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HomeMy WebLinkAboutBLDCI-17-002216-05 . The Commonwealth of Massachusetts ' h it City\Town of ' ' YAR I I 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: Ropes End Famiy Restaurant BLDCI-17-002216-05 Trade Name: Ropes End Family Restaurant , Identify property address including street number,name,city or town and county Certificate Expiration Located at 908&928 ROUTE 28 12/31/2021 SOUTH YARMOUTH, MA 02664 1 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 39 A-2 Nightclub/Restaurant/Bar/Banquet Hall 39 persons Allowable Other 12 A-2 Nightclub/Restaurant/Bar/Banquet Hall 12 persons-outside Occupant Load deck • 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 Grylls Date of /��� Fire Chief Building Commissioner Inspection Signature of Municipal Signature of Municipal Date of Fire Chief j. ' Building CommissionerIssuance j 'co' ji- /�• I�• ZbZU Fee: $100.00 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: Ropes End Family Restaurant ADDRESS: 908 Rte 28 Yarmouth 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 Re Date Comments Approved for License Issuance 400111101. No Fire Department Rep. Date Comments Approved for C QP t1 i'OC� License Issuance Yes No Board of Health Rep. Date Comments Approved for License Issuance Yes No Plumbing/Gas Inspector Date Comments Approved for License Issuance Yes No II Electrical Inspector Date Comments Approved for License Issuance Yes No Taxes Paid Yes No Rev.Sept.2003 /ki TOWN OF YARMOUTH 0 BUILDING DEPARTMENT G MATTA n �SEj�' '4.„.,,.,. 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION October 1, 2020 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: 4,4 Name of Premises: gra I/r/ `,�"+r, /Y 4t/,t1 Tel: s0(9- 3 fa P<P` Purpose for which permit is used: 4/cc(<1/G. ,67` c-' 4 Jt License(s) or Permit(s) required for the premises by other governmental agencies: License or Permit Agency - 'e -lit-Djef(-- &f /4 r-G- Certificate to be issued to 7alet- S"4-1/` ""'1/ L Tel: Sr'& 3 y C?SS k Address: 9Gi--- Owner of Record of Building UCi,'l Address j/'3 ,,/ya)r(r 5;. 64045 Present Holder of Certificate ;#4u5 f ' / /1/iciet"e•1/0 Signature of person to whom Title Certificate is issued or his agent Date Email Address: / 61.41Z(e: / 0�' 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# B L)C I-17-0'):,ai to-kQ n,Ut1 12/31/2020-12/31/2021 S. t t / TNTFAMI-01 ASANZO A Rii, DATE(MM/DD/YYYY) k.:...----- CERTIFICATE OF LIABILITY INSURANCE 10/6/2020 T-11S 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 License#1780862 CONTACT nee.certificates@hubinternational.com HUB International New England PHONE HON o,Ext):(508)945-0446 FAX No):(508)945-9136 266 Orleans Road North Chatham,MA 02660 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Arbella Protection Insurance Company 41360 INSURED INSURER B:Massachusetts Retail Merchants Workers'Compensation Group,In 34355 TNT Family Enterprises,Inc.DBA Ropes End INSURER C: Family Restaurant 908 Route 28 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD IMM/DD/YYYYI (1NM(DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 7620076620 8/1/2020 8/1/2021 DAMAGE TO RENTED PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY Flea: LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea accident81NGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ — OWNED SCHEDULED _ AUTOS ONLY _ AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE _ AUTOS ONLY — AUTOS ONLY (Per accident) $ $ _ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS- MADE AGGREGATE $ DED RETENTION$ $ B AND EMPLOYERS LIABILITY STATUTE ERH Y/N 014006034637119 1/1/2020 1/1/2021 600,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 600,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 600,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Liquor Liability 7620076620 8/1/2020 8/1/2021 1,000,000 i DESCRIPTION OF OPERATIONS/LOCATIONS/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 Town of Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ACORD 26(2016/03) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD