HomeMy WebLinkAboutBLDCI-22-006081 The Commonwealth of Massachusetts
•
City\Town of
a ; YARMOUTH
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: Westerly Winds Motel BLDCI-22-006081
Trade Name:Westerly Winds Motel
Identify property address including street number, name,city or town and county Certificate Expiration
Located at
77 ROUTE 28 04/29/2023
WEST YARMOUTH, MA 02673
Use Group Floor Occupancy Use Group Other
Classifications(s)
R-1 01st Floor 15 R-1 Hotel/Motel/Boarding House/Transient 15 Units
Mangers Apt
Allowable Storage Room
' Outside Pool
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 Name of Municipal Mark Grylls Date of ��
Building Commissioner Inspection C9 +�Y!40
Signature of Municipal Signature of Municipal / Date of ��Building Commissioner Issuance ///7/G�f/`
Fee: $172.00
BLDCertofl nspection.rpt
w"\
A t, .t TOWN OF YARMOUTH
r�' � �\,d ay.
ro. °_-? v.t . 2) BUILDING DEPARTMENT.
;y(.4\M �a� [.` 1 Tom'
•`�-:',.", _—f V., 1146 Route 28, South Yarmouth, MA 02664 508-398 2BEela INN E
APR k 2022
APPLICATION FOR CERTIFICATE OF INSPECTION 1 L _
f3UILDIN y;y itr Nf /
March 1, 2022 PAYABLE UPON RECEIP I -• c< `J
(X) Fee Required $172.00
( ) 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: 2-e? 6C3 5 C`'f'if
U_G1-4-e4coi& Z6-O£SName of Premises: Tel: J C•
,gy 02�0 --6 cl67
Purpose for which permit is used: / 2 7 p Y. i -,`e-s
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
Fit ii
Certificate to be issued to L65)(( V1 A4C. O 3 1 Tel: .5�s--�d-- j;7
Address: 7 Mf .� , (,o, ,, -�6?
Owner of Record o(Building y\y % t k(�CA P fr1.�2 r �
Address_ 1 q [` ,,_, •4• . , Z , :,,,, A O-D ( -13
Present Holder of Certificate ( \(r Ce vac 6--'d j
Sigi-
/(4?- --'-- ---.--.p rson tow om Title
Certificate is issued or his agent ' ' jai /aD
Date/ /
Email Address: _h_gAzonA,631Seiwatir ,
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# o1 -CD(d&I i
04/29/2022-04/29/2023
.� ; `.
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,t_, - - - - - ___ . _
XS BROKERS
Renewal Insurance Quotation
Reference#: 1427046A-Chris Kiely
DATE: January 13, 2022
XS CLIENT: The Oceanside Insurance Group
52 W Main Street
Hyannis, MA 02601
RENEWAL OF: XSZ171482
INSURED: The Village Center Group LLP
77 Route 28
West Yarmouth, MA 02673
LOCATION ADDRESS: 77 Route 28 , West Yarmouth MA, 02673
INSURER: Lloyd's of London AM Best rating: A
Non-Admitted
POLICY PERIOD: 3/8/2022 TO 3/8/20.23
COVERAGE: Property -Monoline TERM: 12 Months
12:01 A.M.STANDARD TIME AT THE LOCATION ADDRESS OF THE NAMED INSURED.THIS INSURANCE QUOTATION WILL
BE TERMINATED AND SUPERSEDED UPON DELIVERY OF THE BINDER OR FORMAL POLICY(IES)ISSUED TO REPLACE IT.
LIMITS OF LIABILITY: $800,000 Building
$150,000 Business Income with EE: 1/6 Monthly Limit
$950,000 Equipment Breakdown
RC Valuation
80% Coinsurance
POLICY FORM: Special Form X F&C,
DEDUCTIBLE: $2,500 All Perils
$16,000 Wind Deductible, if different than above.
PREMIUM $4,280.00
TAXES $171.20
Policy Fee $50.00
TOTAL $4,501.20
TRIA: If the insured desires Terrorism Coverage, add an additional premium of$428.00 plus applicable state tax
of$17.12.
ENDORSEMENTS / EXCLUSIONS:
CF150s 11-85 Commercial Property Coverage Part Declarations
CG2170 01-08 Cap On Losses From Certified Acts Of Terrorism