HomeMy WebLinkAboutBLDCI-23-001973 The Commonwealth of Massachusetts
City\Town of
.i _u —
li 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:Thirwood Place BLDCI-23-001973
Trade Name:Thirwood Place
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
237 NORTH MAIN ST 12/31/2023
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 Person-2 Studios
Allowable 01st Floor 321 A-2 Nightclub/Restaurant/Bar/Banquet Hall 196-Dining
Occupant Load 20-Function
Rm-24Function Rm
49-Fu nction Rm-32Privat
e Dining
CORE SECTION NOT
TO EXCEED 300
PERSONS AT ANYTIME
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 � �`
Fire Chief �j`p n sly c� r Building Commissioner �-- Inspection `/
-21
Signature of Municipal / Signature of Municipal Date of
Fire Chiefr--- Building Commissioner 4j
;I Issuance /4/4"?
Fee: $150.00
BLD_Certofl nspection.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: Thirwood Place Assembly ADDRESS: 237 North Main Street
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
3- ® No
Fire Department Rep. Date Comments Approved for
/ License Issuance
Wag ►� �('(�.2 2 alp No
Board of Health Rep. Date Comments Approved for
License Issuance
Yes No
Plumbing/Gas Inspector Date ///p/Zti Comments Approved for
License Issuance
Yes No
Electrical Inspector Date Comments Approved for
License Issuance
Yes No
Taxes Paid Yes No
Rev.Sept.2003
0 YaR4,o TOWN OF YARMOUTH
BUILDING DEPARTMENT
}.....,..��'� $ 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
September 16, 2022 PAYABLE UPON RECEIPT
( h'') 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: 2�7 N. o' <'� • S• Y6n.A.0 MA 0 2-(4).4,
Name of Premises: I {n l YW o o .1 71 4,2K4.. Tel: 40 39/- evef
Purpose for which permit is used: WaCE)11.D t(_ i>c✓.u41.L L Ccr3...e _
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit Agency
Certificate to be issued to ill VIM eI L1 47.1 Tel: ciiik;9/- °
Address: 237 N • Mr}-i'/l 5T . 5.• ; M►4 02-4(o �--
Owner of Record of Building 11JctNAT L�V�+��c, T R E C E i V E 0
Address 2a N • Mk- S i• 5- WY)/n" M -0Z-44Y1 -__-
Present Holder of Certificate Kc n nc*A (3 . Sty,t'►1-1 _ OCT 07 2022
' E?c<c.. +i r.ci iccjguii
Signature of person to whom Title
Certificate is issued or his agent /�' /9" 7-2--
Date
Email Address: l�.rr'''i; -G9
)141-1wove P/ice,- Ce n"
Instructions: Make check payable to: Town of Yarmouth
1 146 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# (3L L)C/-23-CX0/
1/01/2023 — 12/31/2023
No.: 00084-CL-1518
LICENSE
ALCOHOLIC BEVERAGES
THE LICENSING BOARD, TOWN OF YARMOUTH, MASSACHUSETTS
HEREBY GRANTS A
Non Profit
License to Expose, Keep for Sales, and to Sell
All Kinds of Alcoholic Beverages
To Be Drunk On The Premises
To: THIRWOOD CLUB LTD Date: 1/1/2022
DBA:THIRWOOD PLACE Ref: LICA-15-0276-07
237 NORTH MAN STREET
SOUTH YARMOUTH, MA 02664
Fee(s): 635.00
License Duration Type: Annual Manager: KENNETH SMITH
License Conditions
BUILDING CONSISTS OF 206 ROOMS,ALL AREAS OF COMMUNITY CENTER AND
RESIDENTIAL WINGS,DECKS AND PORCHES.NON-PROFIT CORPORATION,CONGREGATE
LIVING FACILITY.
On the following described premises: 237 NORTH MAIN ST, SOUTH YARMOUTH,MA 02664
This license is granted and accepted upon the express condition that the licensee shall in all respects,conform to all the
provisions of the Liquor Control Act,Chapter 138 of the General Laws,as amended,and any rules or regulations made
expires December 31,2022,unless earlier suspended,cancelled or revoked.
IN TESTIMONY WHEREOF,the undersigned have thereunto affixed their official signatures.
<�.—.
The Hours during which Alcoholic Beverages LICENSE
maybe sold are From: granted by: ` - A i
8:00AM- 1:00AM WEEKDAYS& "' ! r�= :`
SATURDAYS I �►. �,
10:00AM 1:00AM SUNDAYS LICEN.:" G Ai, 0' ( IES
DECK SERVICE UNTIL 11:00PM
This License Shall be Displayed on the Premises in a
conspicuous position where it can be easily read
DAVEREA-01 OKAY
AC,RL7' CERTIFICATE OF LIABILITY INSURANCE DAT/16/2OrYYYY'
2116J2022
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).
C
PRODUCER NnnME:QNTACT l
Valley Forge Captive Advisors (a�ic Na,Eel):(610)458-3659 ((A AiCC,No):(484)965-9627
630 Freedom Business Center Drive
Suite 203 ADoNEss:
King Of Prussia,PA 19406 INSURER($)AFFORDING COVERAGE NAIC II
INSURER A:Zurich American Insurance Company 16535
INSURED INSURER B:
Thirwood Place L.P INSURERC:
c/o 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 ADDL SUER POLICY EFF POLICY EXP UMITS
TYPE OF INSURANCE D POLICY NUMBER
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS•MADE I X I OCCUR GL08196255 3/1/2022 3/1/2023 DAMAGETORENTED 1,000,000
PREMISES fEa nccurtencel S
MED EXP(Any one person) S 1,000
PERSONAL&A INJURY $ 1,000,000NW
GEM_AGGREGATE LIMIT APPLIES PER.
GENERAL AGGREGATE $ 2,000,000
X POLICY( (jTNf [LOC PRODUCTS-COMP(OPAGG S 2,000,000
OTHER: S
A AUTOMOBILE LIABILITY COMBINED SINGLE UMIT 1,000,000
IEa accident) S
X ANY AUTO BAP8196256 • 3/1/2022 3/1/2023 BODILY INJURY(Per person) S
^_ AUTOS ONLY _D AUTnOSSyy�NEEOp BODILY INJURY(Per accident) $
- AUT05 ONLY _ AUOTOS OwtV PROPERTY DAMAGE
(Per accident) S
S
UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE S
DEO RETENTIONS S
A WORKERS
ND EMPLOYERS'LIABILITY X I STATUTE I ERH
ANY PROPRIETOR/PARTNER/EXECUTIVE YjN WC8196035 3/1/2022 3lU2023 EL.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N(A 1,000,000
(Mandatory In H) E.L.DISEASE-EA EMPLOYEE S
If Yes,describe under E.L.DISEASE-POLICY LIMIT S 1,000,000
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it mare 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
4340.
• ACORD 25(2016/03) 0 1988-2015 ACORD CORPORATION. All rights reserved.
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