HomeMy WebLinkAboutBCOI-23-1760 2025 The Commonwealth of Massachusetts _
* • Town of g YA
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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: Oliver's and Planck's Inc BCOI 23 1760
Trade Name: Oliver's & Planck's Tavern
Identify property address including street number, name, city or town, and county Certificate Expiration
Located at 960 ROUTE 6A December 31, 2025
YARMOUTH PORT, MA 02675
Floor Occupancy_ Use Group Other
Use Group Classification(s) 01st Floor 227 A-2 Restaurants,Night Clubs,or 85-Main Dining
similar uses 67-Small Dining
Allowable Occupant Load 74-Bar Lounge
Total-227
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 Building j
Name of Municipal Chief Enrique Arrascue Commissioner Mark Gr�/IIs Date of Inspection / / ,���j Signature of Municipal FireS_±_-'
Signature of Municipal Buildin \ ! h Jj, L),_3 (11
Chief --�"' Commissioner `/. ; Date of Issuance ` //Vz-y .
1:5 TOWN OF YARMOUTH
' Office of the BuildingCommissioner
is - # - r, 1146 Route 28, South Yarmouth, MA I 'air:
' ,
r y 508-398-2231 ext. 1260 Fax 508-398 I 6
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,,` , MATTAEHEESE q f� OCT O�' 1DLLL
.-RPORAisv , T
. APPLICATION FOR CERTIFICATE OF INSPECTION
BUILDING DEPARTMENT
September 23,2024 PAYABLE UPS " '1
(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: 96o (Tr c ) 5 j COLYre G F} I -IAaniar[hi Por►, in A, 026 3.
Name of Premises: Ot,cues 0oa P(,Fitjo S l PII1Q JTel: Cng--a (2,(,Q 6 ,
Purpose for which permit is used: LiTOC 1--Ce n)Se �`7 `g5'f - CRO S-
License(s) or Permit(s)required for the pr mises by other governmental agencies:
License or Permit Agency
1 .i quo l L ice n)SS
Certificate to be issued to 0 t;J€`(S pa:.) Pl rY°,j (tk)C., Tel: 00- ,-� 60 6674.,
Address: 6O cc tJ . ~ 6'9S
Owner of Record of Building nn P 1-\1 0 Q(1,r /..)
Address 149 CRrc\QLOT- eOpof �C°w�ye2 CllYNRr Or26 1
Present Holder of Certificate INA JGF,�c,Sp0 CoeL}-iQ
t\IPIIJOIffSW Coel,d) 0 Nr e e
Signature of person to whom Title
Certificate is issued or his agent 1 Q 102 f oW024
Date
Email Address: wpm)De eSO,3CQF L . eh OLijEQS Aa)D P LAN)c c.Corn
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# 13 co 3 i (d)
12/31/2024-12/31/2025
•
NOTICE NOTICE
TO TO
EMPLOYEES EMPLOYEES
The Commonwealth of Massachusetts
DEPARTMENT OF INDUSTRIAL ACCIDENTS
LAFAYETTE CITY CENTER, 2 AVENUE DE LAFAYETTE,BOSTON, MASSACHUSETTS 02111
617-727-4900 - http://www.state.ma.us/dia
As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we)
have provided for payment to our injured employees under the above-mentioned chapter by insuring with:
MA Retail Merchants WC Group Inc.
NAME OF INSURANCE COMPANY
PO Box 859222-9222, Braintree, MA 02185-0000
ADDRESS OF INSURANCE COMPANY
014005035572124 01/01/24 - 01/01/25
POLICY NUMBER EFFECTIVE DATES
RogersGray 410 University Avenue, Westwood, MA 02090 O
NAME OF INSURANCE AGENT ADDRESS PHONE#
Oliver's & Planck's Tavern 960 Route 6A, Yarmouthport, MA 02675-0000
EMPLOYER ADDRESS
01/11/2024
EMPLOYER'S WORKERS' COMPENSATION OFFICER(IF ANY) 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