Tobacco & Nicotine Delivery Products Sales 2025/Ventas de productos de suministro de tabaco y nicotina en 2025
May 21, 2024
submission
#369
Petitioner Application
New Applications 500 Feet from a School.
| I can attest that my establishment is in compliance with the regulation of not being 500 feet of a public or private school . | --- |
| Abutters list from Public Records Request | --- |
Application
| Type of Application/Tipo de aplicacion: | --- |
| Business Name/Nombre del Negocio: | --- |
| Owner Email address/correo electrónico | [email protected] |
| Owner Telephone number/Número de teléfono | 7816967377 |
| Mailing address(if different)/Dirección postal (si es diferente) | SAME |
| Establishment physical address/Dirección física del establecimiento | 560 WASHINGTON AVENUE |
| Owner Name/Nombre del dueño(a) | SAMIR B PATEL |
| Business Address/Direccion del Negocio: | --- |
| Business Telephone/Telefono del negocio: | --- |
| Owner's Name/Nombre del dueño: | --- |
| Owner's Address/Dirección del propietario: | --- |
| Owner's Telephone/Teléfono del propietario: | --- |
| Email Address/Correo Electrónico: | --- |
| Emergency Response Person/Nombre del contacto de emergencia: | --- |
| Emergency Person Telephone/Teléfono del contacto de emergencia: | --- |
| MA Dept. of Revenue Retailer's License number for Sale of Cigarettes/Número de licencia de minorista del Dept. de Ingresos de MA para la venta de cigarrillos: | --- |
| Type of Products Sold/Tipo de productos vendidos: | --- |
| Are you the owner of the business? | Yes |
| Other/Otro: | --- |
| Federal Tax ID Number/Número de identificación fiscal federal: | --- |
Petitioner Document Check
Documents
| Copy of Cigarette Retailer's License, issued by Massachusetts Department of Revenue/Copia de la licencia de minorista de cigarrillos, emitida por el Dept. de Ingresos de Mass.: | --- |
| Certificate of Good Standing from the Massachusetts Department of Revenue; masstaxconnect.com/Certificado de buena reputación del Dept. de Hacienda de Mass; masstaxconnect.com: | --- |
| A Certificate of workers compensation insurance or Certificate of Compliance/Un Certificado de seguro que muestre compensación para trabajadores o un Certificado de cumplimiento: | --- |
| Wage Theft Certificate Form/Formulario de certificado de robo de salario: | --- |
| Proof that any/all tobacco sales citations have been paid/Prueba de que se ha pagado alguna / todas las citaciones por venta de tabaco: | --- |
| Proof that City personal property tax has been paid (obtain at City Treasury)/Prueba de que se ha pagado el impuesto a la propiedad personal de la ciudad (obtenga en la Tesorería de la ciudad): | --- |
| Certificate of Occupancy/Certificado de ocupación: | --- |