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Home My WebLink AboutBLDCI-17-002511-02The Commonwealth of Massachusetts City\Town of 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 Ad furt to her 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 Issued to Business Name: SKIPPY'S PIER 1 Trade Name: SKIPPY'S PIER 1 RESTAURANT Identify property address including street number, name, city or town and county Located at 17 NEPTUNE LN SOUTH YARMOUTH, MA 02664 I Certificate No. BLDCI-17-002511-02 Certificate Explratlon 12/31/2019 Use Group Floor Occupancy Use Group - Other Classifications(s) A-2 01st Floor 252 A-2 Nightdub/RestauranVBarBanquet Hall 68-2 SM. DINING - - 142 -MAIN DINING 422SM Allowable - - DINING -OPPOSITE BAR occupant Load 1STFLOORTOTAL- 252 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 III Name of Municipal Mark Grylls Date of Inspection Fire Chief Building Commissioner Signature of Municipal Signature of Municipal Date of Fire Chief&zz CA'417;� Building Commissioner _ _ Issuance v `J BLD_Certoflnspection.rpt c o .0 .YAR ` TOWN OF YARMOUTH BUILDING DEPARTMENT 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 $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: Street and Number: 1`r) w t F' ^` eyt L 6 h -c n 4 Name of Premises: S K i ;0�`{ S Y I -c f Tel: � og- l0 " SS� —ter Purpose for which permit is used: rr'St&�-ky-a f— License(s) or Permit(s) required for the premises by other governmental agencies: License or Permit Certificate to be issued to Address: 19 ► I RECE cr 26 2018 so, LOING o 6Y 01�1_.14fSNr I Agency SQjR 9---q 5S1 Owner of Record of Building SK Pf rnI L L C Address Present Holder of Certificate -Sk P r Yn1 L C1 t✓ /y1Qn¢ f -tip Signature of person to whom Title Certificate is issued or his agent _ //,-,) �--le Date Email Address: 5' �JQS1 l (An QJ Q 0 I , Lff1n7 Instructions: Make check payable to: Return this application to: Town of Yarmouth 1146 Route 28, South Yarmouth, MA 02664 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 # &DC_1- /7- D4 R 511 _ 492- I/l/2019-12/31/2019 Z1/1/2019-12/31/2019 SKP/M-1 OP ID: DIP ACORG'TEowowTY DAYY) CERTIFICATE OF LIABILITY INSURANCE 1010312017 - THIS -CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS. NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYAMEND, 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(fes) must be endorsed: H SUBROGATION 13 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A Statement on this certificate does not confer tights to the Certificate holder In Hou of such end s .PRODW- , - GP-MERNAME: DGP-Miles Insurance A , Inc. - 3 Schools Insurance ox 101 inc. Nn 508-880-2734 3 IF urdool Street P.O. Box 1018 vNONE 508-824 8901 f'-rd n MA 02780-0307 ' E �=^rdon QAsack AooaEss:' URED SKPIM,LLCdba Skippy'sPier I -'.,.. 731 Main Street, LLC dba Tavem 731,277 S. Shore Dr' LLC dba Surf & Sand Motel _ Sandra DI Giovanni • . P.O. Box 370 - - S Yarmouth, MA 02884: IVERAGE3::: rFrmclrreTr ulnunco. eaeew, m nm .THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE OSTEO 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 THEPOLICIESDESCRIBED HERON 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS..MR - LTR TYPE OF INSURANCII POl1Cp NUMOFTI I'DUCY EXP D I16NT3 OENERALLIABRnY - . - EACH OCCURRENCE S .. COMMERCIAL GENERAL LIABILITYPREMISE 4. CIAMS4"E ❑ OCCUR nEff .. MEO MfAn art antiq 4 PERSONA. S ADV INJURY S - GENERAL AGGREGATE 4 , .. GENLAGGREGATE LIMIT APPLIES PER: PRODUCTS -CONPIOPAGO 4 POLICY MIn . LOC .. s AUTOMOBILE LIABILITY. ANYAUTOALL B000.YINAAtY(P0TPrw,) S El BOONLY tlLtl1MlPArROUeNiq f - AUTOS AUCHT(Sey'LED .. OVJNE HIREDAUTOS AUTO AUTOS - PERA CNIE 4 UMBRELLA UABOCCUR - .. EACH OCCURRENCE S EXCESSLM, CLAM,&Al1E _ AGGREGATES OED ON S - VJORKMCOMPENSAMM S A A ANOEMPLOYERS'LIABa1TY- IN EL EACH ACCIDENT f 100, ANYPROPRIETOR1PAR}NEREI( cure) OFFICERAAEMBER E%CIUDEOT NIA 628 368 OSf30@018 05J30/2019 (MeWalgyMNH) _ tlyyeqa Eesnbe WM E.L DISEASE. EA EMPLOYE 4 100,00 E.L DISEASE -POLICY UNIT S 500,00 ESCRIPTIDN OF RA MIOw - - DESCRIPTIONOFOPERATIONSILOCATIONSIVONCIAS IAtbeNACORDI01,Adit8"RMedFSa W%ft NRwFApeF%N*d,a) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Yarmouth THE . EXPIRATION DATE' THEREOF, NOTICE WILL BE DELIVERED IN :. 1146 Route 28 - ACCORDANCE VMH THE POLICY PROVISIONS. S. Yarmouth, MA' - AVTHOR fo REPRESENTATIVE' . . - Gordon G. Asack • - - - m ISM2010 ACORD CORPORATION. All rights reserved. wn,i w {<v,wuol - 1 ne A{i{JKU name and logo are registered marks of ACORD TOWN OF YARMOUTH ELELCA \ti' GAS - 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 PLUMBING Telephone (508) 398-2231, Ext. 261 — Fax (508) 398-0836 SIGNS BUILDING DEPARTMENT NOTICE OF VIOLATION Inspection Date: !�% xJ /S` ��/� Inspection Type: C-7- Property ? Property Address: Name: � h] , L LL P �fJ Owner M/11*� Tenant ❑ D/B/A: �' oie �� T, Telephone: Mailing Address: City/Town: State: Zip Code: An inspection of the above captioned property was conducted by the undersigned, during which the s You are hereby ordered to abate or correct said violations within 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: Copy Re Original - Owner/Tenant Yellow Copy - Licensing Authority Pink Copy - Bldg. Dept. ,TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 026644451 Telephone (508) 398-2231; Ext. 261 — Fax (508) 398-0836 BUILDING DEPARTMENT NOTICE OF VIOLATION BUILDING ELECTRICAL --GAS PLUMBING SIGNS Inspection Date: Inspection Type: C-7- Property ?Property Address: Name: h,- I- /�7 L Owner all", Tenant ❑ t D/B/A: Telephone: Mailing Address: An'z City/Town: State: Zip Code: An inspection of the above captioned property was conducted by the undersigned, during which the fVowingVIOLATIONS were observed: A t, You are hereby ordered to abate or correct said violations within 7 ays. 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: «S G' ��•� �. l<� �•m . Insyector TT Title Copy Received By:.= -- Original - Owner/Tenant Yellow Copy - Licensing Authority Pink Copy - Bldg. Dept.