HomeMy WebLinkAboutBLD-23-006109 food truck TOWN OF YARMOUTH Building Department CERTIFICATE OF
(508) 398-2231 ext.1261 OCCUPANCY
PERMIT NO Bld-23-006109
ADDRESS:550 Route 28, West Yarmouth, Ma 02673 ZONING DISTRICT Bldg. Type: Commercial
SUBDIVISION MAP BLOCK 031.88
USE & OCCUPANY-Junior Betts BBQ
CERTIFICATE OF INSPECTION
DATE: BUILDING OFFICIAL:
550 RTE Realty Trust
53 Aunt Dore
Yarmouthport, MA 02675
PHONE
• THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE
APPROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FROM THE DEPARTMENT OF PUBLIC WORKS.
CERTIFICATE OF OCCUPANCY
BUILDING INSPECTIONS APPROVALS
FIRE:
DATE: OTHER
INSPECTOR DATE:
ELECTRICAL BOARD OF HEALTH
DATE: DATE:
INSPECTOR: INSPECTOR:
PLUMBING/GAS FINAL BUILDING
DATE: DATE:
INSPECTOR: INSPECTOR:
COMMUNITY DEVELOPMENT: DATE NAME
RECEIVED
Town of Yar rz � x �-�,�uI ..-..-..T,.._........_._
h-8 � i;ng Department
APR 27
114e route 28, South Yar,�` c� '* , °" "° I�► ������ 2023
, S 4,tel. 508-398-2231 ixxt.1261
, � , BUILDING DEPARTMENT
Use and 'ccu m A BY,, iii� t'= ppli�ation,, ,
In accordance with the provisions o, t^ ► --assacs cS s State Building y J
_- !J, Code, section 105.1
Application for a certificate" use and occupancy permit
Name of Business
Jcvr►,3r lei /3136). Phone # colt-964 -stir,
Type of Business /0i cr44/, .,,,4/- ,,,,,,,6,4 s&rvr7,o Email Sa h,La-dr/ts8/3 -,
Property Address �s"U ,2t 2 ! jejr 1,,,-,po,,, ,,j jv,r 0. 613 Unit # /Uf0}
*Square Footage to be occupied m9x a7ad *attach floor plan Fee: $60
•
The applicant is required to obtain approval sign offs from the following departments as
checked off below:
X Health Department— 508-398-2231 ext. 1241 r
X Fire Department— Fire Prevention, 96 Old Main Street, 508-398-2212
Other
, 4,:iriit
Building owners Signature 47 Applicant Signature
Please note: this permit is for use and occupancy only. Any work requiring a building permit
will require a licensed contractor to submit an additional application with all the required
information based on the scope of the project.
**Office use only** 8,Lb-2 3— VI
J
Zoning District i"Z Proposed Use , t , Change of Use: Yes K No
Allowed Use: Yes V No APD Waiver: Yes No N/A
()4a
5/7/23
Building Officials Signature Date
Updated 3/21 J S t 0 GC cSXPiJZ�,S
r.'.GL,.AND 1111E
y,t401Ii/j``I TOWN OF y't P,, O'JT[
R Chia ` ', F.
v'`
DATE 3-S'23
Ll"'�—�
,v►,, YARMOUTH FIRE PREVENTION
S-„:,,c. eel% New Business Transmittal
Project Name: Auctits BBQ Address: 5 Bray Farm Rd S
Contact Name: Haley Bernard Phone: 508-776-7323
Description of planned project or business: Food Truck/Trailer
Y N NA Subject Regulation
X Building Numbers MGL Chapter 148;sec 59
X Fire Lanes 527 CMR 1; 18.2.1
X Extinguishers 527 CMR 1; 13.6,Chapter 148;sec 28
X Maintence of any equipment,system relating to 527CMR1 1.1.4,MGL 148 section 27a
Fire Protection.
X *Hazardous Materials Storage 527 CMR l;60.1,20.15.4
X Emergency Plan Required 527CMR1 10.8.1
X Commercial cooking,Hood systems 527CMR1 50.2.1.1
X Commercial Cooking Hood Systems Cleaning 527CMR1 50.5.4
X *Commercial Cooking Extinguishment System 527CMR1 50.4.3
X *Candles,open flames,and portable cooking 527CMR1 10.10.2,20.1.5.2.4
X Blocking electrical panel 527CMR1 10.19.5.1
X Blocking exits 527CMR1 14.4.1
Extension cords shall not be used as a 527CMR1 11.1.5.6,
X substitute to permanent wiring
XX Limit storage heights to 24 inches below 527CMR1 10.18.3
ceiling without sprinklers 18 inches with
X Maintain Aisle width of 36 Inch's(3 Feet) 780CMR 1101.1
X Storage inside/outside Buildings 527 CMR 1; 10.18.1,4.4.3.1.1,19.1.2,34.1.1
_The right to inspect MGI.Chapter 148 Sec.4
X *Upholstery 527 CMR l;20.1.2
X *Trash Containers 527 CMR 1; 19.1.1, 1.12
Any Hazard to the Public Chapter 148;sec 28
X *Curtains, Draperies. Blinds _ 527 CMR 1; 12.6.2
* YFD permit required-depending on occupancy and submittal
Regulations based on NFPA I (2021 edition)with mass amendments adopted 12/09/22
A Permit from YFD is required any time a fire protection system is shut down,altered or removed.
All existing fire protection systems to be inspected and upgraded as needed.
The YFD support the application,subject to applicable submissions,permits and inspections.
Plan Reviewed By: Lieutenant Matthew Bearse Date: March 8, 2023
Copy for Applicant I Copy to Building Department l X I Copy to Fire Prevention
Entered in Firehouse Final Inspection
Scanned with CamScanner
Frit
E
TRUCK REGISTRATION *Restriction: Sandwiches,Soda& Other
NUMBER
TZ81273 FEE $55.00
THE COMMONWEALTH OF MASSACHUSE1-1S
Town of Yarmouth
Board of Health
PERMIT TO OPERATE A MOBILE FOOD SERVER
Permit No. 23-003 Date: 3/8/23
In accordance with Regulations promulgated under authority of Chapter 94, Section 305A and Chapter 111.
Section 5 of the General Laws a Permit is hereby granted to:
Junior Betts BBQ Driver: Haley Bernard
Whose place of business is 5 Bray Farm Road, Yarmouth Port,N1A112675
To operate a mobile food server in Yarmouth,MA
Permit Expires
BOARD OF HEALTH: giiilayd Awiteit, elicibtmait
Vice Mumma
Medea ..0 eta&
Bruce G. Murphy, M H, R. 0 Data Situneoge
Director of Health &i.c Weistont6
0
The Commonwealth of Massachusetts
Fee
Town of Yarmouth $125.00
Food Establishment License
Number: BOHF-23-3594 Issue Date:
Mailing Address: Location Address:
HALEY & SAMUEL BERNARD 5 BRAY FARM RD
JUNIOR BE Fl S BBQ YARMOUTH PORT. MA 02675
22 CHASE GARDEN LANE
YARMOUTH PORT, MA 02675
IS HEREBY GRANTED A 2023 LICENSE
TO OPERATE:
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2023 unless sooner suspended or revoked and is not
transferable.
. ,
Board Hillard Boskey, M.D.,Chairman
Mary Craig, Vice Chairman
of Charles T. Holway,Clerk
Debra Bruinooge ,
Health
K.............
Eric Weston
J -
Bruce G. urphy, H, R .. CHO/James G. Gardiner..000)
Health Direc or/Assistant Health Director
Acoofzu CERTIFICATE OF LIABILITY INSURANCE DATEIMM,DD'YYYY)
a3tOs/23
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(les)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:
Cohen-Miles Insurance Agency Inc PHONE
o,Est): 617-489-1213 {v,No): 617-489.0151
105 Chestnut St,Suite 31 DI fA E-MAIL io@cohenmiles.com
Needham,MA 02492-2520
INSURER(S)AFFORDING COVERAGE NAIL C
INSURERA: Norfolk&Dedham
INSURED
INSURER B
Junior Betts BBQ LLC INSURER C
Samuel Bernard
22 Chase Garden Lane INSURER
Yarmouth Port,MA 02675 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 ADULSUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE JNSD WVD POLICY NUMBER (MMIDDIYYYY) IMM/DD/YYYY) LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000
DAMAGE TO RENTED
CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 50,000
MED EXP(Any one person) $ 5,000
A R2350371A 03/02/23 03/02/24 PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY PRO-
JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident) $ 1,000,000
ANY AUTO BODILY INJURY(Per person) $
A AUTOS ONLY OWNED X SCHEMA
AUTOS OSFD 92385235A 03/02123 03/02124 BODILY INJURY(Peracodent) $
HIRED NON-OWNED
Ng. AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE $
— (Per accident) 1,000,000
$
,X` UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
A EXCESS LIAB CLAIMS-MADE U2303973A 03/02/23 03/02/24 AGGREGATE $ 1,000,000
DED RETENTION$ $
WORKERS COMPENSATION PER 1 I OTH-
AND.EMPLOYERS'LIABILITY Y/N STATUTE I I ER...
ANY PROPRIETOR/PARTNER/EXECUTIVE—
N/A E-L..EACH ACCIDENT
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
,
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more 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
Junior Betts BBQ LLC ACCORDANCE WITH THE POLICY,PROVISIONS.
MA f
AUTHORIZED REPRESENTATI ,V
':::—,, ."---
1 , :2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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AOMO)� YARMOUTH FIRE DEPARTMENT
UTIV 96 OLD MAIN STREET
ON SOUTH YARMOUTH, MA 02664
ICPH.:508-398-2212 /FAX:508-760-4861
kiloFIRE AND SAFETY INSPECTION REPORT
ADDRESS OF INSPECTION: `
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1 Q 8 C mr CMG(' /' /�� / c Li
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❑ YARMOUTH PORT Li SOUTH YARMOUTH / ❑ WEST YARMOUTH
NAME: 5,v) ,- 4, -r` B
OWNER ❑ MANAGER ❑ TENANT OTHER(explain):
DATE: 3-g .2 3 TIME: NO 0 PHONE:
NAME: /1/9-Lij B ar'N'!6Y^1' PHONE: ,�Z 7 )6 — 7.�0Z 3
OWNERS MAILING ADDRESS:
An inspection of the above captioned property was conducted by the undersigned during which the following
fire or safety deficiencies (D) or violations (v) were observed and noted for correction:
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You are hereby ordered to abate or correct the deficiencies or violations within days. Failure to do
so may result in civil and /or criminal complaints being filed.
Signed: 21, vV Title: I • / 57
Copy Received By: [At)
Original-Owner/Tenant Yellow Copy-Fire Department FBP 99-1
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