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HomeMy WebLinkAboutBldci-22-002945 The Commonwealth of Mas sachusetts _ =1 = City\Town of _ram'= _u 0 v 1f YARMOUTH '!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 Issued to Certificate No. Business Name:The Grill at Bayberry Hills Trade Name:The Grill at Bayberry Hills BLDCI-22-002945 Identify property address including street number, name, city or town and county Located at Certificate Expiration 635 WEST YARMOUTH RD WEST YARMOUTH, MA 02673 12/31/2022 I Use Group Floor Occupancy Use Group Classifications(s) Other A-2 01st Floor 41 A-2 Nightclub/Restaurant/Bar/Banquet Hall 41 Person/Tables& Allowable Chairs 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 III Fire Chief Name of Municipal Mark Grylls Date of Building Commissioner �7 /�--7 eR( Signature of Municipal Inspection Fire Chief Signature of Municipal Date of .... ildin Commissioner 9 C____ v/� Issuance /2- ¢./ _ u j� Fee: $0.00 BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG - 2022 NAME: The Grill at Blueberry Hills ADDRESS: 635 West Yarmouth RD 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 /,,,,, ,1 /-2— 9-2I es No Fire Department Rep. Date Comments Approved for Li ense Issuance ).1Attz%‘Cikir---' I) " ( et. No Board of Health Rep. Date Comments Approved for License Issuance Yes No Plumbing/Gas Inspector Date /1/3/2> Comments Approved for License Issuance �e'sJ No Electrical Inspector Date Comments Approved for License Issuance Yes No Taxes Paid Yes No Rev.Sept.2003 TOWN OF YARMOUTH BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION October 1, 2021 PAYABLE UPON RECEIPT /0 (X)Fee Required 0.00 ( )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: (© '✓''� 41.51- U �ate Name of Premises: G c`t II c t Tel: Purpose for which permit is used: 2A.5 Adu3%nt I .5 License(s) or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Ouvz. t-k le.t - •k1 G riru' U-C 1 Certificate to be issued to „L► b h. JI Q r it o.�} jl iz 1 : 413 . 1 'Od6.'% °"14-'� — RF � EIVFD Address: P 0 6„x. L14 e b-9V W\� r,r Cr o [�C1)A _.__.__._._ _ Owner of Record of Building Tow-rt at �440j- ..n NOV 19 2021 Address I H&c g-.k- �� S Q t'(n �.rr�o� lr1A C (ot' Present Holder of Certificate CW,z t.v5p vt- --- — --� BUILDING AR -MENT By: C3-NrIni (114 C\) 'Signature of erson to whom Title Certificate is issued or his agent to 13$l.t Date Email Address: L 41„.1Qy e C' Z ktu,s r,.tt&l,ki . C.el 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# 12/31/21-12/31/2022 Nob:06264-RS-1518 LICENSE ALCOHOLIC! BEVERAGES THE LICENSING 30ARD, TOWN OF YARMOUTH, MASSACHUSETTS HEREBY GRANTS A COMMON 'VICTUALER License to Expose, Keep for Sales, and to Sell All Kinds of Alcoholic Beverages a I To Be Drunk On The Premises To:CHEZ HOSPITALITY GROUP LLC w — .. µ — .__ Date:08/05/2021 DBA:THE GRILL AT BAYBERRY HILLS Ref:LICA-21-0047 635 WEST YARMOUTH RI). WEST YARMOUTH,MA 02673 Fee(s): 1,762.50 License Duration Type: Annual Manager:HALEY MATHIEU License Conditions THE RESTAURANT LOCATION IS LOCATED INSIDE THE CLUBHOUSE AND THE GOLF COURSE IS IDENTIFIED AS THE 27 HOLE GOLF COURSE ADJACENT THERETO.. BEVERAGE CARTS WILL BE USED UPON THE COURSE.ALCOHOLIC BEVERAGES WILL BE STORED WITHIN THE CONFINES OF THE CLUBHOUSE. THIS IS ONE FLOOR FOR SERVICE WITH ALCOHOL STORAGE WITHIN A SECURE ROOM IN THE BASEMENT OF THE CLUBHOUSE. On the following described premises: 635 WEST YARMOUTH RD,WEST YARMOUTH,MA 02673 u 4C tented and accepted upon the express condition that the licensee shall in all i WeI ts,conform to all the Thisprovisions of the Liquor Control Act,Chapter 138 of the General Laws,as amended,and any rules or regulations made expires fiber 31,2021,unless earlier.suspended cancelled or revoked. IN TESTIMONY WHEREOF,the undersigned ed have thereunto affixed their official signatures. 1. �. Houn Ong which Alcoholic Beverages LICENSE-.•-C1� �'Oi' --- + may be sold are From; granted bye a AM- 1:OOAM .�. . 8 WEEKDAYS&SATURDAY5 M► _.. . =_: 1 O;OOAM- 1:00AM LI/ 1146 A O SUNDAYS • i mkt Lwow Shell be Displayed en t�Premises In• . ._ ._.. .. ._ .peaks where it can be sally read • —�..mmio CHEZHOS-01 DALDRICH A�ORO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ODYYYY) 10/28/2021 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 CONTACT NAME: Haberman Insurance PHONE i FAX 95 Ashley Ave (AlC,No,Ext):(413)781 7000 (A/C,No):(413)733-9545 West Springfield,MA 01089 E-MAIL DREss:irtfo@habermaninsurance.com INSURER(S)AFFORDING COVERAGE NAIC S _ — INSURER A:Hartford Insurance INSURED INSURER B: Chez Hospitality LLC INSURER C_ PO Box 498 INSURER D East Windsor,CT 06088 INSURER E: I 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 POUCY NUMBER POUCY EFF POLICY EXP LIMITS LTR INSD WVDIMM/DD/YYYYI (MM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $_ ' CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) i$ D EXP_Olny one person) $ PERSONAL&ADV INJURY 1 $ GENY AGGREGATE LIMIT APPLIES PER: F_I GENERAL AGGREGATE $ POLICY PRO- LOC r$ JECT PRODUCTS-COMP/OPAGG OTHER: $ AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT Via-accident) {ANY AUTO ' BODILY INJURY(Per person) $ OWNED SCHEDULED BODILYINJURY(Per accident) $ AUTOS ONLY AUTOS I i j HIRED NON-OWNED I PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY I (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE I$_ EXCESS LIAB CLAIMS-MADE AGGREGATE S L._ DED RETENTION$ 3 A WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N l STATUTE_X i ER 500,000 O8 W ECAL1 FG D 3/29/2021 3/29/2022 ANY PROPRIETORPARTNER/EXECUTIVE j E.L.EACH ACCIDENT _ -_$_,.,-_ OF igIty EMBER EXCLUDED? j Y I NIA, (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes describe under - 500,000 DESCRIPTION OF OPERATIONS below E.LDISEASE-POLICYLIMIT 4 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Sc hedule,may be attached if more space is required) Marc Sparks is excluded from workers compensation coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The Grill at Bayberry Hills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y rY ACCORDANCE WITH THE POLICY PROVISIONS. 635 West Yarmouth Road West Yarmouth,MA 02673 _ AUTHORIZED�]]]..��� REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts • City\Town of s = . . YARMOUTH 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:TOWN OF YARMOUTH BLDCI-16-003472-03 Trade Name:GRILL AT BAYBERRY HILLS Identify property address including street number,name,city or town and county Certificate Expiration Located at 635 WEST YARMOUTH RD 12/31/2020 WEST YARMOUTH,MA 02673 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 41 A-2 Nightclub/Restaurant/Bar/Banquet Hall 41 Persons/Tables& Chairs 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 Philip Simonian Ill Name of Municipal Mark Gry Date of Fire Chief Building Commissioner Inspection //_/2 Signature of Municipal Signature of Municipal 4111111111. Date of Fire Chief /' Building Commissioner Issuance ZS*/1 Fee:$0.00 BLD_Certofinspection.rpt of Y'9R TOWN OF YARMOUTH ff BUILDING DEPARTMENT ° • 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION October 1,2019 1111-1 _� [f.l�� PAYABLE UPON RECEIPT (X) Fee Required 0.00 ( ) 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/9/e premises located at the following address: ` Street and Number: b 34S e5 ST mouT� Ro A b Name of Premises:61 l! S ,gam/berry i/W4S" Tel: (re,- 77 /- J /6/ Purpose for which permit is used: Res ,erQhT License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency rear L,GCrls�n� - -, , ,, •,, 8o4r- , d 4 /M Certificate to be issued to /hC /- /l Tel: tag'- 77f1-,s—b/.1; Address: G 33- k4 yew- 47A c Owner of Record of uildin' 7— /7 Address /!f/G Aye Present Holder o C ificate �-.. r ' P Co/ A.41)00 Dir1C� S ature of person to whom Title Certificate is issued or his agent /U /� Date Email Address: SO iimerd &arvphatili •A74,. /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# ABl DC.7 -/f-Oa 3 y7.2'G3 12/30/2019-12/30/2020 I � ` Y W'd TOWN OF YARMOUTH BUILDING AL GAS l' 1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451 PLUMBING Telephone (508) 398-2231, Ext. 261 —Fax(508) 398-0836 SIGNS BUILDING DEPARTMENT Inspection and License Report .../ Date //X 2 / —, Address (;7./..-35.71 /y�ri e �� Business Name g/,11� �l/'y i4%S�L-C> Contact Phone / During the Annual Inspection of your premises,performed in accordance with the provisions of Section 110.7 of 780 CMR(Massachusetts - State Building Code),the Board of Selectmen,and/or the Board of Health rules,the following violation(s)were observed: ❑ mE ergenry egress signage Location �4.4 rt ��, Yt ❑Emergency egress lighting Location ----1 Y'S / GJ 6-F"-lei, ❑Maintenance of exits Location �J /'�� ' �/�� ❑ Guards/handrails Location /,3 /- �-�-/ �7e J/7 Y s�iC`' C /i'L •ec' �7 ,Zoning ❑Signs Location ❑Parking Location ❑ Other Location Mechanical ❑Combustion Air Location ❑Storage in Boiler Room Location ❑Vents Location • ❑Automatic door dosures on boiler room doors Location ❑ Clothes dryer vents Location Location The State Building Code,Section 1001.3-Maintenance,provides that the owner as defined in Section 780 CMR shall be responsible for proper maintenance. In order to abate the above violation(s)you must: o Make corrections immediately and contact this office for a follow-up inspection. o Make corrections prior to opening and contact this office for a follow-up inspection. o Make corrections prior to your next annual inspection. o Make corrections within_ 7 days and contact this office for a follow-up inspection. Local Official/Inspector tr3 o Recei Tide Revised 2/8/13