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HomeMy WebLinkAboutBCOI-23-1755 2026 rry 2,,iff,. _..„) TOWN OF YARMOUTH Office of the Building Commissioner 1146 Route 28, South Yarmouth, MA 02664 N M� - 508-398-2231 ext. 1260 Fax 508-398-0836 /�c�RPORA?E���� ?LIGATION F I I ERTIFICATE OF INSPECTION August 15, 2025 � PAYABLE UPON RECEIPT AUG 29 2025 (X) Fee Required$150.00 ( ) No Fee Required BUILDING DEPARTMENT In accordance with the pro i s 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: �jl�0 e- 28 Name of Premises: 0PTA)t3 pae �S R43 Tel: O `7-1 I 9 Z 66 Purpose for which permit is used: „r� �-t`C�L &1 rt�r 1A , A 1YI t -� Cn'�( �(�rt�, License(s) or Permit(s)required for the premises by other governmental agencies: License or Permit Agency Co o D ..Q' ,tl4 C9- A Hh Olt. ,To Y Cc,r .Peon Vito? Q-Q. Licons.f..)BotV2..0,THY +r .N (u t ' I Sl.+'c 41l L.i 021\SI Bo A�,T Certificate to be issued to C, , ;t,,,C) (YIA�f NhN ti Tel 50` 36y 8-70a Address:C68 QJ9, C, 28, c.34- L(4,QN`d �Ln,rna OZ(,K7 3 Owner of Record of BuildingQi L0 (Y)ANplilJC1 Address $ Present Holder of Certificate e_m n r,,Rl iv t rv/7 .�/ld. / /r'-f-- )-- 64/h e/e/i1Rih4y i e/c ignature of person to whom Title a Certificate is issued or his a t r-- D2 o- ;S-- Date Email Address: CO rJTA c i ci\PTA1 T,,Pa!C.y,5. (.Osv 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#_BCOI-23-1755_ 12/1/2025-12/31/2026 g YA TOWN OF YARMOUTH ,� - - C Office of the Building Commissioner O 1h y. 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-398-0836 9 NCOAPORATEO`y9 August 15,2025 Capt.Parker's Pub 668 Route 28 West Yarmouth,MA 02673 Re: Annual liquor license inspection Fee$150.00 Pursuant to the provisions of the Massachusetts State Building Code 780 CMR,Section 106.5 and Table 106,you are required to apply for a Certificate of Inspection for the building located at 668 Route 28,West Yannouth, MA 02673 DBA Capt.Parker's Pub Please complete the enclosed application and return it with the appropriate fee payment to the Town of Yarmouth Building Department,1146 Route 28,South Yarmouth,MA 02664. Checks should be made payable to the Town of Yarmouth. Please note that you must return your application and have your inspection scheduled before September 15,2025,Inspections must be completed by November 14,2025 to ensure that your liquor license will be renewed by the Board of Selectman on December 2,2025. If your liquor license is not renewed at the December 2,2025,Board of Selectman meeting,then the next available date may not be until after your current license expires on December 31,2025. Unless otherwise requested,inspections will be performed unannounced. Typically,the following elements /systems are inspected:fire protection equipment,means of egress,including emergency lights,exit signs,egress doors & hardware, clear path of travel, adequate lighting and occupancy total. Also, the building shall be maintained and adequate housekeeping provided to ensure public safety. Rooms such as basements and attics are included. Violation details will be provided in the form of a Violation Notice and may delay the issuance of your certificate and/or license,if applicable. BE ADVISED after receiving your application a minimum of 2 weeks'notice is required for an inspection. One re-inspection will be included in the initial fee to confirm the abatement of any violations.Additional re-inspections will cost$80 each,which is payable in advance of the re-inspection. truly, Mark A. s Building Commissioner t _ • 1. / 1 • DATE(MMIDD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE `..----- 03/25/2025 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 NAMEACT Joseph Dupuis McShea Insurance Agency, Inc (A/C.PH No,ExtJ: (508)420-9011 (A/C,No): (508)420-9010 1645 Falmouth Road, Rt 28 BLDG D ADDRESS: joe@mcsheainsurance.com Centerville, MA 02632 INSURER(S)AFFORDING COVERAGE _ NAIC# INSURER A: The Hartford Insurance Company 11000 INSURED INSURERS: NATIONAL GRANGE MUTUAL _14788 Captain Parkers Pub, Inc. INSURER C: The Hartford Insurance Company 22357 688 Route 28 INSURER D: West Yarmouth, MA 02673 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 00000413-764534 REVISION NUMBER: 5 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 SUER POLICY EFF POLICY EXPIY LIMITS LTRINSR WVQ. POLICY NUMBER (MM/DDYYY) (MM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY 08SBANX5037 04/05/2025 04/05/2026 EACH OCCURRENCE $ 2,000,000 DAMAGE D CLAIMS-MADE X OCCUR PREMISESO(EaENTE occu occurrence) $ 1,000,000 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 X POLICY JECOT LOC PRODUCTS-COMP/OP AGG $ 4,000,000 OTHER: , $ COMED B AUTOMOBILE LIABILITY M 1 T2388U 08/07/2024 08/07/2025 (Ea accidentSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY (Per accident) $ A UMBRELLA LIAB X OCCUR 08SBANX5037 04/05/2025 04/05/2026 EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ C' AND EMPLOYERS WORKERS �,/N 08WECCM3443 04/01/2025 04/01/2026 X STATUTE OTH- ER 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT _ $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Liquior Liability 08SBANX5037 04/05/2025 04/05/2026 Per Occurrence 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE InterExchange Work&Travel USA THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN gACCORDANCE WITH THE POLICY PROVISIONS. 600 California Street, 10th Floor San Francisco, CA 94108 AUTHORIZED REPRESENTATIVE (JFD) ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are re eyed marks of ACORD Printed by JFD on 03/25/2025 at 10:59AM