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HomeMy WebLinkAboutBLDCI-16-003273-04 The Commonwealth of Massachusetts } n r, City\Town of YARMOUTH im l 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: DAVENPORT/MUGAR LTD PARTNERSHIP BLDCI-16-003273-04 Trade Name:THIRWOOD PLACE Identify property address including street number, name,city or town and county Certificate Expiration Located at 12/31/2021 237 NORTH MAIN ST SOUTH YARMOUTH, MA 02664 l Use Group Floor Occupancy Use Group Other Classifications(s) A-2 Basement/Lower 27 A-2 Nightclub/Restaurant/Bar/Banquet Hall 27 Persons-2 Studios Allowable 01st Floor 321 A-2 Nightclub/Restaurant/Bar/Banquet Hall 196-Dining 20-Function Rm Occupant Load 24-Function Rm 49-Function Rm 32-Private Dining CORE SECTION NOT TO EXCEED 300 PERSONS AT ANY TIME 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 r ' Building Commissioner _-- Issuance A� ,e41.9 C , file Zj249 Fee: $150.00 D I r r.,.�..;I i..... ...4 TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG - 2021 NAME: Thirwood Place Assembly ADDRESS: 237 North Main St, Yarouth This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office and/or the Health Department in order to obtain your license. Licenses will be withheld until all inspectors have signed. Building Commissioner Rep. Date Comments Approved for License Issuance ��� 20 es- No Fire Department Rep. Date Comments Approved for J I4- /UQ Lice.. Issuance No Board of Health Rep. Date Comments Approved for License Issuance Yes No Plumbing/Gas Inspector Date Comments Approved for License Issuance Yes No Electrical Inspector Date Comments Approved for License Issuance Yes No Taxes Paid Yes No Rev.Sept.2003 1'YA#i TOWN OF YARMOUTH o y BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 c.: APPLICATION FOR CERTIFICATE OF INSPECTION // /, PAYABLE UPON RECEIPT 0 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-named premises located at the following address: Street and Number: 237 North Main Street Name of Premises: Thirwood Place Tel: 508-398-8006 Purpose for which permit is used: Liquor License Inspection License(s)or Permit(s) required for the premises by other governmental agencies: License or Permit Agency Common Victualler R E C E ¢ . Alcoholic Bev Club Lic !!' Food Establishment OCT 5 2020 f } Certificate to be issued to Thirwood Place Tel: 508-398-8006 eui -�:-4 •1 Address: 237 North Main St, South Yarmouth, MA 02664 _ . Owner of Record of Building Davenport Realty Address 20 North Main St., South Yarmouth, MA 02664 Present Holder of Certificate Same /_2 Assistant Controller Signature o person to whom Title Certificate s issued or his agent 10/7020 Date Email Address: mcekuAthirwoodplace.com 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. CeVicle of Inspection #/WC8196035 g I� 1 —cO 30773_12_,€,C)--a �., DAVEREA-01 NCANUSO .a►`ORo" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYVY) 2/26/2020 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 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 I CONTACT i NAME: ValleyForge Captive Advisors PHONE FAX 630 Freedom Business Center Drive 1(A/C,No,Ext):(610)458-3659 (A/C,No):(484)965-9627 E-MAIL Suite 203 ADDRESS: King Of Prussia,PA 19406 4 INSURER(S)AFFORDING COVERAGE NAIL ft INSURER A:Zurich American Insurance Company 16535 INSURED INSURER B: Thirwood Place L.P INSURER C: c/o Davenport Realty Trust 20 North Main Street I INSURER D: South Yarmouth,MA 02664 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER 1 IMMIDDIYYYYI JMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 CLAIMS-MADE X I OCCUR GL08196255 3/1/2020 3/1/2021 DAMAGE TO RENTED 1,000,000 PREMISES(Ea occurrence) S MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY 5 1,000,000 2,000,000 GEN'L AGGREGATE LIMIT APPLIES�IE PER: GENERAL AGGREGATE $ X POLICY 1 I jEN7 IJ LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT i 1,000,000 (Ea accident) 5 X ANY AUTO BAP8196256 ', 3/1/2020 3/1/2021 BODILY INJURY(Per person) 5 AUTOS OSDONLY I I AUTOS BODILY BODILY INJURY(Per accident) $ HIRED NON-AWNED ( err aociident)AMAGE $ AUTOS ONLY AUTOS ONLY 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 '-- EXCESS LIAB 1 CLAIMS-MADEI AGGREGATE $ DED i RETENTION 5 I I I $ A AND EMPLOYERS'LIABILITY X I STATUTE I ,EERH ANY PROPRIETOR/PARTNER/EXECUTIVE YIN WC8196035 3/1/2020 3/1/2021 1,000,000 N/A E.L.EACH ACCIDENT $ OFFICER/MEMBERt EXCLUDED? 1,000,000 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT 5 I I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. Route 28 South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE 4i7A0 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD