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HomeMy WebLinkAbout(INC) SPICE BOSS Foodware Decision FormTOWN OF YARMOUTH HEALTH DEPARTMENT 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 extension 1240 DISPOSABLE PLASTIC FOODWARE DECISION FORM Application Date: ___________________________________ Issuance Date: __________________________________ Applicant Name: ___________________________________________________________________________________ Business/Organization: _____________________________________________________________________________ Property Address: __________________________________________________________________________________ WAIVER REQUEST DECISION (per the Disposable Plastic Foodware Rules and Regulations for Food Establishments) ☐APPROVED - Waiver is granted. Applicant has demonstrated grounds for a Waiver from these regulations. ☐DENIED - Waiver is denied. Applicant has not demonstrated grounds for a Waiver from these regulations. Reason:_____________________________________________________________________________________________________ ☐NOT APPLICABLE Conditions of Approval (if applicable): Duration of Waiver (if approved): VARIANCE REQUEST DECISION (per the Disposable Plastic Foodware Rules and Regulations for Food Establishments) ☐APPROVED - Variance is granted. Applicant has demonstrated that the enforcement of these regulations would create an undue hardship and that due diligence has been exercised in seeking compliance with these regulations. ☐DENIED - Variance is denied. Applicant has not demonstrated that the enforcement of these regulations would create an undue hardship and/or that due diligence has been exercised in seeking compliance with these regulations. Reason:____________________________________________________________________________________________________ ☐NOT APPLICABLE Conditions of Approval (if applicable): Duration of Variance (if approved): HEALTH AGENT OR DESIGNEE ONLY Printed Name: Title: Signature: Date: NOTICE TO APPLICANT: Any Food Establishment or Takeout Food Delivery Service aggrieved by a decision of the Health Agent, or designee, on its request for a variance or waiver, may appeal that decision to the Board of Health within 30 days for a public hearing to amend, overturn, or otherwise modify the decision. The hearing before the Board of Health shall be a de novo review. Grantley McIntosK /24/ May , 2026 Spice Boss Restaurant and Grill Barry Lewis MBA CHO Assistant Health Director  RT  SoutK YarmoutK 5/18/2026 December