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Home My WebLink AboutApplications-CertificationsDetails Lodging/Motel lnformation Establishment Name* Ambassador lnn and Suites Tax lD f' FEIN Establishment Slreet Address- 1314 Route # 28 Owner's Name' Gunvantrai S. Patel Owner's Street Address 1314 Route 28 I Check if Mailing Address is different EmailAddress' info@ambassadorcapecod.com The Health Department will not use past years' records for any certifications. You must provide new copies and maintain a file at your place of business. Owner lnformation Establishment Phone # 508-3944000 FEIN' 0066 Establishment City, State, ZIP* South Yarmouth, MA 02664 Owner's Phone #* 508-394-4000 Ovyner's Adress City, State, ZIP South Yarmouth, MA 02664 Corporation Name Gayatri krupa Corp. Manager's Phone #* 774-251-0451 Lodging Type Cabin Motel DOCUMENT Expiration Datet 12t31t2026 Conditions Units - 80; Bedrooms - 89 r I lnn I I I Manager's Name' Peter Patel B&B Lodge Trailer Park I For purposes of the limitations of Motel or Hotel use, Transient occupancy shall be limited to the temporary and short{erm occupancy, ordinarily and customarily associated with motel and hotel use. Transient occupants must have and be able to demonstrate that they maintain a principal place of residence elsewhere. Transient occupancy shall generally refer to continuous occupancy of not more than thirty (30) days, and an aggregate of not more than ninety (90) days within any six (6) month period. Use of a guest unit as a residence or dwelling unit shall not be considered transient. Occupancy that is subject to the collection of Room Occupancy Excise, as defined in M.G.L. c. 64G or 830 CMR 64G, as amended, shall generally be considered Transient. Click to get a copy of the Worker's Compensation lnsurance Affidavit: General Businesses The Town of Yarmouth taxes and liens have been paid prior to renewal or the issuance of your licenses.* I I acknowledge that I have read and understand the conditions of 521 CMR 8 regarding transient lodging facilities. Transient lodging shall include but not be limited to hotels, motels, bed and breakfasts, inns, boarding houses, dormitories and resorls.' Peter Patel Nov 1, 2025 & cPo cEnrrFrco rooL 6 SPA OPEEATOR' Certified Poo! & Spo Operotor Certificqtion for Piyush Patel as an Operator ofAquatic Facilities issued by the Pool & Hot Tub Allionce on Certifi cation Date: 3/ 1 /2024 Expiration Date: 3131 12029 Certifi cation Number. g-974697 lnstructor Name(s) Brian Stewart POOL & HOT TUB ALLIANCE Sabeena Hickman, CAE President & CEO Pool & Hot Tub Allionce For verificauon, telcphone PHTA 6t 719'54O'9119 or email servicer0pht6.or8 $u/ugld-_ Jr Piyush Patel ce(ified 31 1 /2024 Certrficanon ttumber i C-074587 rnstructor Name: Brian Stewart Erpnes:313112029 ,'. CG.rlticd pool & Spl Op6rotor (CPO)i , ,1r L, r |.l.rl , , 'l 1,. ,", -il :,. IiL-, ' 'l , !r|r , t.pool, HOT TUB pht .ora cPoSignoture ::nsc National Safety Council SECURITY CONTROT NO. It0743DFE05268 Certificcrtion Ccrrd Peter Pqtet hos successfutty compteted the cognitive ond skitts evotuotions for the fottowing: COMPLETION DATE tl/22/2024 INSTRUCTOR Richord Todd (#1040918) EXPIRATION DATE TRAINING CENTER r/30/2026 fh,s coulse is eguivalent to AHA ond meets ECC ond ITCOR guidelines. This credentiol con be verified of nsc.orglFAverify First Aid, Adult, Chitd qnd lnfqnt CPR & AED 4.00 hrs Cope Cod Sofety Troining TRAINING CENTER ID 207)55A lr I'nsc SECURITY CONTROL NO. l75l87E9l982lC National Safety Council Certificcrtion Ccrrd hqs successfuIty compteted the cognltive ond skitts evotuotions for the fottowing: First Aid, Adult, Chitd crnd lnfqnt CPR & AED 4.00 hrs COMPLETION DATE 11/22/2024 INSTRUCTOR Richord Todd (#1040918) EXPIRATION DATE TRAINING CENTER 11/30/2026 Cope Cod Sqf ety Troining TRAINING CENTER ID 2071554 Pinot Pqtel fhis course is eguiyolent to AHA and meets ECC ond rLCOR guidelines. This credentiql con be verified of nsc.orglFAverify ::nsc SECURITY CONTROL NO, 1to7 469F AE23FE National Safety Council Certificcrtion Cord Kerry Ann Simms hqs successfutty compteted the cognltive ond skitts evotuqtlons for the fottowing: First Aid, Adutt Chitd qnd lnfqnt CPR & AED 4.00 hrs COMPLETION DATE 11/22/2024 EXPIRATION DATE TRAINING CENTER 11/30/2026 Cope Cod Sofety Troining TRAINING CENTER ID 2071551 fhis course is eguivalent to AHA ond meets ECC o nd ILCOR guidetines. This credentiql con be verified ot nsc.orglFAverify INSTRUCTOR Richord Todd (ttl0409,I8) ::nsc SECURITY CON]ROL NO, 17518424766E92 National Safety Council Certificotion Ccrrd Dqvid Dumcrs First Ai{ Adutt, Chitd qnd lnfqnt CPR & AED 4.00 hrs COMPLETION DATE )1122/2024 INSTRUCTOR Richord Todd (*1040918) EXPIRATION DATE TRAINING CENTER 11/30/2026 Cope Cod Sofety Troining TRAINING CENTER ID 2071551 fhis course is equivalent to AHA ond rneets ECC ond /ICOR guidelines. This credentiot con be verified of nsc.orglFAverify hqs successfutty compteted the cognitlve ond skitls evotuotions for the fottowing: Technology lnsurance Company, lnc. A Sbd( lnarianco cornpany NP ! 5.1332244 wc990001 B 1of 5 INFORMATION PAGE WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Ncci Codc: 1907 I Insured: Gayatri Krupa Corporation DBA: Ambassador Inn & Suitcs l3l4 Route 2E South Yamouth. MA 02664 Other workplaces not shown above: Nonc Producer: The Baldwin Group Southeast LLC 410 University Ave Westwood. MA 02O9G 231 I PolicyNumber: TWC4572715 _lndividual X Corporation Federal Tax lD Risk Id: Renewal of: Panncrship 2(X)55(X)66 TWC.1.195642 2. The policy period is from 31912025 to 71912026 l2:01 a.m. at thc insurcd's mailing address 3.A workers Compensation Insurance: Pan One of thc policy applies lo the Workers Compensation Law of the states listed here: Massachusetts Employen Liability Insurancc: Pafl Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two arc: Statc Bodily Injury by Accident Bodily Injury by Disease Bodily Injury by Disease u $50O.0O0 each accident $-sOO.ff)O Frclicy limit $50O,0O0 cach employcc C. C)thcr statcs [nsurance: Pan Three ol thc policy applies to thc statcs. if any. listed here: All states except ND, OH. WA. WY and Statels) Designatcd in hcm 3.A D. This policy includes these endonemcnts and schedulcs: See Extension of Information Page -1. Thc premium for this;xrlicy will bc dctcrmincd by our Manuals of Rulcs. Classifications. Rates and Rating Plans. All infbrmation rcquired helow is suhjcct to vcrification and chaogc by audit. See Extension of Inlbrmation Pagc TOTAL ESTIMATED ANNUAL PREMIUM STATE ASSESSMENT TOTAL ESTIMATED COST Minimum Premium Drposit hemium lssue Datc: 7l12025 Countersigncd by zcd Rcprcscntativc 22js &7 2322 396 ', 1)) LI a N I ffi I p Details Business lnformation Applicanl Name- Representative Establishment Name' AMBASSADOR INN AND SUITES Mailing Address - City, State, ZIP- Establishment Email Address' info@ambassadorcapecod.com Manager's Name* PETER PATEL Manager's Mailing Address - Street, City, State, ZIP 1314 ROUTE # 28, SOUTH YARMOUTH, MA 02664 Tax lD (FEIN or SSN) FEIN or SS #- FEIN Legal Business Name* GAYATRI KRUPA CORP Mailing Address . Street' Establishment Phone Number' 508 394 4000 Ov/ner's Name' GUNAVANTRAI S. PATEL Manager's Phone #* 508 394 4000 FEIN - ..-*-0066 Type of Facility Please select ALL that apply lndoor Pool* Yes Outdoor Pool* Yes Outdoor Hot Tub. NA lndoor Wading* NA 0utdoor Wading- NA lndoor Pool* Outdoor Pool* lndoor Hot Tub' Outdoor Hot Tub* lndoor Wading* Outdoor Wading' lndoor Hot Tub- Yes # of Pools Pool lnformation Type of Pool* Special Purpose How many Lifeguards?* 0 Length of Pool 33 Pool Capacity (Volume in Gallon) 32600 # of Pools Do you have Lifeguards?* No Source of Water Private Width of Pool 22 Type of Finishes Concrete Sampling Frequency - Must be min 4x times daily* 4 times daily Method of Water Treatment Chlorine Certified Pool 0perator #1* Piyush Patel Certificate Number #1' c-o74687 Water Filtration System Sand Filter Certified Pool operator f2 Rupal Patel Certificate Number #2 02-154501 Hours of 0peralion 9 am to 10 pm for lndoor Pool Certified Pool Operator lnformation ln the State of Massachusetts, it is required to have a certified pool operator for all public and semi-public swimming pools. Section 435. l7: Pool Supervision states: All public and semi-public swimming pools when open for use shall be under the management of a supervisor, who shall be responsible for all phases of the pool operation. The pool supervisor may be the property owner, a facility employee or an employee ofa contracted pool service. The pool supervisor shall be available to respond to mechanical and maintenance problems, and to detect the potential ofsuch problems before they occur. It is not required that the pool supervisor be on the premises at all times. The pool supervisor shall be: (a) at least 21 years of age (b) knowledgeable of 105 CMR 435.00, and (c) responsible for all phases ofthe operation. Expiration Date of Certificate #1 03t31t2029 Expiration Date of Certificate #2 Each Pool Operator Must List Minimum of Two Employees Who are Certified in Standard First Aid and CPR. Telephone #1 508-394-4000 Certified CPR #1- Piyush Patel EmailAddress #'l info@ambassadorcapecod.com Certified CPR #2 Pinal Patel Certified CPR #3 Dave Dumas Certified CPR lt4 Kerryann Simms Pool Opening/Closing POOL OPENING: All swimming, wading and whirlpools which have been closed for the season must be inspected by the Health Department prior to opening. Contact the Health Department to schedule the inspection three (3) days prior to opening. PLEASE NOTE: People are NOT allowed to sit in the pool area until the pool has been inspected and opened. POOL WATER TESTING: The water must be tested for pseudomonas, total coliform and standard plate count by a State certified lab and submitted to the Health Department three (3) days prior to opening, and quarterly thereafter. POOL CLOSING: Every outdoor in ground swimming pool must be drained or covered within seven (7) days of closing Acknowledgment I have read and understand the Board of Health regulations as they pertain to pools.* Peter Patel Nov 1, 2025 Restrictions: Indoor Pool Whirl Pool Outdoor Pool Ghemical Standards PERMIT EXPIRATION DATE 12t31t2026 Details lnternal Only License Restrictions/Conditions Continental Breakfast Only Expiration Date* 1213112026 Business lnformation Business Name* Ambassador lnn and Suites Business Mailing Address (if different) Business E-Mail* lnfo@ambassadorcapecod.com Business Legal Entity Corporation Business Address in Yarmouth * 1314 Route 28, South Yarmouth, M402664 Business Phone #* 508-394-4000 Business Type* Retail Service Corporation Name (if applicable) Gayatri Krupa Corp. Tax l0 (FEIN or SSN)* FEIN ls this a NAME CHANGE? No Owner / Manager lnformation Owner's Name- Gayatri Krupa Corp. Manager/Contact Person Name' Peter Patel FEIN *-...0066 Owner's Phone Number 508-394-4000 Manager / Contact Person Phone Numbe/ 508-3944000 PLEASE LIST STAFF MEMBERS WHO HOLD THE FOLLOWING CERTIFICATIONS AND ATTACH COPIES OF CERTIFICATIONS Name of Certified Food Protection Manage(S) All food service establishments are required to have at least one (1) PERSON lN CHARGE on site during hours of operation Telephone Number 508-394-4000 Emergency Telephone Number 774-251-0451 Please attach copies of certifications for all listed below; List all Certified Food Proteclion Managers' Joy Allen Lisl all employees with Allergen Certification* Joy Allen Establishment Operations Length of Permit Annual Address 1314 Route # 28 Email info@ambassadorcapecod.com Location is Permanent Structure? Yes Name and Title Piyush Patel Establishment Type I I I t I I I I Continental Breakfast Common Victualler Non.Prorit Wholesale Residential Kitchen for Retail Sale Food Service Frozen Dessert Retail Service I Vending Food Other I Name Change Only Affidavit New construction, remodel or conversion requires an Occupancy Permit from the Building Department in order to receive a valid Food Permit. I l, the undersigned, attest to the accuracy of the infomation provided in this applicalion and laffirm thal the food establishment operation will comply with 105 CMR 590.000 and all other applicable law. I have been instructed by the Board of Health on how to obtain copies of '105 CMR 590.000 and the Federal Food Code. Pursuant to MGL Ch. 62C, Sec. 49A, I certify under the penalties of periury that l, to the best of my knowledqe and belief, have filed allstate lax returns and paid taxes required under law.* Piyush Patel Jan 9, 2026 Worker's Compensation lnsurance Affidavit Type of Business' I am an employer with employees * Submitted by Staff I Business Other Other Business Hotel Motel I do hereby certify, under the pains and penalties of perjury, that the informalion provided above is true and correct.t Piyush Patel Jan 9, 2026 lnsurance Policy lnformation Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of lnvestigations of the DIA for insurance coverage verification. lnsurance Company Name Technology lnsurance Company Policy # or Self-ins Lic. # TWC4395642 lnsurer's Address 410 University Avenue Expiration Date 03t0912026 Food / Retail Service SEASONAL FOOD SERVICE OPENING: All food service establishments must be inspected by the Health Department prior to opening. Please contact the Health Department to schedule the inspection three (3) days prior to opening. CATERING POLICY: Anyone who caters within the Town of Yarmouth must notify the Yarmouth Health Department by filing the required Temporary Food Service Application form seventy-two (72) hours prior to the catered event. These forms can be obtained at the Health Department, or from the Town's website at www.yarmouth.ma.us under Health Department, Downloadable Forms. FROZEN DESSERTS: Frozen desserts must be tested by a State certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Department. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms have been met. OUTSIDE CAFES: Outside cafes (i.e., outdoor seating with server service), must have prior approval from the Board of Health. OUTDOOR COOKING: Outdoor cooking, preparation, or display of any food product by a retail or food service establishment is prohibited. I acknowledge that I have read and understand the information above.' Notice PERMITS RUN ANNUALLY FROM JANUARY 1 TO DECEMBER 3,1. IT IS YOUR RESPONSIBILIry TO COMPLETE THIS APPLICATION EACH YEAR. ALL RENOVATTONS TO ANy FOOD ESTABLTSHMENT (pAtNTtNG, NEW EQUtPMENT, ETC.) MUST BE REPORTED TO AND APPROVED BY THE BOARD OF HEALTH PRIOR TO COMMENCEMENT. RENOVATIONS MAY REQUIRE MA ENGINEER SITE PLAN. I acknowledge that I have read and understand the Notice informalion above. tr NP 19332244 Tedtnology lnsuence Company, lnc. A S-tod( ln*ranco Co.npdty WORKERS COMPENSATION ANO EMPLOYERS LIABILITY INSURANCE POLICY wc 99 00 01 B 1of 5 INFORMATION PAGE Ncci Code: 3907 I lnsured: Cayatri Krupa Corporation DBA: Ambassador Inn & Suitcs l3l4 Roure 28 South Yarmouth. MA 02664 Other workplaces not shown above: None Producer: The Baldwin Group Southeast LLC 410 University Ave Westwood. MA 0209G231 I PolicvNumber: TWC4572735 _Pannership_lndividual X Corporation Federal Tax lD Risk Id: Renewal of: 200550066 TWC4395642 ?. Thc policy period is from.l/9/2025 tct 31912026 l2:01 a.m. at thc insured's mailing address .l A. Workers Compensation Insurance: Pan One of the policy applies to the Workcrs Compensation Law of the states listed here: Massachusetts B. Employers Liability Insurancc: Pan Two of thc policy applies to work in cach statc listed in item 3.A. The limits of our liability under Pan Two are: State Bodily lnjury by Accident Bodily tnjury by Diseasc Bodily Injury by Diseasc $500.000 each accident $500.000 policy limit 5500'000 each employee Other States Insurance; Pan Three of the policy applies to the states. if any. lisled here: All states except ND, OH, WA. WY and State(s) Designated in ltem 3.A This policy includes these endorsements and schedules: See Extension ol lnformation Page C D -1 The premium for this policy will be dctermined by our Manuals of Rules. Cla.ssiftcations. Rates and Ra(in8 Plana. All information required below is subjcct to vcritication and changc by audit. See Extension of Information Page TOTAL ESTIMATED ANNUAL PREMIUM STATE ASSESSMENT TOTAL ESTIMATED COST Minimum Premium Dcposit Premium Issuc Date: Zll2025 Countersigncd by 22t5 a7 .t96 2.]]2 tl Rcprcscntative a fl a ffi p CERTTFICATE oF ATLERGEN AwIRENE S S TnruN ING Name of Recipiglls rcv ater.l Certifi cate Nurnber. 527260e Date of Completion: e/2s2021 Date of ExPira(rort st2et2o26 Issucd By:/fint / ri-{L-dn,I 1r:1-.1i,'.1, NATIONAL r RESTAURANT ASSOCtATIONo 800.765 .2122 rr/ww.rc6taufent.otg Massachuectts Rcstaurant Association 333 Tiunpikc Road, Suitc 102 Southborough, MA 01772 508-303-9905 xrvw.mirncStauiantaSmc.orS Efi#E'+iErr.r-' ffiffi lhe abooe-naned person is bereby issued tbis certifcate for comphting an allergcn auarmest ttaining program recogniztd by tlte Massacb setts De?a/firurrt of Public Heahh in accordance with 705 CMR 590.009(C)(3)(a). This certifcate usill be validforfve (5) yea$front date ofcom?hrtln. ServSafe National Restaurant Association Servsqfe' CERTIFICATION JOY ALLEN for successfully completing fie stondords set fortfi for the ServSqEo Food ProeAion Monoger Certificolion Exominotion, which is occredited by the Americon Notionol Stondords lnstitute (ANSllConGrence for Food Protection (CFPI. ER 10752 EXAM FORM NUMBER 12t11t202 12t11t2026 DAT E OF EXPIRATION lor recer ficotion r€quir€menh. DAT E OF EX Locol lows opply. Ch she iotion Solulions d':'.t \z/ acciE0trE0 P[00iAM ArDrlcrn iLddEl SLndad. rh.dbr. and fi. Cdll.|tG tq F@d ?6i*tid #0655 S. SoL hgo @ to&ho.lc ol *! NRAtt tlolioid Rabuor Aruiaio@ ond fu r &ign Ccibd u wii q@tid or 233 S W*1, D'i!, Soite 36m, di6go, tL 6OaO6{383 q S..6ofrOebrot.d! Ed€E Hffi (/ E {ATIO h yoUI locol reguloi,or) IA rdrid A.Dil N 068-201 3 lp!€ddi ddi6lNeAtr). AI is[E B$.d. IEx6t Arkiiion Edelhol ftlllidEl Rchtul Aciiid rthrrrcdoccdoolrtd. l,hq,CaE t 2006.