HomeMy WebLinkAboutCertificate of Inspection r
: '` The Commonwealth of Massachusetts
_ _. .tr City\Town of
irlirEs
` � — 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:GRIFF HOLDING CORPORATION BLDCI-16-005980-03
Trade Name:YARMOUTH GARDENS MOTOR LODGE
,
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
497 ROUTE 28 04/18/2020
WEST YARMOUTH, MA 02673
Use Group Floor Occupancy Use Group Other
Classifications(s)
R-1 01st Floor 38 R-1 Hotel/Motel/Boarding House/Transient BLDG. 1 -6 UNITS
BLDG.2-12 UNITS
Allowable I BLDG.3-8 UNITS
BLDG.4-12 UNITS
Occupant Load 02nd Floor 5 R-1 Hotel/Motel/Boarding House/Transient BLDG.1-12 UNITS
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 Grylls Date of
Building Commissioner Inspection 2"V�/
Signature of Municipal Signature of Municipal Date of
Building Commissioner (______)14, Issuance . 2 .1 7
Fee:;199.00
BLD_Certoflnspection.rpt
...,...YaR o TOWN OF YARMOUTH
O . _H
BUILDING DEPARTMENT
'-:Cs, 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
March 1,2019 PAYABLE UPON RECEIPT
(X) Fee Required 199.00
( ) 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 emises located at the following address:
Street and Number: /J 7 p z/7 .� z?, /94 .
Name of Premises: \ 0.4,/y,7d)J ( ��eyx1,4/aA4
el: ,e ���-9l "/ S�
Purpose for which permit is used: ,�e)7`C/ i E C E^I_V F; ,:
License(s) or Permit(s)required for the premises by other governmental agencies:
i
License or Permit Agency
APR 0 3 2Li1
Certificate to be issued Jo 1�C.�,4z6 / 66, i/e7- S •. el: 00k- 29/%9��
Address: ,f ,, ,: pe
Owner of Record of Building / / / .► - -
Address ,,/92 A 4- o?c-- - 1 C/,�',,i,d/
Present Holder of Certificate /� 1/, e_.,
Z . (/7 --' ----'7,z---s f 71—
ignature of per on to whom Title
Certificate is issued or his agent �.. /_/j
Date
Email Address: J/' /ate i ee 'S I,
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# L X!j - V OV S V1--0
4/18/2019-4/18/2020
- .t
VDAC
IOWTHIS IS A QUOTE , NOT A POLICY
TRAVELERS J WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
QUOTE PROFILE — VERSION 01
POLICY NUMBER: (7PJUB-2E19400-8-1 9)
RENEWAL OF (7PJUB-2E19400-8-18)
INSURED'S NAME AND ADDRESS
WORKERS COMPENSATION
YARMOUTH GARDENS INC INSURANCE PLAN
497 MAIN STREET A/R (WCIP) # MA
WEST YARMOUTH MA 02673
POLICY PERIOD FROM: 05-02-19 TO 05-02-20
TOTAL ESTIMATED ANNUAL STANDARD PREMIUM $ 310
PREMIUM DISCOUNT NONE
0900-20 EXPENSE CONSTANT 250
TERRORISM 6
TOTAL ESTIMATED PREMIUM 586
TAXES AND SURCHARGES 12
DEPOSIT AMOUNT DUE 598
Employer's Liability BI Limit: $ 100000 Each Accident
500000 Policy Limit
100000 Each Employee
INSURER: TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
Adjustments of Premiums shall be made ANNUALLY
******************************* Deposit Amount Due: $ 598 ******************************
POLICY NUMBER: (7PJUB-2E19400-8-19)
DATE OF ISSUE:03-07-19 WC ST ASSIGN: MA
OFFICE: DIRECT ASSIGNMENT701
PRODUCER: BENSON YOUNG & DOWNS INS 26WDM
"1
VA�
O
_firSi
, _: TOWN OF YARMOUTH BUILDING
ELECTRICAL
1:t 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 PLUMBING
1� Telephone(508) 398-2231,Ext.1261—Fax (508) 398-0836
SIGNS
- BUILDING DEPARTMENT
Inspection and License Report - Date '" 1�_:/7
�Address // 7 / E5ZT Business Name )" a�� 011ey A' .,
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 d of Health rules,the following violation(s)were observed:
AgMt Em si Location eay 57�/i StCI cy
laEmergency egress lighting Location V CA /S P2 rr-et'S- ��
❑Maintenanceofexits L.ocatio //2 '' '' a-- r
❑Guards/handrails Location �/ � 1 ���,1- , -.-1-3iVi < /15� /
SignsZoning '
U Location /
kii
I>Parking Locxuon i �1 SS / //►�4 i i?e(( i `l /7 bi
❑ Other Location /6 ,.�/r�G�' 13}9. )//O!4i 44 l d j
SS"
Mechanical ' G - }
❑Combustion Air Locatio c, 7t 75 , / t,iel"0 J /`1 / Gj `> J1 e x P6,'4
3 flit )/6't 5-/� R/.52 //4- 5 Tregc/ ee,g,/❑storage in Boiler Room L,ocatio / �C/_�f' A /
ca vents LoQtior G 44/ 1/lei/tS 1 ;ri:5 Gt/a/ y /mac-,4/4,r, C,.
El Automatic door closures '
on boiler mom doors Location , 607`el S Ter- Al*/J/vr I2P/:4 /V id&it%/4G4r/�
❑clothes dryer vents Location 7/349th Y9 / 4!G 4 L`'�0 V-
�j�
� r
Location 57
on t� �`'�
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 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 ,�/3 days and contact this office for a follow-up inspection.
Local OffiriaVInspector B', -0 j/1`d '
Received By L 4 4 ( Title
Revised 2/8/13