HomeMy WebLinkAboutBLDCI-22-005232-01 11/30/23
Dear Brad,
I recently received a violation notice that we missed our inspection this year.
never received anything saying that we needed to schedule one in the first place.
Am I supposed to receive something or some kind of reminder each year? My
apologies if this is something I should've done.Should I just plan on reaching out
in January every year to book an inspection.
We can schedule an inspection for the current year and next year whenever you
would like. Please let me know a day and time that works for you.Feel free to
email or give me a call,my cell is 508 685 4694. Again my sincere apologies.
Best regards,
Meredith Katz
Meredith@discoverpirates.com
REC
EIVED
8 2023
BUILDING DEPARTMENT
By:
-
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•
•
. . . .
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. .
• ;•
The Commonwe of Massachusetts
} = � City n of
at;= YARMOUTH
MT LW
New and Renewal Certificate of Inspection
1
In accordance with the Massachusetts State Building Code, Section 110.7
Identify Name of Establishment Certificate No.
Issued to
Business Name:Whydah Pirate Museum BLDCI-22-005232-01
Trade Name:Whydah Pirate Museum
Identify property address including street number, name,city or town and county Certificate Expiration
Located at
674 ROUTE 28 1/1/2023
WEST YARMOUTH, MA 02673
Use Group Floor Occupancy Use Group Other
Classifications(s) A-3 A m/L ibrary/Museum
A-3 01st Floor 294 musement/Church/Gy
Allowable
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 �j!
Building Commissioner Inspection / /�
Signature of Municipal Signature of Municipal Date of
Building Commissioner Issuance 4/12/ 2Z
(�L i
Fee: $100.00
DI r1 !'`e 4,fIncnnrtinn rnf
The Commonwealth of Massachusetts
City\Town of
t� ="t r= YARMOUTH
T+ •:yam
L#�
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:Whydah Pirate Museum BLDCI-22-005232
Trade Name:Whydah Pirate Museum
Identify property address including street number,name,city or town and county Certificate Expiration
• Located at
674 ROUTE 28 1/1/2022
WEST YARMOUTH, MA 02673
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-3 0isi Fk,ui 294 A-3 Amusement/Church/Gym/Library/Museum
Allowable
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
Signature of Municipal Signature of Municipal Date of
Building Commissioner Issuance
Fee: $100.00
Nar CO/ifp1.17400
BLD Certoflnspection.rpt
.oF-YaR
,� . o TOWN OF YARMOUTH
oµ , ,y BUILDING DEPARTMENT
MA �� [S��'� v
�.:n1, �., 1146 Route 28, South Yarmouth, MA 02664 508-398-22 . . , ,
APPLICATION FOR CERTIFICATE OF INSPECTION I MARc pjz ,
December 3, 2021 PAYABLE UPS e etl PPEPARTMENT j
(X) Fee Requir-• i i.i i ----
( )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:
1 1-4Street and Number: (q -T_Z (,l /
S
�.. Yarn-mca' )
Name of Premises: W tA5V1 (-A,e-M e M..)5E'U C' Tel: -5 3 v-95 71
Purpose for which permit is used: Mora n
License(s) or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency
Certificate to be issued to ukLicbr i P,r-4e (Yl Evrri Tel: 5(J - 5- i-/-95-7/
Address: (g-7 y RI_2._ W.Varrrokkr., NIA (o(o 1 5
Owner of Record of Building
Address
Present Holder of Certificate Wh IC/8h Pi Gle mu ur,-)
Signature of person hom Title
Certificate is issued or his agent 1 13y 1,�
Date
Email Address: Mecr=.<\, eci;,(- 0-2; C's Ccen
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# e1-tCI-ZZ-Cc 3,)_,
1/1/21-1/1/22
TOWN OF YARMOUTH
,o 4 . y BUILDING DEPARTMEN
1146 Route 28, South Yarmouth, MA 02664 508-398-•2R a1CIS(f' V E D
ra- m
M 72
APPLICATION FOR CERTIFICATE OF INSPECTION
BUILDING DEPARTMENT
December 3, 2021 PAYABLE U' e.
(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: (.01(4 r))1_ "/orrncu -h
Name of Premises: UOINCbh { faite" (Y1t, Carl Tel: c -5.3L/-c157 /
Purpose for which permit is used: rno,543r
License(s) or Permit(s)required for the premises by other governmental agencies:
License or Permit Agency
Certificate to be issued to (,(,lh i h P,-ie Mus-eufn Tel: 5(4-531-1-9S7/
Address: (.7L/ / T- 2' WAS( VV,-m0:,,61. mr i
Owner of Record of Building
Address
Present Holder of Certificate UJ .io i- 1',,-- k' ry?.t, ir1
raY1it
Signature of person to whom Title
Certificate is issued or his agent j J L)
Date
Email Address: NYPk6j►6.2d'S6Overpir es.,
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# t3(.�CI 22 D ,3Z -e-ji_ D/
REINSTATEMENT NOTICE
Insurance
Company NorGUARD Insurance Company
Policy Number CLWC229445 Reinstatement is effective 10/23/2021
Insured's Name and Address ❑x 12:01 A.M. ❑ NOON
Standard Time
Clifford Explorations, LLC
DBA/TA Whydah Pirate Museum
PO Box 493
Provincetown, MA 02657 Please disregard the
Notice of Cancellation
previously sent to you.
Producer's Name and Address
Your policy has been
FIRESIDE INSURANCE AGENCY, INC.
36 Shank Painter Road#10 reinstated on the date
P.O. Box 760
Provincetown, MA 02657 and time shown above.
Mortgagee/Loss Payee and Address
Date 10/18/2021
GU 275(5-85)UNIFORM PRINTING&SUPPLY,INC.
NOTICE NOTICE
TO =: TO
EMPLOYEES EMPLOYEES
41 y i1.1 5y
The Commonwealth of Massachusetts
DEPARTMENT OF INDUSTRIAL ACCIDENTS
1 Congress Street, Suite 100, Boston, Massachusetts 02114-2017
617-727-4900 - http://www.state.ma.us/dia
As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice
that I (we) have provided for payment to our injured employees under the above-mentioned chapter by
insuring with
NorGUARD Insurance Company
NAME OF INSURANCE COMPANY
P.O. Box A-H, 39 Public Square, Wilkes-Barre, PA 18703-0020
ADDRESS OF INSURANCE COMPANY
CLWC194660 08/06/2020 08/06/2021
POLICY NUMBER 36 Shank Painter Road #10 P.O. Box 760 EFFECTIVE DATES
FIRESIDE INSURANCE AGENCY, IF Provincetown, MA 02657 508-487-9044
NAME OF INSURANCE AGENT ADDRESS PHONE #
Clifford Explorations, LLC PO Box 493 Provincetown, MA 02657
EMPLOYER ADDRESS
07/02/2020
EMPLOYER'S WORKERS' COMPENSATION OFFICER (IF ANY) DATE
MEDICAL TREATMENT
The above named insurer is required in cases of personal injuries arising out of and in the course of
employment to furnish adequate and reasonable hospital and medical services in accordance with the
provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the
injured employee. The employee may select his or her own physician. The reasonable cost of the ser-
vices provided by the treating physician will be paid by the insurer, if the treatment is necessary and
reasonably connected to the work related injury. In cases requiring hospital attention, employees are
hereby notified that the insurer has arranged for such attention at the
0 LC /1-05/0/./7( 44,1 n4/4-
F HOSPITAL ADDRESS
TO BE POSTED BY EMPLOYER
11/30/23
Dear Brad,
I recently received a violation notice that we missed our inspection this year.
never received anything saying that we needed to schedule one in the first place.
Am I supposed to receive something or some kind of reminder each year? My
apologies if this is something I should've done.Should I just plan on reaching out
in January every year to book an inspection.
We can schedule an inspection for the current year and next year whenever you
would like. Please let me know a day and time that works for you.Feel free to
email or give me a call,my cell is 508 685 4694. Again my sincere apologies.
Best regards,
Meredith Katz
Meredith@discoverpirates.com
REC
EIVED
8 2023
BUILDING DEPARTMENT
By:
-
„.\ The Commonwe 1 of Massachusetts
►� === -= �r City0 not
=.` ! .
'� . — . YARMOUTH
♦ �•, ■ -
ti.>T 4''
.. ..............................-.................J New and Renewal Certificate of Inspection
'II INIII
�In accordance with the Massachusetts State Building Code, Section 110.7
Identify Name of Establishment Certificate No.
Issued to BIDCi-22-005232-01
Business Name: Whydah Pirate Museum
Trade Name: Whydah Pirate Museum
• on
Identify property address including street number, name, city or town and county Certip �
Located at 674 ROUTE 28 1/1/2023 _
WEST YARMOUTH, MA 02673 g "
i , i\C-tA
Use Group Floor Occupancy Use Group
Other
Classifications(s) " -------
01 st Floor 294 A-3 Amusement1Churc Gym/ brary/Museum
A-3
Allowable
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 T *0....../47,....VA,
Building Commissioner --� • = •
Signature of Municipal Signature of Municipal / %' Date '
Building Commissioner , 'f'V, Z
I' Fee: $100.00
} 14 71" e,vio /, / / / / no r1 resr+nflr+er+aMinf reti
•;'\ The Commonwe of Massachusetts
; n
► 4 6City n of
mats .I YARMOUTH
New and Renewal Certificate of Inspection
In accordance with the Massachusetts State Building Code,Section 110.7
Identify Name of Establishment 1 Certificate No.
Issued to t BLDCI-22-445232-01
Business Name:Whydah Pirate Museum
Trade Name:Whydah Pirate Museum
Identify property address including street number,name,city or town and county Certificate Expiration
Located at 1
674 ROUTE 28 1/1/2023
WEST YARMOUTH,MA 02673
Use Group Floor Occupancy Use Group Other
Classifications(s)
A-3 01st Floor 294 A-3 Amusementichurch/Gym/Ubrary/Museum
Allowable
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
Signature of Municipal Signature of Municipal '' Date of
Building Commissioner 1� Issuance If'til 7Z
/ Fee:$100.00
DI r1 (`nr+nflncnar'tirtrf mt