HomeMy WebLinkAbout2012 Jun - Cape Cod Antique Show - Temp Food LicenseM
June 1, 2012
Attn: Phil
Yarmouth Board of Health
Dear Phil:
Riverway Lobster House
1338 Route 28
South Yarmouth, MA 02664
508-398-2172
Please find below the process for providing lobster at the Cape Cod Antique Show on June 2,
2012.
If you should have any further questions please do not hesitate to call my cell
508-789-3226.
1. Lobster stored in tank at Riverway
2. Transferred to cooler.
3. Transported in cooler in refrigerated vehicle 24 at a time.
4. Brought to location— stored on site in cooler in refrigerated vehicle
5. Cooked as needed in boiling water on 1 of 4 portable burners. N i> +o -4,—kcz&J ►
6. Burner is not under tent. o' e- P. &r Ghee T%
7. Served with melted butter.
8. Disposable utensils provided.
9. Tent w/tables and chairs provided.
Verbal approval by Inspector Sawyer of Yarmouth Fire Department.
Sincerely,
b"L
Jason D. Siscoe
°F r4R TOWN OF YARMOUTH Board of
. _ .. Health
= 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS =� _ 66�F
E;E Hea th
Telephone (508) 398-2231, ext. 1241
Fax (508) 760-3472 MAY 0 1 2012T�'vi, �n
TEMPORARY FOOD SERVICE APPLICATION
FEE: $15.00' per even
Nanie of Event: 0 4i11 Date of Event: f',"J'\1 n
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ck
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Location of Event: ( /� al, ca _ � ,-- ��� k \jt :5— L;
Name of Business:.
Business Address:
Mailing Address: A ti�
Contact Person:
Is business under a non-profit organization? Yes
If yes, name of organization:
List all foodstobe served:
Contact Phone Number: —
No
Supplier:
*NOTE: 1. All foods must be labeled with ingredients.
2. Individual food items must be wrapped and labeled.
3. Outside display of items must be under a tent.
Ice obtained from:
Procedure for keeping potentiq
l
dous food below, 41 F o above 140E F:
c SecA C
c
J
Describe hand washing facilities/ 'rocedur s d me ods or was . ' g and unitizing cooking utensils:
Signature of Applicant: Date:
NOTE: The Yarmouth Board of Um���st be notified 72 hours prior to service of catered event.
Caterers located outside of the Town of Yarmouth must also submit a copy of their current local food service permit,
last inspection report, and ServSafe food' certification.
All applicable items must be completed in order for your application to be processed.
ovmni
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THE COMMONWEALTH OF MASSACHUSETTS
TOWN OF YARMOUTH
BOARD OF HEALTH
PERMIT NUMBER: #12-004
This is to Certify that Riverway LobsterHouse
IS HEREBY GRANTED A LICENSE
FEE: Waived
For NAME OF EVENT: Cape Cod Antiques
DATE OF EVENT: June 2, 2012
LOCATION• L. MacArthur School Field Route 28 South Yarmouth, MA
FOOD SERVED: Soft drinks chowder, sausage burgers, chips, candy, sandwiches.
This permit is granted in conformity with Article VI of the Sanitary Code of The Commonwealth of Massachusetts, and
expires June 3, 2012 unless sooner suspended or revoked.
May 7, 2012 BOARD OF HEALTH: J u� l�wgn a dl C'Pw&nt zrt
X d &id JB it.D., `Dice eha wma
&w4a
Director of