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HomeMy WebLinkAboutBldci-16-003273-05 The Commonwealth of Massachusetts } • City\Town of 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 Certificate No. Issued to Business Name: DAVENPORT/MUGAR LTD PARTNERSHIP BLDCI-16-003273-05 Trade Name:THIRWOOD PLACE Identify property address including street number, name,city or town and county Certificate Expiration Located at 237 NORTH MAIN ST 12/31/2022 • SOUTH YARMOUTH, MA 02664 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 Basement/Lower 27 A-2 Nightclub/Restaurant/Bar/Banquet Hall 27 Persons-2 Studios Allowable 01st Floor 321 A-2 Nightclub/Restaurant/Bar/Banquet Hall 196-Dining Occupant Load • 20-Function Rm 24-Function Rm 49-Function Rm 32-Private Dining CORE SECTION NOT TO EXCEED 300 PERSONS AT ANY TIME 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 Gryll- Date of //_ r� Fire Chief Building Commissioner Inspection J • Signature of Municipal Signature of Municipal rize Date of Fire Chief Building Commissioner / Issuance Fee: $150.00 BLD Certofinspection.rpt BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG - 2022 NAME: Thirwood Place Assembly ADDRESS: 237 North Main St 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 #724j,.. (T-8-.21License Issuance No Fire Department Rep. Date Comments Approved for Lic e Issuance No Board of Health Rep. Date Comments Approved for License Issuance Yes No Plumbing/Gas Inspector Date 4,, / .1 Comments Approved for Lice)Issuance No Electrical Inspector Date Comments Approved for License Issuance Yes No Taxes Paid Yes No Rev.Sept.2003 .1rdi TOWN OF YARMOUTH o ; ' y BUILDING DEPARTMENT fio"" . 'cc? 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION 10/1/2021 PAYABLE UPON RECEIPT ®✓ Fee Required $ 150.00 (0) 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: 237 North Main Street Name of Premises: Thirwood Place Tel: 508-398-8006 Purpose for which permit is used: Liquor License Inspection License(s)or Permit(s) required for the premises by other governmental agencies: License or Permit Agency Common Victualler r� Alcoholic Bev Club Lic R E C E I v Food Establishment OCT 19 2021 Certificate to be issued to Thirwood Place Tel: 508-398-8006 _ Address: 237 North Main Street, South Yarmouth, MA 02664 , Owner of Record of Building Davenport Realty Dvj_ Address 20 North Main Street, South Yarmouth, MA 02664 Present Holder of Certificate Sam )/> `� al Assistant Controller Signature of erson to whom Title Certificate is issued or his agent 10/1/2021 Date Email Address: mpurrieradavenportcos.com 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# WC8196035 _12/31/21 - 12/31/22 3 LDC,10 OD ��..,...40 DAVEREA-01 OKAY AFRO" CERTIFICATE OF LIABILITY INSURANCE DATE 2/2/2 D/YYYY) 2/2/2021 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). CONT PRODUCER NAMEACT Valley Forge Captive Advisors PHONE ) IC,No);(484)965 9627 E-M 630 Freedom Business Center Drive No,Ext):(610 458-3659 I E-MAIL Suite 203 ADDRESS: King Of Prussia,PA 19406 INSURER(S)AFFORDING COVERAGE NAIC q INSURER A:Zurich American Insurance Company 16535 INSURED i INSURER B: Thirwood Place L.P INSURER C: do Davenport Realty Trust 20 North Main Street 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 IADDL SUBR POLICY EFF POLICY EXP LIMITS LTR, TYPE OF INSURANCE 'INSD WVD POLICY NUMBER (MMIDD/YYYY) IMMIDDIYYYYI A X COMMERCIAL GENERAL LIABILITY I I I EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR GL08196255 3/1/2021 3/1/2022 DAMAGETO Eorg, 1,000,000 � PREMISES(Ea occurrence) - S MED EXP(Any one person) 5 1,000 PERSONAL 8 ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000 X POLICY I JECT I LOC PRODUCTS-COMP/OP AGG S $ OTHER: COMBINED SINGLE LIMIT 1,000,000 A AUTOMOBILE LIABILITY (Ea accident) S ANY AUTO BAP8196256 3/1/2021 3/1/2022 BODILY INJURY(Per person) S AUTOSOWNED ONLY AUTOSSULEDpp BODILY INJURYp (Per accident)I$ AUTOS ONLY AUOTOS ONLY (I-err accident)AMAGE $ I S UMBRELLA LIAB i OCCUR I EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION 5 _ $ A WORKERS AND EMPLOYERS'LIABILITY N X STATUTE ERH YIN WC8196035 3/1/2021 3/1/2022 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEMBERo EXCLUDED? 1,000,000 E.L.DISEASE-EA EMPLOYEE 5 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below 1 DESCRIPTION OF OPERATIONS I 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. Route 28 South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE .• 47Aa ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD