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Home My WebLink AboutApp-License-Cetifications The Commonwealth of Massachusetts Fee Town of Yarmouth $110.00 Swimming Pool Operations License Number: BOHSP-14-0390-08 Issue Date: 1/1/2022 Mailing Address: Location Address: RJ RESORTS BLUE ROCK RESORT OWNER LLC 39 TODD RD BLUE ROCK CLUB SOUTH YARMOUTH, MA 02664 65 E. 55TH STREET, FLOOR 33 NEW YORK,NY 10022 IS HEREBY GRANTED A 2022 LICENSE This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2022 unless sooner suspended or revoked and is not transferable. Conditions OUTDOOR SWIMMING POOL Board Hillard Boskey, M.D.,Chairman Mary Craig,Vice Chairman Of Charles T. Holway, Clerk Debra Bruinooge Health Eric Weston 1111 Bruce G. Murphy MP R.S., CHO Health Director The Commonwealth of Massachusetts Fee Town of Yarmouth $110.00 Lodging License Number: BOHL-14-0389-08 Issue Date: 1/1/2022 Mailing Address: Location Address: RJ RESORTS BLUE ROCK RESORT OWNER LLC 39 TODD RD BLUE ROCK CLUB SOUTH YARMOUTH, MA 02664 65 E. 55TH STREET, FLOOR 33 NEW YORK, NY 10022 IS HEREBY GRANTED A 2022 LICENSE TO OPERATE: Motel This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2022 unless sooner suspended or revoked and is not transferable. Conditions UNITS- 44; BEDROOMS- 44 Board Hillard Boskey, M.D., Chairman Mary Craig, Vice Chairman of Charles T. Holway, Clerk Debra Bruinooge Health Eric Weston Bruce G. Murphy, 'H, ' .S.,CHO Health Director The Commonwealth of Massachusetts Fee Town of Yarmouth $185.00 Food Establishment License Number: BOHF-14-0392-08 Issue Date: 1/1/2022 Mailing Address: Location Address: RJ RESORTS BLUE ROCK RESORT OWNER LLC 39 TODD RD BLUE ROCK CLUB SOUTH YARMOUTH, MA 02664 65 E. 55 r" STREET, FLOOR 33 NEW YORK,NY 10022 IS HEREBY GRANTED A 2022 LICENSE TO OPERATE: Food Service; Common Victualler This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2022 unless sooner suspended or revoked and is not transferable. Conditions SEATING: 83 Board Hillard Boskey, M.D., Chairman Mary Craig, Vice Chairman of Charles T. Holway, Clerk Debra Bruinooge Health Eric Weston A.- 4 41 t/ Bruce G. Murphy, M H, :. ., CHO ...woo) Health Director (IA's.'s. TOWN OF YARMOUTH BOARD OF HEALTH APPLICATION FOR LICENSE/PERMIT-2022 - *Please complete form and attach all necessary documents by December 18,2021. Failure to do so will result in the return of your application packet. ESTABLISHMENT NAME: t.tefit:Cr"N: C.2+. b TAX ID: 87-2915826 LOCATION ADDRESS: 39 Todd Road,S Yarmouth,MA 02664 . TEL.#:(508)398-6962 MAILING ADDRESS: 65 E 55th Street,Floor 33 New York,NY 10022 E-MAIL ADDRESS: !meg@eoinvestors.com OWNER NAME: Jonathan Wang CORPORATION NAME(IF APPLICABLE): RJ Resorts Blue Rock Resort Owner LLC MANAGER'S NAME: EOS Hospitality LLC TEL.#: (212)630-5028 MAILING ADDRESS: 65 E 55th Street,Floor 33 New York,NY 10022 POOL CERTIFICATIONS: The pool supervisor must be certified as a Pool Operator,as required by State law. Please list the designated Pool Operator(s)and attach a copy of the certification to this form. 1. Robert Curley 2. Pool operators must list a minimum of two employees currently certified in standard First Aid and Community Cardiopulmonary Resuscitation (CPR),having one certified employee on premises at all times. Please list the employees below and attach copies of their certifications to this form.The Health Department will not use past years'records. You must provide new copies and maintain a file at your place of business. 1 Robert Curley2 Kristin Brewer 3. ._ 4. FOOD PROTECTION MANAGERS-CERTIFICATIONS: All food service establishments are required to have at least one full-time employee who is certified as a Food Protection Manager,as defined in the State Sanitary Code for Food Service Establishments, 105 CMR 590.000. Please attach copies of certification to this application. The Health Department will not use past years'rec5rds. -; You must provide new copies and maintain a file at your establishment. 1. Kristin Brewer 2. -_ UEC 1 0 2021 PERSON IN CHARGE: HEALTH DEPT. Each food establishment must have at least one Person In Charge(PIC)on site during hours of operation. i Kristin Brewer 2. ALLERGEN CERTIFICATIONS: All food service establishments are required to have at least one full-time employee who has Allergen certification, as defined in the State Sanitary Code for Food Service Establishments, 105 CMR 590.009(G)(3)(a). Please attach copies of certification to this application. The Health Department will not use past years'records. You must provide new copies and maintain a file at your establishment. Kristin Brewer I 2. HEIMLICH CERTIFICATIONS: All food service establishments with 25 seats or more must have at least one employee trained in the Heimlich Maneuver on the premises at all times. Please list your employees trained in anti-choking procedures below and attach copies of employee certifications to this form. The Health Department will not use past years'records. You must provide new copies and maintain a file at your place of business. I Kristin Brewer 2. 3. 4. RESTAURANT SEATING: TOTAL# 125 OFFICE USE ONLY LODGING: LICENSE REQUIRED FEE PERMITS LICENSE REQUIRED FEE PERMITS LICENSE REQUIRED FEE PERMITS B&B S55 _CABIN $55MOTEL $110 INN $55 CAMP $55 �SWIMMINGPOOL$IIOea. _LODGE $55 _TRAILER PARK $105 ,,_..'WHIRLPOOL $110ea. FOOD SERVICE: LICENSE REQUIRED FEE PERMIT# LICENSE REQUIRED FEE PERMITS LICENSE REQUIRED FEE PERMIT S 0-100 SEATS $125 _CONTINENTAL $35 _NON-PROFIT $30 , >I00 SEATS $200 , 'COMMON VIC. $60 _WHOLESALE $80 —RESID.KITCHEN $80 RETAIL SERVICE: LICENSE REQUIRED FEE PERMITS LICENSE REQUIRED FEE PERMITS t4CENSEREQUIRED FEE PERMITS <50 ssqq a. $50 >25,000 xq.rt. $285 VENDING-FOOD S25 =<25,000 sq.fl. $150 _FROZEN DESSERT $40 _TOBACCO $110 NAME CHANGE: $15 AMOUNT DUE = $ .) PLEASE TURN OVER AND COMPLETE OTHER SIDE OF FORM"4" \,4 0 759 r at' b.311 b ADMINISTRATION Under Chapter J 52,Section 25C,Subsection 6.the Town of Yarmouth is now required to hold issuance or renewal of any license or permit to operate a business if a person or company does not have a Certificate of Worker's Compensation Insurance. THE ATTACHED STATE WORKER'S COMPENSATION INSURANCE AFFIDAVIT MUST BE COMPLETED AND SIGNED,OR CERT.OF INSURANCE ATTACHED X OR WORKER'S COMP.AFFIDAVIT SIGNED AND ATTACHED Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of you:.permits. PLEASE CHECK APPROPRIATELY IF PAiD: YES NO MOTELS AND OTHER LODGING ESTABLISHMENTS TRANSIENT OCCUPANCY: For purposes of the limitations of Motel or Hotel use,Transient occupancy shall be limited to the temporary and short term occupancy,ordinarily and customarily associated with motel and hotel use. Transient occupants must have and be able to demonstrate that they maintain a principal place of residence elsewhere.Transient occupancy shall generally refer to continuous occupancy of not more than thirty 1301 days.and an aggregate of not more than ninety(90)days within any six (6) month period. Use of a guest unit as a residence or dwelling unit shall not he considered transient. Occupancy that is subject to the collection of Room Occupancy Excise,as defined in M.G.L.c.640 or 830 CMR 64G.as amended.shall generally be considered Transient. POOLS POOL OPENING:All swimming,wading and whirlpools which have been closed for the season must be inspected by the Health Department prior to opening. Contact the Health Department to schedule the inspection three 13)days prior to opening.PLEASE NOTE:People are NOT allowed to sit in the pool area until the pool has been inspected and opened. POOL WATER TESTING: The water must be tested for pseudomonas,total coliform and standard plate count by a State certified lab,and submitted to the Health Department three(-)days prior to opening,and quarterly thereafter. POOL CLOSING:Every outdoor in ground swimming pool must he drained or covered within seven 17)days of closing. FOOD SERVICE SEASONAL FOOD SERVICE OPENING: All food service establishments must be inspected by the Health Department prior to opening. Please contact the Health Department to schedule the inspection three(3)days prior to opening. CATERING POLICY: Anyone who caters within the Town of Yarmouth must notify the Yarmouth Health Department by filing the required Temporary Food Service Application form 72 hours prior to the catered event. These forms can be obtained at the.Health Department.or from the Town's website at www,sarmouth.mu.us under Health Department.Downloadable Forms. FROZEN DESSERTS: Frozen desserts must be tested by a State certified lab prior to opening and monthly thereafter,with sample results submitted to the Health Department. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms have been met. OUTSIDE CAFES: Outside cafes(i.e..outdoor seating with waiter/waitress service),must have prior approval from the Board of Health. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a retail or food service establishment is prohibited. TOBACCO PRODUCT PERMIT CAP A tobacco permit holder who has failed to renew his or her permit within thirty(30t days of the previous year's permit expiration date is considered an expired license,and the tobacco license cap is reduced. NOTICE:Permits run annually from January Ito December 31. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED RENEWAL APPLICATIONS)AND REQUIRED FEE(S)BY DECEMBER 18,2020. ALL RENOVATIONS TO ANY FOOD ESTABLISHMENT. MOTEL OR POOL (i.e., PAINTING, NEW EQUIPMENT,ETC.),MUST BE REPORTED T( ND APPROVED BY THE BOARD OF HEALTH PRIOR TO COMMENCEMENT./ RENOVATIONS MAY CQ r''RE A SiTE PLAN. DATE: 1'x,344 /tea OD-1 SIGNATURE: PRINT NAME&TITLE:, Iona; Wang-President Re:.I(UIS/ra CD it m 1y� :i iroiiY / pr,'n n 0 c g L C ,of CD n d nn Rl t7 $AN1 ;1 n a C. AvtA m � F °" , n rip 0 °D ,D .V n �? n to h h > 3m > D n &r fill • to '5. 3 ' to �' r.. k 71 CL 3 s a ' o a _ r iiii or ,. ,-e a 0 rill i n n �:. vli Z A--A2fA,1). '''P'' el f.,,,v0,,,revt,... ,,1 5 8 3 . (...1 141,44.4 l'f,k,. 3 a a c lr Iy ;,,el r n3m c s m F n Ia ° M W { av Yl'e.,,,e.,:),,Y,,,,,,; (O N 4 0 alro /Aro � _ �t g 5 ci po vieb n n543 �re, W j , 7 tic' 140, ( Fh. N 35 0o cn _ kfi t " a, i jm � v h 0. c fil) " !t. r` tlqn N ^ o c S Q- n ( y ,* G3 AN '. �A / g_ y Ll j w ,tr." 1:7';1,014, 4.0 2 z at 8 ("/ = n -> 7g q e e e a O ..i C !I::!ii'''' ''Irl:;li . 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