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HomeMy WebLinkAboutBldci-17-002508-03 The Commonwealth of Massachusetts ‘s ` _eft City\Town of — a. �_ 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:TAVERN 731 BLDCI-17-002508-03 Trade Name:TAVERN 731 Identify property address including street number,name,city or town and county Certificate Expiration Located at 731 ROUTE 28 12/31/2020 SOUTH YARMOUTH, MA 02664 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 90 A-2 Nightclub/Restaurant/Bar/Banquet Hall 50 Seats 20 Bar Stools TOTAL OCCUPANCY Allowable PER FIRE Occupant Load DEPARTMENT:90 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 Gryll Date of If—PT Fire Chief Building Commissioner Inspection //` Signature of Municipal ti Signature of Municipal Date of Fire Chief Building Commissioner Issuance 17 ,/p Fee:$100.00 B LD_Certofl nspection.rpt Yg4� TOWN OF YARMOUTH .�,� �� ,_110 DEPARTMENT o 1 BUILDING �� 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 '1'ocroutoaa' APPLICATION FOR CERTIFICATE OF INSPECTION October 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: 113 i ".`of r S c 4- Name of Premises: -roort-r in J Tel: 'COS' Co ! i-13 31 Purpose for which permit is used: (rS 4zOrq✓)e' License(s) or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be issued to 3 1 Plain 51-07 fi, Z C" Tel: J 3 9,e- 5S (' Address: PO 6l 370 SgQrrn 1i A- d)--C.aGy RECEIVED Owner of Record of Building q 31 ►Nt 41 v S=1rc L -- 1 c -- Address P O (j by 3'? 6 S 01 Y►vi a:A%I Y''1,� Present Holder of Certificate 13i 1116t✓1 SirttL C OCT 2.2 2019 Bytjatit Signature of person to whom Title C� Certificate is issued or his agent /G"g 1 Date Email Address: .S pashoin. 0 661 . G k 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 d/6L°.,5 0 g— D 3 12/30/2019-12/30/2020 DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 10/08/2019 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(les) 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 lieu of such endorsement(s). PRODUCER CONTACT NAME: THE OCEANSIDE INSURANCE GROUP PHONE (866)467-8730 FAX (888)443-6112 06084400 (NC,No,Ext): (A/C,No): 411 ROUTE 28 E-MAIL ADDRESS: • W YARMOUTH MA 02673 INSURERS)AFFORDING COVERAGE NAICS INSURER A: Hartford Accident and Indemnity Company 22357 CURED INSURER B: SKP1 M,LLC.,731 MAIN STREET LLC,277 S.SHORE INSURER C: DRIVE LLC DBA SKIPPY'S PIER 1 PO BOX 370 INSURER D SOUTH YARMOUTH MA 02664-0370 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP UNITS LTR ,INSR WVD , (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE❑OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY II PRO- 1-1 LOC PRODUCTS-COMP/OP AGG JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT — (Ea accident) ANY AUTO BODILY INJURY(Per person) —ALL OWNED SCHEDULED —AUTOS _AUTOS BODILY INJURY(Per accident) HIRED NON-OWNED PROPERTY DAMAGE AUTOS _AUTOS (Per accident) _ UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS- MADE AGGREGATE PED RETENTION$ WORKERS COMPENSATION PER x OTH- AND EMPLOYERS'LIABIUTY STATUTE ER ANY Y/N E.L.EACH ACCIDENT $1,000,000 PRIETOR/PARTNER/EXECUTIVE A PRO OFFICER/MEMBER EXCLUDED? C N/A 08 WEC AD1A4A 05/30/2019 05/30/2020 E.L.DISEASE-EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION 731 Main Street,LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Tavern 731 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED Sandra M DiGiovanni IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 370 AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • OF ' _ T O WN OF YARMOUTH ELLEECTTIRIIC.AL 4-149 GAS 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 -;11 ' Telephone(508) 398-2231,Ext. 261 —Fax (508) 398-0836 PLUMBING SIGNS BUILDING DEPARTMENT Inspection and License Report Date 1/ Address 73/ i?oore 9 Business Name 77 rA/ 7 3/ 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 obstved: > t2/ _ Egress � /J—� ,� � cI� r ❑ Emergency egress signage Location i �i���' J ❑ Emergency egress lighting Location ❑Maintenance of exits Location ❑ Guards/handrails Location Zoning ❑Signs Location ❑Parking Location ❑ Other Location Mechanical ❑Combustion Air Location ❑Storage in Boiler Room Location a Vents Location • ❑Automatic door closures on boiler room doors Location ❑ Clothes dryer vents Location Qt r 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 2 days and contact this office for a follow-up inspection. Local Official/Inspector ?r D _it/ (may Received By ` C Title Revised 2/8/13