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Home My Public Portal AboutFarmer's Market Retail Food Permit ApplicationTOWN OF BREWSTER 2198 MAIN STREET BREWSTER, MA 02631 PHONE: (508) 896-3701 EXT 1120 FAX: (508) 896-4538 BRHEALTH@BREWSTER-MA.GOV WWW.BREWSTER-MA.GOV OFFICE OF HEALTH DEPARTMENT TOWN OF BREWSTER FARMERS’ MARKET RETAIL FOOD PERMIT APPLICATION FEE: $30.00 _____________________________________________________________________________ Name of Establishment Operator Contact Telephone __________________________________________________________________________________________ Name of Market/Location Date(s) of Market/Hours of Operation __________________________________________________________________________________________ Operator Mailing Address Operator Email __________________________________________________________________________________________ 1. List the town your food establishment is licensed in ____________. If food items are prepared or processed outside of Brewster please attach a copy of your state or local food processing facility license, food establishment permit, food manufacturing license or residential kitchen permit. 2. Please provide a copies your Certified Food Manager’s and Allergen Awareness Training Certifications. 3. Are you a licensed wholesaler? ___ if so please attach a copy of your state permit. 4. Please list all prepackaged prepared food items or crustaceans, finfish, or shellfish you intend to sell. Any changes must be submitted and approved by the Board of Health or its Agent. __________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 5. If you are retailing crustaceans, finfish, or shellfish please attach copies of all pertinent state and local permits. 6. If you are retailing shellfish a copy of a written operational and HACCP plan must be submitted. 7. If you are retailing meat or poultry a copy of the federally inspected facilities license number must be submitted. 8. If your retail food(s) items need to maintain at 41⁰ F or below, how will this be achieved? _________________________________________________________________________________________ TERMS OF PERMIT  All product must be properly labeled in accordance with Massachusetts requirements for labeling. This shall include: Common name, ingredients, (listed in descending order of predominance by weight), net weight, name and address of manufacturer, all FDA colors. All ingredients that contain a major food allergen MUST be listed. If perishable the product must be open dated and labeled with proper storage information such as “keep frozen” or “keep refrigerated”.  This permit is for retail sales only, no food handling, food preparations, food sampling, or food demonstrations are allowed.  Shellfish tags must be available on site and maintained for a minimum of ninety (90) days.  Meat and poultry products must be maintained and sold frozen.  This permit is only valid for the farmers’ market that it is approved for. I agree to any conditions specified by the Brewster Board of Health Farmers’ Market Policy, 105 CMR 590.000 Minimum Standards for Food Establishments – Chapter X, the Federal 1999 Food Code, and 105 CMR 520 Requirements for packaged-food Labeling, and that I will comply with the terms established in this permit. __________________________________________________________________________________________ APPLICANT’S SIGNATURE DATE MARKET MANAGER APPROVAL As the Market Manager I have authorized the applicant to participate as a vendor. _________________________________________________________________________________________ MARKET MANAGER SIGNATURE DATE BOARD OF HEALTH OR ITS AGENT COMMENTS: __________________________________________________________________________________________ __________________________________________________________________________________________ APPROVED _____ NOT APPROVED _____ _______________________________________________ Approved by Date