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HomeMy WebLinkAboutBCOI-23-1774 2026 The Commonwealth of Massachusetts Town of /z°1 744o YARMOUTH o 'y 4c.o.pORATE,,`b,9 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:Teddy's Three Sons LLC BCOI 23 1774 • Trade Name: Crazy Rooster Identify property address including street number, name, city or town, and county Certificate Expiration Located at 1329 ROUTE 28 December 31, 2026 SOUTH YARMOUTH, MA 02664 Use Group Classification(s) Floor Occupancy_ Use Group Other 01 st Floor 96 A-2 Restaurants,Night Clubs,or Allowable Occupant Load 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 Chief Enrique Arrascue Name of Municipal Building Mark •Gr 5 Date of Inspection •? Commissioner /� �> -�( - `1`" Signature of Municipal Fire .� Signature of Municipal Buildi g ' Chief ✓ ' G' Commissioner �— /Date of Issuance /y y- Z.7-- ' Y`e_--�� TOWN OF YARMOUTH_ Office of the Building Commissioner (c t :� ,o �; 1146 Route 28, South Yarmouth, MA 02664 = y" 508-398-2231 ext. 1260 Fax 508-398-0836 dATLAC$*CSC ,,4.PpRATE. f APPLICATION FOR CERTIFICATE OF INSPECTION August 15, 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: Street and Number: /3.2 4? S. \f A R Ike)U c/h P b .2 g Name of Premises: GQf1Z.y R O O s i'CY' Tel: sD g - _F -, la 9, Purpose for which permit is used: License(s)or Permit(s)required for the premises by other governmental agencies: , I V k __.._ ,rPermit Agency RE '�^- SEA 0 3 2025 Certificate to be issued to Tel: B�-LI i ;{ /s40,0c2,50 v,c2?0 Address: l "Y 1 1 1 -_k Owner of Record of Building Address Present Holder of Certificate rAsl.". Q id/tics Q . Signature of person to whom Title Certificate is issued or his agent 9",2 -- Date Email A 33. 4 L .. .�n UP:40i 1. Co M 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-23-1774_ 12/1/2025-12/31/2026 THEOD-6 OP ID: EB .ACG1F2O. CERTIFICATE OF LIABILITY INSURANCE DATE 09(03//03/2025Y) 025 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 508-771-3300 NAME CT Martha J Findlay Olde Cape Cod Insurance PHONE 5087713300 I FAX 508-775-3821 - - 300 Winter Street (A/C,No,Eat): (NC,No): Hyannis, MA 02601 ADDRESS:marthaf@occia.com Martha J Findlay INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:American Automobile Ins Compan INSURED INSURER B:Associated Industries of Mass The Crazy Rooster-TATA Inc Westchester Specialty Ins Co Teddy's Three Sons LLC INSURER C: P Y 25 Pine Grove Ave Hyannis,MA 02601 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD (MM/DD/YYYY1 (MM/DD/YYYY1 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR SAG 2005797-24 07/01/2025 07/01/2026 DAMAGES t RENTED 100,000 PREMISES(ER occurrence) $ Liquor Liab SAG 2005797-24 07/01/2025 07/01/2026 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE,T LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSRE ONLY AUTOS BODILY p BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONLY (Peer acEcident DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATIONPER AND EMPLOYERS'LIABILITY STATUTE ER H Y/N VWC-100-6025324-2025A 04/27/2025 04/27/2026 • ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Property Section FSF16987955 001 07/01/2025 07/01/2026 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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. Town of Yarmouth 1146 Route 28 South Yarmouth, MA 02664 AUTHORIZED REPRESENTATIVE aSL ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD