HomeMy WebLinkAboutLicenses TOWN OF YARMOVTH
BOARD OF HEALTH
PERMIT TO OPERATE A FOOD ESTABLISHMENT
PERMITNUMBER: #11-l87 FEE: 585.00
In accordance with regularions promul�ated under authoriry of Chapter 94,Secrion 305A and Chapter I 11,
Secrion 5 of the General Laws,a pecmrt u hereby ganred to:
KC Piva Inc. 23T White's Path South Yarmouth MA
Whose place of business is: Domino's Pizza
Type of business: Food Service
To operate a food establishment in: Town of Yarmouth
Pernrit expires: December 31. 2011 BOARD oF HEatTH: 58�riart��itetan.SenAi�fll, Cqh�a�wrntaet
SEAIING: O J QItl6Q. ��� t/�CE l.R(lIA'/Nq/!.
�snercnoxs:l. No fryers. 2.IVo dishwasher machine. �fi�Qp+�td.rQpe�, ,M,�,, �,(.e�
3. No clothes washer machine. 4.No seats-take out only. t��. ,`�fay�¢o
5. No stove-pizza ovea only. 6. Single service/paper items only. `U1' C. Snotuc�¢a III
�. Separate water meter,for this unit 23T required.
8. All pizza ingredients are to be obtained as pmooked.
9. Maximum daily water usage not to exceed 263 gpd; � I� d ��
A monthly log is to be maintained with a yearly report
submitted ro the Health Departrnent with permit application.