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Home My WebLink About09-01-2022 Gourmet Brunch Insp GOURMET BRUNCH,THE 517 Main St:1`gannj'5 1 �- 094 E i o x Town of Barnstable BOARD OF HEALTH H John T. Norman Board of Health Donald A.Gaudagnoli,M.D. r� ac.e. F.P.(Thomas)Lee,. q ^ 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt. �8 a Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 256 Issue Date: 01/01/2022 DBA: GOURMET BRUNCH OWNER: JOHN COTELLESSA Location of Establishment: 517 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 70 OutdoorSeating: 24 Total Seating: 94 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - MOBILE- FOOD: MOBILE-ICE CREAM: C,�� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: MUST POST VARIANCE LETTER. A conditional variance was granted to allow an increase in seating to 94 seats with the minimum of 1,000 gallon capacity grease trap. TORTi1 of Ba1'll2StablaV ' Date PaiaJ, ,,. Inspectional Services - '�Q Public Health. Division Thomas McKean,Director 200 Main Street Hyannis,MA 02601 Office: 508-862-4644 Fax-, 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT; DATE 30 2Cla! NEW OWNERSHIP RENEWAL z NAME OF FOOD ESTABLISHMENT: L✓ (�r^ i /� l G'f�- � �"� ��f ADDRESS OF FOOD ESTABLISHMENT: / /?7/�y Al a�2 d-611 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): / E-MAILADDRESS: (rt�t��{:7Y1G`� u !/� +[ (r"./�l/` �r� �G�/�J TELEPHONE NUMBER OF FOOD ESTABLCSHMENT: (ml-J771 TOTAL NUMBER OF BATHROOMS: WELL WATER:YES_NO� ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: L_/_ TO NUMBER OF SEATS:INSIDE: OUTSIDE: TOTAL: SEATING:MUST OBTAIN A.COMMON VICTUALLER'S LICENSE FROM LICENSING.DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING.MUST BE APPROVED BY THE HEALTH DIV.AND LICENSE AND MEET UL`TSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? 71 IS AN AIR. CURTAIN PROVIDED AT WA.ITSTAFF SERVICE DOOR(S)?Yam_ - TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL.FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD _FROZEN DAIRY DESSERT MAC I1liNES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRE BEFORE EVENT(SEEPAGE#2) *** SEASONAL,MOBILE&NEW.FOOD ONLY REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 QAAphlication FormsWOODAPP 2020.doc K. OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER:JYE /l NO OWNER PHONE## 7 �✓� f ADDRESS_ Yb 2 S,CA(It T/7 7' CORPORATE OWNER: 5 / G CORPORATE ADDRESS: Sy /t1 Gy PERSON IN CHARGE OF DAILY OPERATIONS: List(2)Certified Food Proteeti,on Managers AND at least(I)Allergen Awareness Certified Staff All,FOOD ESTABLISHMENTS must have 1 Certified Food.Protection Manager PER SHIFT. **ATTACH COPIES OF.CERTIFICATES" The Health Div.will NOT use past years'-records.You must provide.new copies:and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date ell 2a SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION** - SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be:inspected by the H"eal"th Div. prior to opening!! ;Please call Health Div,at 508-862-4644 to schedule your inspection .Please call at least(7)days?in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results.submitted.to the Health Div. 'Failure to do so will result in the suspension or.revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone w•ho caters within the Town of Bamstable trust notifytheTownn by fax or mail prior to catering event. You must complete a catering notice found at httn://,vvww.townofbarnstable.iis/healthdivision/applications:asp. OUTDOOR COOKING: Outdoor.cool in&preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January lst to Dec.31"each calendar.year. IT IS YOUR RESPONSIBILTTY TO RETURN 1 HE COMPLETED APPLICATIONS)NND.REQUIRED FEES BY DEC lst: QANpplication ForinsTOODAPP REV3-201:9.doc i Y Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. RNSTAB .: Paul J.Canniff,D.M.D. M F.P. Thomas Lee Alternate � � �•� 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790 6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 256 Issue Date: 01/01/2021 DBA: GOURMET BRUNCH OWNER: JOHN COTELLESSA Location of Establishment: 517 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 70 OutdoorSeating: 24 Total Seating: 94 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: G�n FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: MUST POST VARIANCE LETTER. A conditional variance was granted to allow an increase in seating to 94 seats with the minimum of 1,000 gallon capacity grease trap. For Office Use Only: Initials: Town of Barnstable QO Date Paid Amt Pd : .LMUMA„s, : Inspectional Services AM •�� Public Health Division Check# 2�13 oZ� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE `2_a `a NEW OWNERSHIP RENEWAL -i- NAME OF FOOD ESTABLISHMENT: ®b l'�r '�/3 7 GU w/� lYll ! , GL/LL �7 ADDRESS OF-FOOD-ESTABLISWVIENT: l /4 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): �s E-MAIL ADDRESS: G�'cC,tC�e w G / � (rx(k,— l o4 r'4 C'C0/!i TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ,j- TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO X ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: '7 0 OUTSIDE: '2-�( TOTAL: 9 ,X SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING.MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? �S IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? /4V� TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) KFOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES...(MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL.MOBILE&NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-8624644 Q:\Appfication FormsTOODAPP 2020.doe OWNER INFORMATION: FULL NAME OF APPLICANT �J�J/7/✓ C �� CJ��Li S �� -� SOLE OWNER: n /NO OWNER PHONE# / / 23 ADDRESS sS G2 S th -5- L CORPORATE OWNER: S/9 In GS CORPORATE ADDRESS: 5/9 In r% PERSON IN CHARGE OF DAILY OPERATIONS: List(2)Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div.will NOT use past years' records.You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1.JG�,,.. C�,fi-0'ies ya 22 2 i 1. �oh� Cr�� i 2,"/iN XA&,,v C /22 /---2-% t 2 421 2 / AIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please can at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/bealthdivision/aPpHeations.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.31 s`each calendar year. IT IS3YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doe l pFS Town of Barnstable BOARD OF HEALTH QY John T.Norman Board of Health Donald A.Gaudagnoli,M.D. nn Paul J.Canniff,D.M.D. MAM 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 256 Issue Date: 12/10/2019 DBA: GOURMET BRUNCH OWNER: JOHN COTELLESSA Location of Establishment: 517 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 70 OutdoorSeating: 24 Total Seating: 94 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: GQ� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: MUST POST VARIANCE LETTER. A conditional variance was granted to allow an increase in seating to 94 seats with the minimum of 1,000 gallon capacity grease trap. a ~ Town of Barnstable For Office Use Only: Initials: ` Inspectional Services Date Paid „ Public Health Division check# a Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE /2- :-2_'2o/y NEW OWNERSHIP RENEWAL / NAME OF FOOD ESTABLISHMENT: j� el/`/v &Z 611kZ ADDRESS OF FOOD ESTABLISHMENT: e;- -I MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: e-w-/S M G- 1-64!1-t-c U! 0, TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (P lr-) 77 TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: X- SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? 'y IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? �f TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) t4-FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL.MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-8624644 QAApplicatlon FormsTOODAPP REV3-2019.doc n 1 ,OWNER INFORMATION• FULL NAME OF APPLICANT J"2o4 ti SOLE OWNER:'E 1NO OWNER PHONE# 7 `27j yl�i ADDRESS_ �2 5Gl.c- Li `j 71 eLl�4 CORPORATE OWNER: In U' CORPORATE ADDRESS: sty PERSON IN CHARGE OF DAILY OPERATIONS: l7/i/ rO List(2)Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records.You must provide new copies and POST THE CERTIFICATES at your food establishment Certified Food Managers Expiration Date Allergen Awareness Expiration Date � l 22/2a2< 1.J-aX . ('�j 110r5ll 2.7�,9rrl�a1A SC61gAt,fl= 202o 12 / l � f � IGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the'Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at httv://www.townofbarnstable.us/healthdivision/aoDlications.aso. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January I st to Dec.31'`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\AppGcation FormsTOODAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. DARNS:ti6LF, John T.Norman �$ MASS, 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment , In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 256 Issue Date: 12/20/18 DBA: GOURMET BRUNCH OWNER: JOHN COTELLESSA Location of Establishment: 517 MAIN STREET HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 70 OutdoorSeating: 24 Total Seating: 94 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: --- --- - - - - MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: j FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: MUST POST VARIANCE LETTER. A conditional variance was granted to allow an increase in seating to 94 seats with the minimum of 1,000 gallon capacity grease trap. A variance was granted to allow three restroom facilities in lieu of the four required for establishments with over 50 seats. These variances are not transferable to another operator of this food establishment. ti r F "o Town of Barnstable Initials: / BARNSTA Date Paid � V i Amt Pd$ • AS& • Inspectional Services 7� 16J9. 10� ArEp�e Public Health Division Check# (� Cash Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 J r✓ �_� � l Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE /'/-,2U /� NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: 9V(A=4/Ii A ,6 A(Lfv C ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): ` E-MAIL ADDRESS: 4U-A hJ (? TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (5Wk TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO-.,. (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: ?,0) OUTSIDE: TOTAL: 9 �/ SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV. AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? VC5 IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? T,Y//PE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q\Application FormsTOODAPPREV2018.doc PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT Gdfi?; SOLE OWNER: YES/NO OWNER PHONE# —I 7 ct ADDRESS_ //JL1,4 CORPORATE OWNER: FEDERAL ID NO. G f CORPORATE ADDRESS: l ,A-,' l/ PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least(1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Aflergen Awareness Expiration Date 22/ 2. // f IGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at htti)://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC Ist. Q:�Application FormsTOODAPPREV2018.doc F IHE,° TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: 8ge: of .° Kq OFFICE HOURS °: PUBLIC HEALTH DIVISION 8:00-9:30 A.M. dAa E 200 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN O CORRECTION Date Verified � HYANNIS,MA 02601 M-8 -FRI.-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY �659• �0 p'F°"""`' FOOD ESTABLISHMENT INSPECTION REPORT 508 ea Name q Date Type of Mtge of Inspection Roirz�pt-:4 j . Risk Address spec Level pry wou on Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP JA In: Other Inspector Out: Each violation checked requires an explanation On<e narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) aj ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives 17113.Personnel with Infectious Restricted/Excluded ❑.15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) 1714.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violation Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ® Yes Non-critical(N)violations must be corrected immediately or Overall Rating 4onn 11 within 90 days as determined by the Board of Health. Voluntary Compliance ❑ Employee Restriction/Exclusion Re-inspection Scheduled ® Emergency Suspension ffiC N Ocial Order for Correction: Basens ection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4npn-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to anon-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y IN Pf Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 590.003(A) Assignment of Responsibility* F_8 Cross-contamination 14 Food or Color Additives Law Cooled to 41'F/45*F Within 4 Hours* Assignment 590.003(B) EDemonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 1=9 PHF Hot and Cold Holding Contamination from Raw Ingredients 1=5 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintairied At or Below 41*F/45*F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140*F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*7-202.11 Restriction-Presence and Use* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge*. 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 9 F590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-80 1.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-80 1.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring I 3-80 1.11(C) Unopened Food Package Not Re-Served*I 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* lConcentration and Hardness* 3-40].IIA(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-60 1.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-40 1.11(A)(2) Comminuted Fish,Meats&Game Pathogens* hfftwe 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-401.11(B)(1)(2).Po 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source Pork and Beef Roast-130°F 121 min* 4-702.11 Frequency of Sanitization of Utensils and Food 3-40 1.11(A)(2) Ratites,Injected Meats-155°F 15 sec* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* F Proper,Adequate Handwashing Ratites-165'F 15 sec* ing,mobile food,temporary and residential Game and ld Mushrooms Approved By 3-401.11(C Wi )(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165*F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* Good Hygienic Practices LL7 Reheating for Hot Holding practices should be debited under#29-Special -- - I lRequirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 see* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 _Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock- -590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* E13 _Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41*F/45'F Item Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 - 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(BI) Cooling PHFs Made from Ambient 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41*F/45*F 25. Equipment and Utensils FC-4 .005 Supplied with Soap and hand Drying Devices Within 4 Hours* 1 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* 27. Physical Facility FC,-6 .007 7 Conformance with Approved Procedures 1 16-301.11 Handwashing Cleanser,Availability Item Good Poisonous or Toxic Materials I FC-7 .008 - HACCP Plans 16-301.12 Hand Drying Provision 129. 1 special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 1 3-502.12 Reduced-Oxygen Packaging Criteria* 8_103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF. r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date Page: of -%l OFFICE HOURS p ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified M639. �0� HYANNIS,MA 02601 More.-FRI.862�644 No Reference R-Red Item PLEASE PRINT CLEARLY,. Oren a 508 FOOD ESTABLISHMENT INSPECTION REPORT b Name Date 'Tyoe ofjarj[e-oRection O i Routin Address 5 Risk ood ection Level e a Previous Inspection - Telephone Residential Kitchen Date: _-- Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 1 In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. � Anti-Choking Items g 590.009(E) ❑ 90" N ) Violations Related to Foodborne Illness Interventions and Risk Factors( L Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) (s^' f FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities Q EMPLOYEE HEALTH PROTECTION FROM CHEMICALS od 2.Reporting of Diseases by Food Employees and PIC 14.Approved Food or Color Additives J o_ ' ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals eHLFOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Poten o ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating r' ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling i ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)l ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY zIlL ❑ 11.Good.Hygienic Practices ❑22.Posting of Consumer Advisories - Violations Related to Good Retail Practices(Blue Itenns) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: No ❑ Yes Non-critical(N)violations must be corrected immediately or (� within 90 days as determined b the Board of Health. Overall Rating Y y � ��. I � ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled " ❑ Emergency Suspension C N Official Order for Correction:Based on an nsi: ay,the items t checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4non-critical violations 9 if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) -30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dum ter screened from public view f W Permit Posted? N Grease Trap Previous Pu {mping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI +'s Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N V\ A- Dumpster Screen Y N LLL --'V/ ` Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Y Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) [Demonstration signment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chazge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41*17AFT EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) * 2 590.003(C) Responsibility-of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* y * Pe 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* t - 3-201.13 Fluid Milk and Milk Products 4-501.112 Mechanical Wazewashing-Hot Water Monitoring 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS - 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* x Concentration and Hardness* 3-401.11 A(1)(2) Eggs-i 55°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* 590.006(A) Bottled Drinking Water* * 4-602.11 Equipment* Surfaces of Equipment cy of Utensils and Food 3-401.11(A)(2) Comminuted Fish, IS sects&Game * Pathos*OtherwiseProcessed 0 to Eliminate .` 590.006(B) Water Meets Standards in 310 CMR 22.0 * 3-302.13 Pasteurized Eggs Substitute for Raw Shel' s° Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast 130 F 121 min Eggs* 4-702.11 Frequency rf Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 A D m cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )`( )" * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' P �S' Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiceRequres rhos ld be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sect 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23.30) 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 1 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. 1 Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Fofmback&2doc 'Denotes critical Rem in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Op 114E rpm TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: Page: of ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. s BARNSTABLE. 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �'reo rAPy� INSPECTION � 508$62-4644 -FOOD ESTABLISHMENT INSP CTION REPORT 4 kff IAX j /11 Name - D ``f Tyne of Tyoe of Inspection 15 Routine Address Risk F d Servi spection; Level I e pection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: "'Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2:Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control, ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashin*9 CONSUMER ADVISORY ( ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories bb,� Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations Iand no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations 9 )( ) cited in this report may result in suspension or revocation er the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations y of receipt observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) p within 10 days t of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: I pector's Sign ture Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N F A1'11W1Vjj- #Seats Observed Frozen Dessert Machines: Outside Dining Y N P 's Signat re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N �' Dumpster Screen? Y N / / Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredlents 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 3 Responsibility of the Person-in-Charge[o * 590.00 (C) po y7-102.11 Common Name-Working Containers * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Tem eratures* Raw Seed Sprouts Not Served* Y _P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water I Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens* _ 590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game g * ery cme ranom 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and a ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3 401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-40311(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items non-critical 23-30) 3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 6-301.11 Handwashing Cleanser,Availability 28. Physical Facility FC-6 .008 7 Confonrnance with Approved Procedures/ 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements '009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. �FIKE,pk, TOWN OF BARNSTABLE. _ _ HEALTH INSPECTOR'S Establishment Name: Date: Page:, of q OFFICE HOURS PUBLIC HEALTH DIVISION 8:00.9:30A.M- BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,639. �� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY ""' 508-862-4644 FOOD ESTABLISHMENT INSP C ION REPORT Name Da t T e o Tyne of Inspection C� p e RoutineIRA Address Risk od ce i Level ail us Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness 'n"IL Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector - Out: s Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G).❑ 44 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals ' FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY S� ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories : - 9 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations _ Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. B=One critical violation and less than 4npn-critical violations re 9 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically o la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to Snon-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N ev Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chazge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH., 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 590.003(C) Responsibility of the Person-in-Chazge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(13) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rated or of Food*Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. LL6 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective/112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf aces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in-cater- Sources* Ratites-165°F 15 sec* ing'mobile food,temporaryand residential Game and Wild Mushrooms Approved By 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145*F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-102.11 Package Integrity Y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling 3-202.18 Shellstock Identification ( ) g Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oFI E h TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: 1 l Page: of. •^ytp....'{$/�/nq. OFFICE HOURS BARNSTABLE O, PUBLIC 2 0 MAN STREET 3:3030-4:30 P.M.DIVISION :00- :30 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 508-862-4644 No Reference. R-.Red Item . PLEASE PRINT CLEARLY 'FDN1 FOOD ESTABLISHMENT INSPECTION REPORT ® 15zO Name DV.10ate'`� a of o Inspection D O utine Address Risk od Service pection fvl, Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness rX, L Caterer General Complaint e Person in Charge(PIC) Time Bed&Breakfast HACCP iI _ s �� nrn Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ - ` Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ r/ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ✓ ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating oelf ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY a ❑ 11.Good Hygienic Practices. ❑22.Posting of Consumer Advisories Lu Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 111 Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ETI ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:_Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than Orion-critical violations regardless of the number,of critical,results in an F. 25.Equipment and Utensils • (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically la hot C=2 critical violations and less than 9rion-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8rion-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dump r screened from public view • Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PICVSignatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y . N Dumpster Screen? Y N v l '� - „�-'-�.•.!"__ •.. :�'..-`r---�J - � - - 'a �- . ..:t4_ �.-f.. _ � .. •'fir '.Y _ _ r-...... .. _ r _ _�` t Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se aration-Stora e* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 .Washing Fruits Restriction-Presence and Use*its and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS,FOR 3-306.14(A)(B)Returned Food and Reted of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* 1 Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME)TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Eggs Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef dw 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.ou Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-0Ol.11(B)(1)(2) Park and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency r f Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Cough[Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-361.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. W 2-301.14 When to ash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. $ Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2 401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) RemainingUnsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item I Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 :003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(]) labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12- Reduced-Oxygen Packaging Criteria* 8103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000: oF'IKE TOWN OF BARNSTABLE, HEALTH INSPECTOR's Establishment Name: 0vr Ane- grw-, L!n Date: -2 Page: C of / OFFICE'HOLIRS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSrAB,E. . 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified n HYANNIS MA 02601 MON.-FRL No Reference R Red Item PLEASE PRINT CLEARLY , �A .639• 0 508-862-4644 'FD^""" FOOD ESTABLISHMENT INSPECTION REPORT - Name ��,v � Date Tyne of of Inspection - e g Routin Address Risk'1 Food Se = pection AA/ n ` d r^I Level I Previous ns ection dk� Telephone Residential Kitchen Date: /' �.r Mobile Pre-op ati n Owner HACCP YIN Temporary Suspect Illness Z r�G: ," t Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP In: Other LL Inspector ol Vr n h Out: a T" Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ RX I' L. Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ CI OP S t FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands Jc ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives G �. C C- tD ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals t FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) N I ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures r ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP t ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories �z Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue 8.red items) ® Corrective Action Required: ❑ No es Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating v�I� luntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled El Suspension o C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. B=One critical violation and less than 4 non-critical violations 9 25.Equipment and Utensils (FC4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other _ DATE OF RE-INSPECTION: Ins cto' ignature Print: c 31.Dumpster screened from public view V\/V+ qV P(/1 vJ. .S-}m�► Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N y #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) I Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties - Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding _ Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other*. 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* _ Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cave uirzom 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR.22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* faces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.1](A)(1)(b) All Other PHFs-145°F 15 sec* Other es shoo violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g• g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.1](B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 ..Preventing Contamination When Tasting* * (Blue Items 23.30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands - 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F. 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°17/45°17 Item Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 . 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal1999 Food Code or 105 CMR 590.000. °F 1HE rp TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: i'°vr C'4 Date: ( l Page: of / OFFICE HOURS PUBLIC HEALTH DIVISION 8:00--9:30 A.M. BARNSTABLE, ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified FZf 'gp 08-8-3-a. HYANNIS,MA 02601 508-8 -FRI.62�644 No Reference R-Red Item PLEASE PRINT CLEARLY 'FDM FOOD ESTABLISHMENT INSPECTION REPORT 1v G , Name DU4 Date ( T e o T f Ins ection AAII ! p ou Address A ^ Risk oo Servi spection Level Re ai Previous Inspection fA/e_f) Telephone Residential Kitchen Date: '019 ( vQrQ� ^� _ 0" Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness `" Caterer General Complaint t ' 1 C 0117 �®► viUQ Person in Charge(PIC) Time Bed&Breakfast HACCP ° i�Ak V In: Other Inspector ` 1/U Out: I NL W(Rr .'er OUE over Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ ) _ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ 2 0 v FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands Da ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals ) FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures 4 to IrP ❑ 5.Receiving/Condition ❑ 17.Reheating (jj* 1V1 ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULAT NS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories we � Violations Related to Good Retail Practices(Blue Items Total Number of Critical Violations I,. Critical(C)violations marked must be corrected immediately. (blue&red items) Corr tive Action Required: ❑ No es Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal F] Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations re ardiess of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than on-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations obsery ,7 to anon-critical violations. If 1 critical refrigeration. 'ithin 10 days of receipt of this order. viola 0 8 'critical 4iola ns=C. w 29.Special Requirements (590.009) y p / Inspect is Sign I 31.Other PATE OF RE-INSPECTION: �v' 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining N PI ' Ign ure P tn� � Self Service Wait Service Provided Grease Trap Size Variance Letter Posted y Y N Dumpster Screen? Y N (/ C� - IL , Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross contamination 1 q Food or Color Additives y Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) ::[Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 - Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* *- -. 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - - 3-302.14 Protection•from Unapproved Additives - Contamination from Raw Ingredients 15 Poisonous or Toxic Substinces 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) *- - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 3-501.16(A) Hot PHFs Maintained At or Above 140°F 590.003(C) Responsibility of the Person-in-Charge to Other* - - 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Storage*- Applicants* 3-302.11(A) Food Protection* - 7-201.11 Separation20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15_ .Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 - Variance Requirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7.203.11 Toxic Containers-Prohibitions* ( ) q - - Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR. 3-306.14(A)(B).Returned Food and Reservice of Food* 7-204.12 Chemicals for Washin Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g - - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* q Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* _ 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* _ * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* s7/°"°e rnrzoo1 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards m 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* _ Contact Surrff aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' S90.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11 A)( )( )1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23-30) 3-202.15 Package Integrity Tti ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 6 - Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification g Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within'4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004 Labeling of Ingredients* Supplied with Soap and hand Drying Devices (J) 9 9 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 lReduced-Oxygen Packaging Criteria* - 8-103.12 Conformance with Approved Procedures* S:59017ormback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. of Own of Barn.'S' table* Barnstable y Board of Health A/-AmedcaCity BARNS`rABLE, ' - y MASS. Q 200 Main Street,Hyannis MA 02601 ej i639. `�Rr t pTf0 MAy A 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi May 30, 2008 John E. Cotellessa Original Gourmet Brunch 517 Main Street Hyannis, MA 02601 RE: Gourmet Brunch, 517 Main Street, Hyannis Map/Parcel 308-094 Dear Mr. Cotellessa: You are granted the second of two variances applied for as owner of Original Gourmet Brunch at 517 Main Street, Hyannis. Approval is granted for a temporary variance from Section 322-3 of the Town of Barnstable Code requiring an increase in the minimum 1,000 gallon capacity grease traps for additional seating for their establishment. This temporary variance allows you to operate a food establishment at 517 Main Street, Hyannis, with 94 seats provided the following conditions are met: (1) A licensed septage hauler shall be hired to conduct two inspections, one during June 2008 and one during August 2008. A written report must identify the levels and the ratio of grease observed. (2) If the grease trap is emptied between May and August, documentation must show the amount of grease removed. All results,from #1, above, and #2 shall be brought to the October 2008 Board of Health meeting for evaluation by the Board. (3) All other regulations of the Board of Health, the Federal Food Code, and the State Sanitary Code for Food Establishments, shall be strictly adhered to. (4) This variance is not transferable to another operator of this food establishment. (5) This variance decision letter shall be posted on the wall adjacent to the food establishment permit in an area that is easily accessible 1 for viewing by a health inspector. Q:\WPFILES\Food Var Gourmet Brunch May2008.doc Page 1 Of 2 1r The Board voted to approve this variance upon review of this situation and also due to the limitations of space required for an increased grease trap. Sincerely yours, r Wayne ille , M.D. Chairm n Q:\WPFILES\Food Var Gourmet Brunch May2008.doc Page 2 Of 2 I t '4 t DATd3: �� f ` FRE: �5 tanRrsty+trt� KM MC. BY C✓Y�� ` Town ®f Barnstable SCMID. DATE: Lk 0 Ts Board ®f Huth 200 Main Street,Hyannis MA 02601 Office: 508-862 46444 Wayne A.Miller,M.D. FAX 508-790b304 Paul J.Canniff,D.M.D. VARIANCE RE VEST FORM r Cy LOCATION Property Address: � rg,t�' Assessor's Map and Parcel Number. 0�; o 9, Size of Lot: Wedands Within 300 Ft. Yes Business Name: O ICY 1`�/fj 0 i.e-� /M `t No_D Subdivision Name- - APPLICANT'S NAME: Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: 5 U f7 4/ i-(J 1 j t��s S� Name: l/✓� �f Address: '67 s6r/ws C",/ e l G= Address: Co ) --t Phone: ' �7 d S �i'l Phone: VARIANCE FROM REGULATION(t istReg) REASON FOR VARIANCE(May attach if aim space )GA ` rn -�v Gr c 2 NATURE OF WORK: House Addition ❑0® House Renovation ❑ Repair of Failed Septic System ❑ Checifilist (to be completed by ofce staff person receiving variance request application) Please submit copies in 4 separate completed sets _ Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e&septic system plans) Four(4)copies of labeled dimensional flom plans submitted(e&house plus or restaurant kids plans) G Signed letter sing that the property owner arlhor¢ed you to represent himlher for this request Applicant undaVands that the abutters must be notified by ceRrfred mail at least ten days prior to meeting date at applicant's ccpew (forTtle V and/or local sewage regulation variances only) ✓ Full menu submitted(for grease hap variance requests only) _� Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[am ow wfieasee only), outside dining variance renewals[same ownwAeasee only),and variances to mpau failed sewage disposal systems[only if no expansion to the building trop"SOD t Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chainran NOT APPROVED Paul J.CmmK D.M.D. REASON FOR DISAPPROVAL C:\Documents and Setti.ngs\decollik\Local Settings\Temporary Internet Fi1e8\0LKl\VARIREQ.DOC AWr ' Al s7- LANDSCAPONG n aFfa�g+Ian�op�Sp pm+'QA The e ' ' l Gourmet Brunch4ngma 517 Main St. Hyannis,Ma 02601 F QA& & s is - CJd an f West Yarmouth,MA 02673 • (800)698-3993 www.abcanco.com FAX:(508)778-9628 Septic Services: Mechanical Services: Design&Installation Plumbing&Heating Pumping&Repairs Fire Sprinklers Since 1930 August 23, 2007 Gourmet Brunch 517 Main Street Hyannis, MA 02601 C/O John --- B-O - dattheposibii to-Increase the- of hebscr ---A« ha c eas — - trap. The property boundaries make it impossible to expand the existing capacity. A & B Canco suggests the installation of an internal grease interceptor as an alternative for increased seating. We presently provide pumping service for the subsurface 1000 gallon grease trap on a 90-day basis. The grease accumulation is less than 25% tank capacity with this pumping schedule. A & B Canco suggests to shorten the pumping time cycle to allow additional seating. Sincerely, Richard K. Cannon RKC: jmh Holly Briar Leasing Corp.,D/B/A A&B Canco Welcome to The Original Go*runch.A unique concept in dining where our freshly pre- pared foods are just for you'. our ment.If your meal is not to your satisfaction or the service THE OMELET 0 NATURE'S OMELAS JUICES AND FRUITS only fair,please let us know.If everything is satisfying,please let us know that also.BON Our omelets are individually made to order,specially beaten,with nothing added,just 3 fresh eggs and are Fresh Squeezed or Grapefruit g g (bean sprouts,zucchini,mushrooms Oran APPETIT!! served with Buttered Toast,Jams&Jelly,'Gourmet'Fries and"taste stimulants".We offer you a choice and other great things) g 1.85 of Mushroom or Herb Sauce to compliment your omelet,the one dish for breakfast or lunch. Apple Juice 1.75 May Your Life Be Long and Happy Sprouts Tomato,Muenster&Olive 8.00 Cranberry Juice 1.75 Joe and Anne Cotellessa -2 egg omelets by request- Sprouts Zucchini&Cheddar 7.75 Tomato Juice 1.75 -Please consult us for our Special Omelets- Sprouts Mushroom&Cheddar 7.75 Fresh Chilled Pineapple cuts 2.50 Fresh Strawberries(if available)2.95 BRUNCH SUPREME Sprouts Zucchini,Tomato&Mushrooms 8.00 Fresh Blueberries(if available)2.95 A tender Artichoke Heart hidden in a light golden pastry Puff topped with lean Ham,covered by Sprouts Peppers,Onions&Cheddar 8.00 a fresh Poached Egg and'Gourmet's'special cheese sauce.Sprinkled with luscious Crabmeat. S routs Spin Tomato&American 8.00 Bowl of fruit 4.75 6.25 Garnish of pineapple and orange 7.25 CHEESE OMELETS HICKORY OMELETS P P Cheddar,Swiss,Muenster,Provolone, (Smoked Cocktail Sausage) Sprouts Mushrooms,Onions&Swiss 8.00 CHILI A LA GOURMET American,Feta or Gourmet Cheese Sauce. Hickory Omelet 7.50 Sprouts Cheddar 7.50 BEVERAGES Our sauteed Onion and Cheddar Omelet,served in its own dish and smothered with Chili Con Your choice 7.25 Hickory Tomato&Cheddar 8.00 Sprouts Spinach,Onion&Olive 8.00 Carve and baked Cheddar Cheese. 8.25 A mixture of two cheeses 7.75 Hickory Mushroom 7.75 Zucchini Tomato&American 7.75 'Brunch Blend'Cafe Hickory Cheddar 7.75 Zucchini Tomato,American&Onions 8.00 (bottomless cup of coffee)1,75 EGGS BENEDICT `BRUNCH STYLE' Hickory Asparagus&Cheddar 8.00 Zucchini Sprouts&Peppers 7.75 Cocoa Cafe OMELETS A LA FLORENTINE P PP A olden buttered English Muffin capped with lean Ham,fresh Poached E and topped with Hickory Swiss Cheese 7.75 (Hot cocoa made with our coffee)2.50 g g PP Egg, PP Spinach Omelet 7.25 Zucchini Celery,Tomato,Sprouts&Onions 8?5 Fresh Brewed Decafe 1.75 Gourmet's special cheese sauce.Single 4.50 Double 5.75 Spinach Cheddar 7.50 Hickory Mushroom&Muenster 0 00 Zucchini Onions,Spinach&Cheddar 8.00 P Hickory Peppers&Cheddar 8.00 P Herb Teas 1.75 Spinach Bacon 7.75 Hickor Onion,Mushroom&Cheddar 8.25 Zucchini Mushroom,Onion&Cheddar 8.00 Earl Grey (No Caffeine) CONQUISTADOR SCRAMBLE Y Spinach Mushroom 7.50 HickorySpinach&Cheddar 8.00 Your Choice of 4 Ingredients 8.00 Constant Comment Peppermint Three farm fresh Eggs scrambled with sauteed Onions,Sweet Peppers,Tomatoes,a touch of Spinach Onion&American 7.75 P m P HickorySprouts,Celery&Cheddar 8.25 English Teatime Camomile Jalapeno Peppers,Parsley and Herbs.Served on its own platter and topped with Cheese,baked Spinach Sausage 7.75 P y P g HickoryOnion,Tomato&Swiss 8.25 Plantation Mint Country Apple until golden.Served with'Gourmet Fries',Toast Tips.7.00 Spinach Peppers&Cheddar 7.75 Lemon Lift Choice of any meat 8.00 Spinach Bacon&Mushroom 8.00 Hickory Sprouts,Mushroom&Cheddar 8.25 P Hickory.Mushroom, Pepper&Onion 8.25 Cinnamon Stick QUICHES Spinach'Gourmet'Cheese Sauce Hickory Sausage,Mushroom&Cheddar 8.25 Spinach Mushroom&Onion 7.7575 Hickory Your choice of 3 ingredients 8.25 Tea(with lemon if desired)1.75 QUICHE LORRAINE-A fine light Custard,Bacon,sauteed Onions and our blend of Cheeses. Spinach Sausage&Mushroom 8.00 y g EGG DISHES Iced Tea or Coffee 2.25 Choice of'Gourmet Relish'or a Garden Salad.7.25 Spinach Sausage&Sprouts 8.00 Three farm fresh Eggs-any style-with your "Gourmet Hot Chocolate'2.00 QUICHE FLORENTINE-Ham and Spinach are substituted for Onions and Bacon,and of course, Spinach Bacon&Cheddar 8.00 BACON OMELETS choice of Ham,Bacon,Loose country sausage,or Chocolate Milk 1.75 your choice of'Gourmet Relish'or a Garden Salad.7.25 Spinach Onion,Peppers&Sprouts 8.00 Bacon Omelet 7.50 Hickory Smokes.Served with"Gourmet"Fries, Milk 2.00 Spinach Hickory&Cheddar 8.00 Bacon Tomato&American 8.00 buttered toast,Jam 6.50 Cola 1.95 QUICHE DU JOUR-(Please consult us).7.25 Spinach Sour Cream 7.75 Bacon Asparagus&Cheddar 8.00 Same as above with two Eggs 6.25 Diet Cola 1.95 GOURMET DELIGHTS Bacon Onion&Cheddar 8.00 Same as above with one Egg 6.00 Lemonade 1.95 Bacon Mushroom&Cheddar 8.00 Same as above without meat: Sprite 1.95 French Fried Breaded: HAM OMELETS Bacon Peppers&Mushroom 8.00 3 Eggs 5.00 Mushrooms 5.75 Zucchini 5.75 Ham Omelet 7.50 gg Bacon Cheese(your choice)7.75 2 Eggs 4.75 Cauliflower 5.75 Brunch Mix(a little of each) 5.75 Ham Cheddar 7.75 Bacon Sprouts&Tomato 8.00 1 E 4.50 Ham Spinach 7.75 Egg Bacon Onion&Peppers 8.00 GOURMET SAMPLER Ham Swiss Cheese 7.75 Bacon Ham&Cheddar 8.00 (VM A little Quiche,Brunch Mix,Rolled Stuffed Ham and a sampling of Cheeses and Fruit.8.25 Ham Onion&Mushroom 8.00 Bacon Tomato,Onion&Swiss 8.25 Ham Bacon&Muenster 8.00 Bacon Asparagus&Mushroom 8.00 BRUSSELS BELGIAN WAFFLES Ham Peppers,Tomato&Cheddar 8.25 Bacon Sprouts,Olive&Mushroom 8.25 Waffle 5.75 Peach or Pear Topped Waffle 6.25 Ham Tomato&American 8.00 PP Bacon Your choice of 3 ingredients 8.25 Waffle and Bacon,Ham or Smokies 6.75 Fresh Strawberry,Blue berry or Pineapple Ham Asparagus&Cheddar 8.00 A LA CARTE The above served with Butter,Syrup and Topped Waffle(if available)6.75 Ham Spinach&Cheddar 8.00 JU and Garnish The above topped with Whipped Cream. Ham Onions,Tomato&Cheddar 8.25 DIETER'S OMELETS Toast 1.50 Includes Garnish Ham Zucchini&Onions 8.00 (No'Gourmet'Fries,unless requested) English Muffin 1.50 Sauteed Banana Pecan Topped Waffle(with Syrup or Whipped Cream)7.00 Ham Asparagus,Peppers&Cheddar 8.25 Cottage Cheese Omelet 7.25 Sour Cream 1.00 YOUR PATIENCE IN ALLOWING US 100%Maple Syrup Available 1.50 Ham Your choice of 3 ingredients 8.25 Cottage Cheese Onion 7.50 Cream Cheese 1.00 ADEQUATE TIME TO PROPERLY PREPARE Cottage Cheese Tomato 7.50 Peanut Butter 1.00 YOUR MEAL IS APPRECIATED. THICK FRENCH TOAST WITH GARNISH Cottage Cheese Sprouts&Onions 7.75 Asparagus,Cauliflower or Broccoli 2.75 SUBSTITUTIONS-We'd love to but we can't. Gourmet'Style French Toast(dipped in pure a batter,cooked'tit olden 6.50 CHOPPED SAUSAGE OMELETS Cottage Cheese Spinach 7.50 Y PP P egg g Sausage Omelet 7.50 g P Honey(1 oz).75 3.25 Minimum per person Cottage Cheese Asparagus&Sprouts East Indian Cinnamon French Toast 7.00 7.75 .00 Sausage Mushroom&Cheddar 8.00 "Gourmet Fries" 1.75 2.25 extra plate service Your choice of Whipped Cream or Butter and Syrup on above. Ctage C heese Your c Onions&ingredients 8.00 Sausage Onion 7.75 "Gourmet Relish" 1.75 Sorry,we cannot be responsible for lost articles. Fruit Topped French Toast 1.00 additional. Cottage Cheese Your choice of 3 ingredients 8.00 Y• P French Toast with Ham,Bacon,HickorySmokes or Loose Sausage 1.00 additional Sausage Bacon&Swiss 8.00 A Rasher of Ham 2.50 *Consumingraw or undercooked meats,poultry, P Y• Sausage Tomato, Bacon&Cheddar 8.25 A Rasher of Bacon(4)2.50 seafood,shellfish,or eggs may increase your risk Children under 12 portion of French Toast deduct 75¢ Sausage Peppers&Mushroom 8.00 SPECIALTY OMELETS Sausage(Loose Country)2.50 of food bourne illness. Sausage Tomato&Cheddar 8.00 Ole Omelet(Hearty Chili Con Carve)8.00 THE CLASSIC DESSERT Hickory Smokes(8)2.50 Sausage'Gourmet'Cheese Sauce 8.25 Omelet Macedoine Mild Herb saute of Triple Layer German Chocolate Cake alternated and frozen together with French Vanilla Ice Sausage Asparagus&Cheddar 8.00 Mushroom,Onions,Tomatoes,Zucchini, (lean baby sausages) The Menu is subject to Massachusetts Meals Tax. Cream and topped with rich,Chocolate Sauce and Whipped Cream.6.25 Sausage Sprouts,Onion&American 8.25 Cottage Cheese 1.75 g p Celery&a touch of Peppers 8.25 g Sorry,no personal checks cashed. Sausage Tomato,Celery&Cheddar 8.25 Peanut Butter&Jelly(unique)7.25 Corned Beef Hash 3.25 We accept Mastercard&Visa. CHAMPAGNE Sausage Mushroom,Onion&Peppers 8.25 g PP Spanish Omelet 7.50 Hot Oatmeal 3.25 Champagne 6.25 Sausage Your choice of 3 ingredients 8.25 Four Meat&Cheese Omelet 8.50 Positive ID required for Wines&Malts. Champagne and Strawberries 6.75 Western Omelet 8.25 Our foods are the finest available. Champagne and Fresh Orange Juice 6.75 It has been said,"You are what you eat." Champagne and Cranberry Juice 6.75 You are about to become better!!! (VM We offer ! • selected wines WINE(by the glass) &malts Chablis,Rose,Burgundy 4.75 Wine Cooler 4.25 Your favorite combined BEER and ALES 4.50 with club soda LUNCHEON Please ask your server. S.Pellegrino 2.25 DON'T FORGET WE OFFER OUR ENTIRE MENU ALL THE TIME for BREAKFAST, 41TEWAS 0s CAPE 000 • Oft- 0,6 BRUNCH OR LUNCH,BUT FOR THOSE OF YOU THINKING OF LUNCH... . 'o bsrgr AJh1v tb f AWARD WINNING CLAM CHOWDER 4.75 �a ° r<�+tad CAPETOM MALL Barnstable Municipal Airport ONION SOUP&MELTED CHEESE 3.75 CHILI CON CARNE 4.75CAP •se ray P x 4 DIETER'S LUNCH . . . .. . LIKE NO OTHER!! j . VA Coo Lean Ground Beef Steak,Chilled Fresh Pineapple,Cottage Cheese, # ee 1 `° ; Hard Boiled Egg Halves,Sauteed Asparagus,Peaches&Tomatoes 8.50 « 10 mmotn„ BURGERS&FIXIN'S CHAR BROILED ANGUS BEEF Served w/fries,lettuce&tomato,6 oz.6.75 ` ri t •�r r ,p Your choice of cheese or with fresh sauteed mushrooms,onions&peppers please add.75 r� �� + Also your choice of the following:ham,bacon,chili please add 1.00 �'ro crr,rrr g �° to V SPECIAL SANDWICHES a u ./]� Our OPEN FACED ASPARAGUS,HAM&"GOURMET CHEESE SAUCE"served on r t•" 4 a` E the e Pumpernickel broiled'til Hot,also fries&garnish 7.25 ■erne tr wl"tt.x• 9' •' 10" THF."COT JRMET"TUNA MELT topped with bacon,tomato,and cheese then broiled E w`�`rA � t� iq �•pe Cod original and served with fries&garnish '7.25 Qn. G THE"COMBO!"A Sandwich and your choice of onion soup or chili served with relish ate s;r wl"e Market PLKC r•1 tt �" !go� ��Y Brundi and garnish Soup 7.50 .-to� .,a • � � tst oodacN� MOUNTAIN BURGER 6 oz.pure ground beefsteak with fresh sauteed mushrooms, ..moo E,et" ot�s<� famous for thousands TM onions,peppers,then lettuce,tomato,cheese,bacon,ham,fries&garnish(Mayo on the 'OiAt to w�„ •y• of different omelets and much more side) Limit one per customer per visit 8.50 t r`"�•,r° .t«ua•ot.n g ,�' """` GOURMET REUBEN Imported Ham,our famous Gourmet Relish,imported Swiss t c Cheese melted to perfection on Pumpernickel Toast served with Fries&Garnish 7.25 1 —OPEN YEAR ROUND— VEGGIE MELT Your choice of our Vegetables cooked'al dente'with your selection s �� a 7:00 A.M.-mid afternoon daily of melted Cheese on Pumpernickel Toast served with Fries&Garnish 6.75 f � • CLUBS t o.ywe , �t (Sunday'til 2:00 P.M.or everyone is served) On WHEAT,WHITE or PUMPERNICKEL TOASTED 517 MAIN STREET TUNA CLUB TURKEY CLUB HAM CLUB BURGER CLUB r+v.roo. (Downtown Hyannis) ALL SANDWICHES Served with FRIES&GARNUSH 7.50 5 Y CAPE COD SANDWICHES s MASSACHUSETTS �. ? 771-2558 (Wheat,White or Pumpernickel) M Ham,tomato&lettuce 6-50 Turkey,tomato.&lettuce 6.50 KBWM WINES&MALTS Tuna,tomato&lettuce 6-50 B.L.T. 6.50 Sbett hacq thh Wo Ham&Swiss,lettuce&tomato 6.50 Grilled cheese 525 tro•.reta t THE"GOURMET"SALAD BOWL j ,,.,,�.. "rants Harbor Cover your bed of lettuce with a choice of tomatoes,bean sprouts,zucchini,onions,peppers, F Kc ca•oan0 celery and mushrooms 6.75 Chefs Salad 725 ) PLEASE DON'T FORGET,EACH DAY WE OFFER SPECIALS,NOT MENTIONED ON OUR REGULAR MENU.IF YOU HAVEN'T CHECKED OUR BLACKBOARD,PLEASE ASK YOUR ATTENDANT (remember the only reason our menu stops here is we ran out of room) t` Prices subject to change without notice. t Visit our website-www.oiiginalgourmetbrunch.com a EXCERPT FROM BOARD OF HEALTH MEETING—MAY 13, 2008: V. Variance — Food (Cont): John Cotellessa, owner, Original Gourmet Brunch at 517 Main Street, Hyannis, requesting grease trap variance and expansion in seating from 70 to 94. John Cotellessa stated he spoke to Brian Dudley, DER Brian explained that because it is on town sewer and town water, he does not need to approve. The business is short 47 gallons on the 94 seats for the grease trap and does not have any place to increase the grease trap. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to approve a temporary variance to expire Oct 30, 2008 with the condition that two inspections will be done: in Jun 2008 and Aug 2008 showing the ratio of grease, then bring the results in to the Oct meeting and at that time the Board will use the data to evaluate the frequency needed for future pumping during their heavy season especially. (Unanimously voted in favor.) Bellaire, Dianna From: McKean, Thomas Sent: Wednesday, October 02, 2019 12:07 PM To: Bellaife, Dianna Subject: Re:The Gourmet Brunch It can be removed. From: Bellaire, Dianna Sent: Wednesday, October 2, 2019 10:15 AM To: McKean, Thomas Cc: McKenzie, Marybeth; Bellaire, Dianna Subject: FW: The Gourmet Brunch Tom; Please read below and let us know if the second part of this variance needs to be on there still. Thank you. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us From: McKenzie, Marybeth Sent: Tuesday, October 01, 2019 8:30 AM To: Bellaire, Dianna Subject: RE: The Gourmet Brunch That would be a Tom question because it was a board of health decision. Not my call.Thanks Mb From: Bellaire, Dianna Sent: Monday, September 30, 2019 12:59 PM To: McKenzie, Marybeth Cc: Bellaire, Dianna .Subject: The Gourmet Brunch Hi Marybeth; This has a two part variance. I know the first part should stay. Just wondering if the toilet variance should come off. Please read the variance below: MUST POST VARIANCE LETTER. A conditional variance was granted to allow an increase in seating to 94 seats with the minimum of 1,000 gallon capacity grease trap. A variance was granted to allow three restroom facilities in lieu of the four required for establishments with over 50 seats. These variances are not transferable to another operator of this food establishment. EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES 10/14/2008: F.(,gO ginaLGou'rmet Br unch;51L'Main-7street HHya nn is(from May 2008), results of grease trap log to determine frequency of grease trap pumping, seating. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to approve the 1,000 grease trap for 94 seats. The Board is still interested in seeing the pumped information each time it is pumped; however, they do not need to come before the Board again. (Unanimously voted in favor.) NoR--- FRis ................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................/40.clerl?.7.......OF........ 3 4—Ir X/ Appliration fax Dispaiial Works Tomitrurtion VrrU1t1.L, ...'_' Application is hereby made for a Permit to Construct ( X) or Repair an Individual"Sewage Disposal System at: .... ....................................................R7............................................ A*1 0 Location-Add,es or a....... .......................................... OwnerXw�r_e,s"s--------------------------------------- Installer Address Type of Building Size Lot.............................Sq. feet U Dwelling—No. of Bedrooms_________________________ _..__Expansion Attic Garbage Grinder Other—Type of BuildingZUec ...... No. of persons............................ Showers Cafeteria P4Other fixtures ...................................................................................................................................................... Design'Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid'capacity/&Le.gallons Length.Fnd.... Width.6....e..... Diameter________________ Depth_.______-_._.... Disposal Trench—No..................... Width_____...__._..______ Total Length.____.__.______.-_._ Total leaching area....................sq. f t. Seepage Pit No..................... Diameter.__._._.______.._.__ Depth below inlet__.._._____..._._._. Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) 14 Percolation Test Results Performed by.......................................................................... Date_________._._____.....______________.... Test Pit No. I................minutesperinch Depth of Test Pit_______.____________ Depth to ground water_---___________________. (i Test Pit No. 2................minutes per inch Depth of Test Pit__.____.__________._ Depth to ground water...____.._.____.__.._... ............................................................................................ 0 Description of Soil....................................................................................................... X ------**--------------------------------------------------------------------------------------------*-----------------------I-0------------------------------------------------------------------ ................................................................................................................................................ ........;;;;�...... .... .............. U Nature of Repairs or Alterations—Answer when applicable---------- .............. ..........................C-Z......... 46 V .1..........e��....... ...... Rerlle�e�f.,6........ .................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'1I'L IE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has Signed. .......... ? at ............. Application Approved By---- ..... .................. ...Al�:�---------- Date Application Disapproved 4�Ietoilowsing reasons:................................................................................................................ ....................................................................................................................................................................................................... Date PermitNo......................................................... Issued.................................."-------------------- Date ------------ --------------------------------------- No................_....... Fps.... .._....._........ THE COMMONWEALTH OF MASSACHUSETTS TV BOARD OF HEALTH Ql44.0. . ....OF........�: Appliration for Disposal Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct (),() or Repair ( ) an Individual Sewage Disposal System at: R&I.v..... .....-•-----------------------------•-------•----------.......--------........•-•-..............•. Location-Address or Lot No. A_. 1��1- ?.�t +7"• t ski ....... ...........-...............................................-•----•--............---------...... Owner Address ataC .' ......-- s......._.. Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building k4ol _,f .... No. of persons................_•..-__-_-_- Showers ( ) — Cafeteria ( ) Other fixtures --------------------------------------------------•-••. W Design Flow............................................gallons per person per day. Total dai flow--------------------------------------------gallons. WSeptic Tank—Liquid capacit}/OIR.gallons LengthP`Z_.._. Widthe............. Diameter________________ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Ix ..•-•••••--•-•---------••---•....................••••••---•.........-•-........................................................................•............. 0 Description of Soil........................................................................................................................................................................ x V ----------------------------------------------------•-•------------•-•-•----------•-----------•-------•--------------------•----------------------------------------------------........-•-•-••-•--..•-- W ----•-•----•----------------------------••••-•-••-----••-•------••--•-•--------•-•-•••--•-••-•---•••-•-••-•••---•--•••---•--••-----•••••----•••- U Nature of Repairs or Alterations—Answer when applicable__________ __ __ ' ..._ _ ............................................. i~ -_-----___. ----------------------------------------------------------•------•---------------..................---......-----------------------------------••... - Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be is h board of health r Signed ...-• ApplicationApproved B .•-•-•-•••-•--•-••••••••-••••-•-••--•.....-•--••......-•-•-•-•--•• -------------------------Y '3t r � at Z ." Date Application Disapproved for the following reasons---------------•----------------------------------------------------------------------------•••-•......•---•---- ••.......•••••••-•••--••-----•-•••----••••••-•••••--••-•-••••-----•-•......--••••------••-•-••--•--------••----•-••-•-•........_..•-----•••--•----•--------••••••••••••••------•---•-•-••--••-•••---.... -'Date - --- -- - - Permit No................----. .................................. Issued----------------------------------•---------........•. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF................................................ . ......... Trr#if iratr of Tontlitia `fir IDS ) TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired rVRe, 4 by------... .•• ••• -•----••--•--•4.. mit ............................................................................................................. � nstaller 4 � at-••••••--•-••••••-•-•••-•---••......••-•-•=• ............. ...... ----------------------------------------- -------------------- -----•--- --•-------------------- has been installed in accordance with the pof T ;W_ x, 6 The State Sanitary C e as bed in the application for Disposal Works CorIstructioNo......................................... dated- __' __......_________............... THE ISSUANCE OF THIS.CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................................................:::f� Inspector THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH FEE........................ - �t��t nrk�- -�I1tt��rltr�illn Prnttf Permissionis hereb grante . ••••• •••-•••-•---•-•••--••••--••-•---••---••--•-•••-•-•-•--••••••••••-•-•••--•-•---•-•••.....•-•-••••.......•-•-•.................••---•. to Constc�t 19` ) a dixidual.-Sewage_Disposal System atNo..................................................................................................................................................... ................ Street as shown o/the plican n for Disposal Works Construction Per o..................... Dated"'._. ................ .... " ..... ............................................................................ DATE..... ••---................................................. Board of Health FORM 1255 A. M. 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'i _. , '. , -f �t ±`: S.`,' D,1 +� 't y S�., y`• ,at t+ r' r a . `%Jt• 1 i., i q s r• , . `•+r t ip.r `. i S, K t r• if ;i. , •L•• I. .3 < fi:%� , • q •.:`..•j f-` ., } , 'j,'{ / e"• f1 .: : , , + • a tit cL a,r , , ,._ 'r r < �.+ " �' e r , , }L frt S S. s u .. , +. �.. a k;} : r r rs .:., ir;., • Sfe ;kV T'ari sFnt i s fin,• N4ARSAN & MARSANAkLA CODE 617 ATTORNEYS AT LAW 238-017e 567-5800 .43 BELMONT STREET EASTON, MASSACHUSETTS 02375 DAVID E. MARSAN GERA7tD 5. MARSAN - - July 24 , 1981 J. Mark Associates, Inc. d/b/a Gourmet Brunch 517 Main: Street Hyannis , MA 02601 ATTENTION: Mr. Mark J. Grant Dear Mr. Grant: This office has been retained by Philip and Faith Simolari , owners of an apartment building at 521 Main Street, Hyannis, loca- ted directly behind your place of business . Mr. Simolari has attempted to discuss with you, the fact that your kitchen fan is blowing obnoxious odors directly onto his property and is covering his building with dirt and grease. Apparently, you have chosen to ignore Mr. Simolari and have done nothing to alleviate this situation. You are hereby advised that unless you install a deflector cover or take some other appropriate step to resolve this problem, I will be forced to commence legal proceedings for damages for your negligence, nuisance and continuing trespass . This letter is notice to you of the damage you are causing, and if your present course of action persists, it may result in a criminal complaint for malicious damage to property. Very truly yours, MARSAN & MARSAN David E. Marsan DEM:rly bcc. Mr. Philip Simolari West Elm Hotel 56 West Elm Street Brockton, MA 02401 ,i'rF S .- 1 +..* ra"' , }1 > k- , r M e t a2 A v'` a ?t. ,rt t. - F F ,k,+e L'a';:tf! s{r f s e L,/t+^"kTs{" }r'^�� wtt•+ t` b} ? 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