HomeMy WebLinkAboutApp-CertsDetails
Mobile Food Vendor License
lf you are currently an approved Mobile Food /lce Cream Truck in the Town of Yarmouth you
M UST select Renewal
lf you are seeking to have a Mobile Food /lce Cream Truck Vendor License in the Town of
Yarmouth for the first time, please select NEW.
Please Note: To ensure that we have the time to review your material, we ask that you
submit all required documents to us at least 15 business days prior to opening!
THE MOBILE FOOD / ICE CREAM TRUCK LICENSE MUST BE RENEWED ANNUALLY
Are you renewing an existing License or are you a NEW
vendor?
NEW
Type of permit you are applying for?
Mobile - Annual
General Application lnformation
Business Name / DBA'
The Music Room
Operations Address (Street, City, State, Zip)
541 Route 28 South Yarmouth, MA02664
Type of Mobile Unit?"
Mobile Food Truck
LICENSE EXPIRATION DATE-
1213112026
Phone Number*
617-821-1204
tt'lailing Address (it different than Operations Address)
License Plate Number
Vehicle Make/Model
Name of Operator / Driver
Mobile Food Vending Equipment
Do you have propane on your mobile unit?*
Yes
Deep Fryers
I
Vehicle Registration Number
Vehicle Year
0perator / Driver Phone #
Do you have a class K extinguisher?*
No
Grill on mobile unit
Do you have an Ansul syslem in your mobile unit?
Do you have a cunenl lire inspection/permil from the Fire Department where the food truck is housed?
Do you have the following cooking equipment? (Check all that apply)
I
Grill on wheels Smoker on wheels
I I
Smoker Stationary Proofing Cabinets
II
Podable lnduction Burners Steam Tables
I I
0vens Commercial Ranges
I I
Toaster Hot Dog Machine
II
Pasta Cookers Broilers
I
Gyro machine / vertical broilers Rice CookerrI
Commercial Crepe Maker Sous Vide Circulators
I
Pressure Smokers Sandwich Press
I I
Microwave ovens
I
I
I
Do you have the following cold holding equipment? (Check all that apply)
I
!I
Refrigerator
I
Condiment Station
Freezer(s)
!
Name and Title'
Brian Serbone
Refrigerated Prep Tables
t
Chef Bases
Coolers
Phone*
6',t7-921-1204
lce Cream Maker Other
Person Directly Responsible for Daily Operations (Owner, Person in Charge, Supervisor,
Manager, etc.)
EmailAddresst
brian@musicroomcapecod.com
Food Protection & Allergy Awareness Contact lnformation
The person who holds the certified food protection manager and allergen awareness certificates
must be the same person.
Name of Person Certified in Food Proteclion Management
ftft
Expiration date of Food Protection Manager Certificate
lacknowledge that an Allergen Advisory must be posted on my
menu and labels.*
STAFF
Jan 5,
2026
Type of Operation
ls this an ice cream lruck?*
No
ls this a truck that sells raw fish, shellfish or lobsters off of it?'
No
Expiration date of MA Allergen Awareness Cerlificate
Location of Event*
541 Route 28
Definitions:
TCS: Time/Temperature Control for Safety Food (TCS) means a food that requires temperature
controls to limit pathogenic microorganism groMh or toxin groMh. Refer to the FDA Food Code for the
complete definition.
Non-TCS's: non-Timellemperature Control for Safety Food (TCS) means a food that does not require
temperature controls to limit pathogenic microorganism growth or toxin growth. Refer to the FDA Food
Code for the complete definition.
RTE: readyto-eat foods (Ex. sandwiches, salads. muffins which need no further processing)
Please check the one that best fits your business. (YOU MUST SELECT ONLY ONE)
RISK 1: Examples include most convenience store operations,
hot dog carts, and coffee shops. Establishments that serve or
sell only pre.packaged, non-time/temperature control for safety
(TCS) foods. Establishments that prepare only non.TCS foods.
Establishments that heat only commercially processed, TCS
foods lor hot holding. No cooling of TCS loods. Establishments
that would otherwise be grouped in Category 2 but have shown
through historical documentation to have achieved active
managerial control of foodborne illness risk factors,
I
RISK 3: An example is a full service restaurant. Extensive menu
and handling of raw ingredients. Complex preparation including
cooking, cooling, and reheating for hot holding involves many
TCS foods. Varieg of processes require hot and cold holding of
TCS food. Eslablishments that would otherwise be grouped in
Category 4 but have shown through historical documentation to
have achieved active managerial control of foodborne illness
risk factors. Newly permitted establishments that would
otherwise be grouped in Category 2 until history of active
managerial control of foodborne illness risk factors is achieved
and documented.
RISK 2: Examples may include retailfood store oporations,
schools not serving a highly susceptible population, and quick
service operations. Limited menu. Nost products are
prepared/cooked and served immediately. May involve hot and
cold holding of TCS foods after preparation or cooking.
Complex preparalion of TCS foods requiring cooking, cooling,
and reheating for hot holding is limited to only a few TCS foods.
Establishments that would otherwise be grouped in Category 3
but have shown through historical documentation to have
achieved active managerial control of foodborne illness risk
factors. Newly permitted establishments that would othenrise
be grouped in Category I until history of active managerial
control of foodborne illness risk factors is achieved and
documented.
RISK 4: Examples include preschools, hospitals, nursing
homes, and establishments conducting processing at retail.
lncludes establishments serving a highly susceptible
population or that conduct specialized processes, e.9., smoking
and curing; reduced oxygen packaging for extended shelf-life,
I
I
tr
Location and Hours of Operation
Food Service
Provide a list of all foods and/or beverages to be sold'
sandwiches, hot dogs, hamburgers, potato chips, ice cream
Add Location and Hours of Operation
Willyou be providing individually pre-wrapped single use
utensils or muhi-use utensils?
Other
Number of Food Handlers
Type of Products to be Vended
Sandwiches
Candy/Gum
Hot Dogs / Hamburgers
Will food be prepared onsite?
Yes
Potato Chips
Soda
Popcorn
II
I
I I
n
Other
Frozen Dessert lnformation
Do you serve lce Cream?
Yes
Check all that apply:
Pre-Packaged
Homemade Hard lce Cream
lce Milk
Frozen Malt
I
Facility lnformation
I
I
I
Soft Serve
I
Store Bought lce Cream
I
Sherbert
Other
I
I
Description of On-Site Facilities & Equipment . List all equipment
Location of a Off-Site Food Preparation/Storage
Type of Sanitizer in Use
Does the MFE use propane?
Where will grey/waste water be disposed of?
Do you have a grease trap on sile?
Do you have a hood ventilation system?
Are the toilet facilities public bathrooms?
Location of handwashing sinks
How will sanitizer be stored?
How will potable water be supplied?
Name of grease trap service company
ls ventilation provided over all equipment which produces
grease laden vapors?
ls there a first aid kit on site?
Number of handwashing sinks
Please Read the Following Rules and 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 (AKA 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 (20) minute stay in an area. However, time may be extended if there
are people waiting to be served.
6. Afee (please contact the Select Board c/o Town Admin's ofiice for current amount) must be paid to
the Parks & Recreation Department prior to operating within the Town of Yarmouth.
7. Any vendor found to be in violation of the above cited rules/regulations will have their license
revoked and all privileges of operating within the Town of Yarmouth suspended.
8. These rules/regulations will be enforced by the Board of Health, Parks & Recreation Department,
and the Police Department.
I have read the following rules and regulations:*
Acknowledgment
STAFF
Jan 5,
2026
I do hereby certify under the pains and penalties of perjury that
the information provided above is true and correct.'
STAFF
Jan 5,
2026
Conditions / Restrictions
Conditions / Restrictions
Menu:
Meatballs, chicken tenders, fries, onion rings, salads, burgers, wraps, quesadillas, hot dogs, and
pizza.
1/15/26. 9:O5 AM
STARTERS
Arancini (frozen?)
Meatballs (ground beef. marinara, shredded mozzarella)
Chiclen Tenders (chicken, all purpose flour)
Fries (frozen)
Onion Rings (onions, all purpose flour)
Fried Pickles (pickles, all purpose flour)
ffetu - b.iateryirsirmmcapecod-corn - The MuSc Room Maal
lvtu€- t
SALADS
Caprese (tomato, basil, fresh mozzarella, balsamic)
Caesar (romaine, Caesar dressing, Parmesan cheese, croutons)
House (romaine, tomalo, onion, shredded cheese blend, bacon, croulons)
Wedge (ic€burg, blue cheese dressing, Uue cheese crumues, tomatoes, bacon, balsamic)
BURGERS
1 American cfieese, l€ttuce, oniofl, lomatro, pickle, 1000 island
2 Cheddar ctpese, Bacon, Bbq sauce, 2 onion rings
3 Blue dreese crumbbs, saut6d onion, balsamic mayo
4 (Anyhing eh€ is essentia[y.iust whatever varialion d#1, wtletter it's mayo, cfieddar, ketcfiup, mustad, or trfiatever. That's
why I lean towards build your own, p€opl€ are going to rnodiry and make substitrrtions to them regardless- #1 would get a lot
of add bacon, change cfieese, change sauce, no thb, no that thal, i think itd be rnore Fodudive to iust have them build
they're own from the start, less mistakes and mix upymore efEcbnt)
WRAPS
Bufialo Chicken (Bufrb ctlicken tenders, lettuce, tomato, blue cieese dressing, tortilla)
BBQ Chicken (bbq cfikl(er tenders, lettuce, tornato, brlifia)
Caesar Chicken (cfiki(en breast, lettuce, Caesar dressing, Parmesan cheese, tortilla)
OUESADILLAS
Cheese (shredded cheese blend, tortilla)
Chic*en (chl*en breast shredded crEese derd, tortilla)
Veggie (shrBdd€d cllees€ blend, tornato, saute€d onion, peppers, iceburg lettuce gamish, tortilla)
DOGS
Hotdogs (bun, hotdog, ketc*rup, mustard, onions???)
Sausage (bun, sauteed oflion ard peppers, bbq sauce or marinara)
PIZZA
Ch€ese (dough, marinara, shredded mo;rzarella)
Margherita (dough, marhara, tomab, shEdded mozzardh, fresh mozarella, basil, balsamic drizzle)
Veggie (dough, marinara, shredded mozarefla, tomato, onim, peppers)
Pepperooi (dor4h, rnarinara, shEdded mozarefla, popperoni)
Bufialo Chicken (blue cheese dressing, shredded mozarefla, Buffalo chicken tenders)
BBO Chic*en (dor.rgh, btq sauce, stlredded mozzarella, sauted onions, bbq cfiiden breast)
Big Mac (dough, 1000 islard, shreddd filo,zatdla, burger, onion, tomato, pidde, iceburg lettuce gamish)
M€at Lovers (dowh, marinara, shrcdd€d fin2zarella d]eese, pepperoni, bacon, burger, sausage)
THE MUSIC ROOM. DINNER MENU
PTZZA
CHEESE PIZZA. parmesan and fresh basil. $r8
PEPPERONI PIZZA. parmesan and fresh basil . Szo
VEGGIE PIZZA. onion, pepper & tomatoes, parmesan, fresh basil . $zo
MARGHERITA PIZZA . fresh mozzarella, parmesan, fresh basil, and drizzle
of balsamic glaze . $zz
B U FFALO CHICKE N PIZZA. crispy buffalo chicken, parmesan, fresh basi [,
and drlzzle of ranch . $24
QUESADILLA
CHEESE OUESADILLA four ble nd ed cheese with a side of so ur cream and
fresh salsa. $r5
VEGGIE QUESADILLA. four blended cheese, onions, peppers, and tomatoeswith a side of sour cream and fresh salsa sr6
BUFFALO CHICKEN QUESADILLA. four blend cheese and crispy buffalo
chicken with a side of sour cream, f resh salsa. $r7
APPETIZER
BASI(FT OF FRIES served with side of ketchup . S7add c heese . $z
IALAPENO Po PPE RS . served with side of ranch $ro
CHICKEN TENDERS served wi th a side of honey mustard, buffalo or BBesauce $r2
FLAVo RE D cHICKEN TENDERS . rossed in choice of buffalo or BBe sauce,served with side of ranch $r4
cHICKEN TEND E R PLATE served wi th a side of honey mustard,buffalo orBBQ sauce, and a side of ranch, with French fries . sr5
or BBQ sauce, and a side of ranch, with tossed in choice of buffalo
French fries. $18
8efo.. pla.i!8 you r o.d. r, pl.ase i n fo.D you...rv.r ifa pcrron in your p.rry lrDe.r,, poo r r.y, se.food, sr!.ltfisn, or.rrs may rn...as€ yo!r ris. r r."ro"...",ii.'.?d '11"8, consu m i nB raw or undercook.d
TOWN OF YARMOUTH Board o1'
Health
STATE LICI]NSE NO.
VEIIICLE REG. NO.
I 146 ROUTE 28, SOUTH YARMOLTTH, MASSACHUSEI-TS 02664'2445I
Telephone (50t1) 398-2231' ext l24l
Fax (508) 760-3472 Age
Health
Division
ct^ g'F'161
PERMrrNolq BG - |
FEE: Food --St530
Ice Cream $40.00
SEASONAL
YEARROUND Y
NAME OF BUSINESS
APPLICAT]O N FOR LTCENSES/PERMITS
MOBILE TOOD SERVICE VENDOR
TAX ID (FEIN OR SS].iD ?f- Z IZ7 ZL S
aw A A,o*BUSINESS TEL. NO,.,.(t (
A TowN
6'21- 1zo y'
,.r'v/
HOME TEL. NO.,, t lfzt'' 'u(
L
BUSINESS ADDRESS
OWNER'S NAME ,,.1/<-/Lt + N tu.^/€
HOME/LEGAL ADDRESS-
E-MAIL
anl e tate lcense o
IFMORETHANONEDRIVER,LISTADDITIONALNAMES,ADDRESSES'ETC'BELOW:
p c o
(Town (State (zlp Code(No. Street
PLEASE CHECKTYPE OF PRODUCT(S )TOBE VENDED
FACILITY /L i2rr\-s .5t
x sANDwtcHES XF3l88R^tn"t7 HOT DOCS. HAMBURGERS
/ soDA-r orHER
TI-IRN OVER
CANDY, CUM
T ICE CREAM
/L
UNDER CHAPTER I52, SEC. 25C, SUBSECTION 6, THE TOWN OF YARMOUTH IS NOW
REoUTRED ro HoLD tssii;NEE 6& RErybwAL. or nNv LICENSE oR PERMIT ro
b'FH[it"Ei'BiJSine5s rr ,i"pin"son-on!=o-ur4Nv DoES Nor HAvE A cERTTFICATE
oF WORKER S COMPH,NS;i'ibX iNSUNENCE. THE ATTACHED WORI(ERS
coMpf,NSATrON TNSURAfr'ciili.HoaviT MUST BE COMPLETED AND SIGNED.
TOWN OF YARMOUTH rAxES AND LIENS MUST P.P PAID PRIOR TO RENEWAL OR
rsxiiiutt tjiT6un iERMii"s: iLiesr cHecK eppnopmere, Ir PArD: YES4No-.
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PLEASELISTYOURLICENSEDFooDPREPARA-TIOJ{'C0MMISSARYESTABLISHMENT.AND PROVIDE AN OWNil".S'r6il"gO-iiTiEii.CTNIPYTNC YOUR USE OF THIS
i"Il Town of Yarmouth, MA
Health lnspection
Record No.BLDC-25-67
status Active
Type lnspection
Assignee Phil Renaud
Primary Location
517-541 ROUTE 28
WEST YARMOUTH, MA 02673
Owner
MICHELYN LLC
PO BOX 2128 HYANNIS, MA 0260I
Became Active June 23, 2025
Due Date None
January'15, 2026
Record No: BLDC-25-67
Building Permit - Commercial/Non-One and Two Family
Status: Active
Submitted On: 6/'13/2O25
Applicant
I The Music Room
J 61i-B2t-12o4
@ brianpmusicroomcapecod.com
| 541 Route 28
West Yarmouth, Ma 02664
lnspection Types Overview
Final
ffi scneouleo
Scheduled Appointments
Thursday, January 15, 2026
517-54I ROUTE 28, WEST YARMOUTH, MA 02673
Requested January 5, 2026 at 10:21 am
Q Confirmed
The appointment has been scheduled, and is currently awaiting
inspection.
lnspection Types
Final
Notes
final for food truck
Requested Appointments
None
Past Appointments
Arrival Window
9am - 3pm
lnspector
@ Phil Renaud
None
Messages
No comments yet.
Step Activity
OpenGov system activated this step
Rosa lnkley assigned this step to Phil Renaud
Rosa lnkley scheduled an inspection for Jan 9,
tw lo
Rosa lnkley rescheduled an inspection from Jan
9,2026 to Jan15,2026
OOl23l2O25 at 12:46 pm
10/2112025 at 3:21 pm
0110512026 at 10:21 am
0110912026 at 9iO3 am
Details
Mobile Food Vendor License
lf you are currently an approved Mobile Food /lce Cream Truck in the
Town of Yarmouth you MUST select Renewal.
lf you are seeking to have a Mobile Food /lce Cream Truck Vendor
License in the Town of Yarmouth for the first time, please select NEW.
Please Note: To ensure that we have the time to review your
material, we ask that you submit all required documents to us at
least 15 business days prior to opening!
THE MOBILE FOOD / ICE CREAM TRUCK LICENSE MUST BE RENEWED
ANNUALLY
Are you renewing an existing License or are you
a NEW vendor?
NEW
Type of permit you are applying for?
Mobile - Annual
General Application lnformation
Business Name / 0BA*
Type of Mobile Unit?'
Mobile Food Truck
LICENSE EXPIRATION DATE'
'1213112026
The Music Room
Operations Address (Street, City, State, Zip)
541 Route 28 South Yarmouth, MA
02664
Phone Number'
617-821-1204
1
PLEASE READ FO LLOWING RULI]S/REGULATIONS
TH
PA
ESE RULES/REGUL ATIONS WILL BE ENFORCED BY THE tsOARD OF HEALTH'
RECREATIO N DEPARTMENT, AND THE POLICE DEPARTMENT.
(-u
ALL MOBILE VENDOR VEHICLES MUST BE INSPECTED AND LICENSED BY IIIE.B.OI.NO
OF TIEALTH. AND EACH DRTVER MUST BE IN POSSESSION OF A VALID
SiATE UEWKTNS EruO PEOOLERS LICENSE PRIOR TO OPERATING WITHIN THE
TOWN OF YARMOUTH.
NO MOBILE FOOD VENDORS ARE ALLOWED Ar BASS RIVER BE4.qH-(4/IqA
buu'cb-l-r-ns eEAcHi, SEAGULL BEAqtlr PAMERS RIvER BEncHr,o-R qN
SEE"C-U-I-I i{OEO, WriiOUr PARKS & RECREATION DEPARTMENT APPROVAL.
NO VENDORS SHALL DISPENSE DRINKS IN CANS OR BOTTLES AT ANY TOWN
BEACH OR PARKING LOT.
NoTwoVENDoRSWILLBEALLoWEDINToANYBEACHoRPARKINGLoTATigs Snrtae irrtlE WITHOUT PARKS & RECREATION DEPARTMENT APPROVAL.
VENDORS ARE ALLOWED A TWENTY MTNUTE STAY IN AN AREA' HOWEVER,
TTT',IC TT,IAVEE EXTENDED IF THERE ARE PEOPLE WAITING TO BE SERVED.
AFEE(PLEASECoNTACTTHESELECTMEN'SPERMITSoFFICEFoRCURRENT
nr-,1oUivr-t tn-nlr se pAID ro THE PARKS & RECREATION DEPARTMENT PRISR
iO.OiERAiiNC WIiTTTN THE TOWN OF YARMOUTH. SUCH FEE TO BE PAID AT
THE SELECTMEN'S PERMITS OFFICE.
ANY VENDOR FOUND TO BE IN VIOLATION OF THE ABOVE CITED
nuieslntcuiATloNs wlLL HAVE HIs/HER LIqENSE REVoKED' 4ND-4I-L
iNrVr[Eb"E-S Or OPEINTTNC WITHIN THE TOWN OF YARMOUTH SUSPENDED.
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