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2. Business Name of Caterer*
3. Phone #*
5. Business Address*
   Street Address, Town/City, State & Zip Code
7. Name of Business Owner*
8. Owner Phone #*
10. Email of Business/Owner*
12. Name of Catered Event*
13. Date & Time of Event*
15. Location/Address of Event*
17. Name of Person in Charge (PIC) of food service during the event*
18. PIC Phone #*
20. Does the PIC have a Food Manager Safety Certification? If yes, submit copy to healthdept@winchester.us or mail to Health Dept., 71 Mt. Vernon St, Winchester MA 01890*
    -- Select One --YesNo
22. Will any food be coooked from raw on site? *
    -- Select One --Yes No
24. If yes, food will be cooked on site from raw, please list which foods and equipment used on site:*
26. Describe how foods will be hot and/or cold held at proper temperature during transport and at event:*
28. THIS APPLICATION IS NOT COMPLETE UNTIL THE FOLLOWING ARE SUBMITTED TO THE WINCHESTER BOH: 1) A copy of the food permit for the Catering Business (issued by the Board of Health where the catering business is located; 2) Complete Menu; 3) Paid Fee; and 4) Workers Compensation Affidavit and Coverage Selection Page
30. All required documentation can be submitted to healthdept@winchester.us, mailed to Health Dept., 71 Mt. Vernon St, Winchester, MA 01890, or faxed 781-729-1794. Permits will not be issued until all required information is received.
32. Applicant Signature*
    Once name is typed in, it will be considered an electronic signature.
33. Date*
35. Payment Options
    Payment must be made before a permit will be issued. To pay online click below, or a check payable to "Town of Winchester" can be mailed to: Winchester Health Dept., 71 Mt. Vernon St, Winchester, MA 01890
37. Online Payment
    Catering Permit

    Once online payment is complete, you need to return to this page and “submit” application.
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field