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HomeMy WebLinkAboutApplication 982 Sullivan Avenue (2) SON 5`q<q Town of South Windsor - Health Department ,. 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 SOR-C O` Restaurant Estab ishment Information New Permit❑ Permit Renewal ❑ ***(Please Print Clearly)*** Name of Establishment: 6 (", (, k O f i ( Z 'L/� Manager's Name: D N `11E L TU Aj H L% Street Address: <1LeC� Va 4V e- City, State, Zip Code: W;, G ® �y Phone#: !� $1� 1� g -vo) Cell Phone#: Fax#: E-Mail Address: Seating Capacity: jr,,.ke_,9,U+ Please submit latest copy of the Qualified Food Operator/ServSafe certificates to the offiro Qualified Food Operator: YES$a NO [:] (Required for Certificate#: 21 2 Z J-_07o Class 3& 4) Name: � jam, T"A-1- Date: 3 ( ( Testing Organization: i�/A' b-1A,It (,1V.,, lk-A-, Phone#: E-Mail Address: Alternate Phone#: Designated Alternate 1: Designated Alternate2 Restaurant Owner Contact Information Owner's Name: j 0 N I L ,. T AA, Street Address: t(� 1� o�a� C Y G,5 hO V e, City, State, Zip Code: to. e ,9 Phone#: /^ d*Z ©q h ttL b D Fax #: E-Mail Address: l Cell Phone#: Renovations Were there any renovations made last year? YES❑ NO Will there be any renovations? YES❑ NO Fall If Yes, please list all renovations that were done/to be done: RECEIV Lin%i n A 9f1i7 Mailing Address to send Food License Renewal Permit to: SOUTH WINDSOR HEALTH DEPT. Name of Restaurant/Company: #- P f 92.j Attention: Address: 2 �G Va:, A-V e- City, State, Zip Code: S e i-U J a r L r V(- 0 x 9 Phone#: /� ��q $ I ds S go of Restaurant Menu/List of All Items Served/Sold Latest Menu Attached? YES n( 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: N Bakery ❑ Liquor Permit ❑ None Water Supply: _ 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): r�u S'1�4 C Applicant Signature: Date: l,, 2,41 [ Office Use Only Inspector Name (Print): Inspector Signature: Date: ` 't6hl I Food Class: 1 ❑ 2 ❑ 3 ❑ 4 ❑ Expiration Date: 2 3\ Date Received: Date Approved: To z tI 200 4 k%oZ2 Ut 16 111� PITA tic WRAPS N served with french fries Elm~ [L1 e extra cheese 0.75 • extra meat 1.00 Gyroon Pita................................................................................6.95 f Veggie Wrap VictoryWrap... ..........................................................................6.95 ' breaded chicken breast,mozzarella cheese,roasted peppers ITALIANDINNERS Turkey Wrap..............................................................................6.95 turkey breast,lettuce,tomato,mozzarella cheese servedwith salad&garlic bread Fisherman Wrap........................................................................7.95 fish fillet,lettuce,tomato,m vz._irella cheese&tartar sauce CheeseRavioli..................................................................10.95 Steak Wrap.................................................................................7.95 Meat Ravioli.....................................................................11.95 steak,grilled onion,lettuce,tomato,mayo&cheese 9 Grilled Chicken Wrap �r Stuffed Shells....................................................................10.95 ...............................................................6.95 Thin 111 �ustY. �J tyl�e Pi,z�,Za �j Manicotti...........................................................................10.95 lettuce,tomato,cheese&mayo Spaghetti or Ziti Chicken Caesar Wrap................................................................6.95 Qullllty, a't eSt PYlce w/ Sauce.............................................................................8.95 lettuce,tomato,Caesar dressing,romano cheese ';►� '� w/Meat Sauce.................................................................11.95 w Meatballs....................................................................11.95 - _ '�• �� BakedZiti w/ Cheese.......................................................10.95 Baked Ziti w/Meatballs...................................................12.95 ChickenParmigiana........................................................12.95 MeatballParmigiana.......................................................12.95 EggplantParmigiana.......................................................11.95 Sausage & Peppers Parmigiana......................................12.95 *-Ott-, �.Meat Lasagna .........................................12.95 Eggplant Rollantini............. 12.95 =' -, ham,ricotta,eggplant yr i SALADS " small large DESSERTS 982 Sullivan Ave. South Windsor TossedSalad......................................................5.50..........6.50 Saladw/Cheese................................................6.50..........7.75 Q- Q GreekSalad......................................................7.00..........7.95 olives&feta cheese Cheesecake............................... ....................2.95 Antipasto...........................................................7.00..........7.95 Carrot Cake............................... ......................2.95 0 ham,salami,cheese,pepperoni Chocolate Cake......................................-..::..................................2.95 ChefSalad.........................................................7.95..........8.95 turkey,roast beef,provolone cheese Caesar Salad.....................................................7.95..........8.95 BEVERAGES with chicken Fast & Friendly Delivery TunaFish Salad................................................ 7.95..........9.00 � Grilled Chicken................................................7.95..........8.95 Vmq I to: South Windsor& Parts of East Windsor Minimum $15 • $1 delivery charge servedwith onions,peppers,cucumbers,lettuce,tomato&garlic bread Can Soda............................................................ ...........1.00 19 2 Liter Soda..................................... .2.75 Catering Available • Water................................................................. ..............1.50 I ' '� S Consumer Advisory: O C'Il DaysTOES-WED Thoroughly cooking meats,poultry, rar K UP SPECIAL Lti � g y g p ry,seafood,shellfish or eggs reduce the risk of food-borne illness.Before placing our order, lease inform our server if a person in our a has a Rie-Thurs: I I am - y pin Cheese Pizza ,r P g Y P Y P Y party food allergy. Fri-Silt: I I am - 9:30 pm s ��8. 95 +r�,c P�_p J& Queen Graphics&Printuorks 1-203-859-5195 10/17 Sun: N(wIi — O pin �� k� alp- An PIZZA , , �. ^ " - : Ar Small Medium Large Party Su Ii } 12" 14" 16" 24 _ � � * served with lettuce, tomato, mayo&cheese Mozzarella........................7.95........9.95....... 11.95.....19.95 1 small8" large ITEach Extra Topping........1.00 ........ 1.50.........1.95.......2.95 CAL_Z O N E S Turkey& Cheese..................................................................6.95............. 7.95 Toppings: Pepperoni,Bacon,Sausage, Meatball,Broccoli,Ham, Onion, Ham & Cheese......................................................................6.95............. 7.95 Mushroom,Eggplant,Fresh Tomato, Green Pepper, Olives, Fresh Garlic, made with ricotta&mozzarella cheese Steak & Cheese.....................................................................6.95.............7.95 Jalapenos, Spinach,Feta Cheese Cheese Calzone..........................................................................................8.95 Chicken Cheese Steak..........................................................6.95.............7.95 GOURMET PIZZAS Each Additional Item/Same Toppings of Pizza......................................1.25 Pastrami& Cheese...............................................................6.95.............7.95 Salami& Cheese..................................................................6.95.............7.95 Small 12" Medium 14" Large 16" Party 24" STUFFED BREAD Roast Beef.............................................................................7.95............. 8.95 11.95 14.95 17.95 26.95 - Pepperoni & Cheese.............................................................6.95.............7.95 your choice:sausage,pepperoni, broccoli,spinach Italian Combo.......................................................................6.95.............7.95 Bella House Special-pepperoni, mushrooms, meatball, onion,peppers& "�' All with Mozzarella Cheese......................................................................8.95 ham. salami, cooked salami, onions,peppers,provolone cheese sausage41f'I Chicken Cutlet......................................................................6.95.............7.95 Vegetarian- broccoli,tomato,peppers, onions, olives, eggplant, mushrooms, APPETIZER cheeseburger..........::::::::::::::::::::::::::::::::::::::i:::::::::............••6.95............. 7.95 mozzarella Hamburger............. ..6.95.. . 7.95 Grilled Chicken Breast........................................................6.95.............7. 95 Italiano- roasted red peppers,sausage,pepperoni,basil, mozzarella ............................................••......6.95............. 7.95 Ortalano- eggplant,tomato,spinach, tomato sauce,mozzarella Potato Skins w/cheese..................................................................................6.00 Tuna................................... o Florentine- (white)ricotta,spinach,garlic,fresh tomato,mozzarella Potato Skins w/broccoli or bacon......................................................................6.75 Pepper,E & Cheese..........................................................6.95............. 7.95 3 Cheese- (white)mozzarella, ricotta,parmesan Fried Mozzarella 7pieces............................................................................6.00 pp Egg Tomato Basil- (white)fresh tomato, fresh basil,garlic,mozzarella&olive oil Chicken Fingers 7pieces.............................................................................7.50 Fried Shrimp 8 pieces..................................................................................7.50 PA R M I G I A N A S U 8 S Seafood Pizza- (white or red)shrimp,clams,garlic,olive oil&mozzarella FriedClams...............................................................................................6.5 ,...., Hawaiian- (red)ham&pineapple ............................................................................. Garlic Bread............... ..2.50 Hot Wheel- hot peppers,onions,tomato,garlic,mozzarella small 8" large 12° GarlicBread w/cheese.................................................................................2.95 Chicken Florentine- (white)chicken breast,spinach,onion,fresh tomato, Garlic Bread w/pepperoni&cheese ....................................3.95 Chicken Parm................... "1 , -�..•••••.••••••••••••••••••6.95............. 7.95 ............................. Eggplant Parm �_ ..............6.95............. 7.95 garlic,ricotta,mozzarella French Fries ►g •����•...................................................................small 2.95 large 3.95 � � � ...........6.95............. 7.95 Natural- (white)sliced tomato,fresh garlic,mushrooms,onions,spinach, French Fries w/cheese..................................................................................4.95 Meatball Parm.................. s ..3.95 Sausage Parm............................... ..........6.95............. 7.95 mozzarellaOnion Rings............................................................................................. ............ Mediterranean- (white)spinach, feta cheese,garlic,olives,mozzarella Fried Ravioli..............................................................................................6.50 Sausage & Peppers........................................ ..6.95............. 7.95 Sausage & Meatball.............................................................6.95............. 7.95 BBQ Chicken- bbq chicken,mozzarella V Meat Lovers Special- sausage,pepperoni,bacon&meatball BUFFALO WINGS SANDWICHES Eggplant Special- fresh tomato,broccoli,eggplant,olives,ricotta • � Chicken Special- (white)broccoli,ricotta,roasted peppers, chicken,garlic hot,mild,honey bbq,bbq.served with bleu cheese&celery sticks 12 Pieces. 9.95 served with lettuce,tomato&pickle Buffalo Chicken- (white)bleu cheese,chunks of buffalo style chicken """""""""""""""""""""""""""""""�""•�•���"��•�����•����•�•����•�• deluxe served with french fries 24 Pieces...................................................................................................18.00 regular deluxe Philly Cheese Pizza- steak,cheese,onions,peppers,mushrooms Boneless7 Pieces .......................................................................................7.95 BLT........................................................................................4.75.............6.95 Broccoli- (white)ricotta,broccoli,garlic,mozzarella Boneless 12 Pieces 12.95 ................................................................................... Roast Beef.............................................................................5.50............. 7.95 Chicken Broccoli- (white or red)chicken,broccoli,garlic, mozzarella Chicken Cutlet......................................................................6.50.............6.95 The Napoleon- eggplant,tomato,bacon,onions,garlic, mozzarella '�'' = Hamburger Clams- (white or red)garlic&mozzarella 'fir �...�, �` ..� Cheeseburger........................................................................5.50.............6.95 Clams Casino- (white or red)bacon,baby clams,garlic&mozzarella �1 ;� _� •'� . -- � � Double Hamburger..............................................................6.00.............7.95 French Fries Pizza- with bacon s ...............................6.95............. 8.50 - = Double Cheeseburger............................ --� , Bacon Cheeseburger............................................................6.95............. 7.95 • _, Grilled Chicken....................................................................5.50.............6.95