HomeMy WebLinkAboutCerticate of Inspection ,I
The Commonwealth of Massachusetts
City\Town of
�. ;-1l- YARMOUTH
vonNew and Renewal Certificate of Inspection
In accordance with the Massachusetts State Building Code, Section 110.7
Identify Name of Establishment
Issued to Certificate No.
Business Name:ALL SEASONS RESORTS BLDCI-16-005909-02
Trade Name:ALL SEASONS RESORTS
Identify property address including street number,name,city or town and county Certificate Expiration
1199 ROUTE 28 05/29/2019
SOUTH YARMOUTH, MA 02664
Use Group Floor Occupancy Use Group
p Other
R-1 01st Floor 57 R-1 Hotel/Motel/Boarding House/Transient
Allowable 02nd Floor 57 R-1 Hotel/Motel/Boarding House/Transient
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 the certificate is strictly prohibited.
Name of Municipal Name of Municipal Mark Grylls Date of
Building Commissioner Inspection 7 3-79
Signature of Municipal Signature of Municipal ate of
Building Commissioner Issuance
Fee:$412.00
BLD_Certofl nspection.rpt
•
e • YRk TOWN OF YARMOUTH
''y .H BUILDING DEPARTMENT
r+wtTi� n Ess^4.
�,��••,t•�9� 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
no Se sue 1 fir►-p1 v c !e
APPLICATION FOR CERTIFICATE OF INSPECTION
April 1,2019 PAYABLE UPON RECEIPT
(X) Fee Required 412.00
( ) 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: ( (Q q RD-tc_A-, 7(71-a c/-0171,S
Name of Premises: /1-1 pe_sv.-9 1-: Tel: S-
Purpose for which permit is used: (V\p}c�
License(s) or Permit(s)required for the premises by other governmental agencies:
1n1Q
License or Permit Agency
Certificate to be issued to A-11 Secisayu, 1zx ? � DTel: 5 -3q )(I—u cr
Address: l ta tack _c�..Q sZ s n� \/ v, Tr 4
Owner of Record of'Building
Address 56,,,,E co3 coo v- .
Present Holder of Certificate
Signa e of person to whom Title'''
_.___ Ccrtifrcatc is issued-or-his-agent—_-- �._�-- -.-
Date
Email Address: pr (J ecl�lsccz,�c. (o _
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 C NNOT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection# 00 09 C)
5/29/2019-5/29/2020
Akce4Rt CERTIFICATE OF LIABILITY INSURANCE I u""trv'm'1/V'r
�0,,.! 06/18/2019
—�
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,subect 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). {i
PRODUCER CONTACT Norah Mccormick 1
NAME:
McCorrnick&Sons Insurance Agency.Inc ,PAHONrE extl. (508)586-2973 A/C,No): (508)587-6679 j
800 West Main Street E-MAIL nmccormick@mccormickinsurance.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
Avon MA 02322 INSURER A: Western World Insurance Company
INSURED INSURER B: Underwriters at Lloyds of London
Castle Dawn MCtei,Sainn:fh(Co.,Sladevang Co. INSURER C:
226 RoL:to 28 INSURER D: _1
INSURER E: _
West Yarmouth MA 02673 ,INSURER F: 1
_ _•,µ,
COVERAGES CERTIFICATE NUMBER: CL17112702980 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 -t=QUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OF MAY ER AIN THE:INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITION- OF S H rOLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. •
INSR I `' - POLICY EFF POLICY EXP
I LTR TYPE OF INSURAN-L _ -- INSD MD POLICY NUMBER {MM/DD/YYYY) (MM/DD/YYYY) LIMITS I
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I
Nei DAMAGESORENTED 100.000
CLAIMS-MADE I Nei OCCUR i PREMISES(Ea occurrence) $
MED EXP(Any one person) $ 5,000 i
1 NPP_ 1,000,000
A ^— i
GEN'LAGGREGATE LIMIT APPLIES PER: _ 1412231 05/02/2019 05/02/2020
PERSONAL&ADVINJURV $GENERAL AGGREGATE $ 2,000,000
X POLICY ri - -
RU I PRODUCTS $
Included
_Ir;; "'"
OTHER $
AUTOMOBILE LIABILITYj COMBINED SINGLE LIMIT $
(Ea accident) )
{ANY Au i 0 BODILY INJURY(Per person) $ I
OWNED i r'FDULr i
AUTOS ONLY1 -+ r)S I BODILY INJURY(Per accident) $ I
1 HIRED I I NON-OWNED ! i i I PROPERTY DAMAGE $
AUTOS ONLY _j CS ON r 1 I (Per accident)
— I $ -.a
UMBRELLA LIAE I , 0,.,O,yP T- EACH OCCURRENCE $
EXCESS UAB -I i AGGREGATE $ _J
DEC Rt FNTioN '• I I $ _-—v
I
WORKERS COMPENSATION -- _- _ PER OTH-
IANDEMPLOYERS'LIABLI,Y y/ STATUTE ER
I,! -,
i ANY PROPRIErOH/PARTNER/ErE.OUTIVE —el
II E.L.EACH ACCIDENT $
IOFFCER/MEMBEREX:CL_UDED' I N/A i
i(Mandatory in NH) + I E.L.DISEASE-EA EMPLOYEE $ •_ _
If yes describe under I "
_ DESCRIPTION OF OPERATION:,beF.w j I _ E.L.DISEASE-POLICY LIMIT $
PROPERTY
B 226 ROUTE 28.'IV YARMO'JTH MC I 93306 j 05/02/2019 05/02/2020 BUILDING $850,000
DESCRIPTION OF OPERATIONS I CC::TIONS!'-'ENIC:_ES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Property Address.22'3!tt 6A'W Ynrmol.it%•w1A u2673
� I
zJ
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
_ _�. _ . --- O 1988-2015 ACORD CORPORATION. All rights reserved.w
A(`(lri rl'IC C9M RIn"a Thn Ar'(lO l nfimn mnd Innn m•o rnnic+nrnrl mmr4c of Ar11Rll
r -
°� TOWN OF YA R M O U T H BUILDING
CAI. COS •
t 1146 ROUTE 28 SOUTH YARMOUTEI MASSACHUSETTS 02664-4451 Telephone(508)398-2231,Ext.I261—Fax(508) 398-0836 PLUMBIIVGV
.777. SIGNS
BUILDING DEPARTMENT
Inspection and License Report
Address /",'/?eoie Business Name /4:74 f. '7s
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:
Egral
a Emergency egress signage Location
U Emergency egress 41164 Location y/
•❑Maintenance of exits Location ros-r> gX' 50'' / / I re
05/
❑ Guards/handrails Location ! 4411
❑Signs Location // - ((j f}4-6
❑Parking Location Are 1 J/ AQ i /C Ltnt //o/.
❑Other Location --4c"P d11 j¢5+� J1fit?.il T 1�' (_l7�lr��l• / L: C t i
L
❑CombusnonAtr Locano Si'
ri ' JS,
U Storage in Boiler Room Location G I !` C�
a Vents Location
❑Automatic door closures
on boiler room doors Location
❑Clothes dryer vents Location
Dar 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.
jD 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 /n days and contact this office for a follow-up inspection.
Local Official/Inspector e YA O
Received By Title
•
Revised 2/8/13