HomeMy WebLinkAbout15-023 Cape Cod Kettle Corn . �`���i� RC�C�[�OMGD .
� 2015 Vendor Application JUN '� 5 2015
�Produce, Plants & Non Processed Foods Ontyj
Bass River Farm Market N�TH DEPT.
311 Old Matn Street,8ass River,MA 0266A ��.� �, �`€""' t��� ;
2015 Market Dates: Thursdays,June 11–Sept. 17 9 AM–1:3�M n� ��_.:_ �.y� F.
Saturdays,June 13–Sept. 19 9 AM–1:30 PM
Rain or Shtne ,,:
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Name: � �.p f 1 .�j c. L'1 /� c � -�P �`
Farm/Vendor Name C �J��P C�� �� �T � < �' C���
Farm/Business Address � /V f�c C� � � �9"�''� i �`'�'����1 h, '''��"
, ������ ��
Farm/Business Website:
Telephone (Work) (Home) (Celi) SG�`'���'�Q�/
Email. ���/�` � �I�,��R'/ �C'� / �l��✓l.i r tl/"� /
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Best way to contact you: _ ��►�-�
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Name&contact info for individual manning your space: ��''�
Produce/Product you wiii be selling:
P i i� cY��
Check the foltowfing�at apply and attach copies with appiication:
Product LiabilityJnsurance
ServSafe Certification(if providing samples) ���
G.A.P.Training Certi�icate
Food Ailergy Awareness Training Certificate �
The Market accommodates 18—24 vendors.Spaces will be assigned by the Market Manager.
.../'.
� Fuil Season Fees
7hursdays $200 � Both Days $375 I
� Saturdays $200 '
A 509�b non-refundable deposit is due by April 30,2015. Finai payment is due by May 20,2015.
All full-season vendors are expected to attend weekly. if a seasonal vendor does not show up
at a Market and has not given notice to the Market Manager,that vendor wili receive notice
from the Market Manager that his/her space is forfeited for the remaining season.There are
no refunds.
Educators,Master Gardeners, No charga
N�N PROFIT and Authors and Sustainable Living
fDUCAT10NAl GROkiPS actvocates to share and display
their knowiedge and work.
Must be approved by the Market
Manager
Please Note:
By signing this form the vendor acknowledges that hejshe has read and wiil
compiy with the guidelines for the 2015 Bass River Farm Market which are
availabie on our website. (hard copies can be sent to you upon request)
Applicant's Signature �'�i��'�'�� �-���°�'0�
Date �=�/ �`�
Make your check payable to the Bass River �armers Market
� and
Return with comple#ed applicafiion to
Bass River Farmers Market
P.O. Box 1374
South Yarmouth, MA 02664
Market Manager: Carlene Veara (774) 217-10�7
�
1050 "
ROBERT'M SGHRIB
89 SEANS CIRCLE / /� �q
CENTERVILLE,MA 0263 g IQ"�CJ`�V l�� 53-71b7l2113
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P.O.BOX 10 ORLEANS,MA 02653 g �
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THE COMMONWEALTH OF MASSACHUSETTS
; TOWN OF YARMOUTH
BOARD �F.HEALTH
! ` PERMIT NLTMBER: #15-023 FEE: $50.00 �
;
,
iThis is to Certify that Robert Schriber d/b/a C'ai e Cod Kettle Corn
, 2 Nicole Aveni�e, We�t Yarmol�th, MA
�� IS HEREBY GRANTED A LICENSE
For NAME OF EVENT: B
� ass River Farmers Market
; DATE OF EVENT: Thursday rou h to e�tember 17. 2015=
� LOCATION: 311 Old Main Street. South Yarmouth, MA
� FOOD SERVED: Kettle corn.
This permit is granted in conformity with Article VI of the Sanitary Code of The Commonwealth of Massachusetts,and
expires September 18,2015 unless sooner suspended or revoked.
June 15.2015 BOARD OF HEALTH: J a�u�.a l�au�xzeau�t, �tavunAc�Z
�J`3cr.v�ec�, _.AR.�., `Uice C!Piaucrturxt
'�e>i!�
Fi�e�i�xt✓,
J
ruce G. hy, H, .5., CHO
� Director of Health
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