HomeMy WebLinkAboutApps-CertsDetails
Lodging/Motel lnformation
Establishment Name*
The Mariner Resort
Tax lD #
FEIN
Establishment Skeet Address'
573 route 28
Owner's Name*
Gunvantrai Patel
I
Check if Mailing Address is different Email Address*
info@marinercapecod.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 #'
508-771-7887
FEIN-
-.-.*5766
Establishment City, State, ZIP-
West Yarmouth,MA 02673
Owner's Phone #*
508-771-7887
Owner's Street Address Owner's Adress City, State, ZIP
-l
Corporation Name
Maa Gayatri Mariner LLC
Manage/s Phone ff
508-771-7887
Manager's Name*
Dennis Patel
B&B
Lodge
Trailer Park
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Lodging Type
lnn
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Cabin
Motel
DoCUMENT Expiration Dale'
12t31t2026
Conditions
100 One bedroom Units
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.'
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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,'
Dennis
Patel
Ocl22,
2025
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.
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Certiffed Fool / Spa Operatoro
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as an Operator of Aquatic Eacilities
CPo€ Registration No. 02-/095,95 ,is hereby Certified and Reglistercd
by the
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Details
Business lnformation
Applieant Name*
Owner
Establishment Name*
The Mariner Resort Cape Cod
Mailing Address. City, State, ZIP-
Establishment Email Address-
info@marinercapecod.com
Manager's Name'
Dennis Patel
Manager's Mailing Address - Street, City, State, ZIP
Tax lD (FEIN or SSN)
FEIN or SS #-
FEIN
Legal Business Name'
Maa gayatri Mariner LLC
Mailing Address - Street'
Establishment Phone Number*
508-774-7887
Owner's Name.
U nknown
ilanager's Phone #.
508-771-7887
FEIN -
..--..5766
Type of Facility
Please select ALL that apply
lndoor PooF
Yes
Outdoor Pool*
Yes
lndoor Hot Tub*
Yes
Outdoor Hot Tub*
No
lndoor Wading-
No
0utdoor Wading*
No
lndoor Pool'
Outdoor Pool*
1
1
1
lndoor Hol Tub'
Outdoor Hot Tub*
0
lndoor Wading*
0
0utdoor Wading*
0
2
Pool lnformation
Type of Pool*
Public
How many Lifeguards?*
0
Length of Pool
# of Pools
Do you have Lifeguards?*
No
Source of Water
Public
Width of Pool
Type of Finishes
Gunite
Pool Capacity (Volume in Gallon)
2
# of Pools
Sampling Frequency - Must be min 4x times daily*
4 time daily
Method of Water Treatment
Chlorine
Water Filtration System
Sand Filter
Hours of Operation
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 435.17: 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 ofthe 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 2l years ofage
(b) knowledgeable of 105 CMR 435.00, and
(c) responsible for all phases of the operation.
Certified Pool Operator #1t
Gunvant Patel
Certified Pool Operator #2
Certificale Number #1*
cPo-525525
Certificate Number #2
Telephone #1 EmailAddress #1
Expiration Date of Certificate #'l Expiration Date of Certificate #2
Each Pool Operator Must List Minimum of Two Employees Who are Certified in Standard First Aid and
CPR.
Certified CPR #1*
Dennis Patel
Certified CPR #2
Certified CPR #3 Certified CPR #4
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 pe ain to pools.*
Dennis
Patel
Dec 10,
2025
Restrictions:
Indoor Pool
Whirl Pool
Outdoor Pool
Chemical Standards
PERMIT EXPIRATION DATE
Details
lnternal Only
License Restrictions/Conditions
Continental Breakfast Only
Expiration Date-
12t3112026
Business lnformation
Business Name*
The Mariner Resort Cape Cod
Business Mailing Address (it different)
Business E-Mail*
info@marinercapecod.com
Business Legal Entity
Corporation
Business Address in Yarmouth '
573 Rt 28, West Yarmouth,MA 02673
Business Phone #*
508-771-7887
Business Type*
Food Service
Corporation Name (if applicable)
Maa Gaytri Mariner LLC
Tax lD (FEIN or SSN)-
FEIN
ls this a NAME CHANGE?
No
Owner / Manager lnformation
Owner's Name*
Gunvant Patel
Manager/Contact Person Name'
Dennis Patel
FE IN
---*-5766
Owner's Phone Number
5087717887
Manager / Contact Person Phone Number*
5087717887
PLEASE LIST STAFF MEMBERS WHO HOLD THE FOLLOWING CERTIFICATIONS AND AITACH
COPIES OF CERTIFICATIONS
Name of Certified Food Prolection lttlanage(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 Address
Telephone Number Email
Emergency Telephone Number
Please attach copies of certifications for all listed below:
List all Certified Food Protection Managers'
Dennis Patel
List all employees with Allergen Certification*
Den n is
Establishment Operations
Length of Permit
Annual
Establishment Type
Location is Permanent Structure?
Yes
Continental Breakfast Common Victualler
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Non-Profit Wholesale
Residential Kitchen for Retail Sale Food Service
Frozen Dessert Retail Service
Vending Food Other
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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 information
provided in this application and I atfirm that the food
establishment operation will comply with ,l05 CMR 590.000 and
all other applicable law. I have been instructed by the Board of
Health on how to oblain copies of 105 CMR 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.*
Dennis
Patel
Jan 13,
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 lhe pains and penalties of perjury that
the information provided above is true and corect.*
Denn is
Patel
Jan '1 3,
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
Hartford Casualty lnsurance
Policy # or Seltins Lic. #
lnsurer's Address
One Park Place,300 South state Street,Tth
fl oor,Syracuse,NY-1 3202
Expiration Date
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 DECEIVBER 31. IT IS YOUR RESPONSIBILITY
TO COMPLETE THIS APPLICATION EACH YEAR.
ALL RENOVATTONS TO ANY FOOD ESTABLTSHMENT (PAINTING, NEW EQUIPMENT, ETC.) MUST
BE REPORTED TO AND APPROVED BY THE BOARD OF HEALTH PRIOR TO COMMENCEMENI.
RENOVATIONS IUAY REOUIRE MA ENGINEER SITE PLAN.
I acknowledge that I have read and understand the Notice
information above*
I
NOTNCE TO EMPLOYEES
THE COMMONIUEALTH OF MASSACHUSETTS
DEPARTMENT OF INDUSTRIAL ACCIDENTS
IF YOU ARE INJURED ON THE JOB:
c lmmediately notify your employer that you haye been iniured.
Emplove. HRworkers Compensation Conlacl Phone Number
c T€l! the medical provider lhat you have been inlured at work and give the information below:
lnsurarce Carier
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'1a{.r'a Casualty lnsurance Company
Address
One Park Place, 300 South State St, 7th Floor,
Syracuse, NY, 13202
tc61ag$
Phone Number
(800) 327-3636
E-) cyer Address
l.'AA Gzyatri Mariner, LLC 573 ROUTE 28 WEST YARMOUTH MA 0267}4948
It the employer fails to report the injury to the insurer, the omployee may file an Employee's Claim (Form
110 t.
Additonat intormation regarding your righls and oligibility for benefils pursuant the Workers' Compensation
law may be obtained by conlacling lho Oepadmenl of lndustrial Accidenls at 6t7.727.4900 or visiting
www.mass.qov/dia.:
IF MEDICAL TREATMENT IS NEEDED:
lnjured workers may select their own medical provider. Medical treatmenl costs lhat are rsasonable, necessary,
and rclaled to the work injury will be paid by lhe above-named insurer.
ll rned;Lal tacrlity rnfo.mation is provided bslow, lhs abovs-namod insursr has a
prclefied ptovidet atangemenl and lhe insuror has arrangod loa your initial
treatrrrenl at:
l.liedn,al F ael'ly Addres!,
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