HomeMy WebLinkAboutApplicationDetails
Applicant's lnformation
Name of Establishment*
lsland Tan
Business Address City, State, Zip*
South Yarmouth ,Ma
EmailAddress.
capecodkerrie@icloud.com
FEIN-
*-...0215
Owner's lnformation
Owner's Name*
Kerrie Kirby
Owner's Address City, State, Zip-
South Dennis
Manager's Name*
Kerrie Kirby
Business Street Address.
23 Whites Path
Phone #*
508-394-4447
Tax lD'
FEIN
Mailing Street Address (City, State, Zip) (if different than
Business Street Address)
owner's Street Address*
28 Uncle Bills Way
Owner's Phone Number*
5614757391
Manger's Phone #'
5614757391
Tanning Devices
# of Tanning Beds'
4
Total # of Tanning Devices
Conditions
Four tanning devices in use
2 Stand up and2 Lay Down
License Expiration Date'
1213112026
# of Other Tanning Devices*
0
4
Tanning Device lnformation
Manufacturer.
Royal Sun
Serial #-
350071
Manufacturer*
Royal Sun
Serial #-
350072
Add Tanning Device lnformation
Model #*
38102
Type of Bulb.
160 R+
Model #*
38102
Type of Bulb-
160 R+
Model #'
50/10
Type of Bulb-
160 R+
Model #-
50/10
Manufacturer*
Royal Sun
Serial#-
650292
Manufacturer.
Royal Sun
Acknowledgment
LICENSES RUN ANNUALLY FROM JANUARY 1 TO DECEMBER 31.
YOU MUST RENEW THIS LICENSE ANNUALLY - FAILURE TO DO SO WILL RESULT IN CLOSURE
oF YOUR ESTABLTSHMENT UNTTL THE REQUTRED AppLtCATtON(S) AND FEE(S) ARE
RECEIVED.
A HEARING BEFORE THE BOARD OF HEALTH MAY BE REQUIRED PRIOR TO REOPENING
Serial #t
650293
The Town of Yarmouth taxes and liens must be paid prior to
renewal prior to the issuance of your license. Are your taxes /
liens paid?-
Yes
Type of Bulb*
160 R+
lacknowledge that lunderstand 105 CMR 123.000 as it relates
to licensure procedures and the requlrements for the
maintenance and operation of tanning facilities.-
Kerrie
Kirby
Oct 24,
2025