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HomeMy WebLinkAboutBCOI-24-15- The Commonwealth of Massachusetts Town of YARMOUTH New and Renewal Certification of Inspection In accordance with the Massachusetts State Building Code,Section 110.7 Identify Name of Establishment Certificate No. Issued to Business Name:RJ Resorts Riviera Beach Resorts Beverage LLC BCOI-24-15 Trade Name:Riviera Beach Restaurant Identify property address including street number,name,city or town,and county Certificate Expiration Located at 327 SOUTH SHORE DR SOUTH YARMOUTH,MA 02664 November 30,2024 Floor Occupancy_ Use Group Other Use Group Classification(s) Gist Floor 40 A-2 Restaurants,Night Clubs,or 40 Persons similar uses Allowable Occupant Load 02nd Floor 48 A-2 Restaurants,Night Clubs,or 48 Persons similar uses 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 line safety features.This certificate shall be framed behind clear glass and/or laminated and posted in a conspicuous place within the space as directed by the undersigned.Failure to post or tampering with the contents of the certificate is strictly prohibited. ue Arrascue Name of Municipal Building Name of Municipal Chief Enrique Commissioner Mark Gry Date of Inspection >✓/ Signature of Municipal Fire Signature of Municipal Building Date of Issuance 2� Chief Commissioner =T Y7` °� A� ot, TOWN S F YARMOUTH. O :-;�_'- H BUIL ZING DEPARTMENT nk` MkTTACM 4,c_�Z 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION January 5,2024 PAYABLE UPON RECEIPT (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: 327 South Shore Drive Name of Premises: Riviera Beach Motel Tel: 508-398-6841 Purpose for which permit is used: seasonal liquor license renewal License(s)or Permit(s)required for the premises by other governmental agencies: License or Permit Agency LICA-23-0027 Town of South Yarmouth Certificate to be issued to RJ Resorts Riviera Beach Resort Beverage LLC Tel: 508-398-6841 Address: 327 South Shore Drive,South Yarmouth,MA 02664 E 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 RJ Resorts Riviera Beach Resort Beverage LLC FEB 0 6 2024 r Manager By. — Signs o pers ' whom Title Certific to is issued or his agent 21 a-1 aki Date Email Address: HHandrahan@redjacketresorts.com Instructions: Make check payable to: Town of Yarmouth 91-) • 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# �CU/ � L 04/01/2024-11/3 0/2024 =iB> ��� -;1�� OD ELATE (I EM/DDIYYYY) CERTIFICATE OF LIABILITY N S U R N C 091 19/2023 1/41.11100 • ��gyp R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS • CERTIFICATE DOES NOT AFFIRMATIVELY'ELY 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 INS RER(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 endorsements) PRODUCER CONTACT _. MARSH USA, LLC. i NAME E 1166 Avenue of the Americas .�l�t}'�,.�£aA1C., N I FAX _ , E�6.t�• 1 (A/C, No): 7 New York, NY 10036 E-MAIL INSURER(S) AFFORDING COVERAGE NA.IC CN 133793919-all-GAU 23-241 045 .� _ INSURER : Everest Premier Insurance Company INSURED INSURER B : Everest Denali Insurance Com ano 16044 EOS Hospitality RJR MA Employee LC 20699 L 444 Madison Avenue Hoar 14 , INSURER C : ACE Property and Casualty Insurance CompanyNew York, NY 10022 INSURER D : Everest National Insurance Co INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: NiYC 011567320-02 REVISION NUMBER: THIS IS TO CERTIFY ..E..HATT 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 CERTIFICATEMAY 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 CI...AIMS, INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP E UMITS LTRINSD ' fV* POLICY NUMBER MM/DDYYYY ::MMrDR/YYYY A I X COMMERCIAL GENERAL LIABILITY CC4GL00011-231 09/12/2023 09112/2024 EACH OCCURRENCE $ 2,000,000 DAMCLAIMS MADE X OCCUR PROMISES f EEcc'E r} $ 1,000,E000 E�'E�I':::I�1ISE:�S (Ea occurrence) .� MED EXP (Any one person) $ �t 111 PE::.RSON►Al. &ADV INJURY $ 1,000,000 GEHN1.. AGGREGATE. LIMIT APPLIES PER: GENERAL. AGGREGATE $ 3,000,000 IIIPOLICY PF;n: [ X. LOC PRODUCTS w COMP/OP AGO 2,000,000 E �� OTHER: /�{ )f (� . E .. .. r . ro nib » t. t \ COMBINED SIt�EGL. LIMIT e 2,000,000 CC AI I�+)1 '2J 1 BADS 09112/2023 091212E 24 B AUTOMOBILE ILE LIABILITY l } , .. . ,, (Ea accident3 X ANY AUTO CC4CA00 13M231 (MA) 09/12/2023 09/1212024 BODILY INJURY (Par person) $ OWNED SCHEDULED E BODILY Di;wl' INJURY (Per accident) _Y • AUTOS ONLY AUTOS HIRED NON-OWNED , PROPERTY DAMAGE r AUTOS ONLY , AUTOS ONLY (Per accident) a Garage e Keepers Garage Keepers 1,000,000 C X UMBRELLA LIAB X occuR G28970304001 09/12/2023 09/1212024 EACH OCCURRENCE f. 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE 19,E t ,J00 LED I RETENTION$ Prod Completed $ 10,000,000 ,WORKERS COMPENSATION CC4W C00014-231 21 I 09}12'2024 h PER aril- [ E- [AND EMPLOYERS' LIABILITY' Y f N >.. -I-Al UTE , ER l 1 ANYPROPRIE TOR PARTN� R;E.XECUTIVE EL EACH ACCIDENT $ 1,000,000 �rE'OFFICER/MEMBEREXCLUDED?EXCLUDED? �� N I A � - - - - -(Mandatory in NH) El_ DISEASE w EA EMPLOYEE: $ 1,000,000 If yes, describe under E <i..< DISEASEw POLICY LIMIT 1,300,000 DESCRIPTION OF OPERATIONS below A Liquor Liability .CC4GL00011-231 0911212023 09/1212024 General Aggregate 2,000,000 Retained Limit- $1.94E0 Each Occurrence Limit 2,000,000 DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES (ACORD 101, .Additional Remarks Schedule, may be attached if more spaces required) CERTIFICATE HOLDER CANCELLATION Red Jacket Beach Resort SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 South Shore Drive THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Yarmouth, MA 02664 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE . . © 1988 20 6 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN133703919 LOC if: New York ACo ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA,LLC, EOS Hospitality RJR MA Employee LLC _....... ................................................................................................._........_.............._........................... 444 Madison Avenue I Floor 14 POLICY NUMBER New York,NY 10022 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ............25................. FORM TITLE: Certificate of liability Insurance Garage keepers Legal Liability Comprehensive $1,000,000 Limit $500 Deductible for Each Customer's Auto Loss $2,500 Maximum Deductible for Loss Caused by Theft or Mischief or Vandalism Collision $1,000,000 Limit $500 Deductible for Each Customer's Auto Loss Excess Liability: Insurer:Markel American Insurance Company Effective Dates:September 12,2023-September 12,2024 Policy#DPHX002023 Limit:$15,000,000 excess of$10,000,000 ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD