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HomeMy WebLinkAboutCI-17-546-09 The Commonwealth of Massachusetts J.• — City\Town of WWI* • 1 YARMOUTH 7�1-51 w: 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:OCEAN CLUB HOME OWNERS ASSOCIATION BLDCI-17-000546-03 Trade Name:OCEAN CLUB ON SMUGGLERS BEACH Identify property address including street number,name,city or town and county Certificate Expiration • Located at 329 SOUTH SHORE DR 06/07/2020 SOUTH YARMOUTH, MA 02664 Use Group Floor Occupancy Use Group Classifications(s) Other R-1 01st Floor 32 - R-1 Hotel/Motet/Boarding House/Transient 32 Rooms,Function Room,Enclosed Allowable 02nd Floor 31 Swimming Pool R-1 HotelMotel/Boarding House/Transient 31 Rooms,Function Occupant Load Room, Other 15 R-1 Hotel/Motel/Boarding House/Transient 15 Permanent Efficiency 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 rY Date of ?;17-77 IBuilding Commissioner nspection Signature of Municipal Signature of Municipal Date of Building Commissioner Issuance /p lit /.!Q Fee:;304.00 BLD Certofinspection.rpt .YARD TOWN OF YARMOUTH o . �'! .y BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION May 3, 2019 PAYABLE UPON RECEIPT (X) Fee Required 304.00 ( ) 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: 3a 1 SoU`4 shore_ Dr. Name of Premises: 'ay. C-QV1 �0 Tel: 5-0 2)_3 / 6c1 Purpose for which permit is used: VYISL 50Pi'T Q S or License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit a Agency � 4 Certificate to be issued to lilt, Oc.ean Tel: 5-09 V/ 'L S5— Address: 3aq cr - Owner of Record of Building Address `�, Present Holder of Certificate , h .. Q Gih Ci Lk fatokrele G1 ignature of person to whom Title lopbCertificate is issued or his agent / �y ` r , DateDa Email Address: t ( QId �C_aP l �"`' V Q v/ 'J c 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# 6/7/2019-6/7/2020 I v ® DATE(MM/DD/YYYY) AC-, o CERTIFICATE OF LIABILITY INSURANCE 1/10/2018 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,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 lieu of such endorsement(s). PRODUCER CONTACT WorkCOmp Solutions, Inc. NAME: P.O. BOX 24987 PHONE FAX Lakeland, FL 33802 Extl:E-MAIL IL 863-646-4642 (A/C,No): 863-646-3521 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC N www.workcompsolutionsfl.com INSURER A: Technology Insurance Company,Inc 42376 INSURED INSURER B: National Hospitality Group, LLC 9654 North Kings Highway, #101 INSURERC: Myrtle Beach SC 29572 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 45332965 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 REQUIREMENT, 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR Jt,ISD WVD POLICY NUMBER (MM/DDIYYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES Ea occur ence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION TWC3749341 11/1/2018 11/1/2019 f STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 30 Day Notice of Cancellation Applies CERTIFICATE HOLDER CANCELLATION Ocean Club on Smu lers Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 99 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 329 South Shore Drive ACCORDANCE WITH THE POLICY PROVISIONS. South Yarmouth MA 02664 AUTHORIZED REPRESENTATIVE . Darrell J.Mills ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 45332965 1 18/19 WC 1 Wendy Griner 1 11/10/2018 7:42:40 AM (EST) 1 Page 1 of 1 r ` te BUILDING 011 ' TOWN OF YARMOUTH ELECTRICAL is' F 4s't GAS I _ 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSI:I I S 02664-4451 PLUMBING q Telephone(508)398-2231,Ext.$261—Fax(508) 398-0836 _ 1 SIGNS -= _ BUILDING DEPARTMENT Inspection and License Report 77' Address 3w 51 CfJ`� >'e 27/i Business Name Q" /9 C`t/6/340,. 1!I" / c 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: EWE la E ne gencyegresssignage Location /7.‘gliere.t. 2 Oi / ✓r'I's'r i 5'7`L ❑Emergency egress lightiiig Location L1I( tome / 6f/ e;72 I I \ ❑Maintenance of exits Location ii:r.. -� �� _=......:.�......_ —!• ..►�L:1 / 4? . ❑Guards/handrails Location i /C Zu-- ❑Signs Location . 0 Parking Location 3 0 Other Location Mechanical 4 ❑Combustion Air Location d Storage in Boiler Room Location • ❑Vents Location '"`' • ❑Automatic door dosures on boiler room doors Location - 0 Clothes dryer vents Location aka 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. Local Official/Inspector g` ./1,//`! e Received By Tide .iir'si' / • Revised 2/8/13