HomeMy WebLinkAboutApplication-CertsDetails
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License Restrictions/Conditions
Seating: 1 30 Seats; 18 Barstools
Expiration Date-
12t31t2026
Business lnformation
Business Name*
Sea Dog Brew Pub
Business Mailing Address (if different)
Business E-Mail.
info@seadogcapecod.com
Business Legal Entity
Corporation
Business Address in Yarmouth *
23 Whites Path
Business Phone #-
508-694-6020
Business Type"
Food Service
Corporation Name (if applicable)
Sea Dog Cape Cod LLC
Tax lD (FEIN or SSNI*
FEIN
ls this a NAME CHANGE?
No
Owner / Manager !nformation
Manager/Contact Person Name*
Matthew Barry
FEIN
owneis Phone Number
508-728-1960
Manager / Contact Person Phone Number'
508-367-6894
PLEASE LIST STAFF MEMBERS WHO HOLD THE FOLLOWING CERTIFICATIONS AND ATTACH
COPIES OF CERT!FICATIONS
Name of Certified Food Protection Manage(S)
All food service establishments are required to have at least one (1) PERSON lN CHARGE on site
during hours of operation
owner's Name*
Peter Lucido
Name and Title
Matthew Barry
Telephone Number
508-367-6894
Address
Email
Location is Permanent Structure?
Yes
Emergency Telephone Number
Please attach copies of certifications for al! listed below:
List all Certified Food Protection Managers*
Matthew Barry
List all employees certified in Anti-Choket
Matthew Barry
List all employees wilh Allergen Certification-
Matthew Barry
Establishment Operations
Length of Permit
Annual
I
I
I
I
I
I
Establishment Type
Continental Breakfast
Non-Profit
Number of Seats lnside'
138
174
Mobile
Common Victualler
Wholesale
Food Service
Number of Seats 0utside *
36
Frozen Dessert
Retail Service
I
I
Residential Kitchen for Retail Sale
Total Seats
tr
0ther
Name Change Only
New construction, remodel or conversion requires an Occupancy Permit from the Building
Department in order to receive a valid Food Permit.
l, the undersigned, attest to lhe accuracy of the information
provided in this application and laffirm that the food
establishment operation will comply wilh 105 CMR 590.000 and
all other applicable law. I have been instructed by the Board of
Health on how to obtain copies of 105 CilR 590.000 and the
Federal Food Code. Pursuant to MGL Ch. 62C, Sec. 49A, I certify
under the penalties of perjury that l, to the best of my
knowledge and belief, have filed all state tax returns and paid
taxes required under law.*
Submitted by Staff
Matthew
Barry
Dec 27 ,
2025
I
Worker's Compensation lnsurance Affidavit
Vending Food
I tr
tr
Affidavit
RestauranVBar/Eating Establishment
I do hereby certify, under the pains and penalties of perjury, that
the information provided above is true and correct.*
Matthew
Barry
Dec 27 ,
2025
lnsurance Policy lnformation
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the
imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well
as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against
the violator. Be advised that a copy of this statement may be forwarded to the Office of
lnvestigations of the DIA for insurance coverage verification.
Type of Business-
I am an employer with employees *
lnsurance Company Name
Hartford lnsurance Company
Policy # or Self-ins Lic. #
76 WEG BV7PG1
Business
lnsurer's Address
225 Kenneth Dr Ste 1'10 Rochester, NY 14623
Food / Retail Service
Expiration Date
08t11t2026
SEASONAL FOOD SERVICE OPENING:All food service establishments must be inspected by the
Health Department prior to opening. Please contact the Health Department to schedule the inspection
three (3) days prior to opening.
CATERING POLICY: Anyone who caters within the Town of Yarmouth must notify the Yarmouth Health
Department by filing the required Temporary Food Service Application form seventy-two (72) hours
prior to the catered event. These forms can be obtained at the Health Department, or from the Town's
website at www.yarmouth.ma.us under Health Department, Downloadable Forms.
FROZEN DESSERTS: Frozen desserts must be tested by a State certified lab prior to opening and
monthly thereafter, with sample results submitted to the Health Department. Failure to do so will result
in the suspension or revocation of your Frozen Dessert Permit until the above terms have been met.
OUTSIDE CAFES: Outside cafes (i.e., outdoor seating with server service), must have prior approval
from the Board of Health. OUTDOOR COOKING: Outdoor cooking, preparation, or display of any food
product by a retail or food service establishment is prohibited.
I acknowledge that I have read and understand the information
above.*
I
Notice
PERMITS RUN ANNUALLY FROM JANUARY 1 TO DECEMBER 31. IT IS YOUR RESPONSIBILITY
TO COMPLETE THIS APPLICATION EACH YEAR.
ALL RENOVATIONS TO ANY FOOD ESTABLISHMENI (PAINTING, NEW EQUIPMENT, ETC.) MUST
BE REPORTED TO AND APPROVED BY THE BOARD OF HEALTH PRIOR TO COMMENCEMENT.
RENOVATIONS MAY REQUIRE MA ENGINEER SITE PLAN.
I acknowledge that I have read and understand the Notice
information above*
THE
HARTFORD
THE HARTFORD
BUSINESS SERVICE CENTER
3600 WISEMAN BLVD
SAN ANTONIO TX 78251 September 5, 2025
For lnformational Purposes
23 WHITES PATH
SOUTH YARI\,4OUTH M A 02664.1221
Account lnformation:
Policy Holder Details :
SEA DOG CAPE COD LLC DBA
SEA DOG BREW PUB
E Contact Us
Need Help?
Chat online or call us at
(866)467-8730.
We're here Monday - Friday
Enclosed please find a Certificate Of lnsurance for the above referenced Policyholder. Please contact us if you have any
questions or concems.
Sincerely,
Your Hartford Service Team
WLTROO5
0910512025
THIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AFFIR}IATIVELY OR NEGATIVELY ATIEND, EXTENO OR ALTER THE COVERAGE
AFFORDEO BY TI4E POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BEYWEEN THE
ISSUING INSURER(S}, AUTHORIZED REPRESEI{TATIVE OR PRODUCER, AND THE CERTIFIGATE HOLDER,
IMPORTANT: lf lhe cortiricate hold€r is an AODITIONAL INSURED, the policy(ies) must be ondorsod. lf SUBROGATIONIS wAlvED,
subject lo the terms and conditions of the poli6y, cortain policie3 may require an endorsement. A statem.nt on this certificato does
nol confer rights to tho ceilficato holdor ln lleu ot 3uch endoEement(s).
PRODUCER
PAYCHEX INSURANCE AGENCY INC
76210755
225 KENNETH DR STE I1O
ROCHESTER NY 14623
PHONE
(AJC, No, EIl):
\8OO1472-0472 (s85) 389-7894
/SURER{S) AFFOROTNG COVERAGE
TNSURERA: Hartford Fire lnsurance Company 19682
rirSuREo
SEA OOG CAPE COD LLC DBA SEA DOG BREW PUB
23 WHITES PATH
SOUTH YARMOUTH MA 02664-1221
INSURER 8
o<-fu CERT!FICATE OF LIABILIry INSURANCE
COVERAGES CERTIFICATE NUMBER REVISION NUMBER:
@ 1988-2015 ACORD CORPORATION. All rights reservod'
R
THIS IS TO CERTIFY THAI THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMEO ABO!€ FOR THE POLICY PERIOD
INOICATED,NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ATL THE
TERMS, EXCLUSIONS ANO CONOITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED AY PAID CLA]MS.
LIMTTSTYPE OF INSURANCE
EACH OCCURRENCECOMMERCIAL GENERAL LIABILITY
CLAIMS.MADE OCCUR
MED EXP (Any oe r.,s)
PERSONAL & ADV INJURY
GENE RAL AG6REGATE
PRODI]CTS, COMP/OP AGG
GEN'L AGGREGA-TE LIMIT APPLIES PER
LOC
OTSER:
JECT
BOoILY INJURY (Per a@denl)
AUTOMOBILE LIABILITY
ALL OWNEO
HIRED
AUTOS
SCHEDULEO
NON-OWNED
EACH OCCURRENCEUilaRELLA LIAB
EXCESS LIAA
OCCUR
aercworu $
X
E L EACI]ACCIDENT $1,000,000
E L DISEASE -ErA EMPLOYE€$1.000,000
$1,000,000E,L DISEASE. POLICY LIMTT
oa/1 1t2025 08t11t2026
Ar{D ETPIOYERS'L|AAIIrY
PROPRIEIOFYPARTNEFI/EXECUTIVE
OFFICEF,'I{EMBER EXC!UDEO?
TION
DESCNPTION OF OpERAfIOIVS / tOC4rOrVS / l/E lCtES {ACORD l0l.lRem.rls Sch.dul., m.y b. ,tLch.d ll mom .pa@ l. rcqolnd)
Those usualto the lnsured's Operations
SI]OULD ANY OF THE AAOVE OESCRIBEO
BEFORE THE EXPIRATIOTI DATE THEREOF, I{OTICE wlLL BE OELIVEREO
IN ACCORDANCE WITH THE POLICY PROVISIONS.
POLICIES BE CANCELLED
d:.uun 3 /azd..,.z--:
AUTHORIZEO REPRES€NTATIVE
23 WHITES PATH
SOUTH YARMOUTH MA 026 .1221
For lnformational rposes
acoRD 25 (2ol6103)The ACORD name and logo are registeted marks oI ACORD
INSUR€R E:
76 WEG BV7PG1
laooLlsuBRI poucyNu BER PoLrcY EFF I POLTCY EXP
IINSR IIYVD I TMMIDO/YYYYI llMf/DD,"lYYYl
I sootrv ruunv leer pem;
I
I
T_lg"
NF
ServSafe
SerYSqfe"
CERTIFICATION
MATTHEW BARRY
ftr 3J@nr[rly co.nplcting rh6 d,ondor,& id fudfi for ttE son st' Food hobdirr ,vrcrroger certiffcotr'on Exominotion,whicrt i! occredibd by *e ANSI (Americon florbnol SundonJs hfturs1 ttorirrola."rjirori-, g""rd (ANABF"- ''
ConErsnce for Food Proreaion (CFP|.
7t512024
DATE OF EX
Locol lolls opply
5664
EXAM FORM NUMBER
7t512029
DATE OT EXPIRATION
frr recertiff cotion rrquir.nEnh.
ffi
f1911{$!tj.,u{^fidnicdrltodrGbn ra.qi:rio.&r,rdE. rr( F.ln6,rtqrorriEr F i.inot tr wd.06 aI
#0655
coi'lod 6 eii' rriidr or 23t s. Wod, Dttu, S.jL 3aO, dicqgo, I. .o6oa63si * S.!6*OldrE ,r.
TC('tDII!O PNOGIAM
rLh your locol rsg
c
IIFICATE N
\yLe{v
CT TTFICAIE OF
ATTTRGEN AM.RENE S S TNruN ING
Name of ReciPient MATTEw BARRY
Certifi cate Nurnber' 6050410
Date of Completiot 1112r2on
Date of Expiration' 't2t12t&27
kudBp
Tbe ahNe-named F6on is krcly ksuul tbis certifuate
for ompleting at allergcn swarencrt fi*ining Fogrum
niotoizri ty tt , M^.rhoutts Dcpttmmr of Publk Hcakh" io *tirdorr, *itb 105 CMR 590.009(G)(3)(a).
csl o
Mers*lnrecttr Rcrteurrot &ao&tioa
33 Tirnpitc Rdd,Suitc 102
Soutlrbotang\ MA 01772
508-303-9905
w*w'mrEatdrrotraaoc.or8
8m'765.2122
*Ew.rtltaurant.org
liis ccrtiftatc zoill be vatidfnfu (5) yearsfrom daa ofcompletion'
ffi
Thi9 card certifies thai the individual has succos3fullycompletod the requlrBmonts in accordance wlth th€Nationa! Hsalth & Safety Association cunlcutum.
Course administered by the National Health &Safety Association follo,rring the 2020 ECC/ILCOR
and American Hearl Association guidelines.
cERflFtED ON Dec ,t3, 2022 VALID 2 YEARS lD423300_320153'141
sruDENr Matthew Barry
For couFe detatls and
receftmcatm, visii cpr.ao
You'll find your card above. lt includes the date of certification, a unique id, and the tiue of the course
you took with National Heafth & Safety Association.
Print your card, cut it out, and then fold it down the center. You can then tape or glue it together. Carry
the card in your wallet or purse, to have avairabre if you need to reference it.
We have also sent an email with a link to your wallet card. Make sure to save the email so you can print
additional copies of your card at any time.
Congratulations,
National Health & Safety Association
JL National Health &'ll- Safety Association
Standard CPR/AED (adult, chitd, infant)