HomeMy WebLinkAboutLicense TOWN OF YARMOUTH
BOARD OF HEALTH
PERMIT TO OPERATE A FOOD ESTABLISHMENT
PERMIT NUMBER: #12-077 FEE: 85.00
In accordance with regulatlons promulgated mder authority of Chapter 94,SecHon 305A and Chapter
11 l, Section 5 of the General Laws,a permit is hereby ganted to:
KC Pizza Inc., 23T White's Path, South Yazmouth MA
Whose place of business is: Domino's Pizza
Type of business: Food Service
To operate a food establishment in: Town of Yazmouth
Permit expires: December 31. 2012 BOARD oF HEALTH: �[lait,�llagiataHrS�`mit�, C'.�Ai�YlntuL
SEATMG: O J �Q(I�/[CQl!(.t� �IlCC ��,�Yl�Xf1lQIL
aEsnucr�oNs: 1.No fryers. 2.No dishwasher machine. ��u��oe�, rK.�., �
3. No clothes washer machine. 4. No seats-take out only. F[te�ifa fP. ,�fqufee
5. No stove-pizza oven only. 6. Single service/paper items only. ./Kaau��i[pi9,
7. Separate water meter, for this unit 23T required.
8. All pizza ingre dients are to be obtained as precooked.
9. Maximum daily water usa�e not to exceed 263 gpd;
A monthly log�s to be mamtained with a yearly report
submitted to the Health Department with pertnit apphcation. Bruce G. Mwphy,MP R.S., H
December 2.2011
Director of Health