HomeMy WebLinkAboutBLDCI-16-003267-02 The Commonwealth of Massachusetts
'4=` wry City\Town of
sit(= YARMOUTH
•rte,.. ,. '
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:CALAMARI,INC. BLDCI-16-003267-02
Trade Name: DIPARMA ITALIAN TABLE
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
175 ROUTE 28 12/31/2019.
WEST YARMOUTH,MA 02673
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-2 01st Floor 17 A-2 Nightclub/Restaurant/Bar/Banquet Hall Bar Stools
Allowable 01st Floor 154 A-2 Nightclub/Restaurant/Bar/Banquet Hall 154 persons-tables&
Occupant Load chairs
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 Gryl Date of /
Fire Chief Building Commissioner Inspection l/ 'gtY47
Signature of Municipal 1 4//�/ Signature of Municipal Date of
Fire ChiefArf dr/ // Building Commissioner -- / /Issuance 1z 0 f
•
, Fee:5150.00
ii
BLD_Certofl nspection.rpt
°F YAR ; TOWN OF YARMOUTH
0 -091 BUILDING DEPARTMENT
`:.e.Ct-.-- vg 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: 'Dyck(ns9&G,,, G oar
Name of Premises: ry t._17.A.,1an TG t, Tel: a*- 771-'7'77 to
Purpose for which permit is used: t1'essiCcLxXGw�
License(s) or Permit(s)required for the premises by other governmental agencies:
RECEIVED
License or Permit Agency
OCT 29 2018
•
BUILDING DEPARTMENT
BY:
Certificate to be issue toC4.� rr1/40-nn. �r'lC . Tel:
Address: \"lt `'Jj, 4&'
Owner of Record of Building , • _ c,,, r, ._ Teo r .1 , • . . 'Mks 1
Address \'1'c Al.o jirn
Present Holder/ of Ce ' icate e. A,Lk. :,s..,, . ;,
l/ `--. �(eSIC�ec/�
Sign. ure%f.4cson to whom Title i
',
Certi _ . e is issued or his agent kb 1ak ..`icS
Date
Email Address:
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# BLtd? -/4-0!7 3 a,C 7- et.]
1/1/2019-12/31/2019
'.....r, 0 DATE(MMMO/YT
ACQR?? CERTIFICATE OF LIABILITY INSURANCE 10/17/0018
•
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(ies)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 RIND fREGUL„
NAME:
STANDISH INSURANCE GROUP INC. YAHOO No.EaO. 77472837442* P&eel: 7(4283.4243—
303 COURT STREET UNIT 1B E-MAIL ANDYR@_STANDISHINSURANCE.COM
PLYMOUTH,MA. 02360 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAICa
INSURER A:NORGUARD INSURANCE COMPANY
` U --:41ORGUARD]NS1JRANCEOOMPANY—
MSURED INSURER B
CALAMARI INC. INSURER c7ORG'UARU
175 MAIN ST INSURER D:
INSURER E: I __
WEST YARMOUTH MA 02675 INSURER F:
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.
INSR RDDL16UBR POLICY TY POLID/YYT
LTR TYPE OF INSURANCE IINSDD POLICY NUMBER (MM/DdyyYYl IMM/ODIYYYYL UNITS
X COMMERCIAL GENERALLIABRJTY CABP9094OT6/15/078 6/15/2019 EACH OCCURRENCE S 1,000,000
A DAMAGE TO RENTED
CLAIMS-MADE [ I OCCUR PREMISES IEryccugenceL__ S 50,000
BUSINESS OWNERS MED EDP(Anydnipmsom $ 5000
PERSONAL a ADV INJURY S
GENI.AGGREGATE LIMIT APPLIES PER: .GENERAL AGGREGATE S 2,000,000
— POLICY o 1.702i LOC PRODUCTS_COMP/OP AGG S 2,000,000.
OTHER'. S
AUTOMOBILE LIABIUTY t COMBINED SINGLE LIMIT $
-IE0 accident)__—_
ANY AUTO BODILY INJURY(Per person) S
OWNED SCHEDULED BODILY INJURY(Par accaere) S
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE S
_ AUTOS ONLY _- AUTOS ONLY (Baaccident)
S
UMBRELLA MB OCCUR EACH OCCURRENCE S
EXCESS ma CLAIMS-MADE AGGREGATE S
DED RETENTION S _--_— S —`
I WORKERS COMPENSATION CAWC903875 PER0TH-
1AND EMPLOYERS'LIABILITY STATUTFL1�R
B !ANY PROPRIETOR/PARTNER/EXECUTIVEYIN I 6/01/2018 6!01/019'--
OFFICER/MEMBER EXCLUDED? NIA E L.EACH ACCIDENT S 5004,000
((Mandatory In NH) - E.L DISEASE_EA EMPLOYEE S _500.000
11 e,dead,.under _- .
DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 500 000
LIQUOR LIABILITY CA81,909497 6/15/2018 6/15/2019 31,000,000 PER OCCJRENCE
52,000,000 GENERAL i AGGREGATE
DESCRIPTOR OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,A4dMIonM Remarks Schedule,may be attached R mere apace Is requlrsd)
FULL SERVICE RESTAURANT
CERTIFICATE HOLDER CANCELLATION
TOWN OF YARMOUTH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
1146 RTE 28 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
SOUTH YARMOUTH MA 02664
AUTHORIZED REPRESENTATIVE
® 88-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) - The ACORD name and logo are registered marks of ACORD
'Sr506
,,,.. .YP BUILDING
TOWN OF YARMOUTH ELECTRICAL
-..y l 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 PLUMBING
Telephone(508) 398-2231,Ext.1261 —Fax(508) 398-0836
_ - SIGNS
'`' = BUILDING DEPARTMENT
Inspection and License Report
Date
Address /?5 /SorC7UrC 2 Business Name 47M9,Qn9M
Contact / os 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:
Egrat
❑Emergency egress signage Location
/ Nil 446‘
h2tT 0002- , , ✓ eCI Emergency egress ligting Location
.❑Maintenance ofexits Location kn/ f* A 44 t/34 7tn e_ 7:45-dis
❑Guards/handrails Location
t
Min re rAe t
CI signs Location
❑Parking Location
0 Other Location
Mechanical
❑CombusdonAir Location
❑
Storagein Boiler Room Location
❑Vents Location
❑Aumntazicdoordosures
on boiler room doors Location
❑Clothes dryer vents Location
Other Location
The State Building Code,Section 10013-Maintenance,provides that the owner as defined in Section 780 CMR shall be
responsible for proper maintenance.
In order to abate the aboveyiolatlon(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 correctionswthin/_� days and contact this office for a follow-up inspection.
Local Official/Inspector emd .2i4 /ey
Received13)2791.1552
/// V / Tide
Revised 2/8/13