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BOARD OF HEALTH
PERMIT TO OPERATE A FOOD ESTABLISHMENT
PERMIT NUMBER: #14-186 FEE: $85.00
In accordance with regulations promulgated under authority of Chapter 94,Section 305A and Chapter
111, Section 5 of the General Laws,a permit is hereby granted to:
KC Pizza Inc. 484 Station Avenue, Unit E, South Yazmouth, MA
Whose place of business is: Domind s Pizza
Type of business: Food Service
To operate a food establishment in: Town of Yannouth
Permit expires: December 31, 2014 BOARD OF HEALTH: J aru�a `1)aignnuPt @Rabunan.
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Bruce G. Mu y, MP , ., CHO
Director of Health
October 15 2014
THE COMMONWEALTH OF MASSACHUSETTS
TOWN OF YARMOUTH
PERMIT NUMBER: #14-110 FEE: $60.00
This is to Certify that KC' Pizza Inc d/b/a Domind� Pizza
484 Station Avenue, Unit E, South Yarmouth MA
IS HEREBY GRANTED A
COMMON VICTUALLER'S LICENSE
In said Town of Yarmouth and at that place only and expires December thirty-first 2014 unless
sooner suspended or revoked for violation of the laws of the Commonwealth respecting the
licensing of common victuallers. Tlus license is issued in confornuty with the authority granted
to the licensing authorities by General Laws, Chapter 140, and amendments thereto.
In Testimony Whereof, the undersigned have hereunto �xed their official signatures.
BOARD OF HEALTH: J `l��ai�neauetA,�C'Peabcn►an.
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October 15.2014
Bruce G. Murphy, M , .S., CHO
Director of Health