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HomeMy WebLinkAboutb.good mobile temp permits expire July 16 & July 19, 2015 - Permits - 99 TURNPIKE STREET 11/30/2021 COMMONWEALTH OF MASSACHUSETTS NUMBER ��ctFu,�S BHP-2015-0291 North Andover BOARD OF HEALTH FEE $35.00 b.good DATE ISSUED NAME July 14,2015 99 Turnpike Street Suite 202 NORTH ANDOVER, MA 01845 - - - - --------------------- ADDRESS IS HEREBY GRANTED A Food Est. - Temporary-Permit TEMPORARY FOOD PERMIT This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires-----------------July 16,2015 unless sooner suspended or revoked. RESTRICTIONS: Smoothies ------------------------------------------------------------ BOARD OF ----------------------------------------------------------- HEALTH NOTES: Contact: Aubree Giarrusso 978.335.1 1 18 --------f-F7[LE -COPY-------------- BOARD OF HEALTH CHAIRMAN TOWN OF NORTH ANDOVER Office of C'OMM(jNITV DEVELOPMENT AND SERVICES 1 S 77 HEALTH DEPARTMENT 1600 OSGWD STREET; SUITE 2035 NORTH ANIX)VER. MASSACIA JSEITS 01845 978,689.9540-Phone Susan V.Sawyer,REWSIRS 978.688.9476- FAX Public Fiealth Director E-MAIL althtigo6kowngfianhag ver.coni do Wf-'BSII*r-.:ht1t).1fw%Yw.townofhorthjvAkq KC11wiMED APPLICATION FOR MOBILE FOOD PERMIT JUN 3 0 2015 ➢ Name of vehicle: 46LVL-f If TOWN OF NORTH ANDOVER fjMjFj7DMTMENT > Owner:b Telephone: {,5qb ➢ Address:- a78- 'Pee,-( zz& a t4it > Type of vehicle: tO�-a ('Ly Ero-Mmai Plate#: Aj"71-3&7J- > Day&hours of operation: 1'76,qeia.� - 5ckw6:j tt4f-,Jyw State Hawkcrs License#: List food items sold: '-;&2e->n LeeS ➢ Location of base of operations:_'] > Water System: Hot&cold water under pressure: Yes: No: > Capacity of water supply tank: e� -gals Capacity of waste retention tank:-aj _gals Name of certified food handler: Au ke� 66C, Cr—Qce�52 ;i,, Contact Numbers: Ct t 7 cS r - -7:,)-'5 5-,- I I ( & Where is commissary located. Airt C,�- Ay,b*4, M� e'J'Rlqfir- P1,,E/ASEA-1-1A(114U,[ _O -'R ,�T _E�Stc j&L)(Aj PLEASE A 7TAC11 A CQPY OF YOUR C'0MAfi%AR YA PLEASE A 77A(Y I A COPY OP'YOTLI-R-CU URBIDT-PERMIT(new ile gVV1icqti(2vs.L)n�R A11PLICA7 IONS MUST BE SUBM17TED AT L EAST,o Y.5 B - cymn. (f gr new Lno iUe dap lLc�q nsgidU2 FOOD CAR USIV MICLESMUSTBE INSPE PI ACTIV171'.(&r ae-w-mobilefiaod appFications on1u) Date of Application Signature fte. $140 for on-site prep;or Egg: $95 for non-on-site prep . - COMMONWEALTH OF MASSACHUSETTS NUMBER B • North Andover HP-2015-0306 BOARD OF HEALTH FEE b g d $35.00 DATE ISSUED NAME July 17,2015 ---- -- 99 Turnpike Street Suite 202 NORTH ANDOVER MA Ol 845 ----------- - ADDRESS - ------ -- ---------------- IS HEREBY GRANTED A Food Est. - Temporary- Permit TEMPORARY FOOD PERMIT This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires-----------------July 19,2015 -_-_-- - unless sooner suspended or revoked. RESTRICTIONS: Smoothies ------------------------------------------------------------ BOARD OF ------------------------------------------------------------ HEALTH y------------------ ---- ------------------------------------- BOARD OF HEALTH CHAIRMAN TOWN OF NORTH ANDOVER Office of(,1*0MMUNITY DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET, SUITE 2035 NORTH ANDOVER. MASSACI It 1SLA"I'S 01845 978.688.9540- Phone Susan V.Sawyer,REHS/RS 978.618.84 76- FAX Public 11calth Director F.-MAIL:healthdcrdiiitoA-notho.nhandover.coiii Wf'.'BSII'I-'.:htti):"wvv%k.to-AnofiiorthajuL%rrsiuji Kt:UEIVED APPLICATION FOR MOBILE FOOD PERIMIT JUN 3 0 2015 > Name of vehicle: TOWN OF NORTH ANDOVER tjEACIM DEM MENT > Owner: b - epcxi Telephone: (0 1 Address: a_78- Fe' IICA�L---oa m91- > Type of vehicle; tQ�-a C,6� &�Nnei Plate AJ"713&'J l�`4 - > Day&hours of operation: zv—&A-A�t - 5cva ,ZI State Hawkers License > List food items sold: > Location of base of operations:, Arlekeo.,- AkA > Water System: Hot&cold water under pressure: Yes: No: > Capacity of water supply tank: V- gals Capacity of waste retention tank:-21L-gals Name of certified food handler: Aj6g.:E� -7 Contact Numbers: ' ; .> q 75' Where is commissary located. &ROXIM ZTI�Ll— AL PI-F,1L'?FArrACIIA-00eY F_Q PLE4,13E A TTA CI I A C MA, Yo IR CUR RL:Nyj�_.VRM17'(neivi7ioLi:l_cL�odupl)licationsoniu) APPLICATIONS AILIYI'BESIIBJVf]ITEDA7'LE4,,qY'qo DAYS BE]--(3RL- PLIWn*:D- (-TIVVI (for new inghile pd an rgD ils I/ FOOD C',IRTSI VEHICLES MUST BELNSPEcy DAYS BE PI� L,-Q ACTIVITY.(for peg mobile-food avikeations WIN) Date of Application Signature Be—e--$140 for on-site prep;or Fee: $95 for non-on-site prep Malden Government Center PERMIT a. Two Hundred Pleasant Street Malden,Massachusetts 02148 Malden Board of Health Tel:781-397-7049 FDS4619 Permits) issued in accordance with the Regulations promulgated under the authority of M.G.L. Chapter 31 Section 111 and those Regulations adopted by reference by the Board of Health. The permit types specificied below are hereby granted is herehrgr�rnted to. Permit Expires: 4/30/2016 B. Good 278 Pearl Street ��-23 Malden, MA 02148 Permit Type Permit Regulation Permit Fee Catering-Local State Sanitary Code,Chap X,Min. Standards for Food Service $75.00 Establishments Dumpster Permit Malden Board of Health Rules&Regulations $30.00 Food Processing Mfg. 1000 to 3000 Good Manufacturing Practices for Food $250.00 sq.ft. Waste Grease&Oil Hauler Malden Board of Health Rules&Regulations $0.00 Permits are not transferable to new owners or addresses. Director of Public Health Post this in a conspicuous place. Malden Board of Public Health Z�f a Commonweartb of Aa!6q;*ufSett5 l DEPARTMENT OF PUBLIC HEALTH, BUREAU OF ENVIRONMENTAL HEALTH FOOD PROTECTION PROGRAM, 305 SOUTH STREET, JAMAICA PLAIN, MA 02130 LICENSE / In Accordance with Massachusetts General Laws Chapter 94 Section 305C NUMBER ISSUED EXPIRES TYPE MA-7495 11/10/2014 11/10/2015 Process or Distribute Food for Sale at Wholesale ISSUED TO B.GOOD LLC B.GOOD C 278 PEARL STREET MALDEN,MA 02148 COMMISSIONER OF PUBLIC HEALTH RECIPIENT'S COPY POST IN A CONSPICUOUS PLACE 621052 6J i •; .jjjj Ij �j 11 CERTIFICATE OF AL AL ALLERGEN AWARENESS TRAINING ,.' _ r H •c .. CNameof t Y�. Certificate Number: CW4254 Date of Completion: 05/02/2011 r 04/30/2016 for completing an allergen awareness trainingprogram CompuftrksIssued By: recognized by the MassacbusettsDepartment ofPublic Healtb 591 North Door 2 GJt �n � •• 7his certificate will be validforfive(5)yearsfrom date of completion. �Ywww.compuworks.com , Y Arr f SO ep riv YT-S c-n IF ), EXAM FORM NO. 10212 s CERTIFICATE NO. 7895817 t i ServSafe; ® TO ERICA R. SCHNEIDER for successfully completing the standards set forth for the ServSafel Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute(ANSI)—Conference for Food Protection(CFP). 6/2/2 01 1 DATE OF EXAMINATION 6/2/2016 DATE OF EXPIRATION Local laws apply.Check with your local regulatory agency for recertification requirements. �i NATIONAL Ameri ACCREDITED PROGRAM" — - RESTAURANT can National Standards Institute and the Conference for Food Protection ® A Paul Hineman SSOCIATION o ti0655 Executive Director,National Restaurant Association Solutions 02010 National Restaurant Association Educational Foundation.All rights reserved,ServSafe and the ServSafe logo are registered trademarks of the National Restaurant Association Educational Foundation, and used under license by National Restaurant Association Solutions,I.I.C.a wholly awned subsidiary of the National RestourentAssociation, This document cannot be reproduced or altered. 10070201 v.1103 272 Pearl St- Google Maps Page 1 of 1 ir �Yr�ar 272 Pearl St Malden,:MassachusetSOood Street View-Oct 2013 Image capture:Oct 2013 ©2015 Google r https://www.google.com/maps/@42.419736,-71.077638,3a,75y,75.13h,94.85t/data=!3m6!1... 7/1/2015 ' `" Boston Inspectional Services '1' Health Division - Food Services Inspection "� 1010 Massachusetts Avenue, Boston, MA 02118 h�aa■fi1.A7: "�y Telephone: (617)635-5326 Fax: (617)635-5388 Web www,cityofboston.gov/isd/health Business Name: B. Good(Mobile) License/AP 4: 74250 Type: Mobile Food Walk On Inspection Time: 03:26 PM Address: 131 Dartmouth St Issue Date: 6/08/201.5 Inspector:James Rock Owner/Operator: Olinto,Jon-APPLICANT(P) ■n�s� Med l Initial Inspection PASSED Official Order for Correction:Based on an inspection this day,the items cited below identify the violations in operation or facilities which must be corrected by the date specified below.This report,when signed by a Board of Health(BOH)member or its agent constitutes and order of the BOH to correct violations.Failure to comply with this notice may result in immediate suspension of your permit. if aggrieved by this directive,you have a right to a hearing.Your request must be in writing and submitted to ISD at the above address within ten(10)days of receipt of this order. l Re-inspection Date:_C_! 5,,,ned 6/g/2015 3:27:51PM by Person 1n Ch ugc- Signed 6JR 2oi 5 32R:1 SP�q by 3AfvtES RC)CK•INSPECPOR pace 1 of 1 p 4t TOWN OF NORTH ANDOVER Office of CONIMUNITV DEVELOPMENT AND SERVICES HEALTH DEPARTMENT 1600 OSGOOD STREET. SUITE 2035 NORT11 ANDOVER. MASSAC141 ISIATS 01845 979.689.9540—Phone Susan V.Sawyer,REHSfRS 978.688,8476- PAX Public Ficalth Director E-MAJL:ficalxhdentldloA-notbonhandover.coiii W F BS I I I :httt).!, 'to%4T1ofi1o!!!]! `1[11i6M_ ED APPLIC.1kTION FOR MOBILE FOOD PERMIT JUN 3 0 2015 > Name of vehicle: ''60ve-f J TOWN OF NORTH ANDOVER RETTHTMIPRTMENT > Owner: b Telephone: (o C? ?qq - Lf 5 96 Address: a-?8- Tez,-( 41,k ca,mg- > Type of vehicle-, E-roMmel Plate#: Aj'7fL'3 > Day&hours of operation: State Hawkers License#- A-ILA List food items sold: SM00AINICs > Location of base of operations: AmAki., AtA Water System: Hot&cold water under pressure: Yes- No: Capacity of water supply tank: gals Capacity of waste retention tank:11�:_gals Name of certified food handler: Ao 6;� ce, rro > Contact Numbers: Where is commissary located: Mj PLFASFA7-1AC11ALk!;L01--S .'j (1LZ 5 42PS�V 11M )R 0 1 T"T_eAPL ROX_ PMISF AMACII A COPY OF YOUR LK5,MRYAQR1Mff1LNT PLIiASF-,A 77ACI-1 A 01i YOUR CURMUTFERMIT(neiv mobile food qj)1)1icqtion&,r_)n1W APPLICA77ONS AIUSTBE SUBAf1MDA7*LEAST 3o DAM BFF0RELLAY. ,D CTIV7M (foi-new mohiLe fqQd appliradQn-s QUM FOOD 01 R 7N/I T-IIICI.F,,q MUYF BE IMPECT. , DAYS MEF0 I PI WEDACFIMY. for new mobile food applications only) ti 12 Date of Application Signature Fee- $140 for on-site prep;or 1-Lt-Te: $95 for non-on-site prep Malden Government Center PERMIT } Two Hundred Pleasant Street Malden Board of Health Malden,Massachusetts 02148 ro.I *;- Tel:781-397-7049 FDS4619 Permit(s) issued in accordance with the Regulations promulgated under the authority of M.G.L. Chapter 31 Section 111 and those Regulations adopted by reference by the Board of Health. The permit types specificied below are hereby granted is herebvgranted to: Permit Expires: 4/30/2016 B. Good 278 Pearl Street W-23 vlalden, MA 02148 Permit Type Permit Regulation Permit Fee Catering-Local State Sanitary Code,Chap X Min. Standards for Food Service $75.00 Establishments Dumpster Permit Malden Board of Health Rules&Regulations $30.00 Food Processing Mfg. 1000 to 3000 Good Manufacturing Practices for Food $250.00 sq.ft. Waste Grease&Oil Hauler Malden Board of Health Rules&Regulations $0.00 t Permits are not transferable to new owners or addresses. Director of Public Health Post this in a conspicuous place. Malden Board of Public Health i Oje eommonweattb of A1o5!6oc)U!5ett!5 DEPARTMENT OF PUBLIC HEALTH, BUREAU OF ENVIRONMENTAL HEALTH FOOD PROTECTION PROGRAM, 305 SOUTH STREET, .JAMAICA PLAIN, MA 02130 LICENSE ' In Accordance with Massachusetts General Laws Chapter 94 Section 305C NUMBER ISSUED EXPIRES TYPE MA-7495 11/10/2014 1 1/10/2015 Process or Distribute Food for Sale at Wholesale ISSUED TO B.GOOD LLC B.GOOD C f 278 PEARL STREET MALDEN,MA 02148 -- COMMISSIONER OF PUBLIC HEALTH RECIPIENT'S COPY POST IN A CONSPICUOUS PLACE 621052 CJ f I r r r CERTIFICATE CIF r _ t t t t _ ALLERC- EN _ BARENESS TRAININGr ir t _ t , t t r r r r Name of Recipient: Erica R Schneider r Certificate Number: CW4254 � _ r _ Date of Completion: 05/02/2011 r ' Date of Expiration: 04/30/2016 t t r r �t _ t r Issued By: Be above-named person is hereby issued this certificate for completing an allergen awareness trainingprogram CompuWorks = recognized by the Massachusetts Department of Public Health CompuWorks Systems,Inc. r in accordance with 105 CMR 590.009(G)(3)(a). 591 North Avenue,Door 2 Wakefield,MA 01880 = 113 P:781-224-1 This certificate will be valid for five(5)years from date of completion. F:781-224-0504 113 r www compuworks.com Sol rServia EXAM FORM NO. 10212 fe. CERTIFICATE NO. 7895817 ServSafe@ To ERICA R• SCHNEIDER for successfully completing the standards set forth for the ServSaf&Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute(ANSI)-Conference for Food Protection(CFP). 6/2/2011 DATE OF EXAMINATION 6/2/2016 DATE OF EXPIRATION Local laws apply.Check with your local regulatory agency for recertification requirements. ACCREDITED America"National - RESITOAURANT - n,,,e Conference for Food Protection ® ASSOCIATION Paul Hineman to #0655 Executive Director,National Restaurant Association Solutions 02010 National Restaurant Association Educational Foundation.All rights rosorved.ServSafe and the ServSefe logo are registered trademarks of the National Restaurant Association Educational Foundation, and used under license by National Restaurant Association Solutions,LLC,a wholly owned subsidiary of the National Restaurant Association. This document cannot be reproduced or altered. 10070201 v.1103