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HomeMy WebLinkAboutBldci-23-003816 The Commonwealth of Massachusetts 464 . City\Town of = YARMOUTH xgNI New and Renewal Certificate of Inspection In accordance with the Massachusetts State Building Code,Section 110.7 Identify Name of Establishment Certificate No. Issued to Business Name:Chapman Funerals&Cremations BLDCI-23-003816 Trade Name:Chapman Funerals&Cremations Identify property address including street number, name,city or town and county Certificate Expiration Located at 58 LONG POND DR 2/25/2024 SOUTH YARMOUTH, MA 02664 Use Group Floor Occupancy Use Group Other Classifications(s) A 01st Floor 200 A-3 Amusement/Church/Gym/Library/Museum Allowable Occupant Load 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 Building Commissioner . Inspection o2-�r°23 Signature of Municipal Signature of Municipal 1`- Date of Building Commissioner 'f Issuance n I,6/2r L// Fee:$100.00 BLD_Certofi nspection.rpt TOWN OF YARMOUTH Building Department CERTIFICATE OF (508) 398-2231 ext.1261 OCCUPANCY PERMIT NO BLD-22-004052 ADDRESS: 58 Long Pond Drive South Yarmouth,Ma 02664 ZONING DISTRICT Bldg.Type: Commercial SUBDIVISION MAP BLOCK LOT 050.198 REMARKS Use&Occupancy-Chapman Funerals of Cremations alti,CERTIFICATE OF INSPECT! DATE: /4. BUILDING OFFICIAL: L. -- Chapman Cousins LLC 3778 Falmouth Road Marston Mills, Ma 02648 PHONE 1IS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET. ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR ERMANENTLY.ENCROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE.MUST BE APPROVED BY THE JRISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF JBLIC WORKS. CERTIFICATE OF OCCUPANCY BUILDING INSPECTIONS APPROVALS FIRE: f titC13(397: DATE: ZA N)1-• t4 0-1( )1- kz--- OTHER DATE: ELECTRICAL / BOARD OF HEALTH DATE: q -2,71., DATE: 3 - 0 - INSPECTOR: INSPECTOR: PLUMBING/GAS FINAL BUILDING DATE: e/t)--/z z- DATE: Li 4)NaN INSPECTOR: INSPECTOR: COMMUNITY DEVELOPMENT: DATE NAME } f°1• TOWN OF YARMOUTH 1g( BUILDING DEPARTMENT i V E D vMATTA M SC ,tz Z, 1146 Route 28, South Yarmouth, MA 02664 508 398 223 t t} __- .__ JAN 112023 APPLICATION FOR CERTIFICATE OF INSPECTION BUILDING DEPARTMENT January 1, 2023 PAYABLE UPON RECE (X) Fee Required$100.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 110.7, I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number: S$ L-A 1 Posh 1) fl2 . So-m �„-�„ 1M.4' 02-6 6`f Name of Premises: Clta,vii&,, cr e. is 4. C at t a h s Tel: So$ • 39$ - Z t z I Purpose for which permit is used: PC- u S(AG'`'tZi License(s) or Permit(s) required for the premises by other governmental agencies: License orPermit Agency kSi'iAttsliwe..T � F•c.«& Sy t �.4_4 of „Ata ��t /tFw.�a��.-+` Certificate to be issued to b aJ 1-G( C,V►c..evvt,f t,v Tel: sac 3.3 tc• 21 Z ( Address: S$ 1-00 fo Ai 4 b Z t'E <c)..44 4a-n-vu..tr-#ti., 0.4 4 O L 66e( Owner of Record of Building C ktte w. 4N,h Co s. �.,S LL Address LV? 7 +L1 t2a, OAws S ,tls AAA e2 Present lder of Certificate ►Gi% RcFstbrc Sig atu of person to wh Title Certifi is issued or his agent I - S- 202 3 t ll Date Email Address: J rjlufe p c..Lc fwte4,et uK.er ( . Covet 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# 02/25/2023-02/25/2024 .. • - -- Y - -- --- - - - - - _ -°► CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 01/05/2023 '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 be endorsed. If SUBROGATIONIS 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 NUMBER ONE INSURANCE AGCY INC/PHS NAME: 08088171 PHONE (866)467-8730 FAX No): (A/C,No,Ext): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio,TX 78251 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Twin City Fire Insurance Company 29459 J.B.COLE&SON, INC INSURER B: 3778 FALMOUTH RD INSURER C: MARSTONS MILL MA 02648 INSURER D: 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR ,INSR WVD IMM/DD/YYYYI (MMIDD/Y YYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY PRO LOC PRODUCTS-COMP/OP AGG JECT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) _ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DED RETENTION$ WORKERS COMPENSATION x I PER 0TH- AND EMPLOYERS'LIABILITY STATUTE ER ANY Y/N E.L.EACH ACCIDENT $500,000 A PROPRIETOR/PARTNER/EXECUTIVE N/A 08 WEC AA7QCE 10/15/2022 10/15/2023 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION Town of Yarmouth Building Dept. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1146 ROUTE 28 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED S YARMOUTH MA 02664 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �ic�Gtr�C2347 CRd&fae. ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD