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HomeMy WebLinkAboutBLDSCI-16-003267-05 • The Commonwealth M assachusetts n 1 • it City\Tow of , YARMOL TE L am 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:The Tasity Tidbits Realty Trust BLDCI-16-003267-05 Trade Name: DIPARMA ITALIAN TABLE Identify property address including street number, name, city or town and county Certificate Expiration Located at 175 ROUTE 28 12/31/2022 • WEST YARMOUTH, MA 02673 1 Use Group Floor Occupancy Use Group Other Classifications(s) A-2 01st Floor 17 A-2 Nightclub/Restaurant/Bar/Banquet Hall • Bar Stools • Allowable ()1st Floor 154 A-2 Nightclub/Restaurant/Bar/Banquet Hall 154 persons-tables& Occupant Load chairs 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 / Fire Chief Building Commissioner _ Inspection i( `8—A, Signature of Municipal 9 p Signature of Municipal Date of Fire Chief �-. s . — Building Commissioner 7,..... 61 Issuance it. phi / / Fee:$150.00 BLD CPrtnflncnprtinn mt BUILDING DEPARTMENT EN 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG - 2022 NAME: Diparma Restaurant ADDRESS: 175 RTE 28 This log is to be signed by the appropriate inspectors upon a satisfactory inspection of your building/premises. When all signatures are obtained, this log shall be presented to the License & Permits office and/or the Health Department in order to obtain your license. Licenses will be withheld until all inspectors have signed. Building Commissioner Rep. Date Comments Approved for License Issuance //17 � " No Fire Department Rep. Date Comments Approved for License Issuance No Board of Health Rep. Date Comments Approved for License Issuance Yes No Plumbing/Gas�ctor Date //- p— Z/ Comments Approved for Lice eIssuance ICejj No Electrical Inspector Date Comments Approved for License Issuance Yes No Taxes Paid Yes No Rev.Sept.2003 a O "'*, JHB TOWN OF YARMOUTH BUILDING DEPARTMENT R E C D 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext. 1260 r OCT 22 2021 APPLICATION FOR CERTIFICATE OF INSPECTION BUILDIN By _ October 1,2021 PAYABLE UPON RECEIPT (X)Fee Required 150.00 ()No Fee Required In accordance with the provisions of the Massachusetts State Building Code,Section 110.7,I hereby apply for a Certificate of Inspection for the below-named premises located—at the following address: Street and Number: t-1S 1` 1(LA.►\ L$l Ajl.. Name of Premises` rmQ(._. CX t(t y ( GU-XQTei: q.) 71(- Y71 ., Purpose for which permit is used:--?NeS (61^4- License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be issued to-1)0PG`f '1 \ta��C1/4-)c)le-- Tel: l-j%'s- 1) (- Address: \^lc Ma.A,,r\ Sfir�.v vF _ Owner of Record of Building �i C.S 7_ �[tc-AID d S BlA Address \-1 c M -41 5 ;,,tt Present Holder of Certificate par m u Signaturle n to whom Title Certificate is issued or his agent 1 01141 L. I 1 Date Email Address:y0.f leA '1`olyskiP (e\rui 1a t & .I <<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 C OT ISSIJE YOUR CERTIFICATE OF INSPECTION. Certificate of Inspection# (�- 12/31/21-12/31/2022 ' d ACORD DATE(MMIDDIYYYY1 CERTIFICATE OF LIABILITY INSURANCE 10/20/2021 41/1.-- -". THIS CET TIFIC fA E 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: STANDISH INSURANCE GROUP INC. PHONE 774.283.4425 FAX — 774.283.4243 STREET UNIT 1 B (A/C.No. .Ext): I(A/C,No): TH 303 COURT PLYMOU MA. 02360 ADDRESS: ANDYR@STANDISHINSURANCE.COM INSURER(S)AFFORDING COVERAGE _ NAIC U- INSURER A: BERKSHIRE HATHAWAY GUARD INSURED INSURER B:TWIN CITY FIRE INSURANCE COMPA CALAMARI INC. INSURERC: 175 MAIN ST — INSURER D: __-- ----------------- 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 'ADOLSUBR' POLICY EFF POLICY EXP ' LTR TYPE OF INSURANCE INSD''WVD I POLICY NUMBER I(MM/DD/YYYY) (MM/DD/YYYY)J LIMITS COMMERCIAL GENERAL LIABILITY 84 SBA BD5981 111/27/2020 11/27/2021 i EACH OCCURRENCE S 1,000,000 B --� -- 1 DAMAGE TO RENTED t_ CLAIMS-MADE : OCCUR y I PREMISES(Ea occurrence) I$ 1,000,000 -- I I I MED EXP(Any one person) I s 5,000 1 PERSONAL&ADV INJURY S 1,000,000 LGEN'L AGGREGATE LIMIT APPLIES PER: I _GENERAL AGGREGATE I S 2,000,000 1 POLICY f—j jE I LOC PRODUCTS-COMP/OP AGG !S 2 000.000 OTHER: I i S t—COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY I ((Ea accident) s —ANY AUTO 'BODILY INJURY(Per person) S ' OWNED (SCHEDULED I BODILY INJURY(Per accident) S ,__ AUTOS ONLY __ AUTOS HIRED -I NON-OWNED :PROPERTY DAMAGE S • t AUTOS ONLY - J AUTOS ONLY ;(Per accident) I S • UMBRELLA LIAB I OCCUR • ' EACH OCCURRENCE S EXCESS LIAB l CLAIMS-MADE AGGREGATE $ DED ;RETENTIONS I I$ i WORKERS COMPENSATION PER I 1 OTH- i 'AND EMPLOYERS'LIABILITY i CAWC158929 STATUTE 1 I ER I Y/N ' 1 ! 6/01/2021 6/010022 !ANY PROPRIETOR/PARTNER/EXECUTIVE ( E.L.EACH ACCIDENT i$ 500,000 A i OFFICER/MEMBER EXCLUDED? !N/A! I(Mandatory In NH) I j E.L.DISEASE-EA EMPLOYE S _ 500,0.DQ If yes,describe under DESCRIPTION OF OPERATIONS below i ! E.L.DISEASE-POLICY LIMIT i S 500 000 1,000,000 PER OCCURENCE 3 LIQUOR LIABILITY 84 SBA BD5981 11/27/2020 11/27/2021 1 2,000,000 GENERAL AGGREGATE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) General Liability and Liquor Liability are covered for outside dining. CERTIFICATE HOLDER CANCELLATION TOWN OF YARMOUTH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1146 ROUTE 28 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. SOUTH YARMOUTH MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD