F_s YARMOUTH
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S' 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
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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:THE OPTIMIST CAFE BLDCI-19-002913
Trade Name:THE OPTIMIST CAFE
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
134 ROUTE 6A 12/31/2019
YARMOUTH PORT,MA 02675
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-2 01st Floor 80 A-2 Nightclub/Restaurant/Bar/Banquet Hall 80 PERSONS
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 ortampering with the contents of the certificate is strictly prohibited
Name of Municipal Philip Simonian III Name of Municipal Mark G Date of
Fire Chief Building Commissioner i Inspection �� /8
Signature of Municipal / Signature of Municipal Date of
Fire Chief ; Building Commissioner Issuance
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r,
Fee:$100.00
•
BLD_Certof nspection.rpt
S
TOWN O F YARMOUTH
BUILDING
4m44.4,---- „. GAS
1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451
ilitTelephone(508) 398-2231,Ext.1261 —Fax(508) 398-0836 PLUMBING
SIGNS
•, BUILDING DEPARTMENT
Inspection and License Report Q �y
Date //
Address /3 r i ,0GTC Cy Business Name �'/0— C� /6
(9/9771/22/..5.7— c#fr
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:
IDEmergency egress signage Iucation �IJ// Az / $9 v 179/ltI / ZeeVF t ,
me
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❑ Emergency egress lighting Location `l p' ';': /'r' S?/1/' '( jt t 4 t. /iii-1/4°5 oA ci) 1
✓
CI Maintenance ofesits Location • �'i ' ► / 1/�itq ,i 1 t ��_
❑Guards/handrails Location
onhs
❑ Signs Location
❑Parking Location
0 Other Location - s `••i
Mechanical
❑ Combustion Air Location
U Storage in Boiler Room Location .
❑Vents Location
❑Automatic door dosures
on boiler room doors Location
❑ Clothes dryer vents Location
Other 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.
jn 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 7 days and contact this office for a follow-up inspection.
Local Oficial/Inspector 3640 S,t/k(7
Received By " C-5-1 01=k VV( Mrtc\ ,1 / Tide ���G';c Q_-.)c. h C Lelc r eft
Revised 2/8/13
' , --- yc TOWN OF YARMOUTH I'T.
0w 7.i BUILDING DEPARTMENT 00an-
4.
'N . 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:
Street and Number: 1311 Rm CDA y,,Q.r(11Qti( + /
Name of Premises: Qp UUUU
� U Tel: -30—loa f
Purpose for which permit is used: 9-0&111.../.thealAdt
License(s)or Permit(s)required for the premises by other governmental agencies:
NOV 13 2018
License or Permit Agency .� a
rECEIVE1
UI/.Ui;V, . 4 /1T
'. .
Certificate to be issued to el' In `ss 'N. Tel: —34c.-7day
Address: 134 I - (9A a-m'IDU. *4 petVl'1 'i
A 0&co ,
?
Owner of Record of Building Thatg.40 £ tt LLC_
Address ant,
Present Holder of Certificate D P-h 144'1 St' Ca
/A✓'_: t oUritiA '
ii .ture of person to whom Titlen
Certificate is issued or his agent I/(7(/ b
Date
Email Address: 14111(11l.P' 118@ wine ezyvL
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#80a • 74-oray� 41°P1/1/2019-12/31/2019
117777,
zs °t WC 00 00 00 C)
15 (Policy Provisions:
eJ'�- 88..t
)CL INFORMATION PAGE
WEC WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY
INSURER: HARTFORD INSURANCE COMPANY OF THE MIDWEST .,
ONE HARTFORD PLAZA, HARTFORD, CONNECTICUT 06155 ;• ,
NCCI Company Number. 120605 HTHE_HARTFORD
Company Code: G
Suffix
LARS RENEWAL
POLI Y NUMBER: 08 WEC CL8815 I I I 05 I
Previous Policy Number: 08 WEC CL8815
HOUSING (CODE: DW
1. Named Insured and Mailing Address: KR sTINA'S KITCHEN, INC. DBA
(No.,Street,Town,State,Zip Code) T OPTIMIST CAFE
13 ROUTE 6A
FEIN Number 383892174 YARMOUTH PGRT, MA 02675
State Identification Number(s):
UIN:
The Named Insured is: CORPORATION
Business of Named Insured: RESTAURANT FULL SERVICE (WAI
Other workplaces not shown above: 134 ROUTE 6A
YARMOUTH PORT MA 02675
2. Policy Period: From 02/01/18 To 02/01/19
12:01 a.m.,Standard time at the insured's mailing address.
Producer's Name: DOWLING & O'NEIII INS AGENCY/PHS
301 WOODS PARK DRIVE
CLINTON, NY 133 3
Producer's Code: 088233
Issuing Office: THE HARTFORD
301 WOODS PARK DRIVE
CLINTON NY 13323
(866) 467-8730 V
Total Estimated Annual Premium: $989
Deposit Premium:
Policy Minimum Premium: $267 MA (INCLUDES INCREASED LIMIT MIN. PREM.)
Audit Period: QUA' Installment Term:
The policy is not binding unless countersigned by our authorized representative.
c aezenolt.' Cara Y 12/16/17
Countersigned by Date
Authorized Representative
page)
o%19
Form WC 00 00 01 A (1) Printed in U.S Page 1 (Continued on next Policy Expiration Date:
Process Date: 12/16/17
ptiNunnlikl
off
134 Route 6A,Yarmouth Port,MA 02675
TO: Yarmouth Town Hall-Health Department
FROM: Kristina Dittmer,Owner
DATE: November 8, 2018
SUBJECT: Optimist Café-Temporary Closing for Renovations
This is to inform you that we will need to close temporarily beginning on Wednesday,January 2,2019 for planned
renovations. We will be re-opening around February 16, 2019.
If you have any questions, please contact me at#508-362-1024.
Tha you,
ristina Dittmer, Owner