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Home My WebLink AboutFresh Catch 12/31/2018Commonwealth of Massachusetts Town of Mansfield Board of Health Town of Mansfield 6 Park Row Mansfield, MA 02048 Permit to Operate a Food Service Establishment Type: CATERER In accordance with Regulations promulgated under authority of Chapter 94, Section 305A and Chapter 111, Section 5 of the General Laws, a Permit is hereby granted to:. WILLIAM F. SARRO Whose place of business is: THE FRESH CATCH, INC. 30 CHAUNCY STREET PERSON(S) IN CHARGE: WILLIAM F. SARRO, MANAGER Permit Expires: December 31, 2018 Food Fee: $25.00 License Number: C-3 BOARD OF HEALTH Michae(.%4CCCean, Chairman Milk & Cream W Commonwealth of Massachusetts Town of Mansfield Board of Health License to Sell Milk and Cream This is to certify that. WILLIAM F. SARRO having a place of business at THE FRESH CATCH, INC. 30 CHAUNCY STREET Town of Mansfield 6 Park Row Mansfield, MA 02048 in the Town of Mansfield has been granted a license to sell MILK and CREAM and is subject to the Provisions of the Laws of the Commonwealth of Massachusetts, relating to the terms and conditions, and to the rules and regulations established by the Board of Health, of the Town of Mansfield governing the sale of Milk and Cream and shall remain in force until 1213112018 , unless previous to that time is suspended or revoked. Expires 1213112018 License No.: C-3 Board of Health MichaeC.TlcCCean, Chairman POST THIS LICENSE IN A CONSPICUOUS PLACE This license shall not be sold, assigned or transferred FOR BOARD OF HEALTH USE ONLY Permit# Issued C 3 FOOD ESTABLISHMENT PERMIT APPLICATION (Application must be submitted at least 30 days before the planned opening date) 1) Establishment Name THE FRESH CATCH, INC. 2) Establishment Address 30 CHAUNCY STREET 3) Establishment Mailing Address (if different) P.O. BOX 34 MANSFIELD, MA 02048 4) Establishment Telephone No (508) 339-5187 5) Applicant Name & Title: WILLIAM F. SARRO, PRESIDENT NOV 6) Applicant Address 453 TURNPIKE STREET, UNIT 2, SOUTH EASTON, MA 02375 7) Applicant Telephone No.-(6001.404..a:03, 24 Hour Emergency No.: 508404-6680606369442s506?M-6294 07 '10-7-eV14 8) Owners Name & Title WILLIAM F. SARRO 9) Owner Address (If different from applicant) 453 TURNPIKE STREET, SOUTH EASTON, MA 02375 Owner's telephone number (508) 404-6680 10) Establishment Owned By: 11) If a corporation or partnership, give name, title, and home address of officers 11 An Association or partner. A Corporation Name Title Address I F1 An Individual ";1wt r+ 31-IrlG ( ° 53 6tiY",w 1<: Jf• n"P rx.E;Sk 013115 jk �f2'aew - - I 1 J A Partnership 1 Other legal Entity _ __- 12) Person Directly Responsible For Daily Operations (owner, person in charge, supervisor, manager etc.) Name & Title: WILLIAM F. SARRO, MANAGER Address: 453 TURNPIKE STREET, UNIT 2 SOUT EASTON, MA 02375 Telephone No: (508) 404-6680 24 Hour Emergency No: 508-404-6680508=339rn427'50M3M2e4 FAX: (508)339-3941 I i E-mail: billjr(a)fresheatchinc.com Alt E-Mail: 13) District Or Regional Supervisor (if applicable) Name & Title: - Address Telephone No: 24 Hour Emergency No: FAX: E-mail: 14) WATER SOURCE: TOWN Food Establishment Information 15) SEWAGE DISPOSAL: TOWN DEP Public Water Supply No: (If applicable) ! 16) No. of Food Employees: 17) DAYS/HOURS: MON-TUES-WED 8 AM-8 PM THURS 8 AM-9 PM FRI-SAT 8AM-9:30 PM SUN 8 AM -OM y 18) Name of Person In Charge Certified in Food Protection Management: JOSEPH C. MATRULLO NICOLE I If more than 3 individuals are certified, complete list is on file. VANDEVALK Required as of 101112001 in accordance with 105 CMR 590.003(A) Please attach copy of certificate 19) Person Trained in Anti -Choking Procedures (If 25 Seats or more): n 20) Location: Ili Permanents Location 22) Establishment Type [ J Moblie Moblie Start Date: [. 1 Retail ( Sq. Ft) Moblie End Date:..] Food Service up to 100 or Moblie Comments:, up to 10' PHF display $125.00 21) Length of Permit: L. Food Service up to 101 -200 1 IV, Annual or up to 25' PHF display $150.00 Seasonal I_ ! Food Service up to 201 + or 25'+ PHF display $275.00 Seasonal Dates: -_- - -- 1 Temporary Food Service - Institution - - Temporary Start Date: i ( Meals/Day) Temporary End Date: Temporary Time: ANTONIO BONILLA HENR-Y—ESRIN9ZA- HENRY ESPINOZA RYAN P. KEITH BR [] Caterer $25.00 I✓] Milk & Cream $10.00 ❑ Mobile Food & Consession $75.00 Fi Manufacture Frozen Desserts/Ice Cream -- $25.00/freezer Pushcart $25.00 # of Pushcarts: 0 �] Residential Kitchen $100.00 Retail Food $100.00 [j Retail Snack Food $25.00 ❑ Tobacco Products $25.00 Rain Date: ]..- - 23) Food Operations Definitions: PHF - Potentially hazardous food (time/temperature controls required) Non-PHF'' non potentially hazardous food(no timeRemperature controls required) ;Check all that apply): RTE- ready -to -eat foods (Ex. sandwiches, salads, muffins which need no further processing) IV, Sale of Commercially Pre -Packaged Non PHFs PHFCooked To Order i',, Hot PHF Cooked and Cooled or Hot Held - -- ----- - --- for More Than a Single Meal Service IV! Sale of Commercially Pre Packaged PHFs 1 Preparation of PHFs For Hot And _ _ Delivery of PackagedPHFs -- -�'I Cold Holding For Single Meal Service (._ j PHF and RTE Foods Prepared For Highly ry-- -- -- ----- ---- Susceptible Population Facility --- - 1 Sale of Raw Animal Foods Intended Reheating of Commercially to be Prepared by Consumer j ❑ Vacuum Packaging / Cook Chill Foods for Service — ---- -- -,------- - --� Use of Process Requiring A Variance 4 Hours [/', CustomerdSelf-Service of Non PHF ❑ and Non- II, Customer Self -Service and/or HACCP Plan (including bare hand Perishable Foods Only ---- _-- - - ] contact alternative time as a public health Ice Manufactured and Packaged for ice] Preparation of Non-PHFs Retail Sale control) Other Food Operations I. Juice Manufactured and Packaged for I i ]Offers Raw Or Undercooked Food Of Retail Sale Animal Origin Offers RTE PHF in Bulk Quantities 1 [/I Prepares Food/Single Meals for -__ __ _. Catered Events or Institutional Food Service 1 Retail Sale of Salvage Out -Of -Date —_------------ or Reconditioned Food FTo be completed by the Board of Health Total Permit Fee: $25.00 Payment is due with application ❑ waived I, the undersigned, attest to the accuracy of the information provided in this application and 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. 24) Signature of Applicant: .11 Pursuant to MOL Ch.62C, sec. 49A, I certify and paid state taxes required under law. the penalties of perjury that I, to my best knowledge and belief, have filed all state tax returns 25) Social Security Number or Federal ID: 04-2745150 26) Signature of Individual or Corporate Name: Town of Mansfield Town of Mansfield - Board of Health 6 Park Row Mansfield, MA 02048 Application for Milk and Cream Permit I hereby make application for a MILK AND CREAM PERMIT, which expires on December 31st of each year. NAME OF BUSINESS: THE FRESH CATCH, INC. ADDRESS: 30 CHAUNCY STREET TELEPHONE AT LOCATION: (508) 339-5187 FAX NUMBER: (508) 339-3941 OWNER OF BUSINESS: WILLIAM F. SARRO TELEPHONE OF OWNER: (508) 404-6680 FEDERAL ID/SS NUMBER: 04-2745150 FEE $10.00 PERMIT NUMBER: C-3 SIGNATURE: DATE: �J