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Home My WebLink AboutCertificate of Inspection The Commonwealth of Massachusetts ► _=-•,•_ '� City\Town of —� �— YARMOUTH • New and Renewal Certificate of Inspection In accordance with 780 CMR, Chapter 1 (The Eighth Edition of the Massachusetts State Building Code)and Chapter 304 of the Acts of 2004(an Act to further enhance fire and life safety),this certificate of inspection is issued to the premise or structure or part thereof as herein identified. Identify Name of Establishment Certificate No. Issued to Business Name:99 WEST, LLC BLDCI-16-003266-02 Trade Name:99 RESTAURANT&PUB Identify property address including street number,name,city or town and county Certificate Expiration Located at 14 BERRY AVE 12/31/2020 WEST YARMOUTH,MA 02673 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 142 A-2 Nightdub/Restaurant/Bar/Banquet Hall 142 persons-tables& chairs Allowable 01 st Floor 28 A-2 Nightdub/Restaurant/Bar/Banquet Hall 28 bar stools TOTAL OCCUPANCY Occupant Load LIMITED TO PER BOARD OF HEALTH 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 Philip Simonian Ill Name of Municipal Mark Grylls Date of J Q Fire Chief Building Commissioner Inspection /`/`�Q Signature of Municipal !'�! ® Signature of Municipal Date of Fire Chief / Building Commissioner Issuance ,d/n116" Pitig Fee:$150.00 BLD Certofinspection.rpt TOWN OF YA R M O U T H ELLECI'IRIICGAI. GAS ,11 ♦' 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 � �� _ PLUMBING Telephone (508) 398-2231,Ext.I261 —Fax(508) 398-0836 SIGNS BUILDING DEPARTMENT Inspection and License Report ��/ _ Date 141V' /' G�,f Address ir Business Name 77 A�G's 21e,,22baI 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: Egress ❑Emergency egress signage Location ❑Emergency egress lighting Location /49 (' ijCb177. ❑Maintenance of exits Location ❑Guards/handrails Location aping Q Signs Location L'"te/��"` ?tai t A ❑Parking Location ❑ Other Location Mechanical ❑ Combustion Air Location ❑Storage in Boiler Room Location • ❑Vents Location • ❑Automatic door closures on boiler room doors Location ❑ Clothes dryer vents Location Otlxr 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 in days and contact this office for a follow-up inspection. Loca101ficial/I r e Received By Title Revised 2/8/13 ,o 'it�, TOWN OF YARMOUTH 0� , c BUILDING DEPARTMENT le' I ri n-sv 1146 Route 28,South Yarmouth,MA 02664 508-398-223 R• D [OCT• APPLICATION FOR CERTIFICATE OF INSPECTION [ 212o1i October 1,2019 PAYABLE UPON RECEIP (X) Fee Requir:d 4NX-0bNG DEPART MENT ( ) No Fee Re, 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: A o Street and Number: {r #Name of Premises: 2r005J0 Tel: •�0Sr Rick—a1a190 l 1 '�^�s L j D Purpose for which permit is used: governmental agencies: License(s)or Permit(s)required for the premises by other g License or Permit Agency fBeard o }�eo�l-tit �►�� t� 'fog zes e&iiiaxixic4A'> Tel: � Certificate to be issued to • Address: Owner of Record of Building K,Ny Address Present Holder of Certificate • Sties,Used property Tax Act;alum Title Si azure f person to whom 1-1 4-1 9 Certificate is issued or his agent Date taxes@abrholdings.com Email Address: 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 ill 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 TIOF IN INS ANCE FORM WITH THIS APPLICATION OR WE CANNOT ISSUE YOUR CERTIFICATE � Certificate of Inspection# L — !r- 3 12/30/2019-12/30/2020 . <; , i l . • t.r s • • ' i • • • • • • j • *. SAFETY NATIONAL CASUALTY CORP Workers'Compensation and Employers' Liability 1832 SCHUETZ ROAD Insurance Policy Information Page ST. LOUIS, MO 63146 (888) 995-5300 Policy Period Policy Number From To LDC4055543 08/01/2019 08/01/2020 12:01 A.M.Standard Time at the address of the Insured as stated herein Prior Policy Number I LDC4 05554 3 Transaction Renewal Issue 1. Named Insured and Address"see below Agent ABRH, LLC STEPHENS INSURANCE, LLC. 61088 3038 SIDCO DRIVE 111 CENTER STREET NASHVILLE, TN 37204 LITTLE ROCK,AR 72201 Telephone: Customer# Carrier# FEIN# Risk ID# Entity of Insured 16349 371689186 9170576.80 LLC *If applicable, Item 1 is continued on attached Named Insured and/or Additional Locations Page: 2. The Policy Period is from 08/01/2019 to 08/01/2020 12:01 a.m. Standard Time at the Insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: AL AZ AR CA CO CT FL GA IL IN IA KY LA ME MA MN MS MO NE NH NM NY NC OK OR RI SC TN UT VT VA WV B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 1,000,000 each accident Bodily Injury by Disease $ 1,000,000 policy limit Bodily Injury by Disease $ 1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to states, if any, listed here: All states except ND, OH, PR, VI, WA, WI, WY and states designated in Item 3.A. D. This policy includes these endorsements and schedules: See attached Schedule of Forms and Endorsements. 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates, and Rating Plans. All information required below is subject to verification and change by audit. SEE EXTENSION OF INFORMATION PAGE Minimum Premium Total Estimated Annual Premium $ Expense Constant Assessments and Taxes $ Premium Discount $ (Taxes not applicable in Puerto Rico) Deposit Premium _ This is a Three Year Fixed Rate Policy Premium Adjustment Period: Annual Semiannual _ Quarterly Monthly Countersigned this Day of Authorized Representative Issued Date: 08/29/2019 Issuing Office: Safety National Casualty Corporation WC 99 00 00(07 17) MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904 (617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424 11/16/2019 Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws,Ch.139,Sec.3B YARMOUTH BUILDING DEPT 1146 ROUTE 28 SOUTH YARMOUTH MA 02664 Re: Insured: JAMES T YOUNG&CAROLYN M YOUNG Property Address: 300 BUCK ISLAND ROAD,UNIT 8D.WEST YARMOUTH,MA 02673 Policy Number: 0942548 Type Loss: Water Damage:Appliance failure Date of Loss: 11/03/2019 Claim Number: 444301 Claim has been made involving loss,damage or destruction of the above captioned property,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured,location,policy number,date of loss and claim or file number. MPIUA Claims Division CMA00021