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HomeMy WebLinkAboutBLDCI-17-005620-07 The Commonwealth of Massachusetts City\Town of GG= � YARMOUTH 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: II Montebello BLDCI-17-005620-07 Trade Name: III Montebello Identify property address including street number, name,city or town and county Certificate Expiration 1 Located at I KINGS CIRCUIT 12/31/2023 YARMOUTH, MA 02675 i Use Group Floor Occupancy Use Group Other Classifications(s) A-2 172 A-2 Nightclub/Restaurant/Bar/Banquet Hall 124-Restaurant/Bar waiting Outside Patio seating - Allowable 48 Occupant Load Bar&Lounge-34 chairs/ 10 Bar stools 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 Name of Municipal Mark Grylls Date of /�J` Fire Chief �aN Building Commissioner Inspection �` � i22- Signature of Municipal Signature of Municipal Date of Fire Chief Building Commissioner Issuance /? Z L Fee: $150.00 BLD_Certofl nspectio n.rpt BUILDING DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG - 2023 NAME: II Montebello ADDRESS: 81 Kings Circuit 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 Re Date Comments Approved for Lic Issuance Yes No Fire Department Rep. Date Comments Approved for Lic se Issuance /Z'/�2 7 Yes 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 01.'Y4R o TOWN OF YARMOUTH o , . H BUILDING DEPARTMENT »� '� 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION November 9, 2022 PAYABLE UPON RECEIPT (X) Fee Required 1;03.00 ISO ( )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: j8/ 6 W �� e t1 fec t Yvi riP10a eon f' r✓} I� Name of Premises: 67 Ori '(L CO° T/'G Tel:( 3 2- 0 0 Purpose for which permit is used: / u, ,c-1,11� RECEIVED License(s)or Permit(s) required for the premises by other governmental agencies: NOV 09 2022 License or Permit Agency B Utl{I311ENT Certificate to be issued to Mn,-!1- m id% r C Tel: , S7 6 Z- Sr)© Address: 64 �`'� W Owner of cord of Building ,'(cc��,, t.cJ o y ,G1� ,`C Address 6Y l ) o�j, r��r c t'`F Present Holder f Certlate V ` Sign ure of erson to whom Titl Certificate is issued or his agent 1(1 `2,0'2 2 �„ `> Date CEmail Address: /L 7i kh s% O �/n`��C �') 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 # 36/1-/7. /) 67a D_oy 12/31/2022 to 12/1/2023 'ECG 9 CERTIFICATE OF LIABILITY INSURANCEDATE(MM/DD/YYYY) '►--- I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.ITH S2 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: JIM HINDMAN Schlegel&Schlegel Ins Broker PHONE 34 Main Street (A/C,No,Ext): 508-771-8381 (A/C,No): 508-771-0663 E-MAIL West Yarmouth,MA 02673 ADDRESS: schlegelinsurance@gmail.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: ENDURANCE INSURED _ INSURER B: MT VERNON FIRE INSURANCE IL MONTELBELLO INSURER C: MA RETAIL MERCHANTS WC 64 KINGS WAY YARMOUTH Port,MA 02675 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO'N HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR COND TION 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 CLAIMS-MADE I XI OCCUR PREMISESTO RENTED (Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A DSCGL0110 01/14/22 01/14/23 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO_ GENERAL AGGREGATE $ 2,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE $ AGGREGATE $ DED RETENTION$ WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY PER OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N STATUTE ER C OFFICER MEMBER EXCLUDED? N/A 014005033240120 E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) 01/01/22 01/01/23 f yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 B liquor liability Each occurranence 1,000,000 CL 26408001C 04/19/22 04/19/23 Aggragert 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) INSURANCE COVERAGE IS LIMITED TO THE TERMS,CONDITIONS,EXCLUSIONS AND OTHER LIMITATIONS AND ENDORSEMENTS OF THE POLICY 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. LICENSING DEPARTMENT 1146 ROUTE 28 SOUTH YARMOUTH MA 02664 AUTHORIZED REP NATIVE djconry@conrylaw.comcastbiz.net, I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and loco are registered marks of ACORD 12/7/22,8:31 AM Accela Automation Moved bar/shed relocated no permits Sprinkler head needs trim next to Co Tanks must be chained Bath room removed permits? Remove storage from electrical room Emergency lights foyer,kitchen,basement In swing screen door must be removed Plumbing permit for water line to out door sink Signage on door to hall way must be unlocked during hours of operations https://yarmouth-prod-ay.accela.com/portlets/web/en-us/#/core/spacev360/yarmouth.bldci17005620ren07 1/1