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HomeMy WebLinkAboutBLDCI-23-002794 1 The Commonwealth of Massachusetts P — City\Town of �1= I. _ M YAROUTH x_ 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: Chez Hospitality Group BLDCI-23-002794 Trade Name:The Grille @ Bass River Identify property address including street number,name,city or town and county Certificate Expiration Located at 62 HIGHBANK RD 12/31/2023 SOUTH YARMOUTH, MA 02664 Use Group Floor Occupancy Use Group Classifications(s) Other A-2 01st Floor 162 A-2 Nightclub/Restaurant/Bar/Banquet Hall INSIDE 78 With Entertainment 50 Allowable OUTSIDE 112 Occupant Load Total with entertainment 162 Inside&Out 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 Fire Chief rY e of Q"d S�,,, y t�, Building Commissioner f I pection Signature of Municipal Signature of Municipalar—//..' Date of Fire Chief Building Commissioner %'�� Issuance It it ZL F e:$150.00 BLD_Certofl nspection.rpt BUILDING E A.R. .. MENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 cxt. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG - 2023 NAME: Grille at Bass River ADDRESS: 62 Highbank Road 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 ?i No Fire Department Rep. Date Comments Approved for L k� i'}(/ Lic se Issuance N I)/ es 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 tg,(1:11-17 1 ti BUILDING DEPARTMENT ��":^ "r"_'6 1146 Route 28, South Yarmouth, MA 02664 508-398-22. 1 ►> IOiitE I y E b r _. NOV 181012 APPLICATION FOR CERTIFICATE OF INSPECTION • Lc VM 3 BUILDING D"-"R ENT November 16, 2022 PAYABLE U" (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: 62 Highbank Road Name of Premises: The Grille @ Bass River Tel: 508-619-4280___ Purpose for which permit is used: sale of liquor/restaurant License(s)or Permit(s) required for the premises by other governmental agencies: License or Permit Agency Liquor License Town of Yarmouth Certificate to be issued to Chez Hospitality Group.LLC dba The Grille at Bass River Tel: 860-506-1450 Address: PO Box 498 East Windsor CT 06088 Owner of Record of Building Town of Yarmouth Address 1146 Route 28,South Yarmouth MA 02664 Present Holder of Certificate Chez Hospitality Grouo. LLC 10t 4L� Principal Signature of pe`r�son whom Title Certificate is issued or his agent 11-15-22 Date Email Address: Ihaley@chezhospitality.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# /3(1)C/ 3_ OA79y 12/31/2022 to 12/1/2023 1 CHEZHOS-01 DALDRICHI ACCP I?1) DATE(MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE I 11/4/2022 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 i NAME: Haberman Insurance 1 PHONE 413 781 7000 FAx 4 95 Ashley Ave Imo,No,Ems)- ) (A/C,No}( 13)733-9545 West Springfield,MA 01089 I,E-Iiil I�Ess:infotithabermaninsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Sentinel Insurance Company 11000 INSURED INSURER B: Chez Hospitality LLC INSURER C: PO Box 498 NSURERD: East Windsor,CT 06088 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 D CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF 1 POLICY EXP TYPE OF INSURANCE POLICY NUMBER LIMITS LTR INSD WVD +)MIND/YYYY►f!MM/DD/YYYY} 1 I COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ II CLAIMS-MADE I OCCUR I DAMAGE TO RENTED PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS-COMP/OP AGG $ ,OTHER: $ AUTOMOBILE LIABILITY Ea OMWNEEDaccident,INGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ OWNED i SCHEDULED I AUTOS ONLY i AUTOS BODILYBODILY INJURYp (Per accident) $ AUTOS ONLY i AUUTTNOS ONLY (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ 0 DED !RETENTION$ $ A WORKERS COMPENSATION PER X OT AND EMPLOYERS'LIABILITY STATUTE ERH- ANY PROPRIETOR/PARTNER/EXECUTIVEY/N 08WECALIFGD 3/29/2022 3/29/2023 500,000 OFFICER/MEMBER EXCLUDED? sff Y N/A El.EACH ACCIDENT $ (Mandatory in NH) El.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below El.DISEASE-POLICY LIMIT $ I i DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,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 Town of Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN of Yam ACCORDANCE WITH THE POLICY PROVISIONS. 1146 28 South Yarmouth, MA 02664 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD