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HomeMy WebLinkAboutBCOI-24-17 2024 ,r'•'Y''Fj to TOWN OF YARM•UTH t ` - BUlL*I G EP ': 11,THE T �, M4TTACIS � 8 �� ,,.,..,,s° 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: 291 South Shore Drive Name of Premises: Blue Water Resort Motel Tel: 508-398-6481 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-23-0029 Town of South Yarmouth Certificate to be issued to RJ Resorts Blue Water Resort Beverage LLC Tel: 508-398-6481 Address: 291 South Shore Drive,South Yarmouth,MA 02664 Owner of Record of Building RJ Resorts Blue Water Owner LLC E C tT 4 F. D Address 65 East 55th Street,33rd Floor,New York,NY 10022 - _ r". Pre ent Hold r of Certificate RJ Resorts Blue Water Resort Beverage LLC I t9 FEB 06 2024 BUI dl [ Manager S 7ENT I By_ Sig ire o person to whom Title - - # Certificate is issued or his agent al-i \ 1 , Date Email Address: HHandrahan@redjacketresorts.com 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 IS YOUR CERTIFICATE OF INSPECTION. Certificate of Inspection# �/- vrt7 04/01/2024-11/30/2024 The Commonwealth of Massachusetts r Y Town of 701 .`� YARMOUTH itc H[ c 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 Blue Water Resort Beverage LLC BCOI 24 17 Trade Name: Blue Water Resort Restaurant Identify property address including street number, name, city or town, and county Certificate Expiration Located at 291 SOUTH SHORE DR SOUTH YARMOUTH, MA 02664 November 30, 2024 Floor 1, Occupa _ Use Group Other Use Group Classification(s) 01 st Floor A-2 Restaurants,Night Clubs,or 153 Main Dining Room Allowable Occupant Load similar uses 26-Dining Room 1 26-dining Room 2 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 Name of Municipal Chief Enrique Arrascue Commissioner Mark Grylls Date of Inspection Signature of Municipal Fire Signature of Municipal Building Date of Issuance Chief Commissioner 1 (C\5\' 0/1 O ,_ k yr _ --k_ . Iw__ vv ft,.4 4, . ,• • \ ' ,c).00 ci .._ :w . ..T < r, )6 v a - 1 \ L4 001C 9 i• t c �0 j‘'f ' \ s � f c L zD® DATE(MMIDOnrrY) CERTIFICATE OF LIABILITY INSURANCE 09/19/2023 ,tTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES :JV. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 'PORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. 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 MARSH USA,LLC. NAME: 1166 Avenue of the Americas (A/C,No,Eat): FAX No): New York,NY 10036 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# CN133703919-all-GAU-23-24 INSURER A:Everest Premier Insurance Company 16045 INSURED INSURER B:N/A N/A EOS Hospitality RJR MA Employee LLC 444 Madison Avenue I Floor 14 INSURER C:N/A N/A New York,NY 10022 INSURER D:N/A N/A INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-011556130-05 REVISION NUMBER: 2 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDO/YYYY) (MMIDD/YYYY) LIMITS 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 LIABIUTY 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 UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION CC4WC00014-231 09/12/2023 09/12/2024 X PER OTH- AND EMPLOYERS'LIABIUTY STATUTE ER Y I N 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE N NIA E.L.EACH ACCIDENT $ OFFICER/MEMBE R EXCLU DED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION RJ Resorts Blue Water Resort Owner LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 291 South Shore Drive THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN South Yarmouth,MA 02664 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Town of 7o1 YA • 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 Blue Water Resort Beverage LLC Trade Name: Blue Water Resort Restaurant BCOI 24 17 Identify property address including street number, name, city or town, and county Certificate Expiration Located at 291 SOUTH SHORE DR SOUTH YARMOUTH, MA 02664 November 30, 2024 Floor t Occupa _ Use Group Other Use Group Classification(s) i 01st Floor A-2 Restaurants, Night Clubs,or 153 Main Dining Room Allowable Occupant Load similar uses 26-Dining Room 1 26-dining Room 2 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 Enrique Arrascue Name of Municipal Building Mark Grylls Date of Inspection Commissioner Signature of Municipal Fire Signature of Municipal Building Date of Issuance Chief Commissioner