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Home My WebLink AboutCertificate of Inspection (2) K4 The Commonwealth of Massachusetts ;r, City\Town of — YARMOUTH si 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:WEST YARMOUTH CONGREGATIONAL CHURCH BLDCI-17-005862-02 Trade Name:THRIFT STORE Identify property address including street number,name,city or town and county Certificate Expiration Located at 383 ROUTE 28 05/01/2020 WEST YARMOUTH,MA 02673 Use Group Floor Occupancy Use Group Other Classifications(s) A-3 Basement/Lower 30 A-3 Amusement/Church/Gym/Library/Museum 30 PERSONS Allowable 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 /may Building Commissioner Tr-) ection / (p 7 Signature of Municipal Signature of Municipal ate of Building Commissioner --7j " Issuance Q 71 Fee:$100.00 BLD_Certofl nspection.rpt °Y-44.0 TOWN OF YARMOUTH • BUILDING DEPARTMENT L MATTA M ESE 4' 4�••••«• 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 100.00 ( ) 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: 3,f) 'iTj 2? Name of Premises: 1,4. Aatiof aiYG lr-,f-n-00L Ofddcyf Tel: P 775 0sq( Purpose for which permit is used: /H/t/,GT S�0 License(s) or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be issued to 1, .Y, agbiztg,,rl7P/%}L C/ittedif Tel: Sri' 7 7J'-Qg-47 Address: Owner of Record of Building Address Present Holder of Certificate Sign ure of person to whom Title // Certificate is issued_or his agent ,� Date Email Address: 04/4�L'f C0McaJJ n1 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# C - /9 po S 6 -o2._ 5/1/2019-5/1/2020 .44c- d CERTIFICATE OF LIABILITY INSURANCE 170irmzvvvyy, /101 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 POUCIES 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 poilcy(iss)must be endorsed.If SUBROGATIONIS WAIVED, 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 Mau of such endorsement's). PRODUCER CONTACT NAME: FITTS INSURANCE AGENCY INC 08088026 PHONE (866)467-8730 FAX (888)443.6112 WC,No.EaR$ '114 2 WILLOW STREET SUITE 102 EMIR.ADDRESS: SOL THBOROUGH MA 01745 AFFORDING CONE NAIC/ INSURER A: Twin City Fire Insurance Company 29459 INSURED INSIAIER I: WEST YARMOUTH CONGREGATIONAL CHURCH lesumac 383 ROUTE 28 INSURER : WEST YARMOUTH MA 02673-4721 D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTVNTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THiS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. TtIE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.WAITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. flUR POLICY EFF POLICY EP TYPE OF INSURANCE D POLIGi NU LB 1�DDNY YYY1 LTR eLSR wYD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAI ADE f OCCUR DAMAGE TO RENTED PREMISES(Ea=wine& MED EXP(Any one person) PERSONALS ADV INJURY GENL AGGREGATE LeiIT APPLES PER GENERAL AGGREGATE 1 1 POLICY PRO- El LOC PRODUCTS-COMP/OP AGG JECT OTHER coMBPIED SINGLE tAAIT AUiDMOa.E UTABalIY IEa accident) ANY AUTO BODLY INJURY(Pr person) ALL_OWED SCHEDULED BODILY INJURY(Pr accident) AUTOS AUTOS HIRED — NON-ON ED PROPERTY DAMAGE AUTOS AUTOS (Per accident) U LMB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS AGGREGATE MADE IRETENiioNWORKERS COMPENSATION PER °TH- AW LIABILITY STATUTE X B ER ANY YIN EL EACH ACCHIENT $1,000,000 A PROPRIETOwPAARTNEwocECURVE r WA 08 WEC NN5968 10/01/2018 10I01/2019 ' OFFICER/ ER EXCLUDED? I_ EL DISEASE-EA EMPLOYEE $1,000,000 (IraMabry in liar) B yes,describe under EL DISEASE-POLICY MIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIP►iON OF OPERATIONS I LOCMIOIM3 VEHICLES(ACORD 101,AdGA'wnd Remarks Sd edlte,any be attacked it Tare space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION West Yarmouth Congregational Church SHOULD ANY OF THE ABOVE DESCREED POLICIES BE CANCELLED 383 ROUTE 28 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED WEST YARMOUTH MA 02673-4721 01 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C.(20 401988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD j •ter• .. . pp' y BUILDING 44 TOWN OF YARMOUTH ELECTRICAL GAS 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 p /� Date �/ Address S l�ou r c Z Q �Business Name l fAtO i179 (27 ' C/56IC'/� Conan 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: ECM ❑Emergency egress signage Location ey ern [i Emergenry egress lighting Location ► 1 C/4 ** Led it 4e e CCVC A. ❑Maintenance of exits Location Guards/handrails Location Zaning ❑Signs Location 0 Parking Location ❑Other Location i ❑Combustion Air Location 0 Storage in Boiler Room Location • ❑Vents Location ❑Automatic door closures on boiler room doors Location ❑Clothes dryer vents Location flax 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 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 7 days and contact this office for a follow-up inspection. Loca1Offic r l�O ?7vAl a/ Received By Title Revised 2/8/13