Application For Common Victuallers License Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Application For Common Victuallers License Form. This is a Massachusetts form and can be use in Woburn County.
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Tags: Application For Common Victuallers License, Massachusetts County, Woburn
City of Woburn, Massachusetts
LICENSE COMMISSION
APPLICATION FOR COMMON VICTUALLER’S LICENSE
Fee: $100.00
Date:___________________
NAME OF RESTAURANT:_________________________________________________________
ADDRESS:_______________________________________________________________________
TELEPHONE:_____________________________________________________________________
NAME OF OWNER:________________________________________________________________
ADDRESS:________________________________________________________________________
TELEPHONE:______________________________________________________________________
DESCRIPTION OF PREMISES:________________________________________________________
___________________________________________________________________________________
GIVE NUMBER THAT CAN BE ACCOMMODATED AT TABLES__________________________
AT COUNTER_______________________________________________________________
HOURS OF OPERATION:_____________________________________________________________
IF NEW LICENSE, IS FAST FOOD SPECIAL PERMIT NECESSARY?________________________
DATE RECEIVED______________________________________________________________
SIGNATURE OF MANAGER:__________________________________________________________
PREMISES INSPECTED BY: BUILDING DEPT. __________________________________________
932-4440
HEALTH DEPT.____________________________________________
932-4407
FIRE DEPT.________________________________________________
932-4580
POLICE DEPT.______________________________________________
932-4532
ALL MUNICIPAL TAXES AND FEES MUST BE PAID PRIOR TO LICENSE APPROVAL.
(see attached form)
TREASURER________________________________________________
932-4483
LICENSE MUST BE RENEWED ANNUALLY ON OR BEFORE MAY 1ST
*Massachusetts Workers’ Compensation Insurance Affidavit and City of Woburn Treasurer’s Certificate
must be submitted with this form.
**This license, if granted, cannot be transferred or sold. Any changes in floor plan, hours, or addition to
entertainment must be approved by the License Commission.
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