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HomeMy WebLinkAboutBCOI-24-68 2025 The Commonwealth of Massachusetts Town of .og..Y9 YARMOUTH `-SRPORATEo,// 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:Sunbird Cape Cod Resort Trade Name: Sunbird Cape Cod Resort BCOI 24 68 Identify property address including street number, name, city or town, and county Certificate Expiration Located at 216 ROUTE 28 WEST YARMOUTH, MA 02673 June 3, 2025 Floor Occupancy Use Group Other Use Group Classification(s) 01 st Floor 48 R-1 Hotels,motels,boarding houses, 48 Units etc. Managers Apartment&Game Room Allowable Occupant Load 01st Floor 48 R-1 Hotels,motels,boarding houses, 48 Units etc. 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. Name of Municipal Chief Name of Municipal Building ),..3 bCommissioner Mark Gr�rfls Date of Inspection 7 /, Signature of Municipal Fire Signature of Municipal Building Chief Commissioner �� ate of Issuance / 2 TOWN OF YARMOUTH \ci BUILDING DEPARTMENT a• MATTAGn sE;' 9 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 APPLICATION FOR CERTIFICATE OF INSPECTION May 01, 2024 PAYABLE UPON RECEIPT (X ) Fee Required $241.00 ( ) 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 I�o R t f� Z�, LA&5 5r '(,kQl ortil Name of Premises: ot-cJ 1 R-D 1'E CAD ' Sn21 Tel: .3 3(" 'TOT._ Purpose for which permit is used: AO-C- - -- / AA-©�1— License(s) or Permit(s) required for the premises by other governmental agencies: _ RED iVED1 License or Permit Agency 01:;1,4 MAY U 2024 j Bu' H t 1 MENT t3y Certificate to be issued to e/.//,d/V6a f,9l ',4' /4*"./' Tel: 3-se..3/- Address: / 1r'y 8e�+?✓:S?' Bi�G�/�� �� �� Owner of Record of Building d/0o /,7�//fr', /26r.ee...9'/ e Z 57 Address 97 "-Lef-Es7 Present Holder of Certificate c(/i964' 712G 9 Sig re o pe on to w om Title Certificate is issued or his agent 7/ (3YZI. (3Z Date Email Address: 1-e/,964€44,t/.4G// /1/L!_ 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. s� Certificate of Inspection# 8(7/_-p7y 06/03/2024-06/03/2025 NOTICE , NOTICE TO a *OH / TO EMPLOYEES 4Co EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS Lafayette City Center, 2 Avenue de Lafayette, Boston, Massachusetts 02111 800-323-3249 As required by Massachusetts General Law, Chapter 152, Sections 21, 22, & 30, this will give you notice that I (we) have provided payment to our injured employees under the above mentioned chapter by insuring with: A.I.M. Mutual Insurance Company NAME OF INSURANCE COMPANY P.O. Box 4070 Burlington, MA 01803-0970 ADDRESS OF INSURANCE COMPANY WMZ-800-8008253-2023A 05/16/2023 - 05/16/2024 POLICY NUMBER EFFECTIVE DATES 410 University Ave. Baldwin Krystyn Sherman Partners LLC Westwood, MA 02090 (800)553-1801 NAME OF INSURANCE AGENT ADDRESS PHONE Wagner Hospitality Management LLC 216 Main St West Yarmouth, MA 02673 EMPLOYER ADDRESS 05/16/2023 DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER NOTICE \*: , 11 NOTICE TO TO EMPLOYEES EMPLOYEES .. lem a The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS Lafayette City Center, 2 Avenue de Lafayette, Boston, Massachusetts 02111 800-323-3249 As required by Massachusetts General Law, Chapter 152, Sections 21, 22, & 30, this will give you notice that I (we) have provided payment to our injured employees under the above mentioned chapter by insuring with: A.I.M. Mutual Insurance Company NAME OF INSURANCE COMPANY P.O. Box 4070 Burlington, MA 01803-0970 ADDRESS OF INSURANCE COMPANY WMZ-800-8008253-2023A 05/16/2023 - 05/16/2024 POLICY NUMBER EFFECTIVE DATES 410 University Ave. Baldwin Krystyn Sherman Partners LLC Westwood, MA 02090 (800)553-1801 NAME OF INSURANCE AGENT ADDRESS PHONE Wagner Hospitality Management LLC 226 Main St West Yarmouth, MA 02673 EMPLOYER ADDRESS 05/16/2023 DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER