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Home My WebLink AboutBCOI-24-53 2026 The Commonwealth of Massachusetts h. Town offO YARMOUTH o: 0H 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: Ocean Mist Beach Motel Trade Name: Ocean Mist Beach Motel BCOI 24 53 Identify property address including street number, name, city or town, and county Certificate Expiration Located at 73 SOUTH SHORE DR SOUTH YARMOUTH, MA 02664 May 1, 2026 Floor Occupancy Use Group Other Other 8 R-1 Hotels,motels, boarding houses, Front Bldge 8 Units Use Group Classification(s) etc. Other 14 R-1 Hotels,motels, boarding houses, Middle Bldg 14 Units Allowable Occupant Load etc. 01st Floor 4 R-1 Hotels,motels,boarding houses, 4 Units&Office 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 Building Name of Municipal Chief Commissioner Mark G I ate of Inspection Signature of Municipal Fire Signature of Municipal Buildin ✓t 1. Chief Commissioner Date of Issuance g// 3 `Z f�" RECEIVED YA -441' APR 2 4 2025 -OWN OF YARMOUTH Offic of the Building Commissioner BU I L DI N GI EIWRIVItire La"irk, South Yarmouth, MA 02664 0 - By: 508-3/8-2231 et 1260 Fax 508-398-0836 400. APPLICATION FOR CERTIFICATE OF INSPECTION April 01.2023 PAYABLE UPON RECEIPT ( X ) Fee Required S148.00 ( ) No Fee Required In accordance with the pros isions of the Massachusetts State Building Code. Section I 10.7. I hereby apply for a Certificate of Inspection for the below-named premises located at the following address: Street and Number. -/3 / 7i4e4 - Namee of Premises: A7-4(211 f/17475/7 Awe2-e-h/A6 Purpose for which permit is used: 0, €e License(s)or Permit(s) required for the premises by other governmental agencies: License or Permit Agency S' Certificate to be issued to a /X ///(.1*- alt 1- - — Tel: 4727/727-47.--C—( 7‘,e2 Address: 7,P ,Ye2ee/*IWt:2L_.;L e‘tt e ' z e:).284/2 Owner of Record of Building frie AMY X92_ Address Mt Present Holder of Certificate ive Signature of pe to whom ' Title I Certificate is issued or his agent 1171,-,! 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 he certified. Application must be received before the certificate will be issued. The building official shall he notified within ten(10)days of any change in the abme, 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# BCOI-24-53 01 2025-05'01 2026 AC R El CERTIFICATE OF LIABILITY INSURANCE DA1u4M/DONa Y) kliimilieeTHIS 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; PHILIP GINEXI JR. GENATT V PHONE FAX 3333 NEW HYDE PARK RD U+tcNs,Eau:1-516-387 306s _�.1_A(q,K4a 1-516-869 8765 SUITE 400 AADDDRIEss, _pg nexi enatts Ciatt .com _ NEW HYDE PARK NY 11042 INSURER(,AFFORDING COVERAGE NAIL N INSURER A:Zurich American Insurance Company E 16535 INSURED NEWPHOTE INSURER e.ACE Property&Casualty Insurance Company 20699 Newport Hotel Group LLC, Etal 28 Jacome Way INSURER c: Don McCall INSURER D: �......... _� Middletown RI 02842 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1087423044 REVISION NUMBER: 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. arsa:..._ .._.__.-.._.TYPE OF INSURANCE 4 -661,:SUait ..._... _....____ ._ — -POLICY EFF POLICY EXP ` LIMITS LTR INS° wVD POLICY NUMBER :(MMFDDtYYYYI IMMIDDIYYYYI A I X COMMERCIAL GENERAL LIABILITY Y Y GL0011456109 4/12/2024 4i12/2025 EACH OCCURRENCE S 1.000,000 1 �nM—A-GE TO CLAIMS-MADE _ CLAIMS- DE x` ':OCCUR PREMISES Ea occur*en a 5 1,000 000_ ! :AHED EXP(Any one person) S 10,000 . 'PERSONAL&ADM INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - 'GENERAL AGGREGATE $2,000,000 PRO- ! - POLICY ,I JECT LOC PRODUCTS-COMP/OP AGG $2 000,00G X 'OTHER-. LIQUOR LIABILITY : ',LIQUOR LIABILITY $S1,000,000 A AUTOMOBILE LIABILITY Y BAP011657509 ' 4/12/2024 4112/2025 COMBINED SINGLE LIMIT $1,000,000- A BAP012619007 4/12/2024 , 4/12/2025 I-(Ea° alptt �_ —_... ........... X ANY AUTO .BODILY INJURY(Per person) I S OWN D I t SCHEDULED �, BODILY INJURY(Per arx:ident)LS :AUTOS ONLY AUTOS X FIRED X NON-OWNED PROPERTY DAMAGE $ _.;....—.;AUTOS ONLY L. ...AUTOS ONLY ,(Per acodentj .T ... ...—._• S 9 1 X ?UMBRELLA LAB ' X ;OCCUR ( Y Y 'HLI23AG73922653 ' 4/12/2024 4I12f2025 EACH; OCCURRENCE $50.000 000 i_ . EXCESS LAB CLAIMS-MADE AGGREGATE S 50,000,000 DEG ' XRETENTION S In Ann - A '.WORKERS COMPENSATION WC014008010 11/15/2024 11/15/2025 k PER OTH- 'AND EMPLOYERS'LIABILITY ,.. STATUTE ( ER ANYPROPRIETOR/PARTNER/EXECUTIVE 1" —' i i ;E.L.EACH ACCIDENT S 1,000,000 OFFICER4/EMBEREXCLUDEO� NIA;. (Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE S 1.000,000 :If yes.describe under , .......___—__ _ .._ .. DESCRIPTION OF OPERATIONS below E I..DISEASE•POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached 4 more space is rsquired) LOCATIONS: 2.213 Ocean Street,Hyannis,MA 02601 Bldg#1 &#2 3.178-180 Thames Street,Newport.RI 02840 4.15-13 Kilburn Ct..Newport,RI 02840 5.82 Mt.Hope Street.N.Attleboro,MA 02670 6.72 Common Court,Settlers Green,Ri. 16,North Conway,NH 03860 7.40 Main Street,Falmouth,MA 02540 See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. EVIDENCE OF INSURANCE AUTHORIZED REPRESENTATIVE C'1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD , . AGENCY CUSTOMER ID: NEWPHOTE LOC#: Acc)R;c) ADDITIONAL REMARKS SCHEDULE Page 1 ' of 1 AGENCY NAMED INSURED GENATT V I Newport Hotel Group LLC,Etal 28 Jacome Way — - POLICY NUMBER Don McCall Middletown RI 02842 CARRIER HAW CODE EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE 8.28 Jacome Way,Middletown,RI 02842 10.97 South Shore Road,South Yarmouth,MA 02664 Bldgs.#1,2,3 12.73 South Shore Road,South Yarmouth,MA 02664 Bldgs.#1,2,3 4 13.38 Purgatory Road,Middletown,RI 02842 Bldgs#1,2 14.368 Old Post Road,North Attleboro,MA 02760 15.390 N.Glenwood,Jackson,WY 83001 16. 251,259,267 Thames Street,Bristol,RI 02809 Bidgs#1,2,3,4,5 17.1 State Street,Bristol,RI 02809 Bldg#6 18. 157 Holly Ridge Road,Conway,NH 03818 19.235 Ocean Street,Hyannis,MA 02601 20. 120 Palmer Avenue,Falmouth,MA 01930 21.107-108 Atlantic Road.Gloucester,MA 01930 Bldgs#1,2,3 22.43&45 Hull Shore Drive,Hull,MA 02045 23. 131 Ocean Street,Hyannis,MA 02601 24.149 Ocean Street,Hyannis,MA 02601 25.42 Wylie Ct.#14.North Conway,NH 03860 26.70 Wylie Ct.#26,North Conway,NH 03860 27.70 Wylie Ct.#28,North Conway,NH 03860 • • ACORD 101(2008101) 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD