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HomeMy WebLinkAboutBCOI-24-6 2027 fc Y� TOWN OF YARMOUTH ,/,� ti 0 Office of the Building Commissiotep E C E I V E D i „ 1 511 1146 Route 28, South Yarmouth, MA D2 '0 `, 1,:fc1 508-398-2231 ext. 1260 Fax 508-398-08 (DEC 9 2025 . COft ,a f BUILDING DEPA TM NT �" APPLICATION FOR CERTIFICATE OF INSPECTION By: December 01, 2026 PAYABLE UPON RECEIPT ( X) Fee Required$100.00 ( ) 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: 290 Summer Street Name of Premises: IFAW Tel: 508 744 2115 Purpose for which permit is used:_ Assembly License(s) or Permit(s) required for the premises by other governmental agencies: License or Permit Agency Certificate to be issued to IFAW Tel: 508 744 2115 — Sz 74-Aj Address: 290 Summer Street Owner of Record of Building IFAW Address 290 Summer Street Present Holder of Certificate IFAW AsejOb.iftr"r IT/FAC Coordinator Signature of person to whom Title Certificate is issued or his agent 0 Dec 2025 Date Email Address: itfacinvoices@ifaw.org 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-24-6_ 01/31/2026-01/31/2027 �' Y9 TOWN OF YARMOUTH o\ Office of the Building Commissioner 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260 Fax 508-3980836 December 01,2026 IFAW 290 Summer St Yarmouth Port,MA 02675 Re: Inspection Date—01/31/2026—01/31/2027 Fee$100.00 Pursuant to the provisions of the Massachusetts State Building Code 780 CMR,Section 110.7 and Table 110,you are required to apply for a Certificate of Inspection for the building located at 290 Summer St,Yarmouth Port, MA 02675 DBS IFAW. 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. IMPORTANT:One(1)re-inspection to confirm the abatement of any violations listed during the initial inspection will be included in the initial fee if the abatement is completed during the time period(typically 10 days)listed on the Inspection Report. Additional re-inspections will cost$80 each,which is payable in advance of the re- inspections. 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 total occupancy. 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. Note:After receiving your application,a minimum of 3 weeks' notice is required for an inspection. Finally,applications and fees must be received within ten(10)days of receipt of this letter. Failure to comply may jeopardize your license where applicable,and/or the occupancy of the building per 780 CMR section 110.7 periodic inspections. Very truly yours '(4' - Mark A. Building Commissio er �....41 INTEFUN-02 PSZATHMARY ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `.� 12/9/2025 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 REPRESENTATIVIE 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 License # 1780862 CONTACT HUB International New England , PHONE (978) 657-5100 FAx 978 988-0038 300 Ballardvale Street E-MAIL No, Ezt): (NC, Nol:( ) Wilmington, MA 018137 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A :Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B :Federal Insurance Company 20281 International Fund for Animal Welfare Inc. INSURER C : 290 Summer Street INSURER D : Yarmouth Port, MA 02675-1734 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-1 ADDL SUBR1 POLICY EFF POLICY EXP LTR II TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MMIDD/YYYY) LIMITS A i X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PHPK2570776 6/30/2025 6/30/2026 DAMAGE TO RENTED 100,000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE _IMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ CMBINED A AUTOMOBILE LIABILITY (Ea accident)INGLE LIMIT $ 1,000,000 X ANY AUTO PHPK2570772 6/30/2025 6/30/2026 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED Per PROPERTY DAMAGE) $ . AUTOS ONLY AUTOS ONLY $ B X UMBRELLA LIAI3 X OCCUR EACH OCCURRENCE $ 15,000,000 ' EXCESS LIAB CLAIMS-MADE 79869955 6/30/2025 6/30/2026 AGGREGATE $ 15,000,000 1 DED X RETENTION$ 0 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 71834621 6/30/2025 6/30/2026 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N!A E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $ ' 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule, may be attached if more space is required) Workers Compensation policy above covers the following states: CA CO CT DC FL GA IA IL ME MI NH NJ NV PA TN TX VA VT WV. Massachusetts WC Proof to follow from the carrier if requested. ETET1 DEC 19 2025 CERTIFICATE HOLDER BUI-LDING DEPARTMENT CANCELLATION By: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Yarmouth THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1145 Route 28 South Yarmouth, MA 02664 AUTHORIZED REPRESENTATIVE 4440/A9-4400al. ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD