HomeMy WebLinkAboutBLDCI-17-002508-02 it w
The Commonwealth of Ma -' ac %usetts
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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:TAVERN 731 BLDCI-17-002508-02
Trade Name:TAVERN 731
Identify property address including street number,name,city or town and county Certificate Expiration
731 ROUTE 28 12/31/2019
SOUTH YARMOUTH,MA 02664
Use Group Floor Occupancy Use Group
P Other
A-2 01st Floor 90 - A-2 Nightclub/Restaurant/Bar/Banquet Hall
50 Seats
20 Bar Stools
Allowable TOTAL OCCUPANCY
Occupant Load PER FIRE
i DEPARTMENT:90
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 I
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 III Name of Municipal Mark G lls
Fire Chief ..as
of /(��/� i
Building Commissioner Inspection
Signature of Municipal
Signature of Municipal ' Date of
Fire Chief I
.
t,
Signature
Building Commissioner Issuance
•
orikil
Fee:$100.00 i
1
1
BLD_Certoflnspection.rpt
°F Y9e _ TOWN OF YARMOUTH
e c
0 i. y 47.- BUILDING DEPARTMENT
•553**---u* d 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: 9 3 1 Via G I n ,IT -c refr 7, ��7
Name of Premises:I(diff 1-n '1 3LI Tel: JU p c 1396 /�y J Jb
Purpose for which permit is used: frSUrrt n- _
License(s)or Permit(s)required for the premises by other governmental agencies:
License or Permit RECEIVED Agency
OCT 26 2018
BUILDING DEPARTMENT C
Certificate to be issued to rI3I I'ha I n 9 art f� L L�£. 1 el: SZO 30 P—,5-51°
Address: r4 , 931 Pio n � t {- 1 Sturma itt 01teG LJ
Owner of Record of Bui ding 13% me,I' S k'ct 4- I C'.
Address f/1 Iv(p\tiltt I COI - 1309( 3 r1 (1 S * 1,1 /t^A- G1loGy
Present Holder of Certificate fl 31 MQI n b rk' t LLC d '4her -7 3 I
/7�tahc' rr
Signature of person to whom Title G s�/,e
Certificate is issued or his agent ��
Date
Email Address: S pQ Sal U h Cr) a 01, C 0 r1
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# Rizzi - /7-e?RSa f -D Z
1/1/2019-12/31/2019
SKPIM-1 OP ID:DP
A�R9- CERTIFICATE OF LIABILITY INSURANCE DATE
TE(11 0;;"
THIS CERTIFICATE IS ISSUED AS AMATTER 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 policyQes)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 endorsament(s)..
DGP-Mlles Insurance Agency,ine CONTACT
• won: DGP-Miles Insurance Agy,Inc.
3 School Street P.O.Box 1018 i NONrm E n 508424-8961 I(A"xc N,x 508480.2734
Taunton,MA 02780-0957 . - '
Gordon G.Asack..
INSURERIS)AFFORDING COVERAGE - NAICI
WSURER A:Technology Ins.Co.(AMTRUST) .
INSURED SKP1 M,LLC dba Sklppy's Pier 1 . - INSURER a: .
731 Main Street,LLC dbe • - - .
Tavem731,277S.Shore Dr. INSURER C: '.
LLC dba Surf&Sand Motel - INsuRER o i ' . - •
-
Sandra DI Giovanni - - -
P.O.Box 370.; INSURER!: .
S Yarmouth,MA 02864 : - - - INSURER r;
COVERAGES - CERTIFICATE NUMBER: . . 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. . •
LTR TYPE OF INSURANCE - n R min -POLICY NUMBER POLIO yyl�] Po(YA Ud'/r�j'yI WAITS
GENERAL LABILITY _ - - EACH'oCCLIRRENCE 3
• COMMERCW.GENERAL LIABILITY DAMAGE IO RENrLO
.I ❑Deem PRE EXP( y mn p ri i) $ _
. _ MED ExP(Any arpeNo,)' a _
PERSONAL E ADV INJURY S . ' .
— ' – GENERALAGGREGATE a - __
Gan AGGREGATE MTAPPLESPER PRODUCTS•COMPIOPAGO E :
AVTOMOOt!LAB UTY. _. _ COMU SINGLE LIMIT swirlorD
_ a
ANYAuro BODILY INJURY(Par pato,) e
_ AU satraps' - '- eoolLrEWRYtPrraoUblq $ .
- NON-OWNED. _ PROPERTY
LURED AUTOS
� AUTOS � • _ � (PER ACCIDENT)ENTI
a
a .
UMBRELLA LIAR OCCUR •
EXCESS LIAR ct,.asa1I,DE AGGRE(ATE a - _
DED I I RETENTIONS - - 5
WORKERSCOMPENMTIONWC STATU• 0TH.
AND EMPLOYER$'LAea1TY y - ITORYLR4TRI I ER
A ANY PROPRETORIPARTNEREXECUINE ❑ NIA TWC3628358 : 05/30/2018 05/30/2019 EL EACH ACCIDENT a 100,000
°FPCERMEMBER EXCLUDED?
(tlMya0nAdatory Ns NX) E DISEASE•EA EMPLOYEE a 100,000
DESCRIPTIOONN OF OPERATIONS Calow ''.
. EL DISEASE POLICY LIPMT a 500,000 ..
•
DESCRIPTION MODERATIONS I LOCATIONS/REOaMUS NUInT ACORD IM,Adm$OOY Raamb Salad,M.M moa spa.1 NWnd).
•
CERTIFICATE HOLDER - CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of Yarmouth THE.EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
1148 Rotde 28
S.Yarmouth,MA AUTNOREED REPRESENTATIVE'. .
Gordon G.Mack
•
.
01988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05): The ACORD name and logo are registered marks of ACORD
0
BUILDING
,, ?. °F y---
' q9.----
i.9 TOWN OF YARMOUTH ELECTRICAL 4'1
a
G i - GAS
: ...1,\J •i 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451
= PLUMBING111 / Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-0836 SIGNS
11 MATTACHEESE
%Aum P
BUILDING DEPARTMENT
1
2
7
/
NOTICE OF VIOLATION %�5
Inspection Date: sir .t.nt{,U /3 2 135./. Inspection Type: c 7
Property Address:� / ^3 / iT a er
Name: /, 13/ a. /Z-11 AZ( ( Owner p7.- .Tenant ❑
D/B /A: �,ar-h2 75/ / . Telephone:
Mailing Address: /7 f%rJ_se f � e� 7O -c2.City/Town: / State: Zip Code:
An inspection of the above captioned property was conducted by the undersigned, during which the
following VIOLATIONS were observed:
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pn .7707. ate1/201 -,4-7 _. , e/ ..,. - N
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You are hereby ordered to abate or correct said violations within 7 days.
. Failure to do so may result in criminal/civil complaints being filed against you,which may be subject
to fines as prescribed by pertinent laws and regulations, or may delay the issuance of your license.
You are also required to contact the Building Department for a re-inspection by the time noted
above.
Signed: _ 4� A r' L..Q if A
� l , 7
[nspe [or / / the
Copy Recei ed By:4) ll v / s L_
/
Original - Owner/Tenant Yellow Copy - Licensing Authority Pink Copy - Bldg. Dept.
U
- •O��SOF '4.9----.--- BUILDING
• ,e _ _ TOWN O F YARMOUTH ELECTRICAL. /
GAS
?„,I 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451
--+�� Telephone (508) 398-2231, Ext. 261 —Fax (508) 398-0836 PLUMBING
MATTACHEESE SIGNS.
BUILDING DEPARTMENT /
NOTICE OF VIOLATION
519
.2-'17-.71107. i
Inspection Date: ,,, c�aZ,u /5. =../ /'r/ Inspection Type: C7
Property Address: �•3 / /.-wle .2r — /
Name: 13/ /7f ^ /ZiA .4 r Owner IBJ/ Tenant ❑
` D/B /A: �K t h.i 7-7/ Telephone:
Mailing Address: /-7 4", ,7e..n e 1st.., s q - 7 -e'. re
City/Town: State: Zip Code:
An,inspection of the above captioned property was conducted by the undersigned, during which the
following VIOLATIONS were observed:
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• �„2 -/ .-yr _ Gr,xr-s ....41C T c fj 4,,,_, �-.r , .vp ei. ./1f-.- • \/ /
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imet //r/rw_/- • 2/�de'�.-� /`
fr,/ ,.t..Le /�YY ,T l d 7 h r f7 /i1'—rbc.., ":-Cit-s.>
7 ,,r/„ � -� h7:-.,..e. ' � � / �r - `-� �i
�i"7, r _/_..,.r-R.-„.(
kV/ / ,,telt
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rM•.wt /
/4 4 _ 4, /.-- f. otn40 �, ��..
a 2 r .,r -%tt /
7 . r.a. m lye., :>-�i /, e PI
t,
You are hereby ordered to abate or correct said violations within 7 days.
Failure to do so may result in criminal/civil complaints being filed against you,which may be subject
to fines as prescribed by pertinent laws and regulations,or may delay the issuance of your license.
You are also required to contact the Building Department for a re-inspection by the time noted
above. - A // /7
Signed: ,� /U ,,....-.5.,_.(:_,./
_ - 7/�K !-ereInspector 1 ' 4,67.,--e-
/ Title -
Copy Rece( ed By: /J /l,; / i
Original - Owner/Tenant Yellow Copy - Licensing Authority Pink Copy - Bldg. Dept.