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Home My WebLink AboutCI-17-5596-03 The Commonwealth of Massachusetts „ } 6 City\Town of _ iti YARMOUTH yr. _k. _ w 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: EL MARIACHI MEXICAN RESTAURANT BLDCI-17-005596-03 Trade Name: EL MIRIACHI MEXICAN RESTAURANT Identify property address including street number,name,city or town and county Certificate Expiration Located at 416 ROUTE 28 12/31/2020 WEST YARMOUTH,MA 02673 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 117 A-2 Nightdub/Restaurant/Bar/Banquet Hall 102 lower 10 bar TOTAL PERSONS Allowable ALLOWED:117 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 Philip Simonian III Name of Municipal Mark Grylls Date of �/` /^�� Fire Chief Building Commissioner Inspection Signature of Municipal Signature of Municipal Date of Fire Chief Buil Commissioner Issuance fieGGGfi.'lf Fee:/;11550.00 BLD Certoflnspection.rpt F R4,O • TOWN OF YARMOUTH u� BUILDING DEPARTMENT O . H C MATTA CSC `��4p•.. a 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION October 1, 2019 PAYABLE UPON RECEIPT (X) Fee Required 150.00 ( ) 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-namedpremises located at the following address: Street and Number: Li I V Mai 5$. Name of Premises:Ct MQYIgCI 1 I 1" k CAA Utaf I--Tel: 56% Purpose for which permit is used: bOlubt Lt£fir 3f License(s) or Permit(s)required for the premises by other governmental agencies: License or Permit Agency LqutWr Certificate to be issued to LO PIO nC Tel: 5b8 Address:'1tt Main S. S 1-1mPp 111 A CA03 Or// .'S6.2 19 0,.l1/ Owner of Record of Building tjOgzte3 tr`C,3 Address 1'� F or �J J. c1 Present Holder of Certificate acmeVt of person to whom Title Certificate is issued or his agent /'2io'J/p Date Email Address: UOiDe.-Z Srzi. fk1k0 69 Afri 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,oda -/7-4 .c 9�3 12/30/2019-12/30/2020 18/18/2819 05:33 From: 5097778899 Anderson Lampe, PS Webfax Page: 4/4 AcAI'u1V UI'ILK UK . .4►C DATE(MM/OD/YYYY) .- CERTIFICATE OF LIABILITY INSURANCE 10/18/2019 e 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 poficy,certain poicIes may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 781-247-7800 CO FACT Evan Tobasky Brown&Brown of Mass., LLC PHONE 781-247-7800 I FAX 781-444-0090 dba Rodman Insurance Agency (A/C,No,Eat: (A/C,Nor 145 Rosemary St,Bld A Needham,MA 02494-3 /ADDRESS: Evan Tobasky RCS)AFFORDING COVERAGE NAIC INSURER A:The Hartford-SCIC INSURED LaPlaya d ba El Marinelli INSURER B:Weco0 Insurance Co. 25011 West Yarmouth Location 705 W 7th Ave Suite A3 INSURER C: Spokane,WA 99204 INSURER O: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 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 WDDL SUER POUCY EFF POUCY EXP LIR TYPE OF INSURANCE ROD pito POUCY NUMBER ,(rtomMYYY1 JNBS/DD/YYYYI OMITS A X CONSIERCIAL oENERAI.UABEIT! EACH OCOPRENCE $ 1,000,000 CLAMS-MADE X OCCUR 08SBMAD4757 06/18/2019 06/1812020 DAMAGE TO RENTED 1,000,000 PREMISES(Ea occuDence) $ MED EXP(Any one person) S• 5,000 X Liquor Liability PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLES PER GENERAL AGGREGATE $ 2,000,000 POLICY JECT LOC PRODUCTS-COMP/op AGG S 2,000,000 OTHER $ A AUTOMOBILE UAWLITY (Ea accident) SINGLE LIMIT 1,000,000 1,BOO,B00 ANY AUTO 08SBMAD4757 06/18/2019 06/18/2020 BODILY (Per person) S— OWNED SCHEDULED _ AUTOS ONLY X AUTOS BODLY INJURY(Per acadeld) S HIRED X NL NOOWNED I' OPEP DAMAGE AUTOS ONLY AUTOS ONLY ec� r0 S $ A X UMBRELLA LIAS X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS UAE CLAMS-MADE 08SBMAD4757 06118/2019 06/18/2020 AGGREGATE $ 1,000,000 DED RETENTIONS S B WORKERS COMPENSATION PER AND EMPLOYERS'UABIUTY STATUTEµ ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WWC3426768 08/15/2019 08/15/2020 El.EACH ACCIDENT $ 500,000 FQF CEI RMryEM a EXCLUDED' NIA lMlnaao II Pro E L DISEASE-EA EMPLOYEES 500,000 r describe Under 500,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ OESCRIKION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached I mere apace Is required) 416 Rte 28,West Yarmouth, Mass. CERTIFICATE HOLDER CANCELLATION WESTYAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of West Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. West Yarmouth, MA AUTHO RIZED REPRESENN � TTaallI V ACORD 25(2016/03) 0 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TOWN OF YARMOUTH BUILDING GAS 1 r 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451:11 ' Telephone(508)398-2231,Ext.I261—Fax(508) 398-0836 PLUMBING SIGNS BUILDING DEPARTMENT Inspection and License Report y� / , /� Date ////-7 5) Address //(� /IQ IJOTF pC9 Business Name__! < , iiiie/ Cont-art 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: ESECSE Q Emergency egress signage Location 50iff 4- Req 6 56T a/ I t J Reri c l3 ❑Emergency egress lighting Location 4*3 77 2(51/7 :ir i/c1:240' ❑Maintenance of exits Location ❑ Guards/handrails Location • ❑Signs Location ]Parking Location 0 Other Location M ❑Combustion Air Location ❑Storage in Boiler Room Location • ❑,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. 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. LocalOfficial/Inspector A11-0 Received By Tide Revised 2/8/13