HomeMy WebLinkAboutBOHF-24-197-TOWN OF YARMOUTH Board of
Health
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 -
Telephone (508) 398-2231, ext. 1241 Health
Fax (508) 760-3472 Division
STATE LICENSE NO. �'1 b 1 2 Sq L PERMIT NO.
VEHICLE REG. NO. i(,8Z FEE: Food 55.
Ice Cream $40.00
APPLICATION FOR LICENSES/PERMITS - 2024
MOBILE FOOD SERVICE VENDOR
SEASONAL
YEAR ROUND TAX ID (FEIN OR SSN) 017 - 7G _G 4 7 7
NAME OF BUSINESS AAk;V02VA_ BUSINESS TEL. NO. 7 71-1 - 024Z- 10%,
BUSINESS ADDRESS 7/ P+ Z $ TOWN Guest Ya ymoui(A
OWNER'S NAME (Vi ° k' HOME TEL. NO. 77�
HOME/LEGAL ADDRESS 1% ll�1 jam// t//yr��N V6 rmar� M A 067 tL q
E-MAIL `yrlVlcl�ic1 dOwV1 T�Ut" K' �V q l O V✓t
IF MORE THAN ONE DRIVER, LIST ADDITIONAL NAMES, ADDRESSES, ETC. BELOW:
(Name) (State License No. (Exp. Date)
�No. trect) (Town)(State) (Zip Code)
PLEASE CHECK TYPE OF PRODUCT(S) TO BE VENDED /
SANDWICHES POTATO CHIPS CANDY, GUM _V WDA
HOT DOGS, HAMBURGERS —POPCORN _ ICE CREAM ✓OTHER
PLEASE LIST YOUR LICENSED FOOD PREPARATION COMMISSARY ESTABLISHMENT,
AND PROVIDE AN OWNER -SIGNED LETTER CERTIFYING YOUR USE OF THIS
FACILITY. n `
UNDER CHAPTER 152, SEC. 25C, SUBSECTION 6, THE TOWN OF YARMOUTH IS NOW
REQUIRED TO HOLD ISSUANCE OR RENEWAL OF ANY LICENSE OR PERMIT TO
OPERATE A BUSINESS IF A PERSON OR COMPANY DOES NOT HAVE A CERTIFICATE
OF WORKER -IS COMPENSATION INSURANCE. THE ATTACHED WORKERS
COMPENSATION INSURANCE AFFIDAVIT MUST BE COMPLETED AND SIGNED.
TOWN OF YARMOUTH TAXES AND LIENS MUST BE PAID PRIOR TO RENEW OR
ISSUANCE OF YOUR PERMITS. PLEASE CHECK APPROPRIATE IF PAID: YES O
TURN OVER TURN OVER TURN OVER TURN OVER
11105/19 PAGE 1 OF 2
PLEASE READ FOLLOWING RULES/REGULATIONS
1. ALL MOBILE VENDOR VEHICLES MUST BE INSPECTED AND LICENSED BY THE
BOARD OF HEALTH, AND EACH DRIVER MUST BE IN POSSESSION OF A VALID
STATE HAWKERS AND PEDDLERS LICENSE PRIOR TO OPERATING WITHIN THE
TOWN OF YARMOUTH.
2. NO MOBILE FOOD VENDORS ARE ALLOWED AT BASS RIVER BEACH (A/K/A
SMUGGLERS BEACH), SEAGULL BEACH, PARKERS RIVER BEACH, OR ON
SEAGULL ROAD, WITHOUT PARKS & RECREATION DEPARTMENT APPROVAL.
3. NO VENDORS SHALL DISPENSE DRINKS IN CANS OR BOTTLES AT ANY TOWN
BEACH OR PARKING LOT.
4. NO TWO VENDORS WILL BE ALLOWED INTO ANY BEACH OR PARKING LOT AT
THE SAME TIME WITHOUT PARKS & RECREATION DEPARTMENT APPROVAL.
5. VENDORS ARE ALLOWED A TWENTY MINUTE STAY IN AN AREA. HOWEVER,
TIME MAY BE EXTENDED IF THERE ARE PEOPLE WAITING TO BE SERVED.
6. A FEE (PLEASE CONTACT THE SELECTMEN'S PERMITS OFFICE FOR CURRENT
AMOUNT) MUST BE PAID TO THE PARKS & RECREATION DEPARTMENT PRIOR
TO OPERATING WITHIN THE TOWN OF YARMOUTH. SUCH FEE TO BE PAID AT
THE SELECTMEN'S PERMITS OFFICE.
7. ANY VENDOR FOUND TO BE IN VIOLATION OF THE ABOVE CITED
RULES/REGULATIONS WILL HAVE HIS/HER LICENSE REVOKED, AND ALL
PRIVILEGES OF OPERATING WITHIN THE TOWN OF YARMOUTH SUSPENDED.
S. THESE RULES/REGULATIONS WILL BE ENFORCED BY THE BOARD OF HEALTH,
PARKS & RECREATION DEPARTMENT, AND THE POLICE DEPARTMENT.
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