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HomeMy WebLinkAboutCertificate of Inspection \,� The Commonwealth of Massachusetts it •A City\Town of YARMOUTH `ri%-ems .tom_ 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: SEASIDE COTTAGE COLONY BLDCI-16-006660-03 Trade Name: SEASIDE COTTAGE COLONY Identify property address including street number,name,city or town and county Certificate Expiration 135 SOUTH SHORE DR 05/02/2020 South Yarmouth, MA 02664 Use Group Floor Occupancy Use Group p Other R-1 01st Floor 40 R-1 Hotel/Motel/Boarding House/Transient 39 UNITS(16) BUILDINGS Allowable OFFICE&LOBBY, Occupant Load MNGRS.APT. No Occupancy allowed 10/21 -11/30 each year 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 rY Date of g-/-3--,7 Building Commissioner Inspection Signature of Municipal Signature of Municipal Date of Building Commissioner /J Issuance v Fee:$2205.00 BLD_Certofl nspection.rpt •°1 YAR4 TOWN OF YARMOUTH '° -� BUILDING DEPARTMENT MATTA M CIE 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 205.00 a' ( ) 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: 135 S. Shinee, Y' Name of Premises: 5e0.& tS. 1o0r Tel: 56Z-398-2533 Purpose for which permit is used: 0343,1,42. r444,6 \ License(s) or Permit(s)required for the premisa by other governmental agencies: ` License or Permit E aEIVFD Agency LA_SiKeilo lit,+ 1 s. tyii ji l.;censer Afr* S. — I Certificate to be issued to $Q.as ala a Tel:'j b 398 2S 33 Address: 136 to S. turreDY 1 Owner of Record of Building Yetrimulli Vi l/ar Cont ) 14 ss oduth46, ,� Address Sa".s- 13 Present Holder of Certificate %5212.51d, CA-Oar 10 23 Si ture of perso whom �roT 32, Certificate is issue r his agent _ 4/15 f, — Date Email Address: yvGADfn@iMa„i 1, COM 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# 73GDcJ—/6- 066,6,0—v 3 5/2/2019-5/2/2020 w Y -w (=]2: \ to - NOTICE / NOTICE TO EMPLOYEES EMPLOYEES 7 yW The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114 — 2017 617-727-4900 — http:llwww.state.ma.usldia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO, MA 02344-1450 ADDRESS OF INSURANCE COMPANY UB-2J144116-18-42-G 06-01-18 TO 06-01-19 POLICY NUMBER EFFECTIVE DATES BRIGHT AGENCY INC PO BOX 424 .� MILFORD, MA 01757 NAME OF INSURANCE AGENT ADDRESS PHONE# c= SEASIDE RENTAL ASSOCIATION 135 S SHORE DR SOUTH YARM MA 02664 EMPLOYER ADDRESS r EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT r- The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER 3245 W20P1G15 7 °' y = TOWN OF YA R M O U T Hit BUILDING { AI. - GAS C; 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 _ Telephone (508)398-2231,Ext.I261—Fax(508) 398-0836 PLUMBING SIGNS BUILDING DEPARTMENT Inspection and License Report �f Date — / 3 /9 /Address 3 Soon 5, e fi kC Business Name 5 4 S cl CC"77.15r, Contact Phone fj/J/7 5 /- 7 `.,�-- /y_,,,'�'-- /- ( ,3 -ate -�5= =3,'-,35— Wiring the Annual Inspection of your premises,performed in accordance with t e provisions of Se tion 110.7 of 780 C (Massachusetts State Building Code),the Board of Selectmen,and/or the Board of Health rules,the following violation(s)were observed: peu Emergency /119 p2Y�7 /1✓e) 7- 76 5/lit Emergen egress signage Location ❑Emergency egress lighting Locatio` " 1 O1t/P B.A7- K -- / 5u y( e 4 .,a ❑Maintenance of exits Locano C !'G/a' 1 17e M&A/7- ,7- ' / c77'` ! 1 - X.- r � /4ihct7 [•]Guards/handrails Location l� � " k t✓ �' Zoning GICA 1 N isA 6444C' ❑Signs Location 1 fir- i°1) 64, y2 , �/jI Parku>gLocation t� n! /C ��i! 6? 71 i J 0, ❑Other Location Mechanical d Combustion Air Location Storage in Boiler Room Location❑Vents Location CL/� `- of A Automatic door closures Rnr- on boiler room doors Location { C,7' ❑Clothes dryer vents Location 7•...- —/d Dar Location V/ � 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. 1 o Make corrections within f days and contact this office for a follow-up inspection. Local Offici 63I2 iii `v P4Received By a I The 44/lar " Revised 2/8/13 1 A 1 _,b.< I l'Ir n Ts ,o4 1 J ..__Y TOWN BUILDING It OF YA R M O U T H x ti, GAs _ ` C•It i 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 PLUMBING -It Telephone(508) 398-2231,Ext.1261 —Fax (508) 398-0836 e SIGNS BUILDING DEPARTMENT Inspection and License Report Date 67/7%,, Address /1,,' ,j tall, , Business Name SIstszecovgdpels as/ y 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: g7._ -/'1Tsr Gil Cr❑Emctgenryegresssignage Location / � y !� /��' G �-�-d Emergency� Location // 7/ / /©` , ,, .. �C 7GT!� 3 J •❑Maintenance of exits Location ❑Guards/handrails Location �Ti�ie 1 C71141 Zio kt ee 6e. #0 1/-Ph/if 149 ID Signs Location c , ,Z4y/ifeve ,, 0) t LI Packing Location -' r'�f� CI Other Location 2 I & CJ/ ),in _4zre-AaP4- ❑CombustionAir Location ❑StorageinBoilerRoom Location ❑Vents Location ❑Automaticdoorclosures C Q�on boiler room doors Location �^[]clothes dryer vents Location !+L- �{ JIil Location -✓-/7 5 ^GThe State Building Code,Section 1001.3-Maintenance,provides that theed in Section 780 CMR s 1 be s it responsible for proper maintenance. In order to abate the above violations)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 nual inspection./ o Make corrections within days and contact this office for a follow-up inspection. Local Oflicial/1e -.1,41 41,/ Received By6-t-t- _ i Title ' , trthj Revised 2/8/13