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Home My WebLink AboutCI-17-5596-02 The Commonwealth of Massachusetts ►*w}=Esc City\Town of Sjahl YARMOUTH tff . 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:EL MARIACHI MEXICAN RESTAURANT BLDCI-17-00559602 Trade Name:EL MIRIACHI MEXICAN RESTAURANT Identify property address including street number,name,city or town and county Certificate Expiration Located at 416 ROUTE 28 12/31/2019 WEST YARMOUTH,MA 02673 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 117 A-2 Nightclub/Restaurant/Bar/Banquet Hall 102 lower 10 bar TOTAL PERSONS Allowable ALLOWED:117 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 or tampering with the contents of she certificate is strictly prohibited Name of Municipal Philip Simonian Ill Name of Municipal Mark Grylls Date of Fire Chief Building Commissioner / Inspection / Signature of Municipal '// Signature of Municipal Date of Fire Chief Building Commissioner Issuance afro/ er . Fee:$150.00 BLD_Certofinspection.rpt RECEIVED °? "* o TOWN OF YARMOUTH NOV 7 01a, , ' `�` - BUILDING DEPARTMENT [_ C� Bo ti goowl BUIL 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 extri 260INGDEPARTMENT APPLICATION FOR CERTIFICATE OF INSPECTION October 3,2018 PAYABLE UPO r - (X) Fee Req • • • $150.00 • ' • ( ) No Fee Requ 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. 40 4 Ro u.t., Z Ir • A,C!p7wrtack( L Name of Premises: P P/4-ya _Este Tel:Tel: ..sb8 -fa.7—7.G Purpose for which permit is used: t' li 02 ca`I) License(s)or Permits)required for the preMRises by other governmental agencies: License or Permit Agency r RECEIVED / I NOV 2.7 2018 Certificate to be issued to R Playa, Joe Tel: SDP -rA7- 7/ JJJ Address: 4/6 Wensta, aP BUILDING DEPARTMENT Owner of Record of Building Aksytat a Jae. By. Address 4a 4/14..1 Aw , .5tad 64•7 mire 017.74 Present Holder of Certificate 7.SCm/\e/r .34°4 i/anogere agetr Signature of person to whom Title Certificate is issued or his agent ///7 9 Pi Cr- 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 COT ISSUE YOUR CERTIFICATE OF INSPECTION. Certificate of Inspection#ECD -f?1-0,5 S46• o Il/2019-12/31/2019 • .r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of'a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However,the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply your insurance company's name,address and phone number along with a certificate of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required.Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. Oty or Town Officials • Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number.In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary). A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fixture permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel.# 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 t=am nevtxa 7/2010www.mass.gov/dia TOWN,j ti RMOUTH 1146 Route 28",...r. nn`' �� , aouth, MA 02664 508-398-223e 508-398-0836 Office of the Bin , ommissioner October 3,2018 EI Mariachi Family Restaurant 416 Route 28 West Yarmouth,Ma 02673 Re: Annual liquor license inspection Fee$150.00 Pursuant to the provisions of the Massachusetts State Building Code 780 CMR,Section 110.7 and Table 110,you are required to apply for a Certificate of Inspection for the building located at 416 Route 28,West Yarmouth,Ma 02673,DBA EI Mariachi Family Restaurant. Please complete the enclosed application and return it with the appropriate fee payment to the Town of Yarmouth Building Department, 1146 Route 28,South Yarmouth,MA 02664. Checks should be made payable to the town of Yarmouth. Please note that you must return your application and have your inspection completed before December 1. 2018.to insure that your liquor license will be renewed by the Board of Selectman on December 11.2018, If your liquor license is not renewed at the December 11.2018 Board of Selectman meeting,then the next available date may not be until after your current license expires on January 1.2019, Unless otherwise requested,inspections will be performed unannounced. Typically the following elements/ systems are inspected: fire protection equipment, means of egress, including emergency lights, exit signs,egress doors & hardware, clear path of travel, adequate lighting and occupancy total. Also, the building shall be maintained and adequate housekeeping provided to insure public safety. Rooms such as basements and attics are included. Violation details will be provided in the form of a Violation Notice and may delay the issuance of your certificate and/or license,if applicable. BE ADVISED after receiving your application a minimum of 2 week's notice is required for an inspection. One re-inspection will be included in the initial fee to confirm the abatement of any violations.Additional re-inspections will cost$80 each,which is payable in advance of the re-inspection. Liji nuieO, Mark A.Grylls Building Commissioner ACAPU19 OP ID:DI( ACORD" ' CERTIFICATE OF LIABILITY INSURANCE DA11/19/2018 TE 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 pollcy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED,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 781.247.7800 CONTACT Evan Tobasky Rodman Insurance Agency,Inc, NAME: FAX a Division ofBrown8 ggBrown (A/C,No.Ea):781-247-7800 14LIC Mo):781444-0090 145 Rosemary 02t.,Bldg. DDR Needham,MA CDR�ss Evan Tobasky INSURER(S)AFFORDING COVERAGE NAICI _ INSURER A:Liberty Mutual INSURED LaPlaya dba El Mariachi INSURER e:Staretone National Insurance West Yarmouth Location - 705 W 7th Ave Suite A-3 INSURER C: ' Spokane,WA 99204 INSURER D: INSURER E: 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. INS0. TYPE OF INSURANCE ADDL. POLICY NUMBER POLICY EFF POLICYEXP UNITSITRINSO MD POLICY IMMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 100,000 CLAIMS-MADE M OCCUR BKS56755089 06/18/2018 06/18/2019 PREMISES/Fa DAMAGETORu) i ENTED 100,000 ocwnen _ MED EXP(Any one parson) $ 5,000 X Liquor Liability PERSONAL&ADV INJURY S 1,000,000 GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY I JECT E LOG PRODUCTS-COMP/OP AGG ,3 1,000,000 OTHER: S AUTOMOBILE LIABILITY (Ea acicideentSINGLE LIMIT $ — ANY AUTO BODILY INJURY(Per person) S - OWNED SCHEDULED _ AUTOSEONLY _ AUTOS BODILY BODILY INJURY(Per accident) S — AUTOS ONLY _ AUTOS ONLY (Per PROPERTYDAMAGE— $ $ B X UMBRELLA LIA; 121 OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS UM. CLAIMS•MAOE 80198T182AL1 06/18/2018 06/18/2019 AGGREGATE .1 1,000,000 DEO RETENTION S $ WORKERS COMPENSATION I PER FOR AND EMPLOYERS'LIABIL TY ANYA{�� PROPRIIETORLPARTNER,EXECUTIVE V EL EACH ACCIDENT $ (MenCERAry In NH)EXCLUDED? N I A EL,DISEASE•EA EMPLOYEE, S I yea describe under DESCRIPTION OF OPERATIONS below , E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached I mon space Is required) • Re:416 Route 28,West Yarmouth, Mass. CERTIFICATE HOLDER CANCELLATION WESTYAR • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of West Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town ACCORDANCE WITH THE POLICY PROVISIONS. West of Wes Yarmouth,MA Yarmouth AUTHORIZED REPRESENTATIVE I • a aea ACORD 25(2016/03) ®1988.2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • r J r " °F '49.x=_ TOWN O F YARMOUTH ELECTING ELECTRICAL 111 GAS Ata z 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 Daze /E2/o"/Q Address / /e% 4cr 2're S Business Name ,CL /07./../07./..<441C.")/ 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: ,Egress °cot/ ❑ Emergency egress signage Location ❑Emergency egress lighting Location ❑Maintenance of exits Location 1- ❑ Gnantell.anrin;ie Location Zoning ❑ Signs Location ❑Parking Location ❑ Other Location Mechanical ❑Combustion Air Location ❑ Storage in Boiler Room Location ; Bi` ❑Vents Location ❑Automatic door closures on boiler room doors Location ❑ Clothes dryer vents Location 01hrt 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. border 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 X� days and contact this office for a follow-up inspection. Local O I3ix/1nspector 4 / / Received BCA/, G { SOIcfed'v Tide Revised 2/8/13