HomeMy WebLinkAboutApplication 19 John FItch Bolevard Town of South Windsor - Health Department
0 1540 Sullivan Ave., South Windsor, CT 06074-Mailing Address
1530 Sullivan Avenue, South,Windsor, CT 06074-Office Address
Phone Number: (860) 337-6173 Fax: (860) 644-1930
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Restaurant Establishment Information New Permit❑ Permit Renewal ❑
***(Please Print Clearly)***
Name of Establishment: L--W"
Manager's Name: ZCb6k- puj r;A
Street Address: l q TO�U) r_jfC* 15LU17
City, State, Zip Code: 1;O_ to vjc642 ' C-1-
Phone#: bay 9 -7ig6 Cell Phone#: _���--VaK(�
Fax#: 960-AS l 7 �
E-Mail Address: zpgPu j ooj3a @ e0Wj,(:4"'l Seating Capacity: �o $
sui?rnii latest col?y ofi rr, alified Food Operator/ServSafe certificates to the office.
Qualified Food Operator: YES[a NO ❑ (Required foe Certificate#:
Class 3&4)
Name: Z05UPW DUN* Date:
Testing Organization: Ati4t /A jwr-1N5T- Phone#:
E-Mail Address: .5 AM 6' Alternate Phone#: -7
Designated Alternate 1 PUl`I?A- Designated Alternate2 : 37AgpW W100411n
Restaurant Owner Contact Information
Owner's Name: a5i�PA- Do t),A-
Street Address: /30 6QALM ep
City, State, Zip Code: SaxV} (,U"SO4 i (A-I- -
Phone#: -A0 6 q3-I�,ti d. Fax #: %60,M7-,73-),
E-Mail Address: SD - Dal-t1Pr aae_4^'4, 6401 Cell Phone#:
Renovations
Were there any renovations made last year? YES❑ NO yt Will there be any renovations? YES❑ NO
If Yes, please list all renovations
that were done/to be done:
Mai ing Address to send Food License Renewal Permit to: RECE VED
Name of Restaurant/Company: ReTUAeli nWJ05 MIJV 0 ZUl/
Attention: JOC�'DddJ` VV j 1\A_ ery iTu wwncnR
Address: l r � }•-��{ �!w n HEALTH DEPT.
City, State, Zip Code: lj0OTFk- iLAt,,050n 1 L1- , 060-7`F
Phone#: -36 o— 0111
Restaurant Menu/List of All Items Served/Sold
Latest Menu Attached? YES, NO ❑ NOTE"•(Must have latest copy on file)
Please list all menu items in as much detail as possible or a copy of a menu attached is applicable.
Additional Information
Please check one only:
State Licenses: ZBakery ❑ Liquor Permit _ j None
Water Supply: ,el Public Private Well
Wastewater Disposal: _ Public /On-Site _Other (please use space below to explain)
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that any false
statements or other misrepresentations made on this application may result in immediate shutdown or revocation of my Food
Service License for the Town of South Windsor.
Applicant Name (Print): � �'_ �v i�\Pr
Applicant Signature: Date: 1
Office Use Only
Inspector Name (Print): ,S
Inspector Signature: Date:
Food Class: 1 ❑ 2 ❑ 3 [V 4 ❑ Expiration Date: Z 3\ $
Date Received: Date Approved:
2 �j 2<1b �� 8b 1 ��l ►�t�
I
064-56-1322 06/ 24/97
PUIIA9-- JOSEPH V
19 JOHN FITCH BLVD .
50. WINDS R9 CT - 06074
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Signature
Breakfast Sandwiches Hot Drinks Catering Menu
(Served All Day) Small Medium Large
Morning Rounders On a Bagel or Roll(Croissant99d more) Coffee 12 oz 16 oz 20 oz BREAKFAST PLATTER-large Serves 14-16...................................................... $49.99
smallServes 8-10........................................................ $32.99
Egg and Cheese............................................................................................... $3.69 Regular er Flavors............................................................................. $1.99 $2.19 $2.39 An assortment of Mini Danish,Mini Bagels and Mini Muffins
Egg and Cheese with Bacon,Ham or Sausage.........................................$4.59 a on ed latter.Includes Cream Cheese.
Hot Chocolate.................................................................. $3.29 $3.59 $3.89 arranged P
Rich Chocolate Milk Steamed,Frothed and
FRESH FRUIT PLATTER- large Serves 18 20................................................. $56.99
Morning Wrap Arounds Plain,or Whole Wheat Wrap Topped with Whipped Cream
Western-Egg with Ham,Peppers,Onions and Cheese........................ $4.89 small Serves 10-12................................................. $39.99
Mexican-Egg topped with Salsa and Pepper Jack Cheese................. $4.89 Choi Tea.......................................................... .. . .. .. $3.29 $3.59 $3.89 An assortment of Fresh Seasonal Fruits served on a platter.
Jenkins-Egg,Portobellos,white onions,ham,Swiss cheese............. $4.89 A Spicy Tea blended with Steamed Milk
FRESH Faun BOWL- Serves 10-12............................................................... $39.99
Woodstock-Egg,Portobellos,peppers,tomatoes,Amer cheese....... $4.89 Latee(16 ounce)..................................................................................$3.89
Espresso,Steamed Milk,with a thin Layer of Frothed Milk DELT PLATTER- large Serves 24-26..............................................................$139.99
small Serves 14-16............................................................... $89.99
Bagels* Bagel Rolls Mochaccino(16 ounce)...................................................... $3.89 All Deli Platters come wrapped and garnished,and include Pickles,
Espresso,Steamed Milk,Chocolate Syrup, Whipped Cream Lettuce,Tomato,Mustard and Mayo.Plus your choice of bagels,
Sticks breads or rolls.
HotTen.............................................................................. $2.19 $2.19 $2.19
Each $1.29 $.89 $.99 • Great American Ham,Turkey Breast,Roast Beef,American Cheese
1/2 dozen $6.49 $5.34 $5.94 A variety of Regular,Decaf and Herbal Teas available
(or choice of any 3 meats and one Cheese)
Dozen $9.99 $7.49 $8.99
Joe To 60 (12 Cups)........................................................................................ $17.99
*Premium Bagels $.40 extra Includes cups,creamers,sugars,stirrers,and napkins. GIANT PARTY BAGEL SANDWICH-large 16 pieces....................................... $79.99
w/Cream Cheese $2.99 $2.09 no small 8 pieces.............................................. $49.99
(Plain or Low Fat) A 2 lb.plus Bagel filled with your choice of Meats
Flavored Cream Cheese $3.29 $2.29 na Cold Drinks and Cheeses complete with a Garlic Bagel Chip filled center.
w/Butter or Jelly $2.19 $1.89 $2.09 16 oz 24 oz
w/PB&Jelly or just PB $3.29 $2.29 no Fountain Soda...................................................................................$1.99 $2.29 SANDWICH PLATTER-large Serves 15............................................................$124.99
Cream Cheese & Sliced Nova Lox w/Tomato & Onion... $8.49 Iced Coffees....................................................................................$2.19 $2.59 small Serves 10............................................................. $84.99
Your choice of assorted Sandwiches cut in half and arranged
Fresh Brewed Iced Tea.................................................................$2.19 $2.59 on a platter.Sandwiches are wrapped and come with Pickles and Chips.
Bakery Items Fresh Brewed Flavored Iced Teas............................................. $3.19 $3.59
Muffins $2.49 each (3)$6.99 (6)$12.99
Iced Choi Tea...................................................................................$3.59 na BOWL of TossED SALAD-(serves 8-10)...................................................... $28.99 Iced Latte.........................................................................................$3.89 no Croissants(Buttered)....................................................................................... $2.49 COOKIE PLATTER-large Serves 14-16.............................................................. $35.99
Croissants(Filled)........................................................................................... $2.79 5napple(assorted flavors)........................................................... $2.29 each
small Serves 8-10.............................................................. $25.99
Danish,Turnovers,Cinammon Buns............................................................ $2.49 Milk(assorted flavors).................................................................. $2.19 each An assortment of Premium Cookies arranged on a platter.
Brownies........................................................................................................... $2.49 Bottled Water................... . $1.39 each
..............................................................
Cookies-Assorted............................................................................. Prices Vary DESSERT PLATTER-large Serves 14-16............................................................ $39.99
Breads:Rye,Pumpernickel,Hone Wheat.................................... Prices Vary Tropicana Juices(assorted flavors)................10 ounce:$1.59 • carton: $2.49
Y P Y rY small Serves 8-10............................................................... $29.99
An assortment of Cookies and Brownies arranged on a platter.
Take Home by the Pound Frozen Cocktails (16 ounce)
Our Boar's Head Deli Meats and Cheeses,Deli Salads and Sliced Nova Frozen Cappuccino................................................................................................$4.89
Lox are available to take home.So are our Coffee Beans. Frozen Mochaccino............................................................................................... $4.89 Well Rounded Soups
Plain&Low Fat Plain Cream Cheeses(8 ounce)...................................... $3.99 Frozen Vanilla Latte...........................................................................................$4.89 Your choice of our Soups of the Day(seasonal).
Flavored Cream Cheeses(8 ounce)............................................................ $4.59 Frozen Caramel Latte..........................................................................................$4.89 Served with a Bagel Stick. Soup Chowder
Low fat Veggie,Scallion,Vanilla Raisin Walnut, Cu ................................................ ........................................ 3.99 $4.99
Strawberry,and Featured Flavors Frozen Strawberry.............................................................................................. $4.89 Bowl $
Frozen Peach......................................................................................................... $4.89
...................................................................................... $4.99 $5.99
Coffee Beans-Ground to order.......................................................... 10.99 lb 4.89 Cup of Soup and 1/2 Well Rounded Sandwich
$ Frozen Mango.................................................................................. $
(except Cutlet).......................................................... $7.79 $8.79
Well Rounded Sandwiches Wrap Arounds �� RO
Our Sandwiches and Wraps are made from a 114 pound of Boar's Head Deli Each wrap is made from the very best Boar's Head Meats,Cheeses and Toppings and
Meats and Cheeses with your choice of Toppings served on our own Fresh Bagels, is served with a Pickle and Potato Chips.
Fresh Baked Rolls or Breads.Each Sandwich is wrapped for easy eating and Mediterranean... .... $6.99 y
Aserved with a Pickle Spear and Potato Chips.(Croissant-Add$.99) Fresh Mozzarella,Roasted Peppers,Lettuce and Tomato
Maple Glazed Turkey Breast...................................................................... $7.29 drizzled with Balsamic Glaze in a Spinach Wrap
Oven Roasted Turkey Breast. .................................................. _ __ _ $7.29 Buffalo Chicken................................................................................................... $7.29 O
Chicken Cutlet(served hot)...................................................................... $7.29 Sliced Breaded Chicken Breast drizzled with Buffalo Sauce, • •
Roast Beef...................................................................................................... $7.79 Lettuce and Tomato topped with Bleu Cheese Dressing inside a
Corned Beef $7.59 Classic Flour Wrap W
Pastrami........................................................................................................... $7.59 Chicken Caesar..................................................................................................... $7.59
(premium Boars Head Grilled Chicken Breast and Crisp Romaine topped with Grated
Ham(
P )..................................................................... $7.29
$ Parmesan and Caesar dressing inside a Classic Flour Wrap
GenoaSalami.................................................................................................. 7.29 L
$6.49 Tuna........................................................................................................................ $7.29 • •
s
Chicken Salad(All White Meat)............................................................... $6.99 Tuna Salad with Lettuce and Tomato topped with '4/1/O��MCC Lp�'
Tuna Salad....................................................................................................... $6.99 American Cheese on a Whole Wheat Wrap ►A
AmericanVeggie.................................................................................................. $6.49
Egg Salad......................................................................................................... $6.49 American Cheese,Lettuce, Tomato,Onion and Roasted Peppers,
1/2 Well Rounded Sandwich(on bread-no cutlet)............................. $5.29 with Between Rounds Vidalia Onion&Peppercorn Dressing inside a South Windsor, CT
Extra American,Swiss,Provolone,Cheddar or Pepper Jack Cheese......... add: $.59 Sundried Tomato Wrap
Extra Roasted Peppers............................ .............................................add: $.59 19 John Fitch Boulevard, Route 5
Extra Bacon............................................. .............................add: .79 Well Rounded Salads
����������������� $ Monday-Friday 5:30am-7pm
Toppings-Lettuce, Tomato,Onion,Spicy Mustard, Salads are made fresh,and come with your choice of Dressing:
Golden Italian,Honey Mustard,Lo-Fat Zinfandel Vinagerette,Caesar, Saturday 5:30am-3pm
Honey Mustard,Mayonnaise,and Russian Dressing Between Rounds Vidalia Onion d-Peppercorn,or Bleu Cheese Sunday 7am-2pm
Classic Garden Salad. . _ ___. _. _ $5.79 86�-2('1-878�
Well Rounded Combinations A blend of Mixed Field Greens and Romaine Lettuce with Tomato, v V 77 v v
Each Sandwich is made from Boar's Head Deli Meats,Cheeses and Toppings,served on Red Onion,Carrot,Croutons or Bageltons fax: 860-289-2732
our own Fresh Bagels,Fresh Baked Rolls or Breads,and wrapped for easy eating. With a scoop of Chicken,Tuna,or Egg Salad......................................... add: $2.49 Convenient Drive Thru Window
Served with a Pickle Spear and Potato Chips,
CaesarSalad......................................................................................................... $5.79
All American............................................................................................. $9.59 Romaine Lettuce topped with Parmesan Cheese,
A combined 6 ounces of Oven Roasted Turkey,Roast Beef,and Ham Croutons or Bageltons,and Caesar Dressing
topped with American Cheese,Lettuce,Fresh Tomato and a dollop of
Mayonnaise on your choice of Bagel,Bread or Roll Grilled Chicken Caesar Salad............................................................................ $7.99
Romaine Lettuce topped with Grilled Chicken,Parmesan Cheese,
Tom Tom Club............................................................................................... $8.29 Croutons or Bageltons,and Caesar Dressing
Sliced Maple Glazed Turkey Breast topped with Bacon,Melted Swiss, Cobb Salad....... __ _ _ __ ....................... $8.49
Lettuce, Tomato,and Mayo on your choice of Bagel,Bread or Roll A blend of Mixed Field Greens,Romaine Lettuce, Tomatoes,
Chicken Club................................................................................................... $8.29 Grilled Chicken,Bleu Cheese,Hard Boiled Egg,and Crumbled Bacon OTNER LOCATIONS
Breaded Chicken Breast 6 Crispy Bacon topped with Lettuce, Vernon, CT • 860-870-1114
ChefSalad............................................................................................................ $7.99
Fresh Tomato and Mayonnaise on choice of Bagel,Bread or Roll Manchester, CT• 860-644-9025
A blend of Mixed Field Greens and Romaine Lettuce,Tomatoes,Sliced Hard
Reuben Rounder............................................................................................. $8.59 Boiled Egg,topped with Asiago Cheese,Ham and Oven Roasted Turkey Tolland, CT(limited menu) • 860-872-8936
Hot Deli Corned Beef or Pastrami topped with Sauerkraut,Melted Swiss, Chicken Mozzarella Salad.............. ........ $8.49
and Russian Dressing on your choice of Bagel,Bread or Roll A garden salad topped with Fresh Mozzarella,roasted peppers,
Lets Go Italy.................................................................................................. $8.29 and grilled chicken Delivery Available
Ham and Genoa Salami topped with Provolone Cheese and Roasted Peppers Corporate Accounts Welcome
Fresh Fruit Cup(seasonal)......................................................................... $4.29
Prices subject to change without notice. For Franchise Opportunities please call860-291-0323
Novemberzols Yogurt Parfaits(Low Fat Yogurt,Fruit,Granola)............................... . $4.29
www.betweenroundsbagels.com