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HomeMy WebLinkAboutCertificate of Inspection 1 t 4 The Commonwealth of Massachusetts ` t _ City\Town of 'u� YARMOUTH New and Renewal Certificate of Inspection In accordance with the Massachusetts State Building Code, Section 110.7 Identify Name of Establishment Certificate No. Issued to Business Name: MARMARIS CORP. BLDCI-16-006474-03 Trade Name:WINDRIFT MOTEL Identify property address including street number,name,city or town and county Certificate Expiration Located at 115 ROUTE 28 05/06/2020 WEST YARMOUTH, MA 02673 Use Group Floor Occupancy Use Group p Other R-1 ()1st Floor 36 R-1 Hotel/Motel/Boarding House/Transient BLD 1-20 UNITS, LOBBY Allowable BLD 2-16 UNITS& Occupant Load MNNote:GRS. #1 APT 130 includes Other 7 adjoining kitchen JI R-1 Hotel/Motel/Boarding House/Transient 7 EFF.COTTAGES 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 Name of Municipal Mark G Its '�/'�/ Building Commissioner ry In Inspection ��G�V.� Signature of Municipal Signature of Municipal / Date of Building Commissioner i Issuance 7- -/g Fee:;226.00 B LD_Certofl nspection.rpt .YgRo TOWN OF YARMOUTH -y BUILDING DEPARTMENT k�.•.•,.��"; 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION April 1, 2019 PAYABLE UPON RECEIPT (X) Fee Required 226.00 ( ) 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: //5' /t pE z e a./ re.tr allT Name of Premises: 14'/ /J/)fd ice' r- re c Tel: /- 1106'-3 - / 7 9 Purpose for which permit is used: l7 ' 5 6J- 7£l—Q Co O License(s) or Permit(s) required for the premises by other governmental agencies: License or Permit Agency • 1UN O 201..) Certificate to be issued to fJ(1/se) /f T /QT- Tel: /- 2 a U -..3sV- �l7 Address: Ng' ,2 pj 2 (,(�gS r /A///n r Iv/9 ©_,)6 7 3 Owner of Record of Building ic69.4 iyerpn is Cep Address J3 Sz��j�ap�c R� �2GYt�„! ��► o/-3-O-7 Present Holder of Certificate sHn� ,ze‘t #C4- r`w_p_ns Signature o erson to whom Title Certificate is issued or his agent 6 6 -l 9- Date Email Address: Ai 6 4RO 4 Al >y,41-1 c _ Cc3s9 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#13L -/4, - /r7y -0.3 5/6/2019-5/6/2020 ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE IMM/OOIYYYY) 06/06/2019 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GABRIELIAN INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO BOX 542 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 744 SOUTHBRIDGE ST AUBURN, MA 01501 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A WESCO INSURANCE MARMARIS CORP INSURER U DBA WINDRIFT MOTEL INSURER C 13 STONEYBROOK ROAD INSURER 0 CHARLTON,MA 01507 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REOUIREMENT,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 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1LTR INTRO TYPE OF INSURANCE POLICY NUMBER DA FTAARP,)E FOLIC tJCPIRATION LIMITS GENERALUABIUTY DATE MMIUD/YY) I Ar'110 -NC'_ COMMERCIAL GENERAL LIABILITY DHA*AIE1 kRENIn-(, CLAIMS MADE OCCUR MED EXP CAIN one»ersco, S PERSONAL 8 AOV INJURY I GENERAL AGORE GATE £ GENL AGGREGATE LILUI AI'P ItS PER • ✓iKllriPh •� POLICY f PROS-CI n'GC AUTOMOBILE UABILITY COMBINED SINGLE LIMIT g ANY AUTO fEa acagent' • ALL OWNED AUTOS • SCT?E13ULED AUTO:: BODILY INJURY • HIRED AUTOS BODILY INJURY NON.OWNED AUTOS (Per accirlont: PROPERTY DAMAGE • IPei acodem; GARAGE LIABILITY AI ITV UNt`- tItAt.,JITI-NT J ANY AUTO OTHER THAN I-AACC AUTO ONLY AGG S EXCESSIUMBRELLA UABIUTY EACH OCCURRENCE $ ]I OCCUR El CLAIMS MADE - '' AGGREGATE S _7 DFOUEIINLF I r -1 RETENTION S g WORKERS AND TOYLMS ER LOOR COMPENSATION A ANY PROPRIETOR/PARTNER/EXECUTIVE WWC3338239 04/24/2019 04/24/2020 EL EACH ACCIDENT g 1.000.000 OFFICER/MEMBER EXCI UDED, . ,,.� a 1 COG OUE It.ns n SPECIAL PROVISIONS tUW t100 000 I_DISEASE PO'.!r•r U in OTHER OESLRIP ION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS AIDED BY ENDORSE!ENT i SPECIAL PROV SIO'J5 MOTEL CERTIFICATE HOLDER CANCELLATION TOWN OF YARMOUTH • SHOULD ANY OF THE ABOVE DESCRIBED PO IES BE CELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER ENDEAVOR MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER D LE .BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY A RIND UP THE INSURER.ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 1 ` ACORD 25(2001/08) )ACORD CORPORATION 1988 TOWN OF YA R M O U T H ELF-C�TRICAI. r GAS IV 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSls 11 s 02664-4451 PLUMBING —=:il Telephone(508) 398-2231,Ext.1261—Fax (508) 398-0836 411040411 e SIGNS BUILDING DEPARTMENT Inspection and License Report _ Date fr Address //5 AOCZ9 Business Name ( iIk7"/''" 1 JL Conta r 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: 4.,47' e CaEmergency egresssignage Location �riril ►'' ❑Emergency egress lighting Location [ jr: ' - ❑Maintenance ofexits Location OVl /4 G� T? `/47•1 ❑Guards/handrails Location Zoning ❑signs Location ❑Parking Location ❑Other Location Aftthgaia ❑Combustion Air Location ❑Storage in Boiler Room Location ❑Vents Location ❑Automadc door closures on boiler room doors Location ❑ Clothes dryer vents Location Dime 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. In order to abate the above violationtsl 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 `ddayyss�anndd contact this office for a follow-up inspection. Local Oficiallnspector AE ) „TAW?' J Received By .j 6 Title 41, 1 h tocce, Revised 2/8/13