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HomeMy WebLinkAboutBldci-16-005429-05 The Commonwealth of Massachusetts 1 -""�_ City\Town of r. �� YARMOUTH f ma: . 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: TUGBOATS BLDCI-16-005429-05 Trade Name: TUGBOATS Identify property address including street number, name,city or town and county Certificate Expiration Located at 21 ARLINGTON ST 11/30/2021 WEST YARMOUTH, MA 02673 I Use Group t-loor Occupancy _ Use Group Other Classifications(s) A-2 01st Floor 157 A-2 Nightclub/Restaurant/Bar/Banquet Hall 57-Interior Main Dining 24-Bar Sears,30 Bar StAllowable 46- g Porch- Dining Occupant Load Other 167 A-2 Nightclub/Restaurant/Bar/Banquet Hall 104-Deck Seating 23-Bar Seats 40-Bar Standing 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 /2 72- Fire Chief Building Commissioner Inspection . . V Signature of Municipal41111// Signature of Municipal r Date of Fire Chief / //-N ' Building Commissioner Issuance i 4 Fee: $150.00 BLD_Certofl nspection.rpt BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG - 2021 NAME: Tugboats ADDRESS: 21 Arlington Street 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 3 � � ( c , No Fire Department Rep. Date Comments Approved for License Issuance _ n — 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 TOWN OF YARMOUTH BUILDING DEPARTMENT F Y`\hnT'T LM 3� 4` f 1.146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION Febuary 5, 2021 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: 11 A-41,0is- 7itf sue ` — N.t.j ' ' 1 Name of Premises: !U - r3oi1-TS Tel: ,SU - - 7776 Purpose for which permit is used: Kec' LA.ti. t l t RECEFITEE1 License(s) or Permit(s)required for the premises by other governmental agencies: License or Permit Agency MAR 0 9 2021 BUILDING DEPART ENT By A Certificate to be issued to nkiui 741/3o/2- Tel: ,�D g'-3 6 y-777( Address: S'T. WPC. A f'►'�'►GU t'h, 4A�4 /L(.r7 Owner of Record of Building� ) �j�/A S/N,� Vl r2( " Address •( (-17"7p) ��/ . t sui T'/sz-dlNtid Jr6/ Present Holder of Certificate Gil zc-yr- Signature of a on to whom Title Certificate i 'ssued or his agent 3-- v 'ZO2 Date Email Address: 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# 4/1/2021 -11/30/21 i Y DATE(MM/DD/YYYY) ACC)Rl7 CERTIFICATE OF LIABILITY INSURANCE �-- 03/09/21 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 CONTNAME: PAUL PAUL SCHLEGEL Schlegel&Schlegel Ins Brokers,Inc. (A/CC,No,Ext): 508-771-8381 • FAX No): 508-771-0663 34 Main Street E-MAIL West Yarmouth, MA 02673 ADDRESS: schlegelinsurance@gmail.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: HOUSTON SPECIALITY INSURANCE CO INSURED INSURER B: GUARD INSURANCE ABOVE THE HARBOR, INC. DBA INSURER C: SAFETY INSURANCE TUGBOATS INSURER D 21 ARLINGTON ST WEST YARMOUTH,MA 02673 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 1,000 A Y HOSPK1044054 06/10/20 06/10/21 PERSONAL&ADVINJURY $ 1,000,000 GENII AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ • C OWNED SCHEDULED Y AUTOS ONLY AUTOS COM5535672 06/25/20 06/25/21 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B OFFICER/MEMBER EXCLUDANY D?PROPRIETOR/PARTNER/EXECUTIVE YNN N/A Y ABWC183736 06/08/20 06/08/21 E.L.EACH ACCIDENT $ 100,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below • E.L.DISEASE-POLICY LIMIT $ • EACH OCC 1,000,000 LIQUOR LIABILITY A Y HOSPK1044054 06/10/20 06/10/21 POLICY LIMIT 1,000,000 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 THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD