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Home My WebLink AboutApp-CertsDetails lnternal Only License Reslrictions/Conditions Retail Food <25,000 Sq. Ft. Expiration Date* 1213112026 Business lnformation Business Name' Yarmouth Food Pantry, lnc dba Cape Cod Community Pantry Business Mailing Address (if different) PO Box 982, WestYarmouth, MA02673 Business E.Mail* jill.albright9l @gmail.com Business Legal Entity Corporation Business Address in Yarmouth * 845 Route 28, South Yarmouth, MA02664 Business Phone #' 508-394-0880 Business Type* Food Service Corporalion Name (if applicable) Tax lD (FEIN or SSN)' FEIN ls this a NAME CHANGE? No Owner / Manager lnformation owner's Name* Jack Hynes Manager/Contact Person Name* Susan Martin Name and Title Susan Martin PLEASE LIST STAFF MEMBERS WHO HOLD THE FOLLOWING CERTIFICATIONS AND AITACH COPTES 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 Owner's Phone Number 508-737-9644 Manager / Contact Person Phone Number* 508-280-2225 Address 29 Fairwood Road, South Yarmouth, MA 02664 Telephone Number 508-280-2225 Emergency Telephone Number 508-360-5650 Please attach copies of certifications for all listed below: List all Certified Food Protection Managers' Susan Martin List all employees with Allergen Certification' None Establishment Operations Length of Permit Annual Email cmartin294@aol.com Location is Permanent Structure? Yes Common Victualler Establishment Type Continental Breakfasl II t I I I I I I I Non.Profit Wholesale Residential Kitchen for Retail Sale Food Service Frozen Dessed Retail Service Vending Food Other Name Change 0nly 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 information provided in this application and laffirm 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. 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 laxes required under law.' Jiil Albright Jan 15, 2026 Worker's Compensation lnsurance Affidavit Type of Business* We are a non-profit organization, staffed by volunteers, with no employees. [No workers' comp. insurance requiredl I submitled by statf Business Non-Profit I do hereby certify, under lhe pains and penalties of pe(iury, that the information provided above is true and correct.* Jiil Albright Jan '15, 2026 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 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 ESTABLISHMENT (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 informalion above* Pantry Food Safety Workshop Certificate of Com pletion Susan Martin is recognized for successfully completing the Pantry Food Safety Workshop The Greater Boston FOOD BANK w Presented by the Nutrition Department of The Greater Boston Food Bank 10l2ano24 ls8ue Date 1012812026 Explrrtlon Date lnstructor The Greater Boston FOOD BANK M I I I I Certificote of Achievement This cerlificote is oworded to TERRY TROMBETTA t Sl National Acarcdltatlon Boatd ACCREDITED_--G- CENTHCATE ISSUEA 10655 Nolionol Rcsburont Asociotion 233 S. Wocker Drive, Suib 3600 Chtcooo. lL 606O6"63 83 im7is.zlzz in Chicogo oreo 3 I 2 7l 5 I 01 0 Restouronl.org I ServSofe com Congroblotionsl You hove completed ServSofe" Food Hondler Employee Food Sofety Course ond Exom C6di{icot6 7711914 3t14t2025 Frhi.dri6^ Ddr. 31 1 412028 ffi -- Serr e Pantry Food SafetY Workshop Certificate of ComPletion Jane Kinkow is recognized for successfully completing the Pantry Food SafetY WorkshoP The Greater Boston FOOD BANK M presented by the Nutrition Department of The Greater Boston Food Bank 1012812024 lasuo Date 1012812026 Explration Date lnstructor The Greater Boston FOOD BANK VN I I I