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HomeMy WebLinkAboutTHE VAPE WAY - RETAIL FOOD TMThe Vape Way A3-06j 11 Enterprise Rd. HY I F Town of Barnstable BOARD OF HEALTH John T.Norman (] Board of Health Donald A.Guadagnoli,M.D. Fa BARNsreaM ' F.P.(Thomas)Lee 200 Main Street, Hyannis, MA 02601 Daniel Luczkow Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Sell Tobacco In accordance with regulations promulgated under authority granted by Sections 5,31 and 127A of the General Laws of the Commonwealth of Massachusetts and Chapter 371 of the Town of Barnstable Code, a permit is hereby granted to: Permit No: 1043 Issue Date: 1/1/2021 DBA: VAPE WAY, THE OWNER: NEW VIZION PRODUCTIONS INC Location of Establishment: 11 ENTERPRISE ROAD HYANNIS, MA 02601 Type of Business Permit: Adult Only Annual Seasonal FEES YEAR: 2021 TOBACCO SALES: $85.00 Permit Expires: 12/31/2021 Thomas A. McKean, RS, CHO, Health Agent Restrictions: PLEASE POST CONSPICUOUSLY Town of Barnstable For Office Use Only: Initials Inspectional Services Date Paid Amt Pd$ Public Health Divisionj� • MASS. " Check# 02? P�l� Hass. V b 1bs� ,0� Thomas McKean, Director CFO IM't A 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ADULT ONLY RETAIL TOBACCO SALES PERMIT APPLICATION DATE `Z �� Z® NEW BUSINESS: NEW OWNERSHIP RENEWAL I/ NAME OF ADULT-ONLY RETAIL TOBACCO SALES ESTABLISHMENT: ADDRESS OF TOBACCO ESTABLISHMENT: ��/ J�� '` _ �' ✓emu/�O j MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: r�l-�°f• ��'h BUSINESS PHONE: TELEPHONE NUMBER OF TOBACCO ESTABLISHMENT: OWNER'S NAME: �.�`r/ I7 S OWNER'S ADDRESS: CORPORATE NAME: CORPORATE ADDRESS;�� CORPORATE FID# ANNUAL: 4`000' SEASONAL: DATES OF OPERATION: / / TO DAYS CLOSED EXCLUDING HOLIDAYS(EX. MONDAYS) DO YOU CURRENTLY POSSESS A STATE LICENSE TO SELL CIGARETTES? Yes '-�No DO YOU CURRENTLY POSSESS A STATE LICENSE TO SELL CIGARS/SMOKING TOBACCO? Yes 1-- 1Vo TOWN OF BARNSTABLE COMMA GENERAL LAW INTERNET LINKS: TOWN OF BARNSTABLE TOBACCO CODE LINK FOR CHAPTER 371-9: https://www.ecode360.com/33996392 MA.GENERAL LAW CHAPTER 270/SECTION 6: Pttps://malegislature.gov/Laws/GeneralLaws/Partl V/Titlel/Chipter270/Section6 PLEASE ATTACH A PROPOSED FLOOR PLAN OF THE EST.and a LIST OF PRODUCTS PROPOSED TO BE SOLD A HEARING IS REQUIRED BEFORE THE BOARD OF HEALTH. THE BOARD MEETS ONCE PER MONTH. APPLICANT IS REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT ISSUANCE PLEASE CALL 508-862-4644 SIGNATURE: PRINTED NAME: Q:\Application Forms\TOBACCO App 2020 ADULT Only Retail Tobacco Sales draft 1.docx Town of Barnstable Ew_Qff 19-9 y� initials: r T A..Phi S Inspectional Services ��c �� ► Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, NfA (12601 Office: 508-862-4644 Fw `O( -790 6304 ADULT ONLY RETAIL TOBACCO SALES PERMIT APPLICATION DATE W17 0 NEW BUSINESS: NEW OWNERSHIP RENEWAL V NAME OF ADULT-ONLY RETAIL TOBACCO SALES ESTABLISHMENT: ADDRESS OF TOBACCO ESTABLISHMENT- MAILING ADDRESS(IF DIFFERENT FROM ABOVE): � k:-MAIL ADDRESS: BUSINESS PHONE: 'y+° ` TELEPHONE NUMBER OF TOBACCO ESTABLISHMENT: OWNER'S NAME: �.!��r� �� � 0WNFIt'S ADDRESS: O f J.► G'' „Y '.�J� M'.� C' i" �/Y G � !�� CORPORATE NAME: CORPORATE ADDRESS���� �+�+"� CORPORATE FID$$ ANNUAL: 4+' SEASONAL: DATES OF OPERATION: �l�/ TO l l� DAYS CLOSED EXCLUDING HOLIDAYS(EX. MONDAYS) DO YOU CURRENTLY POSSESS A STATE LICENSE TO SELL CIGARETTES? Yes I" No DO YOU CURRENTLY POSSESS A STATE LICENSE TO SELL CIGARS/SMOKING TOBACCO? Yes i' No TOWN OP ItARNs'rA q1 't CO•ffI1-1A C NFRAI LANK' -aERNET LINKS: TOWN OF IIAR?NSTABLE TOBACCO CODE LINK FOR CHAPTER 371-9: SIA GENERAL 1ANN'C'IIAPTER 27"*E(71'tON 6: hwwlli ak'w?I rik �t 4A!Ygj_'cl/t.h 1?tzr27C1,C ctiou6 PLEASE A`ffAC14 A PROPOSED FLOOR PLAN OF THE ESA'.and a LIST OF PRODUCTS PROPOSED TO BE SOLD r A HEARING IS REQUIRED BEFORE THE BOARD OF HEALTH_ THE BOARC FF—t§ NCE ER';t4t W AI'I`1. 1 C AN I IS I{POUT{t Ft)'t`C3 C'ti1,l IIF,tl,T li DIV FOR INSPECTION PRIOR TO P[^RMIT IS�Ur1NCF PLEASE CALL 508 862-4644 PRINTFD NAMf,; c' / Ct:4Applicaiivn borm,VOIW f,0 App!WO At 01 I Only Ke ail TQbacro Sales draft T,duty ESTAT)LISxtMt N""'S N,lk" ' 2 t -TOBACCO ALF-8 '.mPtt�yre Si}�nnturc lrr�rrtr understood Ctqjpter 71c, eecCs} cif iliia c:Ktnt�lisltrncrttctt rec�C;cnlcr6�lt's+t which descrtbc's le form is for oil`iciat use tc+ ilidic.�tc that theptcr�2'70 Scc.ti►In 6 fti� ►�,dcr►ihcvnF;e of twcx$ty-one (21), l3elati�' is of the Tows of Barnxts�t�tr Cerdc ��► �It,Fprexlucis t►s nn}' person penalties for selling and/or :ion 371-9. of ttie To%ti11 of t3anistablc lionrd of Health It,egutatin►1: Sgles to 11'tinors 371-9. 811Ir and 1)i, lion nfTol►ncco Products. t shall sell or provide a tobacco product, as defined herein, to � person s-abi der 1. too person , ai sates ;tf;c in the Town of Barnstable the minimum tcg.►t sales age. The rninintiun, lt.g is 21 ?ears of nee, herei 2. identification; Each person selling or distributing tobacco product, � defined to�g apt��c shall Nerif}- the age of the purchaser by means of a valid govcrrrchas tss ears old or identification containing, the bearer's date of birth that tkte purchaser is 21 �' older. Verification is required for tiny person under the age of 27. The employee(s) s below received and understood Section 371-9 of the Town of Barnstable Board rd of Health Prohibition of Smoking Regulation and Chapter 270 Section 6 of the Massachusetts �•h Frinted Name Date Signature <71 Printed Name Mate naturc � Signature Printed Name Date _ a S' 11 azure printed Name gate signature Printed Name late Signature Printed game Date signature Printed Name Date a r'.1 0 M Uli 11) L1634350656Common ealth of Massa insetrsNotice gate.Scptember 1,2020 I)cpartmcni tiCRcrcrlac Acciwnt 1C):CR1,-10519335-0}09 Geoffrey E.Snyder,Comm sstoilef rn><,ti.gocldor RETAILER IAC'ENISF I'()!t SAI,F. O CIGA RS AND S'100KINC, "I C)RACCO ll4y,,,��,E1t1111�F�1�1��,�1�1,�I�l�i�llllll�l(tll�l��l�l�lll�lt Ctt ND 111� NJ-v e,l .,�s� t�tt;stet°c�t1�_��s INC d lit V"_at'"t Pt t I10y apt~ ttach d below i,,\��ur Rctaiicl License for Sale of C'igars and Smokirxg Tobacco (Form ("1-3`1}. Cut ,. along the dotted line and display at your business location. At any tirne, you can log into your Mas,;Ta\(. onncct account at nnass,gov/inasstaxconnect to view and re-print a copy of this license, 4 1f you have anyquestions about your license,call us at(617) 887--6367 or toll-tree in Massachusetts at E t,800) 3 -1-6 S9."Monday through Friday, 8:30 a.m.to 4:30 p.m. i DETACH HERE 1.�S, C HUST TTs I)rP kRTm1'1NT OF REVENUE Foam CT ` r ftetstier l,icerrse for Sale ol'C igars and Smoking Tobacco This liccuse must he potistcsd alld visible sat all tildes.The sale of tobacco products to atry€ ic- mider 18 vem's s)C age-is prohibite( . Account 11); 1,trca(iotl1W 10319335-0008 l..icense Ntt nbcr; 18655416.3' m This certi' der C'lltsptcr 64C of'the �1.is'SaCitusettS CJtneral Laws to ;ell at retail at the addtess shown above,Tfil� license it non-transferable and ivay be suspended or revoked for F;: nation ;Bate:September 30, J22 U�tt:t'�3�t,�ber 1, ._0,.. �� R 2r� !ester lE) trt)EyN7RtntT [ common.calth otM1lr�3rchwsclls Notice Date iefatcrrti�t 1,24)20 DcPa inicnt sit RCN-tic Ac-oUnt In <"Gd It�SIJ335 ,Li Cscnffrer(' SrtY+fsr,t`nrraoll"J"et �h t t � mxaaasidu, RETAILER LICENSE FOR SALE OF CIGARETTES (`Ii�'�i�lif'11rIr111r1I"III`I�I1rh�lltrltllli�ttlillili�ilrrlr CHAD PERRY NEW VIZION PRODUCTIONS INC THE VAPE WAY PO BOX 4075 PLYMOUTII MA ()23()1-4075 Attached below is your Retailer License for Sale of Cigarettes(Foon o� assut aalong o g the dotted line at and display at your business location. At any time,you can log l y mass.gov/masstaxconnect to view and re-print a copy of this license. if you have any questions about your license,call us at(617) 887-6367 or toll-free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. j DETACH HERE ' NlASSACIIUSETTS DEPARTNIFNT OF REVENUE Forrn C"1-3 Retailer License for Sale of Cigarettes This license must be posted and visible at all times.The sale of tobacco products,to anyone under 18 years of age is prohibite I*11�;�4r 1%ILtON PRODUCTIONS INC Account ID: CGL-10519335 00G 3"ltF VAPF WAN' 1_.ocation ID: 10519335-0007 I l h.NTTR.PRIS ,RCS S`FF�7 License plumber: 9561 Xtl�lst) it'i'<hNNIS NIA 02601-2256 Thl.s certifies that the tu\Payer named above is licensed under Chapter 64C of tile Massachuseas Cael�(r�l 1�1Y elf =ft s t sl) at tf�c address vl��}��n al7ovc.This lice fd bl;and mab ltjifjait: tt>cmi1ply with staw lairs and regulattons� o 1 f;t1`t(titer 1)<ltc e (),-to wr 1, 2021.1 Fx �r�►twn tc � Commonwealthnifiiaaaachusetts Ltttcrli?`.Lt�3359Z4[s32 tRcvenuc Notice Datc;'vtay 7,2020 i �(5711 n ussiancr Account CD, ED1,10519335-)1& Lb C t:. n do C 1 oRr� �C Y s Y ' w mass.govidor LICENSE FOR SALE OF 'ELECTRONIC NICOTINE DELIVERY SYSTEMS 111 � 11111+u �1�1�1 �11�U�'�'Will"��I�'lll"�iiliililill�l CtiAD PERRY NEW V1ZION PRODUCTIONS INC niE VAPE WILY PO BOX 4075 PLYMOUTII MA 02361-4075 Attached below is your Retailer License for Sale of Electronic Nicotine Delivery Systems. Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov(masstaxconnect to view and re-print a copy of this license. If you have any questions about your license,call us at (617) 887-6367 or toll-free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m. to 430 p,m. DETACH HERE ------------------------------------------------------------------------------------------------------------------------------------------ MASSACHUSETTS DEPARTMENT OF REVENUE f Retailer License for Sale of Electronic Nicotine Delivery Systems > This license must be posted and visible at all times. The sale of r�NIT ab c[s to anyone under 21 years of age is prohibited. NFW lrIZION t'R0D1Jt.TIC)Nq' INC::' Account ID- EDL-1(3519335 C)l8 TII1 V,kl'l WA`t' Vocation ID. 10519335.0022 t t ENTFIItPRISE F I ,"I E ? License Number: I t85486849 HYANNIS MA 02601-2256 Age-Restricted Stare This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to :ell electronic nicotine delivery systems at the address shown above. This license is non-transfervble sand May be suspefided or revoked for failure to comply with state laws and regul.itions, Lffective Date:May ? 2€20 Expiration Date: Septembcj. ',0 �!!�'� h a ,. 022 ? - s: ihsetts Department of Revenue T-I Customer Sake Bureau PO BOA Bostolif, MA 1'C° A-t.,, _ Irr • w .. ... RIntl y4"'t."Y"i."ya"4t1NSr�'X• ""a55 ."s. sell tarp e. perSonal p-rt:)Derty at mail or for resale, Pursuant to the � .n 4 . This registration ',,s effecfivg Only fix the regisitiatit at the locallon r address ni u i-ePQiIW to the D par me nt of Revenue so that a Nor . -1 24 ISSUE Day 1! 5/1 Yf Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Guadagnoli,M.D. t [uILIsrAaLF- 3 " Paul J.Canniff,D.M.D. +rases 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Sell Tobacco In accordance with regulations promulgated under authority granted by Sections 5,31 and.127A of the General Laws of the Commonwealth of Massachusetts and Chapter 371 of the Town of Barnstable Code, a permit is hereby granted to: Permit No: 1043 Issue Date: 6/15/2020 DBA: VAPE WAY, THE OWNER: NEW VIZION PRODUCTIONS INC Location of Establishment: 11 ENTERPRISE ROAD HYANNIS, MA 02601 Type of Business Permit: Adult Only Annual Seasonal FEES 8500 YEAR: 2020 TOBACCO SALES: $ Permit Expires: 12/31/2020 Thomas A. McKean, RS, CHO, Health Agent Restrictions: PLEASE POS CO NSPICUOUSLY ONSPICUOUSLY For Office Us Initials: ML oFIMWE Town of Barnstable !S- � Date Paid 2"!,kt Ed S Inspectional Services ll 8S (nLJ ` sneMA-S& Check# acFri q 1639.�. Public Health Division j AlfDN'°yp Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ADULT ONLY RETAIL TOBACCO SALES PERMIT APPLICATION DATE ?U(MORITORIL'M-NONL.-FvpuS1NESSES) CHANGE IN OWNERSHIP ` ' RENEWAL ADULT ONLY RETAIL TOBACCO SALES ESTABLISHMENT NAME: � jl. :° LJG' ADDRESS OF TOBACCO ESTABLISHMENT: // MAILING ADDRESS(IF DIFFERENT FROM ABOVE): �G�yJ�fjf E-MAIL ADDRESS: f Lr% . TELEPHONE NUMBER OF TOBBACCO E TABLISHMENT: 4 OWNER'S NAME: 'C G s I OWNER'S PH# % �V JIX�� OWNER'S ADDRESS: O�' G� ��� �0�� �0�1?Ip� ✓/�i� �Z 7�� CORPORATE ADDRESS: CORPORATE FID# ANNUAL: SEASONAL: DATES OF OPERATION: / / TO DAYS CLOSED EXCLUDING HOLIDAYS(EX. MONDAYS) TOWN OF BARNSTABLE CODE/MA GENERAL LAW INTERNET LINKS: TOWN OF BARNSTABLE TOBACCO CODE LINK FOR CHAPTER 371-9: https://www.ecode360.com/33996392 MA GENERAL LAW CHAPTER 270/SECTION 6: https://malegislature.gov/Laws/GeneralLaws/PartIV/TitleI/Chapter270/Section6 ***NEW BUSINESSES AND NEW OWNERS ONLY*** A HEARING BEFORE THE BOARD OF HEALTH IS REQUIRED. THE BOARD MEETS ONCE PER MONTH. ALL APPLICANTS MUST SUBMIT ITEMS 1-5. CHANGE OF OWNERSHIP MUST SUBMIT ITEMS 1-7. &0'11) MA State License to Sell Cigarettes 5) Payment of Fee(s)—see page 4 �2) MA State License to Sell Cigars and Smoking Tobacco 6) Proposed Floor Plan t/3) MA State License for Sale of Electronic Nicotine Delivery Systems 7) List of Products Proposed to be Sold ✓n) IRS Federal Tax ID#Document ALL APPLICANTS ARE REQUIRED TO: CALL HEALTH DIVISION AT 508-862-4644 FOR AN INSPECTION PRIOR TO PERMIT BEING ISSUED. SIGNATU INTED NAME: DATE: /7✓7 0,0 C:\Users\Chad\AppData\Local\Temp\TOBACCO ADULT ONLY APP Dtd 5-26-2020- 2.doc i!11t_V ( t) S `\11 I�'trt}►Ittttt ti�i�u,tlur�� 1.4.1 tu iln (ilrttr I', k,l sills. 1.11 ita, ts, 111,11, .th iIIA tit, tr`lsit,%. t -! ,ti . � .i.ri'lc.luiu nt ir, , i�.+,�I .tn,l untl��r,ir+<tti 4�Hlttttt�t 4If ttl th+� i tttfitt trl Wil 11%1altic i 'ath. .U1,i 1,,Il'h t , ,.1I,'I1 r, ul tht K'IAY.t, wy n wlin h l t„ I �,11 'L +�t Iit, I,ntn „I n�uu.t,tl,i, Itn:u,l „I It� .rltl� I', ! +tl;tit„u tie41t`L It1 \littlttti % t'I `! `,=tlt' atttl lYt•,tt�Iritlt,rn +tI it,l,.tt�tr t'tt,rltist�.. tit i11413 40t n Ir,It,I,t 1t Isit'tlu, ( I, Jul, -1 l In nuun�uitu 1,°��.il ,,ilr , ,It�r nt Ih� I n „I ft;iin t.,1Itn i�: d l a rau ti of alit, ?. lcicnilli��itlutI 1 .It h Iit It.t I ,. Iltnt' tst 11itIIly,, I,tl,:1, „ i,t,„htt t�,� :r,tlt_IIIwd itt-IclII ;hall verlh Ih,.� a;�c` t'tl ihc� Ittut ita�a r I,�, ntc�att°�ul a "'Iltci } nwnt i;,ut I 11114itII;,I,Ipll it' itIt-t7tti'it tttic,n t inttltutirIt, Ilic i}t'atc r' t mirth 11wl IIIc Iit11 cI,,,t i; �l v, ,il lit III ttltic r, l ertlic`ItUulr Ir tt°tltutcti list Ia r-,utt tutticl Ow al'r Ill Z7 1'he employcosi below rcc�ckcd and tnulcl•.Ioml `cOwn t7 f '1 nI tltc° i tiwil ul Itatn�;tirlth Ittr,ntl ,tl Ijc'rt1111 11i-iiltthttictn ctl Smoking Rgtitlutiuu antl t Irllth_•I " ,""0 tit�t Ilit" t, 'd tlx° tiic�tutttcrc ,,� Printed Name }t;'t`` Signature Printed Name Date Signaturel rmtc d Nanrc p - ^Printed Name 1?t e _ `+It�nauuc, l'rintcd Nantr .�._.�_ .. .. I>rintcd N;tnter Sienuturc I'rintedNutrtc Signature I ,tie 4'ktadAIM11tat t I,� d I,•tttl,l ul,ht_t t t r1111�L'1 Util.l too Commonwealth of Massachusetts Letter ID:L 103 5924032 �s Department of Revenue Notice Date:May 7,2020 Geoffrey E.Snyder,Commissioner Account ID:EDL-10519335-018 mass.gov/dor LICENSE FOR SALE OF ELECTRONIC NICOTINE DELIVERY SYSTEMS III����IIIII������I�I�1��11�11�'�'�I'lll'I�I�'lll"�IIIIIIIIIII�I CHAD PERRY NEW VIZION PRODUCTIONS INC THE VAPE WAY PO BOX 4075 PLYMOUTH MA 02361-4075 Attached below is your Retailer License for Sale of Electronic Nicotine Delivery Systems. Cut along the dotted line and display at your business location. At any time, you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license,call us at(617) 887-6367 or toll-free in Massachusetts at (800) 392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ----------------------------------------------------------------------------------------------------------------------------------------------- ssF�� MASSACHUSETTS DEPARTMENT OF REVENUE Y 4 Retailer License for Sale of Electronic Nicotine Delivery Systems 7. +4 �"Ehro This,.liceaese must be posted and visible at all times. The sale of tobacco products to anyone under 21 years of age is prohibited. NEW VIZION PRODUCTIONS INC Account ID: EDL-10519335-018 THE VAPE WAY Location ID: 10519335-0022 11 ENTERPRISE RD STE 7 License Number: 1185486848 HYANNIS MA 02601-2256 Age-Restricted Store This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell electronic nicotine delivery systems at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:May 7, 2020 Expiration Date: September 30, 2022 Commonwealth of Massachusetts Letter ID:L1220464512 P99M r Department of Revenue Notice Date:September 18,2019 - .1 Christopher C.Harding,Commissioner Account ID:CRL-10519335-009 4 &IV mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARS AND SMOKING TOBACCO �I'��I'III'II�III�II��'I1�1�1�111�1�1��1�11,�III�'ll�l'I�II�1�11�� o= CHAD PERRY o— NEW VIZION PRODUCTIONS INC N= THE VAPE WAY PO BOX 4075 PLYMOUTH MA 02361-4075 Attached below is your Retailer License for Sale of Cigars and Smoking Tobacco (Form CT-3T). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800) 392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ----------------------------------------------------------------------------------------------------------------------------------------------- ,clivs�'� MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T Retailer License for Sale of Cigars and Smoking Tobacco E�r"oti4 This license must be posted and visible at all tines.The sale of tobacco products to anyone under 18 years of age is prohibited. NEW VIZION PRODUCTIONS INC Account ID: CRL-10519335-009 THE VAPE WAY Location ID: 10519335-0008 11 ENTERPRISE RD STE 7 License Number: 854415360 HYANNIS MA 02601-2256 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:September 18,2019 Expiration Date:September 30, 2020 @11121 Commonwealth of Massachusetts Letter ID:L0146722688 Department of Revenue Notice Date:September 18,2019 [Eris it =` Christopher C.Harding,Commissioner Account ID:CGL-10519335-006 atrt54� mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARETTES 1111111 Jill 11il111 CHAD PERRY o_o NEW VIZION PRODUCTIONS INC THE VAPE WAY PO BOX 4075 PLYMOUTH MA 02361-4075 Attached below is your Retailer License for Sale of Cigarettes (Form CT-3). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE -----------------------------------------------------------------------------------------------=----------------------------------------------- s . MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3 Retailer License for Sale of Cigarettes z f Fn r& This license must be posted and.Visible at.all times.The sale of tobacco products to anyone under 18 years of age is prohibited. NEW VIZION PRODUCTIONS INC Account ID: CGL-10519335-006 THE VAPE WAY Location ID: 10519335-0007 11 ENTERPRISE RD STE 7 License Number: 317544448 HYANNIS MA 02601-2256 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: September 18,2019 Expiration Date: September 30,2020 ao Commonwealth of Massachusetts Letter ID:L0392367360 �g f Department of Revenue Notice Date:November 7,2017 Christopher C.Harding,Commissioner Account ID:SLS-10519335-005 t4rOlt mass.gov/dor SALES AND USE TAX REGISTRATION CERTIFICATE NEW VIZION PRODUCTIONS INC o� NEW VIZION PRODUCTIONS INC. b_— 50 SANDWICH ST o PLYMOUTH MA 02360-3369 Attached below is your Sales and Use Tax Registration Certificate (Form ST-1). Cut along the dotted line and display at your place of business. You must report any change of name or address to us so that a revised ST-I can be issued. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this certificate. DETACH HERE . ----------------------------------------------------------------------------------------------------------------------------------------------- s MASSACHUSETTS DEPARTMENT OF REVENUE Form ST-1 Sales and Use Tax i Registration Certificate� g. 7, This registration must be posted and visible at all E rot times. NEW VIZION PRODUCTIONS INC Account ID: SLS-10519335-005 THE VAPE WAY Location ID: 10519335-0004 11 ENTERPRISE RD STE 7 Certificate Number: 697167872 HYANNIS MA 02601-2256 This certifies that the taxpayer named above is registered under Chapters 62C, 64H and 641 of the Massachusetts General Laws to sell tangible personal property at retail or for resale at the address shown above. This registration is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: October 1, 2013 Y $ ya/.l.roe•w � a � s �chwsdit De artms en ie ustom r" ervice- pure u ;.: _._. . P01 ox T010 s#art A E4 MOZ The vendor herein name d is red+sted s �1tanglbe' arsonepre r regale.foey pur�u�r�t,t4 the en�ral t_sws,;Chatrs 62C4 6H"arid41. Thrs resttEo iffectiue or�iyafarti ristrar�tt#P�e #ion specified. eieirt Arty;cttang of r�rr�e or ac�ressmust.;ba rpotedsto ,�e ©eartrn �fi ofventie;:sa.ttt correct ST=1 can be tssueii. ON qXn FI Yt3 ;1 1�23611-33f9 [WE DA 111�i1t I ris re i tr�Cldn€llu"�#; a u1sp Ka ti r'eus#t�n�c t t see ai is DOT assildt n� lc rsr�rti�f�ral�l�. (XYA Mis'ONIA ra,c�r �trvEINFE Commonwealth of Massachusetts Letter ID:L0146722688 KIM rDepartment of Revenue Notice Date:September 18,2019 9 Christopher C.Harding,Commissioner Account ID:CGL-10519335-006 04� mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARETTES CHAD PERRY o NEW VIZION PRODUCTIONS INC THE VAPE WAY PO BOX 4075 PLYMOUTH MA 02361-4075 Attached below is your Retailer License for Sale of Cigarettes (Form CT-3). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ---------------------------------------------------------------------------------------------------------------------------------------------- s&C MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3 Retailer License for Sale of Cigarettes Vll 9 �Nt This license must be posted and visible at all times.The sale of tobacco products to anyone under 18 years of age is prohibited. NEW VIZION PRODUCTIONS INC Account ID: CGL-10519335-006 THE VAPE WAY Location ID: 10519335-0007 11 ENTERPRISE RD STE 7 License Number: 317544448 HYANNIS MA 02601-2256 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: September 18,2019 Expiration Date: September 30, 2020 o ❑' SHo- Commonwealth of Massachusetts Letter ID:L1220464512 ' Department of Revenue Notice Date:September 18,2019 - l Christopher C.Harding,Commissioner Account ID:CRL-10519335-009 oT� mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARS AND SMOKING TOBACCO �I'��I'III'II�III�II��'II�IIII111� 11111111�1'IIIIII CHAD PERRY o= NEW VIZION PRODUCTIONS INC o— N= THE VAPE WAY e PO BOX 4075 PLYMOUTH MA 02361-4075 Attached below is your Retailer License for Sale of Cigars and Smoking Tobacco (Form CT-3T). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ---------------------------------------------------------------------------------------------------------------------------------------------- SPA s41 MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T Retailer License for Sale of Cigars and Smoking Tobacco 9' F,,Vrcly This license must be posted and visible at all times. The sale of tobacco products to anyone under 18 years of age is prohibited. NEW VIZION PRODUCTIONS INC Account ID: CRL-10519335-009 THE VAPE WAY Location ID: 10519335-0008 11 ENTERPRISE RD STE 7 License Number: 854415360 HYANNIS MA 02601-2256 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: September 18, 2019 Expiration Date:September 30, 2020 r N�cs iiuQ CIA/m Town of Barnstable Public li Health Division ' VAPE WAY '"�`'M a`E 200 Main Street, Hyannis MA 02601 T PO 4075 ° A UTH ?VIA 02361 PLYMO , Office: 508-862-4644 FAX: 508-790-6304 September 10,2019 NOTICE TO ALL OWNERS OF ADULT-ONLY RETAIL TOBACCO STORES Entrance of Persons All owners of adult-only retail tobacco stores are reminded to ensure full compliance with Section 371-1 of the Town of Barnstable Code,which became effective as of July 28, 2019. Specifically,this Section of the Code requires the permit holder to prohibit any and all persons who are under the age of 21 from entering the store at any time. An adult only retail tobacco store is defined as follows: An establishment which is not required to possess a retail food permit whose primary purpose is to sell or offer for sale to consumers, but not for resale, tobacco products and paraphernalia in which the sale of other products is merely incidental, and in which the entry of persons under the age of 21 is prohibited at all times, and maintains a valid permit for the retail sale of tobacco products as required to be issued by the Barnstable Board of Health. To comply with this Section of the Code,you will need to: 1. Station an employee at the front entrance door to check dates of birth(i.e. driver's licenses)of any and all persons before entrance into the store or keep the front entrance door locked until such time an employee is available to the check dates of birth before each customer has the ability to enter the front entrance door into the store and it is suggested you; 2. Post a sign at the front entrance door which reads as follows: `Adult-Only Retail Tobacco Store Persons under the age of 21 years of age prohibited(see suggested sign provided on back of this Page) If you should have any questions,please contact Thomas McKean,Director of Public Health, at(508) 862-4644. .1 Persons under the age of .21 are not permitted to enter this establishment TOWN OF BARNSTABLE MM& BOARD OF HEALTH 1639. 0 1 � ilp04 y Crocker, Sharon From: McKean, Thomas Sent: Wednesday, September 11, 2019 9:50 AM To: Poyant, Lynne; elizabeth@hyannismainstreet.com; BOb Collett (bcollette@barnstablecounty.org); Spillane, Geoff(gspillane@capecodonline.com);Todd Deluca (todd@hyannis.com); 'advertising@barnstablepatriot.com' Cc: Crocker, Sharon Subject: .ANNOUNCEMENT-Workshop Regarding Adult Only Retail Tobacco Stores/ Discussion Topics: Design Standards, Other Products Which May or May Not Be Sold, Discussion of Whether or Not to Establish a Permit Cap ANNOUNCEMENT The Board of Health will be holding a public workshop on Wednesday October 16, 2019 at 4:00 p.m. at the Town Hall, in the second floor Hearing Room, 367 Main Street Hyannis, Massachusetts. Bob Collett, Director of the Cape Cod Regional Tobacco Control Program will be present at the workshop. This workshop is-open to the public. The discussion topics will include suggestions regarding design/construction requirements of adult-only tobacco retail stores wherever flavored tobacco products are sold, including nicotine products used in electronic devices and vaping devices. Also to be discussed will be the types of products which may or may not be sold at adult-only tobacco retail stores. Also open for discussion will be whether or not to establish an adult-only tobacco retail store permit cap within the Town of Barnstable. The Board of Health encourages public participation. ---------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------- NOTE: Also, approx. one month later, a public meeting of the Board of Health will be held on Tuesday November 19, 2019 at 3:00 p.-n.in the Hearing Room at Town Hall, 367 Main Street, Hyannis, Ma. The public is invited to this meeting also. 1 Ot1tJ Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. 'BARNScABM S John T.Norman 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1043 Issue Date: 07/24/2019 DBA: VAPE WAY, THE OWNER: CHAD PERRY Location of Establishment: 11 ENTERPRISE RD. HYANNIS MA 02601 Type of Business Permit: TOBACCO -ADULT ONLY Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: ,, � MOBILE-ICE CREAM: < QE Yamgh) FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: $85.00 FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: rt Town of Barnstable BOARD OF HEALTH Paul J Conniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. DARV5MBM John T. Norman bA 200 Main Street, Hyannis, MA 02601 F.F. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 1043 Issue Date: 01/11/2019 z. DBA: VAPE WAY, THE OWNER: CHAD PERRY Location of Establishment: 11 ENTERPRISE RD. HYANNIS MA 02601 Type of Business Permit: TOBACCO Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: -- --- MOBILE-FOOD:- MOBILE-ICE CREAM: an FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: $85.00 FOR ESTABLISHMENTS WITH SEATING: I PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE i Restrictions: t a Town of Barnstable Initials:LAID Date Paid Apt Ed$ • Ins pectional ectional Services eastvsrnBM ; 1� Check# 1639. Public Health Division CFO MA'1 A 200 Main Street, Hyannis MA 02601 Lo, � t�(0 I(cl Office: 508-790 4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health Fee: $85.00 MAIL TO: TOWN OF BARNSTABLE PUBLIC HEALTH.DIVISION 200 Main Street HYANNIS,MA 02601 FAX 508 790-6304 PLEASE INCLUDE THE REQUIRED FEE OF$85.00 APPLICATION FOR A TOBACCO SALES PERMIT ESTABLISHMENT NAME (D/B/A) ADDRESS OF BUS ESS -- MAILING ADDRESS (IF DIFFERENT FROM ABOVE) 129t2j- �Iw ENWL y PHONE# FEDERAL ID# Do you currently possess a state license to sell tobacco products? Yes No & 1/ i P /r 1�07� j�r5'�/r�� Ti2 � 61t�p e Each employee who sells tobacco products must receive and understand Chapter 371 of the Town of Barnstable Code (copy provided herein) and the Massachusetts General 141 Law Chapter 270, Section 6.00 (a copy is provided on the next page). Each employee who sells tobacco products must sign the Employee Signature Form (provided herein). Signatur Date / P / C:\Users\Chad\AppData\Local\Temp\TOBACCO APP2019 dob.docx ��# v� '+'Bra Y5`k t y 5 a y' F n _� � s .. ya a. r PTF � � r ' l ,"�t:1 `T T� s r y .a� I`O Ir oy igniForm.., , � tlil i' :'� ;1 ttt° t r This form is for official use to indicate that the ernploycc(s) of this establi.5hrrient recel ed all understood ChnIlter 371 of the. Town of Barnstable Code and Cr,aptcr 270 Section�� of the N'lassachusetts General Laws which describes the penalties for selling and/or giving tobacco, products to any pet-soil under the age of twenty--one (21), Below is Section 371 f the Town 'of Bartistable Board of Health Regulation: �� RM d � a rRua a= � Sales to Minors § 371-9.Sale and Distribution ofTobaeco Products. 1 an l. No person shall sell or provide a tobacco product, as defined herein, to a person under The minimum legal sales age. The minimum legal sales age in the Town of Barnstable is 21 years of age. 2. Identification: Each person selling or distributing tobacco products, as defined h " shall verify the age of the purchaser by means of a valid government-issued photo hie identification containing;the bearces date of birth that the purchaser is 21 years old or older. 'verification is required for,any person under the age of 27. lie following employees) received and understood Section 371-9 of the Town. of Barnstable Bomd of Health Prohibition of Snio? ing Regulation and Chapter 270 Section b of the Massachusetts General Laws: / �t21f _ r' :•;is�tiaturc Printed Namea�...._�:�.�....�..:�.4,........,�.. ., s , Printed Name Date p ' - Printed Nd'iri Date '.igraature �� Printed � 'errs<� .�...,,,�..�,�. �Date :;ignatrrre Dale PriitlNaztte'- :t'i ' t3 .��'AtY, P 1 'YOU ACCO SA1,(':S 1{mplo.yve Sigmitttre Form 1"leis t ari t iti tt�� �}iliei:tl tssc i�� indiontt th;tt the elilployce(s) of this establishment received and under tooki Chapter P1 of t1w. "l,o%4°n of Itstl,mtable Codex and Chapter 270 Section 6 of the Nla sachusctts t enrral 1_stty; v high desc:rihc.s the penalties for selling andfor givino tobacco products to any person tender the tts c of me tity-one (Z 1). Below is Section 371_t7 of the To% n of Barnstable Hoard of I Ic Ath Rewil'Ition: :Iles to Minors—k 371-9 Sale and Distribution o jobacco Products. I l. No person shall sell or provide a tobacco product, as defined hero, to a per:oll utt�l%r The minimum legal sales mx. The minimum legal sales age in the Town of Barnstable is 21 years of age. "?. Identification: Each person selling or distributing tobacco products,as defused herein. shall verify the age of the purchaser by means of a valid government-issued photographic identification containing the bearer's date of birth that the purchaser is1 years ilci ur alder. Verification is required for any person under the age of27. The following employee(s) received and understood Section 371-9 of the TaNVn Of 13t11­naahll; Board of Health Prohibition of Smoking Regulation and Chapter 270 Section 6 of the 11a shuse�t `general Laxks: rT Signature f'ri11to NaIIIC T a' iinature W;/;1 hintM Name Date Signature Printed Name Date Sip �� �1 Printed NEtm t�icSe � f+ 3 I Sign ature Printed Name: gate Naim, 5rg matt€rc '"rtrted� �' � 1 r , t l ..a 'r l� 5 � % ^r �' �W ,, C�5L 5E Z)4itt4 t• � �.., a >r3s 6v � ,i f Commonwealth of Massachusetts Letter ID:L0392367360 77 $ Ir Department of Revenue Notice Date:November 7,2017 th Christopher C.Harding,Commissioner Account ID:SLS-10519335-005 mass.gov/dor SALES AND USE TAX REGISTRATION CERTIFICATE NEW VIZION PRODUCTIONS INC o= NEW VIZION PRODUCTIONS INC. 01 50 SANDWICH ST PLYMOUTH MA 02360-3369 Attached below is your Sales and Use Tax Registration Certificate(Form ST-1). Cut along the dotted line and display at your place of business.You must report any change of name or address to us so that a revised ST-1 can be issued. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this certificate. DETACH HERE •----------------------------------------------------------------------------------------------------------------------------------------------- 5�� MASSACHUSETTS DEPARTMENT OF REVENUE Form ST-1 Sales and Use Tax Registration Certificate This registration must be posted and visible at all l ,vr0t`i� times. NEW VIZION PRODUCTIONS INC Account ID: SLS-10519335-005 THE VAPE WAY Location ID: 10519335-0004 11 ENTERPRISE RD STE 7 Certificate Number: 697167872 HYANNIS MA 02601-2256 This certifies that the taxpayer named above is registered under Chapters 62C, 64H and 64I of the Massachusetts General Laws to sell tangible personal property at retail or for resale at the address shown above. This registration is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: October 1, 2013 �tr Town of Barnstable RA Inspectional Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A. McKean,CHO This Cease and Desist Order is issued to: Mr. Chad Perry -The Vape Way 11 Enterprise Drive, Hyannis, MA 02601 Date: 09-25-2019 CEASE AND DESIST ORDER Pursuant to the Commissioner of the Department of Public Health's Order dated September 24, 2019, the sale or display of vaping products is prohibited in Massachusetts. The Vape Way is hereby ordered to immediately cease and desist the violation of the Commissioner of the Department of Public Health's Order. The Vape Way violated the Commissioner of the Department of Public Health's Order by [age shall check all that apply]: the undersigned witnessed the sale of vaping products by The Vape Way the undersigned witnessed the display of vaping products by The Vape Way ❑ other,see the below narrative description, with any necessary additional pages attached: Operation in violation of this Cease and Desist Order is a violation of law and may result in issuance of a $100.00 non-criminal ticket citation. Each day's failure to comply with an order shall constitute as a separate violation. Recurring violations of this nature may result in a show- cause hearing before the Board of Health for a determination as to whether the tobacco sales permit shall be suspended or revoked. N/ ; Signed by: Date: 9 l ; z5PM Name: As agent of[Department of Public Health/TOB] P"*j ease and Desist Order Received by: Date: . <,�- 9/ Name: --5-6,e GfoSj On behalf of The Vape Way Q:\TOBACCO\WP Files\Letters & Memos