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HomeMy WebLinkAboutBCOI-24-80 2026 The Commonwealth of Massachusetts Town of grYAK YARMOUTH 4 • 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: Planet Fitness BCOI 24 80 Trade Name: Planet Fitness Identify property address including street number,name, city or town,and county Certificate Expiration Located at 7 LONG POND DR SOUTH YARMOUTH,MA 02664 October 1,2026 Floor Occupancy Use Group Other 01 st Floor 186 A-3 Lecture halls,dance halls, AEROBICS ROOM-49 churches and places of religious EXERCISE AREAS-137 Use Group Classification(s) worship,recreational centers, terminals,etc. Allowable Occupant Load Other 15 A-3 Lecture halls,dance halls, MEZZANINE-15 churches and places of religious worship,recreational centers, terminals,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 Grylls _Date-pf Inspection Signature of Municipal Fire Signature of Municipal Buildin -7/Date / 3 ��:;� of Issuance Z Z f Chief Commissioner ,j / /3C O/ - 2� �o � A�D® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 9/3/2025 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 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 935-5 NAME ACT 935 935/5 Brown&Brown Insurance Services Inc PHONE FAX (617)479-5147 (A1C,No,Est): (617)471-1220 (A/C,No): 500 Victory Road,Marina Bay ADDRESS: jennifer.wronski@bbrown.com North Quincy,MA 02171 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: A.I.M.Mutual Insurance Company(400) 33758 INSURED INSURER B DC Porcellis Pizzeria&More LLC INSURER C: C/O Candace Cook 130 Cottonwood Rd INSURER D: Harwich,MA 02645 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES(Ea RENTED $ MED EXP(My one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER $ AUTOMOBILE LIABILITY acc denNED SINGLE LIMIT(Ea ANYL`AUTO BODILY INJURY(Per person) $ AUTOS NED AUTOEDULED BODILY INJURY(Per accident) $ -HIRED AUTOS AAUTOSWNED ((Per PROPERTY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION C _ AND EMPLOYERS'LIABILITY Y/N X UTORY LIMIT EERH ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000.00 OFFICER/MEMBER EXCLUDED? n AWC-400-7041052-2025A 5/4/2025 5/4/2026 A (Mandatory in N!A If yes,describe underE.L.DISEASE-EA EMPLOYEE $ 100,000.00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Candace Cook&Eleanor Keleher are excluded from this policy effective 5/4/2025 CERTIFICATE HOLDER CANCELLATION Town of Yarmouth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1146 Route 28 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN South Yarmouth,MA 02664 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,e9 c'.. ©1988-2015 ACORISC.`UI{NONJ 1 ION.Alrrig�fts reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD