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HomeMy WebLinkAboutBLDCI-22-006210 restaurant The Commonwealth of Massachusetts -�——grt City\Town of 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:Riviera Beach Restaurant BLDCI-22-006210 Trade Name:Riviera Beach Restaurant Identify property address including street number,name,city or town and county Certificate Expiration ted at 327 SOUTH SHORE DR 11/30/2022 SOUTH YARMOUTH,MA 02664 Use Group Floor Occupancy Use Group Other Ciassificatlons(s) A-2 01 st Floor 40 A-2 Nightclub/Restaurant/Bar/Banquet Hall 40 Persons Allowable 02nd Floor 48 A-2 Nightdub/Restautant/Bar/Banquet Hall 48 Persons 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 Philip Simonlan Ill Name of Municipal Mark Grylls Date of Fire Chief Building Commissioner Inspection Signature of Municipal Signature of Municipal Date of / Fire Chief • Building Commissioner Issuance r //' 1 Fee:$100.00 BLD_Certofi nspection.rpt RECEIVED ot_:Y4.t,apit,' TOWN 41i6, 14, OF YARMOUTH3 .a ' ~ - a` BUILDING DE.PA �� � ., RTMENT y ~` :f:T ' 1146 Route 28, South Yurniouth, MA 02664 508-398-2221 EPARTMENT APPLICATION FOR CERTIFICATE OF INSPECTION April 5, 2022 PAYABLE UPON RECEIPT (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: 327 South Shore Drive Name of Premises: Riviera Beach Restaurant Tel: 214-773-8671 Purpose for which permit is used: Operation of resort providing food and beverage services. License(s) or Permit(s) required for the premises by other governmental agencies: License or Permit Agency Seasonal Section 12 InnholderAll Town of Yarmouth Licensing Department; Alcoholic Beverages License Massachusetts Alcoholic Beverages Control Commission Certificate to be issued to RJ Resorts Riviera Beach Resort Beverage LLC Tel: 214-773-8671 Address:65 East 55th Street, 33rd Floor,New York, NY 10022 Owner of Record of Building RJ Resorts Riviera Beach Resort Owner LLC Address 65 East 55th Street, 33rd Floor, New York, NY 10022 Present Holder of Certificate LLC Manager Signal a of person to whom Jonathan Wang Title Certif to is issued or his agent 4/7/2022 Date Email Address: gboyer eosinvestors.com 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 of Inspection # 4/1//2022-11/30/2023 3uc _ oo7 Z The Commonwealth of Massachusetts 1 = Department oflndustrialAccidents 11f'_ Office of nvestigations 1 Congress Street,Suite 100 • Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:General Businesses Applicant Information Please Print Lee/bly Business/Organizotion Name: RI Resorts Riviera Beach Resort Beverage Ic Address: 65 East 55th Street,33rd Floor City/State/Zip: New York,Ni"10022 Phone#: Are you an employer?Check the appropriate box:- Business Type(required): 1.® I am a employer with 10 employees(&ill and/ 5. ❑Retail • or part-time).' 6. ®Restaurant/Bar/Eating Establishment 2.❑ I am a sole proprietor or partnership and have no employees working forme hi any Capacity: 1. ❑Office and/or Sales(incl.real estate,auto,etc.) • [No workers'comp.insurance required] 8. ❑Non-profit 3.❑ Wars a corporation and its officers have exercised 9. ❑Entertainment their right of exemption per c.152,(1(4),and we have 10❑manufacti.litg no employees.[No workers'comp.insurance required)' 11. Hrahh c 4.❑ Wears a non-profit organization,staffed by volt/meets, ❑ with no employees.[No workers'comp.insurance req.] 12.0 Other Any spplia,attltat clocks box#1 must ciao fill(media section Wow Aiming the&wakers'compeosstionpolicy infirmsam. .— 'If the corporate ofcern laveexernpld tbemsdvee,bottbecopoxeloahso other employes awvhas'compensation policy is required and such on :gsninedon should check boo#1. "All.employees will be covered under.the Worker's Compensation insurance Policy ivucd to FAs Hospitality anion employer that is providing workers'compensation insurance jor my employees Below is the policy information. rzuranca Company Name: Aotr RiskSenices south.Inc, ]Sifter's Address: 3550 Lenox Road bt Sutte1700 • _ :lfy/StatelZlp:—Atlanta,GA 30326-179Y olicy#or Self-ins.Lic.# wCmoso42-o7 Expiradost Date: 6/1122 ,ttach a copy of the workers'continuation policy declaration page(showing the policy somber and expiration date). allure to secure coverage as required under Section 25A of MOL a.152 can lead to the imposition of criminal penalties of a sae up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine f vp to$250.00 a day agginat.the violator.Be advised theta copy of this statement may be forwarded to the Office of ivestigations of the DIA for insurance coverage verification. do hereby en ' ;un she pains and penalties ofperlury that the information provided above(shun and correct iiiP gSt; — Date:yl 1!Z Z - hose t'_2l 1— Official use only.1)o not write in this area,to be completed by city or town ojfciaL City or Town: _- Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Sclechnen's Office 6.Other Contact Person: Phone#: _ 1 ----- -- - — wwry mass.gav/dia ---- DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 12/10/2021 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 NAME: Doug Jones PHONE FAX c/o Artex Risk Solutions, Inc. (A/C.No.Extl: (480) 951-4177 (A/C,No): (480) 951-4266 P.O. Box 13838 ADDRESS: SDL.BSD.Certificates@artexrisk.com Scottsdale, AZ 85267 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A : American Zurich Insurance Company 40142 INSURED INSURER B : Oasis, a Paychex Company INSURER C 2054 Vista Parkway Suite 300 _. West Palm Beach, FL 33411 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:21FL1751086837 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ _ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X MUTE EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 2,000,000 M.A OFFICER/MEMBER EXCLUDED? N NIA WC 16-85-800-00 10/01/2021 06/01/2022 (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $ 2,000,000 Location Coverage Period: 11/01/2021 06/01/2022 Client# 23984-1 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Coverage is provided for EOS HOSPITALITY LLC only those co-employees 327 S SORE DR of, but not subcontractors SOUTH YARMOUTH, MA 02664 to: CERTIFICATE HOLDER CANCELLATION EOS HOSPITALITY LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 327 S SORE DR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SOUTH YARMOUTH, MA 02664 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 4C. -2.-'40,11111°.°64411111 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD BUILDING DEPARTMENT 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 LICENSE INSPECTION APPROVAL LOG-2022 NAME:Riviera Beach Restaurant ADDRESS:327 South Shore Drive 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 e �J /� License Issuance ' ✓ %�L No Fire Department Rep. Date Comments Approved for e Nv _z Z License Issuance 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 Fallon, Rosa From: Jaclyn Fraser <jfraser@riemerlaw.com> Sent: Tuesday, November 30, 2021 11:35 AM To: Fallon, Rosa; Grylls, Mark; Sears, Tim; Clarke, Kristin Subject Permits/Licenses Question Importance: High Attention! This email originates outside of the organization. Do not open attachments or click links unless you are sure this email is from a known sender and you know the content is safe. Call the sender to verify if unsure. Otherwise delete this email. Good Morning, I hope you all are doing well today! I had reached out in the beginning of November regarding information on properties and licenses/permits that may be needed. We have a client that just closed on several properties in Yarmouth. They will be applying for all the licenses they need regarding the transition of ownership. Dakota in Licensing recommended that I reach out to your department regarding any licenses we may need to apply for regarding the following properties (especially re, arding the pools): �c 411 odd Road (Parcel ID : 10! : ' l g L U 2,esor 18 • ax ra►:vrarmArma BMW" re-alv S o (+ 2: South Shore Drive (Parcel ID: 19.20.1 CC-f' ciG 1 • _ .^ ar. r r.rxxrJJ-l • . 3) Voicfitalv C Y 9 South Shore Drive (Parcel ID: 26.12• U D.c -1-1442 c� 34 South Shore Drive Parcel ID: 26..120) . vvct-�� ® outh Shore Drive (Parcel ID: 26.118) TI •vj„�W- Eaa GI\ Can you please let me know what we may need to apply for regarding each property? If it is easier to talk live please just let me know who the best person to reach out to would be. Please let me know if you need any additional information. Thank you! ! Jaclyn Fraser Burlington Office Manager .i.e.n. .r I Braunstein LLP 700 District Avenue, 11th Floor I Burlington, Massachusetts 01803 d: +1-617-880-3404 f: +1-617-880-3456 f m: jfraser@riemerlaw.com I www.riemerlaw.com .. IRIEmER � IBRA U STEIN :: O TON W1 YORK C �.. 3 ; NOV .� 0202� BUrLuiNLJ VBY chilAk M1 NT 1 Privileged And Confidential Communication. This electronic transmission,and any documents attached hereto,(a)are protected by the Electronic Communications Privacy Act(18 USC§§2510-2521),(b)may contain confidential and/or legally privileged information,and(c)are for the sole use of the intended recipient named above.If you have received this electronic message in error,please notify the sender and delete the electronic message.Any disclosure,copying,distribution,or use of the contents of the information received in error is strictly prohibited. For our Privacy Policy,click here 2