Loading...
HomeMy WebLinkAboutApps-Certs-DocsDetaiis lnternal Only License Restrictions/Conditions Seating: 44 in Breakfast Room 30 Green House Expiration Date' 12t3112026 Business lnformation Business Name* All Seasons Resort Business Mailing Address (if different) Business E-Mail. info@allseasons.com Business Legal Entity Corporation Business Address in Yarmouth * 1199 Route 28 Business Phone #- 508-394-7600 Business Type* Food Service Corporation Name (if applicable) All Seasons Hospitality lnc. Tax lD (FEIN or SSN)- FEIN ls this a NAiIE CHANGE? No Owner / Manager lnformation Owner's Name* Rupal Patel Manager/Contact Person Name' D Patel FEIN **-***2997 Owner's Phone Number 508-394-7600 Manager / Contact Person Phone Number* 843461-5593 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 Name and Title Jagruti Patel Telephone Number 508-394-7600 Emergency Telephone Number 774-268-1654 Please attach copies of certifications for all listed below: List all Certified Food Protection Managers* Jagruti Patel List all employees with Allergen Certification' Jagruti Patel Establishment Operations Length of Permit Annual Address 1199 Route 28 Email allseasonsresort@gmail.com Location is Permanent Structure? Yes Establishment Type I I I I r I I I I Continental Breakfast Common Victualler Non-Profit Wholesale Residential Kitchen for Retail Sale Food Service Frozen Dessert Retail Service Vending Food Other I Name Change Only I Affidavit New construction, remodel or conversion requires an Occupancy Permit from the Building Department in order to receive a valid Food Permit. l, the undersigned, attest to the accuracy of the information provided in this application and I affirm that 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 CltlR 590.000 and the Federal Food Code. Pursuant to MGL Ch. 62C, Sec. 49A, I certify under the penalties of perjury that l, to the best of my knowledge and belief, have filed all state tax returns and paid taxes required under law.' Rupal Patel Ocl27 , 2025 Worker's Compensation lnsurance Affidavit Type of Business' I am an employer with employees * Submitted by Staff I Business Other Other Business Motel I do hereby certify, under the pains and penalties of perjury, that lhe information provided above is true and coffect.* Rupal Patel Oct 27 , 2025 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 Hartford undenrvriters ins co Policy # or Self-ins Lic. # 6S60UBl K20561A lnsurer's Address P O box 5600,Hartford CT 06102 Expiralion Date 03t22t2026 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 RESPONSIBILITY 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 information above* Certificote of Ach ievement This certilicote is oworded to JAGRUTI PATEL ,065tAtll t2659 Nolionol Restouronl Associolion ?33 S Wocker Drive Suile 3600 Ch ccoo I 6060tr383 eOO:"OS :'zf ^ Chrcogo oreo 312 7'5 lO'L Reslouronl org I ServSo{e.com Congrolulotions! You hove completed ServSofe" Food Hondler Employee Food Sofety Online Course ond Exom cerriftco1. Number 6033967 12t3t2022 ExDirorion Doie 121312025 rpoiEIrEAflst ,^. ServSafe - ATTTRCEN AWE.NENESS TnTNING Namc of ReciPienc JoY ALtrN Certificate Number' s2726d) f)ate of ComPletion' E2sr2o21 Date of ExPintion' el2s/?026 EfiffiEtrfiq6.: ffiH Isorcd Bv, lbe ubooe-tt'nn'l prnot k furetl kstnl this cert{irate for omplctingn hrgctt nwtttcncts lraitti,tg proS'l".n . - *!"""ioi i ,fi u^*ritrserts Delnrtnutt oJ hfilic Hcolth" --"'ii ii,oi,,torn, *ith I 0s cMR 500.009(c )( 7 )(a ). 'lltis rctrlfuuwill he wlitl.l'or.t'iw (5) ltorsfron thtt of ronplction /,-mRfl NATIOI{AT . RESTAIJ R/tNT ASSOCTATTON. 800.765.2122Merrachuscto llt*auant A*ociatiou 333Tunpilc Rord, Suitc 102 $uthbon,ugh, MA o1772 508-303-9905 www.miuE taurrn tasaoc, or8 CERTIFICATE OF I o.5t'12J2025 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTET{D OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURAiICE DOES OT COIISTTTUTE A CONTFIACT BETWEEN THE |SSU|NG TNSURER(S), AUTHOR|ZEOREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. subjoct to lhe t.rms and conditions of the policy, ce.lain pollci.s msy requir. an .ndor..m.nt- a .t!r€m.nt on THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIvIATION holder ls an AOOTTIONAL INSUREO, tho pollcy(les) must v6 ADDITIONAL INSURED provision3 or be endorsed to th€ c.rlificat. holder ln rieu of such endors€msn IMPORTANT: It tha cortifical. I' SUBROGATION IS WAIVED, this certificate doe3 not confer Devaralulu Reddy (508) 824-8666 30104HARTFORD UNDERWRITERS INS CO Inist,iEo ALL SEASONS HOSPITALITY INC MA 02664 r i99 RTE 28 SOUTH YARMOUTH ACORi} 128 OEAN ST IAUNTON CERTIFICATE OF LIABILITY INSURANCE MA 02780 OOVERAGES CERTIFICATE NUMBER: 1 1 169:14 REVISION NUMBER: THIS 1S TO CERTIFY THAT THE POLIC!ES OF 1NSURANCE rt.SreO aeLOw x,Ave gfeN ISS!EO TO TF]E INSUREO NAMEO AEOVE FOR fHE POLTCY PERIOO INDICATEO NOTW'THSTANDINGANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OB OTIiER DOCUMENT l/l/ITH RESPEC- TO WHICH THiS CERTIFICATE MAY AE ISSUED OR MAY PERTAIN, THE INSURANCE AFFOROEO 8Y TtE POLICIES DESCRIBEO !!ERE]N IS SUEUECI :O AlL 'IHE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMI'TS SHOWN MAY IIAVE BEEN REOIJCCD BY PAID CLAIMS oE3CRrPTlOr{ OF OPEiAITOXS / LOCAiONS / VEHICLES (ACORD 1q!..AddrtioNl;m.rr. s.h.dur., dv b. !n ch.d ir 60r. 6p... '' t'qui6dl CERTIFICATE HOLDER CANCELLATION WorkeB,comp€nsationbenefitswillbepaidtoMassachusett!employcesonly,PursuanttoEndoEcmentwc2003osB.noaumorlzationisgivenlo pay ctaims tor benerrts to emproyees rn srJlJiffi;i;il;;h;;;'C;tirCinsured hires. or has hired those emplovees outside cf Massachusetts' Thrs ceatificste of insu?nce shows tFe pollcy n force on the dale that lhls '€rtficate was rssued {unless lhe explration date on the above pollcy orecedes rhe ,ssue oare ot tt,s cenincate oilniuili-..] 'ii"-I[ii" iiii'i" iou".ag. ".n u" n'on ored darlv by accessrng tne Ploof ol coverage - 6"-r;r;V;#;id;-s;rctrioot at www mass.gov/lwdi^/o*ers-compensaliodtnvestigatons/ SHOULD ANY OE THE AAOVE DESCRIBED POLICIES 8E CAXCELIEO BEFORE irr exptulott oarE TtiEREoF, NollcE wLL BE DELwEREo lN ACCOROAXCE WTTH TIIE POL'CY PROVISIONS' o 1988-2015 ACORO CORPORATI iC.)MMERCIAL GENERA! UABIL'TY eoclsAGGRE6ATE LIMIT AFPLIES PERl--L rEcr ----.1 L* !!" ,,o*o. [** P'RSO:{AL 6 ADV INJTJRY GENER'.]. AGGREGA-E N/A L BOOIIY NJUIY (P': F,o) - ] SCHEOULE]I AUTOS tt s 500.000 o3t22l2025 A3|2A2C266560UB',K20561A25 eurove, s 500.000 rrrn L g 500.000 WORKERSCOM'ENSANOT ANO EMPLOYERS' LIABIiITY iayrRorR€ToF/pARTNEtuExEcLlrrveIoFFlcERn EvBEiExcLUoEo' DinieiM. c.o;;y. cPcu. vLce President - R$idual Ma*et - vlrcRlBMA AU'HOR:ZEO IIEPRESEMTA'IY6 All Seasons Hospitalitv Inc. MA 02664 1199 Route 28 South Yarmouh ACORD 2s (2016/03)Th. AcoRD name and logo ar€ r.gi3ter€d marks gf ACORD ON. Allrighta reserved rl s BoorLY lluriY (Pr..d...t) I s s N/A I I I I Details Lodging/Motel Information Eslablishment Name' Allseasons hospitality inc. Tax lD # FEIN Establishment Street Address* 1199 route 28 Owner's Name* Allseasons hospitality lnc. Owner's Street Address 1'199 route 28 Check if Mailing Address is different EmailAddress* info@allseasons.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 #. 508-394-7600 FEIN- ** _r.,.*2897 Establishment City, State, ZIP- 02664 Owner's Phone #* 508-394-7600 Owner's Adress City, State, Zlp 02664 tr Corporation Name Manager's Phone # 508-280-3733 Lodging Type lnn Cabin Motel DOCUMENT Expiration Date* 12t3112026 Conditions Rooms: 144 I I I I Manager's Name* Rupal Patel B&B Lodge Trailer Park tr ft For purposes of the limitations of Motel or Hotel use, Transient occupancy shall be limited to the temporary and short-term 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 lo renewal or the issuance of your licenses.* I Rupal Patel Dec 8, 2025 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 resorts.' c cPo cEtrrtEo Pool tor as an Operato. of Aquatic Facilities issued by the Pool & HotTubAllionce on CertificationDate: 3/'1l2024 ExpirBtion Oate: 3131 12029 Certifi cation Numbet: C-O7 4687 lo3tructor Namc(3) Brian Stewart Sabeena Hickman. CAE President & CEo Pool & Hot Tub AllioncePOOL6, HOT TUB LLIANCE Fo. vlriffcotirn td€plb.E pHTA et 79- 54o'9ll9 ol errxii lcrvie GPhts-oe Certified Pool & Spo Operotor Certificotion Piyush Patel o cPo cEt!ttlED Dool Certified Pool & Spo,Operotor Certificotion for It/iguel Wright as an Opcrator of Aquatlc F.rcilitres issucd by thc Pool & Hot Tub Allionce on Certifi catron Date: October 1 2, 2022 Expiration Date:October 3'1, 2027 Certifi cation Number: C{O8509 lnstructor Name(3) Robert Freligh Sabeena Hickman, CAE President I CEO Pool S Hot lub AllioncePOOL & HOT TUB LLIANCE to, verification. telcptpn€ PHTA st 79-54o 9'll9 or cfluil rrvice qpht!.o,8 &Hlu$lid- '.nsc SECURITY CONTROL NO, r75180c9D54D20 National SafetY Council Certificcrtion Cord Tiffony Mois hos successfutly compteted the cognitive ond skitts evotuotlons for the fotlowing: First Ai4 Adutt, Child ond lnfont CPR & AED 4.00 hrs COMPLETION DATE lt/2212024 INSTRUCTOR Richord Todd (#1040918) EXPIRATION DATE TRAINING CENTER 11/sO/2026 Cope Cod Sofety Troining TRAINING CENTER ID 2071554 fhis course is eguivalent to AHA o,nd meets ECC ond ,[COR guldelines' This credentiqI con be verified ot nsc.orglFAverify