Loading...
HomeMy WebLinkAboutBldci-16-003283-04 The Commonwealth of Massachuse s h 1. 4City\Town of YARMOUTH • 5 ) 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: GIARDINO'S RESTAURANT BLDCI-16-003283-04 Trade Name: GIARDINO'S RESTAURANT Identify property address including street number, name, city or town and county Certificate Expiration Located at 242 ROUTE 28 12/31/2021 WEST YARMOUTH, MA 02673 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 241 A-2 Nightclub/Restaurant/Bar/Banquet Hall 94-Bar&Lounge 58-Rear Dining Room 89-Front Dining Room Allowable TOTAL-241 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 Philip Simonian Ill Name of Municipal Mark Grylls Date of //� .�� Fire Chief Building Commissioner /__ ^Inspection OKJ Signature of Municipal Signature of Municipal �_, j Date of �j, Fire Chief Building Commissioner „rr/�: Issuance �/J,/► :'� 'G ��j L-� Fee: $150.00 RI rl C'nr+nflncnon+inn rn+ TOWN OF r MOUTH : BUILDING 1 r 'I , W 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG - 2021 NAME: Giardino's]Tastee Tower ADDRESS: 242 Rte 28, West 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 Rep. Date Comments Approved for License Issuance No //" .14 Fire Department Rep. Date Comments Approved for Li - se Issuance 411 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 °�.Ye/Alt o TOWN OF YARMOUTH BUILDING DEPARTMENT MAT TA •G' 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 xeor01� APPLICATION FOR CERTIFICATE OF INSPECTION October 1, 2020 PAYABLE UPON RECEIPT (X) 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: 07 ' c /4 Name of Premises: Ci 4/Le/ND J n/y e!,1 7-/} ,*.✓/Tel: / ZC- 622ze Purpose for which permit is used: j2 7 ? a4,, License(s) or Permit(s) required for the premises by other governmental agencies: a License or Permit Agency r OCT 15 2020 { BU LUit;G DEPlARTML_.J4 Certificate to be issued to C,4g0/M2( fiTAy �ipow gr. - 'f- Address: '7401 /y9�ti 5 kJ, / J jT j/. r9/1 dab Owner of Record of Building -S v/y Address �1 Present Holder of Certificate &,4/Zgljn/v /.l / 1-1* `C6?_17Y/41,&zew./4, �J &k.cr/.46N r Signature of person to whom Title Certificate is issued or his agent /Q /Q -/9' Date Email Address: eea y, L / Y0 ( I©L �Q M 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# BLOC 1-i(o-{x) 3_Uc/ 12/31/2020-12/31/2021 r A Worker's Compensation and Employer's Liability Policy NorGUARD Insurance Company - A Stock Co. VBerkshire Hathaway Policy NumberGIWC169351 ' G VARD Insurance Renewal of GIWC044696 Companies NCCI No. [25844] Policy Information Page [1]Named Insured and Mailing Address Agency Giardino's Tastee Tower Inc. COMMONWEALTH INSURANCE PARTNERS LLC 242 Main Street 2 Heritage Drive Yarmouth, MA 02673 Suite 301 North Quincy, MA 02171 Agency Code: MACOIN10 Federal Employer's ID XX-XXX0039 Insured is Corporation [2] Policy Period From September 1, 2020 to September 1, 2021, 12:01 AM, standard time at the insured's mailing address. (3) Coverage A. Workers' Compensation Insurance - Part One of this policy applies to the Workers' Compensation Law of the following states: Massachusetts B. Employer's Liability Insurance - Part Two of this policy applies to work in each of the states listed in item [3]A. The limits of our liability ,Inder Part Two are: Bodily Injury by Accident - each accident $500,000 Bodily Injury by Disease - each employee $500,000 Bodily Injury by Disease - policy limit $500,000 C. Other States Insurance - Part Three of this policy applies to all states, except any state listed in item [3]A. and the states of North Dakota, Ohio, Washington, and Wyoming. D. This policy includes these endorsements and schedules: See Extension of Information Page Schedule of Forms [4] Premium The Premium Basis and, therefore, the premium will be determined by our Manual of Rules, Classifications, Rates, and Rating Plans. All required information is subject to verification and change by audit. (Continued on another page) Total Estimated Policy Premium $ 3,002 Total Surcharges/Assessments $ $89.00 Total Estimated Cost $ $3,091.00 JNTF NAI S!s__xx Page - 1 Information Page MGA : 0I/2 /20201 WC 000001A Date : 07/28/2020 MANOTE