The URL can be used to link to this page

Home My WebLink AboutApp-License-CertsDocusign Envelope lDr 34FF5464-87D9{7DE-85F4-E19EFFDFD7D4 **MUST BE POSTED O1{ PRE}IISEST* This License aflirms that the specified premases, structure, or portion thereof has met the necessary conditions including any iaspections required at the tame of issuance.It must be framed or laminated and prominently displayed in a clearly visible localion within the approved premises. lnterim Health Darector James Gardiner Signature of Interim Health Director Jq hrlu.v A The Commonwealth of Massachusetts Town of Yarmouth Health Department FOOD ESTABLISHMENT LICENSE Wise Kids Language & Discovery Preschool ISSUED TO: 134 Ansel Hallet Certificate No. BOHF-26-10 The purpose of 105 CMR 50O.00O is to establish minimum standards for those persons engaged in the business of preparing, processing, or distributing food for sale in Massachusetts. 105 CMR 500.000 shall be liberally constr €d and applied to Bromote the underlying purpose of protecting pubtic health. the License Expiration: December 31, 2026 Fee: $125.OO Restrictions / Conditions: Soard ot HGrlth: Hillard Boskey, M.D., Chairman Mary Craig, Vice Chairman Charles T. Holway, Clerk Laurance Venezia, DVM Eric Weston Details lnternal Only License Restrictions/Conditions Expiration Date' 12t31t2026 Business lnformation Business Name' Wise Kids Language & Discovery Preschool Business Mailing Address (if different) Business E-Mail* wisekidsluiz@gmail.com Business Legal Entity Business Address in Yarmouth * 134 Ansel Hallet Business Phone #* 7744876895 Business Type. Food Service Corporation Name (if applicable) Tax lD (FEIN or SSN)- FEIN ls this a NAME CHANGE? No Owner / Manager lnformation Owner's Name* Luiz Otavio Pereira Teixeira Manager/Contact Person Name' Luiz Otavio Pereira Teixeira Telephone Number 7744876895 PLEASE LIST STAFF MEMBERS WHO HOLD THE FOLLOWING CERTIFICATTONS AND AITACH COPIES OF CERTIFICATIONS 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 FEIN **-***9902 Owne/s Phone Number 5082259200 Manager / Contacl Person Phone Number" 7744876895 Address 99 wilken st, hyannis,02601, Ma Email wisekidsluiz@gmail.com Name and Title Damusia Sulla Silva Menezes Emergency Telephone Number 5082253800 Please attach copies of certifications for all listed below: List all Certified Food Protection Managers* Danusia Su lla Silva Menezes List all employees certified in Anti-Choke- Danusia Sulla Silvas Menezes List all employees with Allergen Certification' Danusia Sulla Silvas Menezes Establishment Operations Length of Permit Annual Establishment Type Continental Breakfast Location is Permanent Structure? Yes Common Victualler II I I 0 I I Non-Profit Residential Kitchen for Retail Sale Number of Seats lnside* 49 Total Seats 49 Relail Service 0lher Wholesale Food Service Number of Seats Outside. Frozen Dessert Vending Food Name Change 0nly I I II I Affidavit 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 the accuracy of the informalion provided in this applicalion and I affirm that the food establishment operation will comply with 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 CMR 590.000 and the Federal Food Code. Pursuant to MGL Ch. 62C, Sec. '19A, I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid taxes required under law.* Luiz O P Teixeira Jan 5, 2026 Worker's Compensation lnsurance Affidavit Type of Business* I am an employer with employees * Submitted by Statf I Business Other Other Business I do hereby certify, under the pains and penalties of perjury, that the information provided above is true and correct.* Preschool Luiz O P Teixeira Jan 5,2026 lnsurance Policy !nformation 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. lnsurance Company Name lnsurer's Address Policy # or Self.ins Lic. #Expiralion Date Food / Retail Service 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 disptay of any food product by a retail or food service establishment is prohibited. I acknowledge that I have read and understand the informalion above.* Notice PERMITS RUN ANNUALLY FROM JANUARY 1 TO DECEMBER 31. IT IS YOUR RESPONSIBILITY TO COMPLETE THIS APPLICATION EACH YEAR. ALL RENOVATTONS TO ANy FOOD ESTABLTSHMENT (pAtNTtNG, NEW EQUtPMENT, ETC.) MUST BE REPORTED TO AND APPROVED BY THE BOARD OF HEALTH PRIOR TO COMMENCEMENT. RENOVATIONS IUAY REQUIRE MA ENGINEER SITE PLAN. I tr THE HARTFORD BUSINESS SERVICE CENTER 3600 WISEMAN BLVD SAN ANTONIO TX 78251 THE HARTFORD January 9, 2026 wlSE KIDS LANGUAGE AND DISCOVE 134 ANSEL HALLET RD WEST YARMOUTH M A 02673-2582 Account lnformation: Policy Holder Details :WISE KIDS LANGUAGE AND DtscovE .fl Contact Us Need Help? Chat online or call us at (866) 467-8730. We're here Monday - Friday. Enclosed please find a Summary Of lnsurance for the above referenced Policyholder. Please contact us if you have any queslions or concems. Sincerely, Your Hartford Service Team WLTROOS trTHE HARTFORD Account Policy lnformation: Agency Name BRZ INSURANCE LLC Agency Code 08081609 Recipient lnformation WISE KIDS LANGUAGE AND DISCOVE 134 ANSEL HALLET RD WEST YARI\,4OUTH MA 02673-2582 SUMMARY OF INSURANCE January 9,2026 Account Policy Recap Policy Number Policy Term Premium Next Gen Spectrum Property and Casualty lnsurance Company of Hartford 08 SBM BX7X1C 11118120251o 11t18t2026 $631 Sum of lnsurance Summary of lnsurance (Continued) Next Gen Spectrum Summary of lnsurance with Property and Casualty lnsurance Company of Hartford A member company of The Hartford 1 1 t18t2025 - 1 1 I 18t2026 PREMIUM SUMMARY COVERAGE PRICE Business Owne/s Policy $381 Educator's Legal Liability $250 LOCAilON(S) POLICY SUMMARY PROPERTY LIMITS Deductible:Windstorm or Hail Percentaqe Deductible Building Business Personal Property (BPP) LOC 1;BLDG 1 NA N/A N/A BUSINESS LIABILITY (AIso known as General Liability) EACH OCCURRENCE LII.,4IT $2,000,000 GENERAL AGGREGATE LII\,4IT $4.000,000 PRODUCTSiCOMPLETED OPERATIONS AGGREGATE $4,000,000 EDUCATOR'S LEGAL LIABILITY COVERAGE EACH CLAIM TIMIT $s00,000 WRONGFUL ACT LIABILITY AGGREGATE LIMIT $1,000,000 RETROACTIVE DATE 11t18t2025 LOCATION DESCRIPTION TYPE AND AREA VALUATION How we calculate the value ofyour property LOC 1; BLDG 1 134 ANSEL HALLET RD, WEST YARIUOUTH,MA 02673-2582 2940 Sum of lnsurance Summary of lnsurance (Continued) CUSTOMIZED COVERAGES FOR YOUR BUSINESS BUSINESS LIABILITY COVERAGE ADDED COVERAGE LIMIT Blanket Additional lnsured by Contract lncludedl Educator's Business Liability Broad Form Endorsement lncluded 1 Included in Business Liability Limit(s) BUSINESS LIABILITY COVERAGES DETAIL This Summary and its attachments provides a high level overview of policy coverages and does not include all conditions, limitations or exclusions. Please refer to the actual policy forms for detailed coverages, limits and deductibles. BUSINESS LIABILITY COVERAGES TOTAL LIMIT OF INSURANCE Business Liability Damage To Premises Rented To You Limit $1,000,000 General Aggregate Limit $4,000,000 Liability and Medical Expenses Limit $2,000,000 Medical Expenses Limit $10,000 Personal and Advertising lnjury Limit $2,000,000 Products-Completed Operations Aggregale Limit $4,000,000 Property Damage Liability Deductible No Deductible Sum of lnsurance Certificote of Achievement alst ,ttootl Accttatltrtlon Boatd ACCFEDITED_-@- CERTIFICATE ISSUER *0655 This certificote is oworded to DANUSIA SULLA SILVA MENEZES Congrotulolions! You hove completed ServSqfe'Food Hondler Employee Food Sofety Course ond Exom c.rrilicor€ Number 8168305 Notionol Rertouront Associotion 233 S. Wocler Dive, Su;te 3600 Chicogo, lt 6O6066383 A@.765.2\22 in Chicogo oreo 3l2.Zl5 Re*ruronl.o€ | ServSofe.com r0i0 Exoirorion Dor6 9l2gl2o2g 9128t2025 National Re.tau.aht Assoclitldl - ServSafe National Restaurant Associetion ServSofe Allerq Certificote of Cori TMens pletion ^(r"ACCFEDITEO -_-@-ca*ffrlrE rssnrEn 10655 art,tllu.l,.s.libllu,qd Aworded to DANUSIA SULLA SILVA MENEZES Provided by the Notionol Resburont Associolion cerf.f.core Number 9169424 potc 9/29/2025 &oirorioo Dore 9n8!2028 8 ..!a{ Vio Pr6iJml, &rlio S.rvicd (>1966-2{.!} r5-rEr t.lM aEtu E d..fil tdndda Fe.tr) Al.]D i.!',-l [.5.,,],r.. s6s!r. rta@r ' rriJ r. knF.l L6rd.,l&rft -d r Ebd r.ed ^E;r t r!&4 l(ieir,,l d.@! urd !.di lqu Lt $116 qlc Bt d b. G.tdr vt d i,bd h . or4 rnxF pa 6br6 .l lh. ;.d.1 Eh rur