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HomeMy WebLinkAboutBCOI-24-16 Restaurant 2025 The Commonwealth of Massachusetts ka ) 4,q:s — .'1,4.-4'-.,, - * , Town of ;og Y44. `` o " YARMOUTH •\,Mc.RPORATo.,° - 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 Beach Resort Beverage LLC Trade Name: Red Jacket Restaurant BCOI-24-16 Identify property address including street number, name, city or town, and county Certificate Expiration Located at 28 SOUTH SHORE DR November 30, 2025 SOUTH YARMOUTH, MA 02664 Floor Occupancy_ Use Group Other Use Group Classification(s) 01 st Floor 120 A-2 Restaurants,Night Clubs,or 18-Persons-bar similar uses 102-Persons-Dining room Allowable Occupant Load 01 st Floor 225 A-2 Restaurants,Night Clubs,or 2nd Floor Meeting Room 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. Name of Municipal Building Name of Municipal Chief Enrique Arrascue Mar ryl Date of Inspection Commissioner 3 I )L)QD_3:::-3 Signature of Municipal Fire _ Signature of Municipal Buildin /, Chief "� Date of Issuance itiG I Z-r- Commissioner O ®g YAK t TOWN OF YARMOUTH _ ``� Office of the Building Commissioner 1146 Route 28, South Yarmouth, MA 02664 o PI I508-398-2231 ext. 1260 Fax 508-398-0836 J MATTA6 HEESE 06 c°RPORAfE0 fib APPLICATION FOR CERTIFICATE OF INSPECTION January 31, 2025 PAYABLE UPON RECEIPT ( X) Fee Required $150.00 ( ) No Fee Required In accordance with the provisions of the Massachusetts State Building Code, Section 110.7, I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: d;U Street and Number: 30 U°4- ShEy� (lnJ Qi , 56 U.-4iNiuF1c4cr. nut,.ci Name of Premises: P c hC..g$U Tel: al? L4 44/ Purpose for which permit is used: License(s) or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Certificate to be issued to ^G ' Tel: Sog 3 ti-L{�t�l Address: oUv* y\V -Ss tALCjhnoX\- ‘NA OLA.6,1 . Owner of Record of��i�dinA�� Address r (>1141A. Pr ent H Ider of Certificate Si ature of person to whom Title Certificate is issued or his agent 9 J`I �26 • ^I Date Email Address: \) 10.-111-►� \a.nd rL� \(,'o '6(,� (,(YY\ V 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# L (� 04/01/2025-11/30/2025 C- zv Ly A DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/15/2024 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: MARSH USA,LLC. PHONE FAX 1166 Avenue of the Americas JA/C.No.Ext): (A/C,No): New York,NY 10036 E-MAIL ADDRESS: INSURERS)AFFORDING COVERAGE NAIC IA CN133703919-all-GAU-24-25 INSURER A: N/A N/A INSURED INSURERS: N/A N/A EOS Hospitality RJR MA Employee LLC 444 Madison Avenue I Floor 14 INSURER C: State National Insurance Company.Inc. 12831 New York,NY 10022 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-012077319-01 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER IIDD/YYYY) (MMDDMMY) COMMERCIAL GENERAL LJABILITY EACH OCCURRENCEDAMAGE TO $ CLAIMS-MADE OCCUR PREMISES(EaENTED occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY CT 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 UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION VTLWC03100600 09/28/2024 09/28/2025 X I PER I I OTH- AND EMPLOYERS'LIABILI Y Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 M yes,describe under 1000 000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Riviera Beach Resort-327 S Shore Dr,South Yarmouth,MA 02664 CERTIFICATE HOLDER CANCELLATION Hospitality RJR MA EmployeeLLC 444 Madison Avenue Floor 14SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE York NY 10022 14 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NewACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE eta ralr ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD