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HomeMy WebLinkAboutDUNKIN DONUTS - FOOD Dunkin Donuts 317 Falmouth Rd. w . w . s FORMELY: DUNKIN DONUTSiTOGO'S ora�. Town of Barnstable BOARD OF HEALTH y John T. Norman Board of Health Donald A.Gaudagnoli,M.D. BARN9TAULE F.P.(Thomas)Lee,. $ MASS, 200 Main Street, Hyannis, MA 02601 Daniel Luczkow M.D. Alt. Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems 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: 611 Issue Date: 01/01/2022 DBA: DUNKIN DONUTS OWNER: CAPE COD ENTERPRISES LLC. Location of Establishment: 317 FALMOUTH ROAD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IncloorSeating: 18 OutcloorSeating: 0 Total Seating: 18 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Ci 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: I r � I a- • Initials: Town of Barnstable Date Paid $-2� BA"STABLB, : Inspectional Services Public Health Division Check# CWP 10 D AAA't s Thomas McKean,Director It, 2A ?� 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 12/27/21 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: Cape Cod Enterprises, LLC DBA Dunkin' ADDRESS OF FOOD ESTABLISHMENT: 317 Falmouth Road, Hyannis, MA 02601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): Go Couto Management Group,169 Main St,Stoneham,MA 02180 E-MAIL ADDRESS: office@coutomanagement.com TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5( 08 ) 775 - 2796 TOTAL NUMBER OF BATHROOMS:, 2 WELL WATER:YES_NO V ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V _ SEASONAL: DATES OF OPERATION:_/ /_ TO NUMBER OF SEATS: INSIDE: 18 OUTSIDE: NA TOTAL: 18 SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIY. ***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? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? 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 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 508-862-4644 QA1Apphcation FormsTOODAPP 2020.doc I OWNER INFORMATION: FULL NAME OF APPLICANT Sallvi Couto SOLE OWNER: YES ED D.O.B 3/7/1979 OWNER PHONE# 781-279-0290 ADDRESS 169 Main St, Stoneham, Ma 02180 CORPORATE OWNER: Cape Cod Enterprises, LLC CORPORATE ADDRESS: 169 Main St, Stoneham, Ma 02180 i PERSON IN CHARGE OF DAILY OPERATIONS: Edilaine Barbiero 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 I i 1, Edilaine Barbiero 12 / 16 /2023 1. Edilaine Barbieroyo' 01/ 22 / 2026 2. Donna Snarsky 02/ 15 / 2023 go 12 /27 / 21 SIGN~AT O A T 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 http:/hvvvw.townofbarnstable.us/henithdivision/applications.asp. 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.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. QA1Application FormsTOODAPP REV3.2019.doc n 4 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. Sett Paul J.Canniff,D.M.D. �� �• 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: 611 Issue Date: 01/01/2021 DBA: DUNKIN DONUTS OWNER: CAPE COD ENTERPRISES LLC. Location of Establishment: 317 FALMOUTH ROAD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 18 OutdoorSeating: 0 Total Seating: 18 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: r � :r �B o 1L For Office Use Only: Initials: 1 _ Town of Barnstable DatLPaid Amt.Pd$ `BARMSrABLE,q Cheek# :- Inspectional.Services Ch ' o Public Health Division - �-- Thomas McKean, Director 200 Main'Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 i APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 11/16/20 NEW OWNERSHIP RENEWAL l NAME OF FOOD ESTABLISHMENT: Cape Cod Enterprises, LLC DBA Dunkin' ADDRESS OF FOOD ESTABLISHMENT: 317 Falmouth Road, Hyannis, MA 02601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): c/o Couto Management Group, 169 Main St,Stoneham,MA 02180 i E-MAIL ADDRESS: office@coutomanagement.com { TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5( 8 ) 775 - 2796 "TOTAL NUMBER OF BATHROOMS: 2 WELL WATER: YES_NO V ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V _ SEASONAL: DATES OF OPERATION: /_/_ TO i NUMBER OF SEATS: INSIDE: 18 OUTSIDE: NA TOTAL: 18 SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM ENSINGDIV. i ***OUTSIDE DINING REMINDER*** f OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING f REQUIREMENTS. 9 IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? 0 IS AN.AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) I 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 508-862-4644 1 Q°\Application FohrsTOODAPP 2020.doc.. i I i I I OWNER INFORMATION: l FULL NAME OF APPLICANT Salvi Couto SOLE OWNER: YES ED D.O.B 3/7/1979 OWNER PHONE# 781-279-0290 .ADDRESS 169 Main St, Stoneham, Ma 02180 ! CORPORATE OWNER: Cape Cod Enterprises, LLC G CORPORATE ADDRESS: 169 Main St, Stoneham, Ma 02180 i PERSON IN CHARGE OF DAILY OPERATIONS: Edilaine Barbiero List(2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff ! All FOOD ESTABLISHMENTS must have I 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. 1 Certified Food Managers Expiration Date Allergen Awareness Expiration Date I, Edilaine Barbiero 12/ 6 /2023 1. Edilaine Barbiero 2 / 12 /2021 } 2, Shrijana Thapa 5/ 8 /2022 - -- 11 /16 / 20 SIGNATURE 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 theTomm by fax or mail prior to catering event. You must complete a catering notice found at hito:Hivww.townofbarnstable.us/healthdivision/appIications.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"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED.FEES BY DEC Ist: E 1 i Q 1Appiication Forms\FOOI)APP REV3-2019.doc I i I t t t Town of Barnstable BOARD OF HEALTH �1+ John T.Norman �Y Board of Health Donald A.Gaudagnoli,M.D. BARNS AuLr Z Paul J.Canniff,D.M.D. NA 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: 611 Issue Date: 12/10/2019 DBA: DUNKIN DONUTS OWNER: CAPE COD ENTERPRISES LLC. Location of Establishment: 317 FALMOUTH ROAD HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 18. OutdoorSeating: 0 Total Seating: 18 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: �0' FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: i 7 C FTHE 1p� , Initials: .r Town of Barnstable • Date Paid Am Pd$� 9umsTABLE,$ Inspectional Services y7 i639. "�0 ,� ArEDru.�a Public Health Division Check# p Thomas McKean,Director 200 Main Street,"Hyannis;MA 0260.1 ?x Office: 508-862-4644 Fax: 508-790-o 4 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 11/14/19 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: Cape Cod Enterprises, LLC DBA Dunkin' Donuts ADDRESS OF FOOD ESTABLISHMENT: 317 Falmouth Road, Hyannis, MA 02601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): c/o Couto Management Group, 169 Main St., Stoneham, MA 02180 E-MAIL ADDRESS: office@coutomanagement.com TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5(�8 - 775 _ 2796 TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES NO V ...(ANNUAL WATER:ANALYSIS REQUIRED) ANNUAL: V- SEASONAL: DATES OF OPERATION: / /_ TO NUMBER OF SEATS: INSIDE: 18 OUTSIDE: N/A TOTAL: 18 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 REOUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? 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 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:Applicatioii FonnsTOODAPPREV2018.doc PLEASE CALL 508-862-4644 .OWNER INFORMATION: FULL NAME OF APPLICANT Salvi Couto SOLE OWNER: YES fN0 D.O.B 3/7/1979 OWNER PHONE.# 781-279-0290 ADDRESS 169 Main Street, Stoneham, MA 02180 CORPORATE OWNER:Cape Cod Enterprises,LLC FEDERAL ID NO. :VA5g W6, CORPORATE ADDRESS: 169 Main Street, Stoneham, MA 02180 PERSON IN CHARGE OF DAILY OPERATIONS. Edilaine Barbiero 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, Edilaine Barbiero 12/ 6 /2023 1. Edilaine Barbiero 2/ 12 /2021 2•Shriiana Thapa _ 5/ 8 /2022 11-/ 14 /2019 SIGNATURE OF APPLICANT DATE ***FOOD POLICY.INFORMATION*** j 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 Pernut until the above terms are met. CATERING POLICY: Anyone who caters within the Tow n wn of Barnstable must notify theTown by fax or mail prior to catering event. Youmust complete a catering notice found at http://www:townbfbatnstable.us/healthdivisidn/applicgtions.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 lstto Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q'.1Application Forms\FOODAPPREV2018.doc / IKF Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. [tARNS ABM, John T.Norman €a °`� 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: 611 Issue Date: 12/20/18 DBA: DUNKIN DONUTS OWNER: CAPE COD ENTERPRISES, LLC Location of Establishment: 317 FALMOUTH ROAD HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: . YES Seasonal: IndoorSeating: 18 OutdoorSeating: 0 Total Seating: 18 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - -- - ------- - MOBILE-FOOD: MOBILE-ICE CREAM: a� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: y x TIME � For Office Use Only.• Initials: o� Town of Barnstable • Date Paid Amt Pd$on BAMSTABLE, Inspectional Services Check# a ;_ 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 11/17/18 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: Cape Cod Enterprises, LLC DBA Dunkin' Donuts ADDRESS OF FOOD ESTABLISHMENT: 317 Falmouth Road, Hyannis, MA 02601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): c/o Couto Management Group, 169 Main St., Stoneham, MA 02180 E-MAIL ADDRESS: office@coutomanagement.com TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5( O8 ) 778 - 6453 TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES NO V ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE:: 18 OUTSIDE: N/A TOTAL: 18 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? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? 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 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:Wpplication FormsTOODAPPREV2018.doc I PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT Salvi Couto SOLE OWNER: YES NO D.O.B 3/7/1979 OWNER PHONE# 781-279-0290 ADDRESS 169 Main Street Stoneham MA 02180 CORPORATE OWNER:Cape Cod Enterprises,LLC FEDERAL ID NO. : 81-0559006 CORPORATE ADDRESS: 169 Main Street, Stoneham, MA 02180 PERSON IN CHARGE OF DAILY OPERATIONS: Edilaine Barbiero 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, Shrijana Thapa 5/ 8 /20 1. Edilaine Barbiero 2/ 12 /2021 � ne.��Qa iaia�,o r 0-7 laic )at�a-3 2. ce 19 11 / 17 /2018 SIGNATURE 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 oyenina!! Please call Health Div.at 508-862-4644 to schedule your inspection. PIease 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 http://www.townofbarnstable.us/bealthdivision/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 anApplication for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1st to Dec.31`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q:1Application FormAFOODAPPREV2018.doc Dpp tME rp TOWN OF BARNSTABLE, _ HEALTH INSPECTORS Establishment Name !1c� � `�-� lr��� Date: �� age: of - OFFICE HOURS P ° PUBLIC HEALTH DIVISION 800-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3.30-a:3o P.M. Item Code. C-C`Pltical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 M-8 -FRI.62-4644 508 No Reference R-Red Item PLEASE PRINT CLEARLY'OrFo MAC° D ESTABLISHMENT INSPECTION REPORT Name , Da�qC)J /a TjTe o ns ec ion ip Routi Address �j Risk god S Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in(-barge(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 TIMEITEMPERATURE 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 ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �!o 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. 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 se n 4 non-critical violations if no critical violations observed, 4 to 6von-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 vI to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspect is tur Pr 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' ature Print. ���Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N lv Dumpster Screen? Y N ;-�.r.+`_,, f-.r--. �.-.�.�..-.-fix .]�'.�" s-°,--•'"rs_y�. -.t.. �.r'_�-. �k-•».Tr....:.ti..•^-.r:...y-�F'°2a.e--_;�.,r-.���..-{.-.�.-..-..._.�:..�..-�..�o ....`�. -.� � - ..-ti -�_�... y��.. -. 7 •�.'r-. • r � - •-- a- '��..�. -. _ " _ � -... .- ,--!'- .' +r �. •...^'�� -r. _.�.. - 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 3-202.1-2. 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 15 590.004(F) 7-102.11 Common Name-Working Containers*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* 2 590.003(C) Responsibility of the Person-in-Charge to Other* 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 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 Re uirements * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge 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 Rrated or of Foam* 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 y 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 Warewashin 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 HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 1 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 S 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* Equipment 3-401.11(A)(2) Comminuted Fish,Meals&Game Pathogens* E7/cme ianoot 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 590.009(A)-(D)in catel- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 1p Proper,Adequate Handwashing g' P raTY 1 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 9 rY tY 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* 1 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) Commercially Processed RTE Food-140°F* Blue Items 23.30) 3-202.15 Package Integrity Y 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* 7 8 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) 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(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 IFC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. special Requirements 1.009 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. TOWN OF BARNSTABLE, HEALTH INSPECTOR'S Establishment Name: �� k _Date: G Page: of . { OFFICE HOURS Aa Eo PUBLIC 2 0 MAIN STREET 3:30-4:30A.M. 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. SS.s�0 HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY rFn MF� 508-862-4644 OD ESTABLISHMENT INSPECTION REPORT Nam �� Dat T e o of Ins ection C\ ` \ V O s Routin Address / Risk ood Semc spection M l Level Retai Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person ingbarge(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. \ C 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 V 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 �, f ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding V 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 f ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories 1�J Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 3 �� 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, a items 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 B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (1FC-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 Snon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7 590.008 9 violation,4 to._, on-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspect s t nt: 31.Dumpster screened from public view __ n S 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 ® % 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* 6 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 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* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge 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 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* p g 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 * 590.004(11)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 7-203.11 Toxic Containers-Prohibitions* Variance Reuirements q 590.003(G) Reporting by Person in Charge , 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 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations 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 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE 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* Eggs 4-601.11(A) Clean 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 ctNe 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* * 3-302.13 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- 70211 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* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meal,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F IS 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* 3-401.11(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 929-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) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* (E) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* �g Proper Cooling of PHFs fallowing 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 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* 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" 1 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. 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. °FINE r°,r TOWN OF BARNSTABLE HEALTH wsPEcroR s Establishment of Name: _ - Date: ® J0/ Page: 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 mAss. g MON.-FRI. OrF'659. HYANNIS, MA 02601 508-662-4644 No Reference R-Red Item PLEASE PRIM CLEARLY D ESTABLISHMENT INSPECTION REPORT r J(Z Name Date�ef l0 Type of of Inspection 4 !�Dam L)perafignisl Routine Address 3//? Risk e-inspection Level Retail Previous Inspection t Telephone Residential Kitchen Date: � �•� 1 i Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness es �� d Caterer neral Complaint Person in Charge(PIC) Time Bed&Breakfast 9TIn: 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 V" 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 HS ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY '(1 ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories �J 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 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 6=One critical violation and less than 4n6n-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 to 6-non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than 9 non-critical. If If 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 Snon-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. wo a' 4 to 8 no ritical violations=C. 29.Special Re uirements (590.009) l 30.Other DATE OF RE-INSPECTION: Ins ector' Si e. 31.Dump er 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 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* 6 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 Ingredients 15 Poisonous o"r'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* 590.003(C) Responsibility of the Person-in-Charge to e Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* o 2 7-102.11 Common Name-Working Containers* P 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* P g 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* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge , 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 Rated or 7-204.12 Chemicals for Washing of Food* Produce,Criteria* HSP HIGHLY SUSCEPTIBLE POPULATIONS 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* Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and * 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hat 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 Equipment 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* Eg°nee 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* * 3-302.13 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 I 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 Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 A in 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 � 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* 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�01.11 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) g �n Critical and non-critical violations,which do not relate to the foodborne 12 Prevention of Contamination.from Hands 3-003.11 fi 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* Lu 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 * 5-205.11 Accessibility,Operation and Maintenance 3-402.12 Records,Creation and Retention 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. 1 Poisonous or Toxic Materials FC-7 1.008 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* - 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. °F.He.°w TOWN OF BARNSTABLE. HEATH INSPECTOR,s Establishment Name/� , Date: / Page: of OFFICE HOURS rk P ~°� PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNS'rABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified mAss. MON.-FRI. �p ,,39.per• HYANNIS,MA 02601 soa-as2-as4a No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTAB_USHMENT INSPEIcTIbN REPORT Name Da e e of sec io Address Sk Food Se Re-inspectio evel -R9fa-T Previou ec Telephone Residential Kitchen Date: Mobile Pre-op I GG Owner HACCP Y/N Temporary Suspect Illness Caterer General ComplaintJAI 11 rV 10- Person in Charge(PIC) Time Bed&Breakfast HACCP AAC'. p2 Other Inspector Lai 7n In I TU Each violation checked requires an explanation on the narrative age(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 TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) YLI- ❑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 wa ❑ 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) IV ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.ProperAde.quate Handwashing CONSUMER ADVISORY I ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories 11/ 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) (� a� l.q 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 item ❑ 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 4non-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 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 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address viol ns observed,7 to 8 non-criti I viola ions. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. 1olation, o 8 non-critical violatio s=C 30.Other DATE OF RE-INSPECTION: In e t is Si Q rint: 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 tU 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* * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives 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 15 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 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* Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* •2 Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage** 3-501.16(A) Roasts Held At or Above 130°F* Applicants*- 3-302.11(A) Food Protection* P 8 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* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 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 Reaervior 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 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) I Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMErfEMPERATURE 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.I IA(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 E s-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* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff dive 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* * 3-302.13 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 r f ces of Equipment* of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan I 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 Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- ' 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 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* 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140`F* (Blue Items 23-30) 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 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* 1 g 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 590.000 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* 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. �p ME Toh, TOWN OF BARNSTABLE EALTH INSPECTOR'S Establishment Name: u n Y- in Don La S Date:�� K Page:�_04 q .4 : *' OFFICE HOURS PUBLIC HEALTH DIVISION �8:00-9:30A.M. BARNBTABLE. • 200 MAIN STREET .30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MON.-FRI. NO Reference R-Red Item PLEASE PRINT CLEARLY HYANNIS,MA 02601 T5I,_8,2-4644 'FD1A�` FOOD ESTABLISHMENT INSPECTION REPORT Name S Dat 5 e of f Inspection YJ on s in Address (" M ut�/1 Risk ood Se-_ Re-inspectionS CA CA r CA v 1 •e- 1 i ► Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness ( r_ Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP sip (� In: Other I CA St�Jh a C Inspector c-fa n e , Out: Each violation checked requires an explanation on th na rative page(s)and a citation of specific provision(s)violated. 0 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) ❑ - V e a Action as determined by the Board of.Health. Allergen Awareness 590.009(G) ❑ t t CA ✓ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ' V (I n1c J c ✓ ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities (� C EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives V ° ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals _ IC1 SGLt ' o t FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) 1' ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures v 1 c- t 3 ❑ 5.Receiving/Condition ❑ 17.Reheating r ck f v c d Gi c ail 3 4 ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling L01f CC, If r ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control Y n ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) T ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP _C.8u In 1� v ❑ 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 Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Q QI Corrective Action Required: o ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating u l� I v �j�� within 90 days as determined by the Board of Health. I-�1J ❑ Voluntary Compliance Employ 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 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 B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 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 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 anon-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: CA 31.Dumpster screened from public view a e 1 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 __ � ._ �• �-,.. �; ._ vac � � _ ._x -� _ _ _. _ -� ___ _ _ - _ F _ .. �..,. ., . . . 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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 P_HF Hot and Cold Holding _ Contamination from Raw Ingredients 1 g Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41 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* 7-201.11 Se aration-Storage* Applicants* 3-302.11(A) Food Protection* P g 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 * Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 3-501.19 Time as a Public Health Control 590.004 11 Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q - 3 590.003(D) 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 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* I 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* I 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* Eggs 4-601 A I(A) Clean 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* Effe cti,e 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* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From arrApproved 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* 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 m catei= 3-201.15 Molluscan Shellfish from_NSSP Listed Chemical* ( ) ( ) ( ) �) 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. Other 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 1 Reheating for Hot Holding practiceess should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition +_� g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* t 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) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 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 590.000 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' Supplied3vith•Soapand 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 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 130. Other 3-502.12. Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Fonnback6-2doc *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. p INE Tp TOWN OF BARNSTABLE - HEALTH INSPECTORS Establishment Name: Date: Page. of .p h� OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARN57'ABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. MON.-FRI. 94, ,639.aim HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY. 'FD1APy FOOD ESTABLISHMENT INSPE TON REPORT Name ''// Dat a of Type of Inspection �F. - O er Address Q �dRisk od Service Re-inspection ' Level nspection 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 Other In: Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. W Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ JVL- 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 P � 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. f ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling a ❑ 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 Violations Critical'(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No 10Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating - `r Volunta Compliance y y ❑ Voluntary p ❑ 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 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.E� Equipment and Utensils (FC-4 590.005 B=One critical violation and less than Orion-critical violations g q p )( ) 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 (FC75)(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 anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to Snon-critical violations=C. 29.Special.Requirements - (590.009) Y P 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 IN #Seats Observed Frozen Dessert Machines: Outside Dining Y IN P 's Signature nt: 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 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 EachContainers* 590.004(F) ( )( P 7-101.11 Identifying Information-Original 7-102 590.003(C) Responsibility of the Person-in-Charge to .11 Common Name-Working Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140'F* 2 Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130°F* 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* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.00411) 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* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reared 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 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 Wazewashing-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* 4501.114 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- mme s sec 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* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 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* * 3-302.13 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 Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 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 AutMidhority Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3401.12 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 1 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 CommerciallyProcessed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) 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 CA4R 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°17 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Withiri 2 Hours and From 70'F to 41°F/45'F Tags/Records:Fish Products P6-301.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction * Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402A2 Records,Creation and Retention 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 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision _ 29. Specal Requirements 009 3-502.11 Specialized Processing Methods* 130. 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. 3� t '� c -F` fr..: M ram, NN 3. `'3. 2 `Q M. • 1D i {•i ri r �,��� �n. ti. s 4 s,i/ ." - "t.e s. 'r�}. •-._ r2 r'� � '. t*s + - ` "k 4 �r "rt d rvPT^f d+��✓ ; 1Y w .i.. ^ i f j/` �i`�',.q,, w h Y t rt # }5. r;..: .. '+ �r1•�X? � 4 '4'#' �'`-^ L, ,.r+ 4 i,•d^3 �� =.e s:F. i�k Y+,T` F ,•,}, � p ds ,,.,�a ` -' � T°�✓ w y.:,.� L4 y � 3„ `•4,• '' ��.'� �. ;_! t d" j" u .�, r .•'' i. q1 :3 lr ,t t� e,., ;.� °�'r '�#,r „� w ' "`if 1 t r•r j'``.-' ti t 'c''� e , r .�: ?• .. x sr,'�'4g"t ' ', a.t�' •; r +, p�, 4;5;, `..�. t ,•. Ytz s, � n , 1 ,x.• •,,: i +:� ,Yy r- ' _A 4 .? r ,j�r �' r •j••aN{+�_ ,. w ts•` November 7•,.$1984' r �# ., +. -1 •N 1 s.j •4 f s ...- .' ' ,� ° , : t. � 7 t f ;r nM s `��"��' `r r'- ..;4' ,`°(- ,Y^' , t :.�s� y� S �.._ = d 1_ '� t df'`.< , � •.t ti 1 �. s's 8 �, : t � #•i• -'.� r[ �'-" 'Y r!• d i `, ...' ;+ 'The Southland Corporation ."^ " =e, 't ,. , - ;• c r ,4f r131 'Middlesex Turnpike } 4 r . r k.#Purlington; Mag:01803' y ;' Attent-{ion of-Susan,,D9�iovann r/'� �4�ra ``^f r�,s �! 'r .,.r'��' •Pc7.+- tr+ y, r 1Fi - r ''+ :� .trk", - R•e0�'C•ITGO PetroleujnrCorporat ion �r of rr i '� Lcit• 5;$tBeai�.se's� Way .arid Flilmouth'Road, Hyannis Proposed.,o�nsit,el sewage ,disposal *system- for 7-11 Food Store, C � j �i, r~i `• k sr -1 k "�, { � `'r� t �ha *; _ M { 4. ,�.�. •'`a +a,,,�.tF f >t r Dea"r"Ms Digiovsnnisc: . '.`sg�`4�^x 4� 44 You-Are,granted 'a�var ansce to instalE an onsite sewage disposgYtsy tetp`in , ,t `i�eu�"of.connecting ,to`TOwm, sewer,�st•the 'Citgo Petroleum Corporation,x1ot ' -:-5, Bearse's •W - y , , sy- and Falmouth load, ,Hjijini's, with the, following condi'tion_sr , tee •,! .�s , K � 1iC 4Y! . ,The ,onsitea sewage--systeti�mu$t be in"sCalle`d inrstrict accordance with 4' Ix ^tea r the: `re uirements a „ i q of,a'Tit1e 5; `of"the State Envit9pti6itall.Codi"Find the :` ,,,•� Town:of 1arn�tabl`e�=:Health Regulations. `� _•..qj, {, �' r,, «i"'•#f .µ r a'x y � i:x k i>^ a �.'` "{ �..�' �� r, ' �41 (2)` The designing�angirieer must 'b present�on site arid� supervise :the -con— t . Pa`� 'sructfon of the''septic s�iit, and must`:cetCify iriF�uiritingr`ti he•Board� that the.,system was,cbnstructed in strict,accordance with his, design. i :- y'.z� s t, ,.fix f ° Sys v, �' 7.. ,• t� t•: • � '` .Yi.` �• �4,f.''ir. �? �r fir. `�� •P. � ;�_. •, + x�, ,• (3) . TheA«onsite' ®ystem=mint Ire impacted':rand ,,Certificsei of Compl2.ance ,issued:prior'. t0 any aoccugattcy, ' S1t.. ^ r �1 l �� y.• r -+ t r%r _° t ,. •y�:tv , r'*.r A' ft * [ i i• `' `yl„� *T^,x�a. '. X � }, •}:" R D`~ y L rs' ,, � +� r w F, Flaq.r plans moat`be-, approved 'by-the'--Board of .Health prior ,tot: _� .. . suance "of'any;building permits: in accordance t4th` k05'CMR ' 9.© �.s 2 r(.t ..•t .;A �� -w^ Retail Food "'Establishments=� ' `. a 4, ,+,r.� F s�.;. �,�,..: t r{ , '' N t ,qy r r. - -M `:. c t}• +',4 7 �,r • w This variance is. granted4,becauee theoDepartment..of Public"Works has denied ,your-,requesCyto' ties`into;tie,'exidei:ng<'sewer'�force main in'tearse's",way'a d r� tyouhave stated Ehe,proposed alteration consst's of^ only approximately.,130 `` t gailons $p�r'�tlay beiag4added -,nto,a reconstructed-'system on site�.�x� xj r , Y .N s;¢This=variance .expires.Decembers }sl, r .:1i' 'S 1. F *'r, `'b ? t ,.-0,'.y,_ a •r T'y as•" <i�;�.s. a re; x +4 3 •;t. j.+4r6 r FM '. } ` y v. t s •; t `��iK. y ,a �Ver truly yours, a 1 Ts �' z r s�•fi ` r '� F•S_ e� .� y, ''�,t.a > r ! ,� r.".a '�••:':• „ � ,fit '>'�`�� �. ,l t ,�'�..r �, t Fy - r `y `. I }'S � }• dr. J Y ti� oF: .. - ' �� d,p -y9� t •[`y �_� �; Fr>•r�1 ��. t.f -,. f obert L. ;Childs, Chairman' ���r, `� •}'+f}F `'i s r is r -,�>"..• n+ j.."4` ,y a ,�"' .•i,. i`y. 'pv?� .t ,"' x ., s f 1 r`p,M.r�...`�`� �, r ( •, t'� °•/ Pw vJ) ..�" s`•r;.^a'7� ti '�. i h}. •E` ,} t r .< ��, �� ., -` "' '. 1..- -.• s .K. �' {y� _q�,`a5ss =a �..sx'r':y 1�' i e' w'� r� *t` r s Ann r iine ?Es h a'g11 1 4 �*� Sr`. y r ��y �T� .t y k�w a., .,,F,r,i- ' ,1,.• y - . * '' r,�' _..' ,; stir•?� F' # , 4y Ay{� g5 * °i• ; �� �s r c.,,, ..i' i 7 :.`a} a.. y5 } .+t.;= , ' .' -�``�r s :, f. •r" # •.r S A��� �f �.�+/�� �q��x � 7�eyy t� � �j, 4 y:� s'fq, L •. .r a '' . BOARD OF, .HEALTH+kA�s '/.tit ={•5 t Yd RF SS r '` L ' ':, G �. ; e •-: :TOWN OF BARNSTABLE w r ; .„ ., s ,f f b r, d J�.�t t S� ' .t•"�'' �'' a {: JMI/mun' ..w s art �'' by; ,ryL.�"'•z+��, r#t!,'r:F t- ��� ' '�.-. x } - i.'F r �' LS t 5 5 `_s" "�Ix:w �:.. •a }mot•: _'7'"r REVIEWED FOR DESIGN CONFORMANCE ONLY APPROVAL FOR THESE PLANS BY ALLIED DOMECQ DOES NOT IMPLY THAT AWED DOMECQ HAS REVIEWED THEM FOR CONFORMITY TO APPLICABLE CODES OR REGULATIONS ❑ APPROVED ❑ APPROVED AS NOTED: Submit Record Copy for Archives ❑ DISAPPROVED AS NOTED: Revise and Resubmit ❑ INCOMPLETE INFORMATION: Add requested informaiton and resubmit Date: AWED DOMECQ QSR Construction Manager Notes: ABBREVIATION INDEX & AND GA. GAUGE Q.T. QUARRY TILE 0 AT GALV. GALVINIZED QTY. QUANTITY A/C AIR CONDITIONING GYP. BD. GYPSUM BOARD R.A. AWED DOMECQ A.D. AREA DRAIN HDWD. HARDWOOD RAD. RADIUS A.F.F. ABOVE FINISH FLOOR HDR. HEADER REF. REFRIGERATOR ALUM. ALUMINUM H.M. HOLLOW METAL REINF. REINFORCING ALT. ALTERNATE HORIZ. HORIZONTAL REV. REVISION APPROX. APPROXIMATE HGT. HEIGHT REQ'D REQUIRED BD. BOARD I.D. INSIDE DIAMETER RESIL. RESILIANT BLDG. BUILDING INSUL. INSULATION RM. ROOM BM. BEAM INT. INTERIOR R.O. ROUGH OPENING BSMT. BASEMENT JT. JOINT SCHED. SCHEDULE BTWN. BETWEEN KIT. KITCHEN SEC. SECTION BOT. BOTTOM LAM. LAMINATE S.F. SQUARE FOOT C.L. CENTER LINE LAV. LAVATORY SHT. SHEET C.T. CERAMIC TILE LT. LIGHT SIM. SIMILAR CLG. CEILING MAS. MASONRY SPEC. SPECIFICATION CLOS. CLOSET MAX. MAXIMUM SQ. SQUARE CM CONSTRUCTION MGR. MECH. MECHANICAL S.S. STAINLESS STEEL CMU CONC. MASONRY UNIl MTL. METAL STD. STANDARD COL. COLUMN MFR. MANUFACTURER STL. STEEL CONC. CONCRETE MIN. MINIMUM STRUCT. STRUCTURAL CONT. CONTINUOUS MISC. MISCELLANEOUS SUSP. SUSPENDED CONST. CONSTRUCTION M.O. MASONRY OPENING TEL TELEPHONE DEPT. DEPARTMENT MTD. MOUNTED THK. THICK DTL. DETAIL N.I.C. NOT IN CONTRACT THRU THROUGH DdF. DRINKING FOUNTAIN NO. NUMBER T.O.P. TOP OF PLATE NOMINAL T.O.S. TOP OF STEEL DI6 1"WSION I N.T.S. :4o", T.O.SL. TOP OF SLAB O.A.-,',­T.,Tt EATI-O DC.Q.G. ON:EI 'TYPICAL y -•� V" - OU'�S!0i . ,_.Ix? ` x s��%: " '"VINYL =MPOSIMON BASO D.S. DOWN SPOUT OPNG. OPENING I �/,:^.`i. VINYL COMPOSITION TILE ; DWG. DRAWING OPT. OPTIONAL VERT. VERTICAL EA. EACH PL. PLATE V.I.F. VERIFY IN FIELD EL. ELEVATION P.LAM. PLASTIC LAMINATE V.W.C. VINYL WALL COVERING ELEC. ELECTRICAL PLUMB. PLUMBING W/ WITH EQ. EQUAL PLYWD. PLYWOOD W.C. WATER CLOSET EQUIP. EQUIPMENT PR. PAIR WD. WOOD EXIST. EXISTING PROP. PROPERTY W/O WITHOUT EXT. EXTERIOR P.S.F. PER SQUARE FOOT WP. WATERPROOFING F.D. FLOOR DRAIN P.S.I. PER SQUARE INCH WT. WEIGHT FIN. FINISH PTD. PAINTED WWM. WELDED WIRE MESH FL. FLOOR P.V.C. POLY VINYL CHLORIDE F.O. FACE OF FT. FOOT FURN. FURNITURE GRAPHIC SYMBOLS SECTION NUMBER FINISH NUMBER 202 P-2, SHEET NUMBER SECTION FINISHES � ~ 4c- -DETAIL NUMBER (DETAIL SHEET NUMBER DETAIL 1Q DOOR MARK `-"'— PARTITION KEY DOOR PARTITION TYPES EQUIPMENT TAG COLUMN REFERENCE GRIDS OR DRAWING NOTES INTERIOR ELEVATION INDICATOR `� I i�u�ONUTS� obbins,. � INDEX OF DRAWINGS � Ti Al Kl _.El P1 TITLE SHEET/ ARCHITECTURAL DATA FLOOR PLAN; REFLECTED CEILING PLAN; LEGENDS EQUIPMENT PLAN; ELEVATIONS; SCHEDULES ELECTRICAL PLAN; LEGEND; ELECTRIC PANELBOARDS PLUMBING PLANS; SCHEDULES FLAME SPREAD AND SMOKE DEVELOPMENT RATINGS FOR INTERIOR CEILING FINISH MATERIALS, (INTERIOR FINISH CLASSIFICATION: III/ MATERIAL FLAME SPREAD RATING FIBERGLASS REINFORCED PANELS 175 WALL AND 76-200): SMOKE DEVELOPMENT 135 VINYL WALL COVERING 5 5 PLASTIC LAMINATE 30 200 ENAMEL PAINT ON TRIM, DOOR 5 FRAMES, WOOD SHELVING WOOD STAIN NATURAL WOOD SURFACES 5 CLEAR SEALER NATURAL WOOD DOORS 5 ACCOUSTICAL CEILING TILES 23 IADA STATEMENT HEREBY FOR THIS PROjECT WERE DRAWN IN ACCORDANCE WITH ALL FEDERAL, STATE ► r LOCAL INCLUDING,i ! TO, DISABILITIESWITH ACCESSIBILITY GUIDELINES, MASSACHUSETTS 521 CMR, AND ANY OTHER LOCAL REGULATIONS STANDARDS. ARCHITECT'S SIGNATURE HERE ALLIED DOMECQ REFERENCES ALLIED DOMECQ SPECIFICATION BOOK (ISSUED 1 /31 /98) NATIONAL ACCOUNT SOURCE INFORMATION BOOKLET (ISSUED 3/6/00) ALLIED DOMECQ EQUIPMENT SPECIFICATION BINDER (ISSUED 6/97) 1999 FDA FOOD CODE (ISSUED 1999) ALLIED DOMECQ DATA SIGNAGE TYPE SQUARE FOOTAGE DIMENSIONS PYLON /MONUMENT 44 S.F. 6'-8" x 6'-8" BUILDING 16 S.F. 15'-O" x 1'-1" SITE DIRECTIONAL SEE SITE PLAN BY OTHERS, AND OWNER STORE DIMENSIONS: SQ. FOOTAGE SALES AREA/ PUBLIC AREAS/ TOILETS 244 S.F. RETAIL/SERVICE N/A S.F. K I TCIH EN N/A S.F. BASEMENT N/A TOTAL: 244 S.F. SEATING: # OF TABLES AND TYPE N/A TABLES STAND-UP COUNTER N/A STOOLS N/A # OF HANDICAP SEATS N/A TOTAL # OF SEATS N/A SEATS BUILDING DATA - MASSACHUSETTS USE GROUP: A3 > 50 OCCUPANCY TYPE OF CONSTR,UCTION: TYPE 5B STORIES: 1 ALLOWABLE FLOOR AREA: 4200 S.F. ACTUAL FLOOR AREA: 244 S.F. OCCUPANCY LOAD: FIXED SEATS: N/A PERSONS EMPLOYEES: N/A PERSONS TOTAL OCCUPANCY: N/A PERSONS FLAME SPREAD: FREEZER CORE MATERIAL: N/A FREEZER METAL (PANEL: N/A SMOKE DEVELOPMENT RATINGS: FREEZER CORE MATERIAL: N/A FREEZER METAL PANEL: N/A BASED ON THE FOLLOWING CODES COMMONWEALTH OF MASSACHUSETTS BUILDING CODE 780 C.M.R. - 11/27/98 DRIVE-THRU: EXISTING YES/NO YES NUMBER OF D.T. WINDOWS 1 MENU BOARD SIZE BY DUNKIN' DOUNTS CAR LENGTHS FROM D.T. WIN. 5 STACKING (# OF VEHICLES) SEE SITE BY OTHERS ESCAPE LANE BY SITE ENG. DRIVE THRU TIMER SYSTEM BY DUNKIN' DOUNTS RESTROOMS: NUMBER HANDICAP RESTROOMS 2 M 0 �LO o i cn 0 0 Z S a w W �U� to W o —� I= —z z Q C� 3 _j oz w < J Z + +► L L 0< m Lj LL1 0 = LLJ V LIJ 1 0 SHEET FILE#: D02109 DATE: 7-15-2003 DRAWNBIG kQ.M. MARK FEUTI 6' X 6' WALK-IN FREEZER GATE POST NOTE END POST TO BE 1 1/2"x5'-O" S.S. POST. DRILL THRU SLAB 24" DEEP FOR POST AND SET IN "POUR -A - ROCK" OR EQUAL FORM 3/4" WOOD POST AROUND METAL POST. FINISH PLYWOOD ALL SIDES/TOP WITH P.LAM PL-21 . FINISH POST 3" SQUARE WITH S.S. POST IN CENTER. LEGEND: NEW STUD WALL FPLAN SCALE: 1 /4"=1'-0" A2 MET 2GR82U6T8A-12OV-EB81 2 X 2 RECESSED FLUOR. W/ACRYLIC LENS A2 W/ GE F32TB/SPX30/U/6 (2), UBENT T8 32w, FLUORESCENT LAMP A2-F MET 2GR82U6T8A-12OV-EB81 2 X 2 RECESSED FLUOR. W/ACRYLIC LENS, W/ FLANGE KIT FCS22WU A2-F W/ GE F32TB/SPX30/U/6 (2), UBENT T8 32w, FLUORESCENT LAMP OTYPE "K" FIXTURE: INCANDESCENT PORCELAIN FIXTURE AC FANTECH AIR CURTAIN - 941-351-2947 DRIVE-THRU - MODEL #AS323, REAR DOOR - MODEL #AC4800 VC 1 2 3 4 5 6 VALUE COMBO & MENU BOARDS ® TYPICAL SUPPLY DIFFUSER ® EXHAUST FAN GRILLE FOR TEF#1 DUPE) pp DUPLEX OUTLET 12" A.F.F. UNLESS NOTED OTHERWISE G=G.F.I. C=ABOVE COUNTER WP=WATERPROOF PDX W X POWER OUTLET - 208 VOLT, X - AMPERE JUN Q JUNCTION BOX Say- Sa SWITCH, 1 POLE, MOUNTED 40" A.F.F., SP=SW. W/PILOT SMALL LETTER KEYS TO FIXTURE SWITCHED. DIS FUSED DISCONNECT SWITCH 6' X 6' WALK-IN FREEZER GENERALNOTES 1. GENERAL CONTRACTOR SHALL REFER TO WRITTEN SPECIFICATIONS FOR ADDITIONAL INFORMATION NOT CONTAINED 1N THE DRAWINGS. 2. GENERAL CONTRACTOR SHALL PROVIDE ADEQUATE BLOCKING AT SHELVING, 3 COMPARTMENT SINK, T & S SPRAY BRACKET, POT RACK, HAND SINKS, PAPER TOWEL DISPENSERS, SOAP DISPENSERS, OTHER ACCESSORIES, ETC. 3. REFER TO THE 'K' DRAWING(S) FOR INFORMATION REGARDING THE EQUIPMENT AND EQUIPMENT LAYOUT. 4. FURNISH ALL LABOR AND MATERIAL NECESSARY FOR THE COMPLETE INSTALLATION OF CEMENT BOARD BACKING FOR F.R.P. AND CERAMIC TILE. 5. GENERAL CONTRACTOR TO PROVIDE FOR P.O.S SYSTEM AS SHOWN ON ELECTRICAL DRAWINGS OR, AT MINIMUM THE FOLLOWING CONDUITS; A) 2 1/2" I.D. PROM 4 x 4 x 3 JUNCTION BOX LOCATED BEHIND OFFICE DESK UP WALL TO ABOVE CEILING; B) FROM A HUB LOCATED IN THE FRONT LINE CHASE UNDER SLAB TO BACK WALL, PROVIDE 2 1/'2" I.D. CONDUIT WITH 2'-0" SWEEPS AT ENDS. TERMINATE ABOVE THE CEILING; C) 1" I.D. CONDUIT FROM BEHIND THE DRIVE THRU CASH STATION UP WAILL TO ABOVE CEILING - USE 2'-0" SWEEPS AT BOTTOM TO SIDE NEAREST FRAME WALL IF WINDOW BEHIND PROVIDING CHASE AS REQUIRED SO NO WIRING BENDS LESS THAN 2'-0" RADIUS, AND D) 2"x4" ELECTRICAL BOX 6'-0" A.F.F. WITH 1" CONDUIT IN WALL TO ABOVE CEILING. CENTER 32" X 32" X 3/4" PLYWOOD BLOCKING IN WALL FOR VDU UNIT. NOTE THAT THE MAXIMUM CONNECTION LENGTH BETWEEN A VDU(S) AND ITS DEDICATED CPU IS 75'-0", AND ONE TELEPHONE JACK IN OFFICE TO BE AN ISDN LINE. NOTIFY DUNKIN' DONUTS IF NOT REGIONALLY AVAILABLE. 6. NOTE: "P.O.S.". ALL POWER OUTLETS FOR P.O.S. DEVICES ARE DEDICATED CIRCUITS WITH THIRD WIRE ISOLATED GROUND. AN IG IS AN INSULATED WIRE, SEPARATED FROM ALL OTHER GROUND WIRES, RUNNING BACK TO THE BUILDING MAIN OR COMPLEX POWER PANEL. NEMA STANDARD L5-15R I.G. FOR THE RECEPTACLE AND PLUG. USE OF IG DUPLEX OR QUADPLEX OUTLETS: (I.E., HUBBELL IG-5262, IG-5362 OR EQUIVALENT). 7. GC. SHALL NOT PROCEED WITH CONSTRUCTION UNTIL V.D.U. LOCATIONS ARE DETERMINED. 8. OWNER'S MECHANICAL CONTRACTOR SHALL BE RESPONSIBLE FOR REVIEWING EXISTING HVAC EQUIPMENT AND MODIFYING AS REQUIRED BY NEW HEATING & COOLING LOADS. SUBMIT SHOP DRAWINGS FOR ARCHITECT APPROVAL BEFORE ORDERING EQUIPMENT OR BEGINNING WORK. 8. DIMENSIONS SHOWN ARE TO THE FACE OF FINISH. 10. THESE PLANS ARE BASED ON MINIMUM ALLIED DOMECQ CORPORATE DESIGN REQUIREMENTS. THE STRUCTURAL DESIGN, FOOTING DESIGN, ADA COMPLIANCE AND GENERAL BUILDING REQUIREMENTS HAVE BEEN EVALUATED TO MEET ALL ADA STATE AND LOCAL CODES. REFLECTED CEILING PLAN SCALE: 1 /4"=1'-0" ro 0 p I 0 0 i= w a cn Ix V) U — (n J w Q ® F Z z • w< U / ® a- < z w O v) 1= Q z IL)0 n Lli z � Q • �► z C) tJ O ® Q J C Ld of l..L.J 0 LL. _j LL, D:f SHEET FILE#: D021 t DATE: 7-15-2003 DRAWN BY: BIG 6' X 6' WALK—IN FREEZER EQUIPMENT PLAN SCALE: 1 /4"=1'-0" ML - MECHANICAL CONTRACTOR CS = SIGN CONTRACTOR GC = GENERAL CONTRACTOR PL = PLUMBING CONTRACTOR EL = ELECTRICAL CONTRACTOR IC = INDEPENDENT CONTRACTOR ES = EQUIPMENT SUPPLIER CO = CONVIENCE OUTLET JB = JUNCTION BOX (J—BOX) FS - FLOOR SINK SP SEE PLAN BR = BASKIN—ROBBINS FRANCHISEE NOTES: 1. EQUIPMENT SUPPLIER TO PLACE ALL NEW EQUIPMENT. 2. GENERAL CONTRACTOR TO PLACE ALL EXISTING EQUIPMENT. 3. GENERAL CONTRACTOR TO MAKE ALL MECHANICAL, PLUMBING, AND ELECTRICAL CONNECTIONS FOR ALL EQUIPMENT. EX — EXISTING N/A — NOT APPLICABLE * — PROVIDE SHELVING FOR REFRIGERATOR AND FREEZER, PER HEALTH DEPARTMENT REQUIREMENTS. WALL FINISH MATERIAL SCHEDULE CODE MATERIAL MANUFACTURER PRODUCT NO. DESCRIPTION B-21 TILE COVE BASE KEOPE DD5052 SERIES: JAPURA 6"X12" UNPOLISHED DARK B-22 TILE COVE BASE METROPOLITAN 507 507 USE WITH T-22 TILES PURITAN GRAY B-23 TILE STRAIGHT BASE USE 0 KICKPLATE KEOPE DD5050 SERIES: JAPURA 6 rox 12" UNPOLISHED DARK) P-22 FIBERGLASS REINFORCED * POLYESTER PANELS MARLITE P-100 WHITE ALT. KEMLITE — 85 WHITE P-22A KEMLITE 185 WHITE ALT. MARLITE — P-100 WHITE * NOTE: IF FRIALATORS OVENS USE CLASS "A" MATERIAL. MP-25 METAL PANEL CITADEL PANEL 15 SHERWIN WILLIAMS PMS 222C ROYAL PLUM COLOR P-29 PAINT SHERWIN WILLIAMS SW 1087 WINDRIFT BEIGE — PUBLIC WALLS P-30 PAINT SHERWIN WILLIAMS SW 1900 LUMINOUS WHITE GLOSS P-34 PAINT SHERWIN—WILLIAMS SW 1567 INAPA GRAPE 1 STRIPE AT TOP OF PUBLIC AREA WALLS PL-21 PLASTIC LAMINATE F R C 5913-58 "RASBERRY VINAIGRETTE" MATTE FINISH (WAINSCOT) PL-28 PLASTIC LAMINATE VOSGES PEAR MATTE FINISH HALF WALL PL-35 PLASTIC LAMINATE A — 8 "DOESKIN" MATTE FINISH HALF WALL T-21 WATER MITE VARNISH SHERWIN WILLIAMS VW82 OVER ST-22 T--22 WATER VNHITE VARNISH' ZAR #116 — CHERRY CHAIR RAIL, TRIM & DOORS WC-23 WALL COVERING SURFACE MATERIALS L1BW21 FRENCH VANILLA WC-24 WALL COVERING RIGHTER GROUP DD200 COFFEE CUP ICON WALLPAPER DECORATIVE WALL ON SALES AREA WC-25 WALL COVERING RIGHTER GROUP 025429A MATCHES DD200 & DD100 DECORATIVE SWIRL BORDER — SALES AREA BELOW CEILING (ALTERNATE TO P-34) WC-26 WALL COVERING RIGHTER GROUP DD100 MATCHES DD200 & 025429A BUT WITHOUT COFFEE CUP ICON ALTERNATE TO L1 BW21 CONSULT ALLIED DOMECQ 18" BACK BAR SINK 1. POS TERMINAL INFORMATION: — 110V AC DUPLEX OUTLETS 2. RECEIPT PRINTER INFORMATION: — 110V AC DUPLEX OUTLETS — SHARED WITH TERMINAL OUTLETS — WIRED DIRECTLY TO TERMINALS 3. REMOTE PRINTER INFORMATION: — 110V AC DUPLEX OUTLETS — WIRED TO TERMINALS VIA RJ-45 J—BOX IN FRONT CABLE CHASE 4. VDU INFORMATION: — 110V AC DUPLEX OUTLETS — MOUNTING: WALL, CEILING, OR PEDESTAL 5. NETWORK HUB INFORMATION: 110V AC DUPLEX OUTLETS LOCATED IN FRONT COUNTER CABLE CHASE — CONNECTS TO TERMINALS, VDU'S, BACK OFFICE COMPUTER SYSTEM — ORDER INFORMATION ROUTED TO POS NOTE: GENERAL CONTRACTOR TO PROVIDE FOR P.O.S. SYSTEM AS SHOWN ON ELECTRICAL DRAWINGS OR, AT MINIMUM THE FOLLOWING CONDUITS: A) 2 1 /2" I.D. FROM 443 JUNCTION BOX LOCATED BEHIND OFFICE DESK UP THE WALL TO ABOVE CEILING. B) 2 1 /2"' I.D. CONDUIT WITH 2'-0" SWEEPS AT ENDS FROM A HUB LOCATED IN THE FRONT LINE CHASE UNDER SLAB TO THE BACK WALL. TERMINATE ABOVE CEILING. C) 1" I.D. CONDUIT FROM BEHIND THE DRIVE THRU CASH STATION UP THE WALL TO ABOVE C IUUG. D 2 x4" ELECTRICAL BOX 6'-0" A.F.F. WITH 1" CONDUIT IN WALL TO ABOVE CEILING. CENTER 32"x32"x3i/4" PLYWOOD WALL BLOCKING IN WALL FOR VDU UNIT. THE MAXIWUM CONNECTION LENGTH BETWEEN A VDU AND ITS DEDICATED CPU IN THE FRONT LINE CHASE IS 75'-0". THE CONNECTION THEN GOES TO THE OFFICE. G.C. TO PROVIDE ONE ISDN TELE:PHONE JACK IN THE OFFICE. NOTIFY DUNKIN' DONUTS IF ISDN SERVICE IS NOT REGIONALLY AVAILABLE. SCALE: 1 /2"=1'-0" MENU PHO O MENU MENU ASK"IN--� ROBBINS EQUIPMENT SCHEDULE05ZO8/03 EQUIPMENT ELECTRICAL PLUMBING ITEM QTY DESCRIPTION MANUFACTURER MODEL NO. LOAD u°P REMARKS ONNNS TI REMARKS VOLT AMPS PH HOT COLD WASTE BACKROOM PRODUCTION EQUIPMENT 460 N/A HARDENING CABINET(2 1/2 DOOR) FRIGIDAIRE / CARRIER T30—HSP 115 11.5 1 CO NEMA 5-15P RECEPTACLE AT 15" A.F.F. INTEGRAL CONDENSATE EVAPORATING PAN RETAIL. AREA EQUIPMENT 15 20 208 30 1 1 1 1 1" SCALE &WARMER STATION F4'-6"BLENDER STATION CABINET ICE BIN 2'-3" SUNDAE CENTER W/OVERSHELF CUSTOM BY SUPPLIER CUSTOM BY SUPPLIER CORNELIUS SILVER KING FRIGIDAIRE /CARRIER N/A N/A 162540000 SKF2A/C4 120 4.6 1 CO NEMA 5-15 RECEPTACLE AT 24" A.F.F. 1" INDIRECT WASTE TO FLOOR SINK INDIRECT WASTE TO .FLOOR SINK INTEGRAL CONDENSATE EVAPORATING PAN INTEGRAL CONDENSATE EVAPORATING PAN BR-271C 115 3.0 1 CO NEMA 5-15 RECEPTACLE AT 24" A.F.F. 35 N/A 2'-2" ICE CREAM, FRUIT &JUICE CABINET SERVICE AREA EQUIPMENT 40 60 60A 61 281 N/A 1 1 N/A 1 BACK LINE SINK 7'-5 1 /8" FRONT LINE DIPPING CABINET DIPPER WELL 5'-8 I/W FRONT LINE DIPPING CABINET UPRIGHT FREEZER FRIGIDAIRE BUILT —IT ENGINEERING FRIGIDAIRE FRIGIDAIRE PER PLAN BRT90P 90023 BRT68P ULG50BCP 115 115 10.8 10.8 1 1 — — POWER CORD 16 AWG POWER CORD 16 AWG 1 /2" 1/2" INDIRECT WASTE TO FLOOR DRAIN INDIRECT WASTE TO FLOOR DRAIN SERVER PRODUCTS METTLER/TOLEDO BLEND TEC WARING COMMERCIAL 82155 & 920t0 8433-2102 DMC 201 120 120 120 120 4.16 20.0 1.0 1 1 1 CO CO CO STANDARD PLUG STANDARD PLUG STANDARD PLUG SMALLWARES BUTTERSCOTCH AND HOT FUDGE WARMER 15B 1 15E 20M 20H 1 1 SCALE IBLENDER THREE SPINDLE MALT MIXER —� 120E 90.1 1 N/A POS do UCR, 27" UCR — FRONT LINE P.O.S. DELFIELD CUSTOM 406—CA PER PLAN 115 5 1 CO STANDARD PLUG MENUBOARDS 806A 806B 1 1 MENUBOARD — ICE CREAM MENUBOARD — BEVERAGES MENUBOARD —ICE CREAM & MORE (LIMITED SPACE) VERIFY W/ OWNER & C.M. VERIFY W/ OWNER & C.M. VERIFY W/ OWNER & C.M. 807 N/A r� 0 p I t` in a 0 fail d w tr v — c w Q F z z • < • A .. • wm SHEET FILE¢#: D021( DATE: 7-15-2003 C.M. MARK FEUTI 6' X 6' WALK-IN FREEZER ELECTRICAL PLAN SCALE: 1 /4"=1'-0" NEW SIGN TO BE MADE OF SAME TYPE MATERIAL AS EXISTING. CONSULT OWNER FOR INFO. BASKIN CIRCUITS VOLTAGE: 120/208 PHASE: 3 LOCATION: REAR ENTRY BUS AMPS: 2255 WIRE: FF MAIN OVERCURRENT DEVICE: ON CIRCUIT #M-1 LY AMPS: 125 REFERF CKT DESCRIPTION BREAKER AMP POLE LOAD KVA HAS CKT DESCRIPTION BREAKER AMP POLE LOAD KVA HAS 1 CAKE DISPLAY, - ULG 50 25 2 1.6 A 2 CAKE DISPLAY - ULG 50 20 1 .7 A 31 1.6 B 4 CAKE DISPLAY - ULG 50 20 1 .7 B 5 FLASH FREEZER 20 2 .7 C 6 CAKE DISPLAY - ULG 50 20 1 .7 C 7 .7 A 8 CAKE DISPLAY - ULG 50 20 1 .7 A 9 SUNDAE CTR BEVERAGEAIR 20 1 .5 B 10 CAKE DISPLAY - ULG 50 20 1 .7 B 11 SUNDAE CTR SCALE 20 1 .2 C 12 CAKE DISPLAY - ULG 50 20 1 1 .7 C 13 1 SUNDAE CTR -WARMERS 20 1 1.5 A 14 CAKE DISPLAY - ULG 50 20 1 .71 A 15 BLENDER 20 1 1.4 B 16 B 17 8LENDER 20 1 1.4 C 18 C 19 MALT MIXER 20 1 .2 A 20 A 21 DIPPING CABINET 20 1 1.8 B 22 B 23 1 DIPPING CABINET 20 1 1.8 C 24 C 25 JUNDERCOUNTER REFRIG. 20 1 .6 A 26 A 27 CASH REGISTER 20 1 .2 B 28 B 29 PRINTER 20 1 .2 C 30 C 31 CLOSET LIGHT 20 1 1 1.6 A 32 A 33 CLOSET LIGHT 20 1 1 1.6 B 34 B 35 C 36 C 37 A 38 A 39 B 40 B 41 C 42 C PHASE A LOAD KVA: PHASE B LOAD KVA: PHASE C LOAD KVA: TOTAL LOAD (KVA): NOTES 1. PANEL 80ARDS ARE PROVIDED FOR CHECKING TOTAL SERVICE REQUIREMENTS E.C. SHALL USE JUDGMENT IN REVISING CERTAIN CIRCUIT'S AND ARRANGING EQUIPMENT ON PANEL BOARDS IN THE MOST ECONOMICAL MANNER. E.C. SHALL DETERMINE FINAL SERVICE LOAD REQUIREMENT FROM LOADS GIVEN IN PANELBOARDS AND PROVIDE SERVICE ACCORDINGLY, 2. INSTALL ALL ELECTRICAL OUTLET BOXES HORIZONTAL AND FLUSH IN WALLS WHERE POSSIBLE. PROVIDE APPROPRIATE FLUSH MOUNTING RECEPTACLE BOXES AND CONDUIT AS (REQUIRED FOR MOUNTING OF OUTLETS ON CONCRETE WALLS. 3. EXTERIOR SIGN JUNCTION BOX TO BE MOUNTED ON INSIDE OF WALL. EXTEND CIRCUIT TO SIGN. 4. SEE "TECHNICAL REQUIREMENTS FOR THE COMTREX SYSTEMS CORPORATION DUNKIN' DONUTS P.O.S. SYSTEM" FOR ALL INFORMATION RELATING TO CASH REGISTER WIRING. (FURNISHED BY DUNKIN' DONUTS.) 5. PROVIDE CORD WITH GROUND AND CAP FOR EACH COFFEE MAKER AND CARBONATOR, 6. SEE INTERIOR ELEVATIONS FOR DIMENSIONS AFFECTING THIS WORK, 7. SEE SHEET K2 FOR EQUIPMENT CONNECTION REQUIREMENTS, 8. E.C. SHALL PROVIDE MUSIC SYSTEM PER DUNKIN' DONUTS SPECIFICATIONS. 9. E.C. SHALL PROVIDE DOORBELLS AND BUZZERS PER DUNKIN' DONUTS SPECIFICATIONS. E.C. SHALL VERIFY LOCATION OF EQUIPMENT WITH DUNKIN' DONUTS FRANCHISE OWNER. NEW CARVED WOOD SIGN BY OWNERS SIGN MANUFACTURER. w christy s DUNKIN DONUTS BASKIN ROBBINS I FRONT DOOR SIGN AGE SCALE: 1 /4"=1'-0" PYLON AND EXTERIOR SIGNS 0 CONSULT OWNER FOR LOCATION AND SIZE OF PYLON SIGN REQUIRED; CONNECT TO A35, SUPPLY ALL WIRE, BOXES, AND CONDUITS REQUIRED. CONNECT EXTERIOR SIGNS TO CIRCUIT A31. CONNECT MENU BOARD TO CIRCUIT A33. VERIFY LOCATION WITH OWNER. ELECTRICAL PLAN KEYNOTES 17 EXTERIOR LIGHTS, PHOTOCELL ON, TIME CLOCK OFF. ®POWER FOR EXTERIOR SIGNAGE. REFER TO ARCHITECTURAL DRAWINGS FOR EXACT LOCATION. LEGEND 04/03 A2 MET 2GR82U6T8A-120V-EB81 2 X 2 RECESSED FLUOR. W/ACRYUC LENS A2 W/ GE F32TB/SPX30/U/6 (2), UBENT T8 32w, FLUORESCENT LAMP A2-F MET 2GR82U6T8A-120V-E881 2 X 2 RECESSED FLUOR. W/ACRYUC LENS, W/ FLANGE KIT FCS22WU A2-F W/ GE F32TB/SPX30/U/6 (2), UBENT T8 32w, FLUORESCENT LAMP TYPE "K" FIXTURE: INCANDESCENT PORCELAIN FIXTURE AC FANTECH AIR CURTAIN - 941-351-2947 DRIVE-THRU - MODEL #AS323, REAR DOOR - MODEL #AC4800 VC 1 2 3 4 3 8 VALUE COMBO & MENU BOARDS ® TYPICAL SUPPLY DIFFUSER ® EXHAUST FAN GRILLE FOR TEF#1 DUPE)DUPLEX OUTLET 12" A.F.F. UNLESS NOTED OTHERWISE 'C7 G=G.F.I. C=ABOVE COUNTER WP=WATERPROOF PDX x POWER OUTLET - 208 VOLT, X = AMPERE JUN O JUNCTION BOX SW- SC SWITCH, 1 POLE, MOUNTED 40" A.F.F., SP=SW. W/PILOT SMALL LETTER KEYS TO FIXTURE SWITCHED. DIS FUSED DISCONNECT SWITCH LIGHTING SCH DU,LE.. NOTES: I. PROVIDE ALL FIXTURES COMPLETE WITH LAMPS, 2. ALL INCANDESCENT LAMPS SHAD_ BE RATED 130 VOLTS. 3. ALL BALLASTS SHALL BE HIGH POWER FACTOR. FLUORESCENT BALLASTS FOR T8 4. LAMPS TO BE OSRAM/SYLVANIA OR MAGNATEK FULL -OUTPUT ELECTRONIC, EXCEPT OUTDOOR FIXTURES TO BE ZERO -DEGREE MAGNETIC BALLASTS. 5. PROVIDE HOLD DOWN CUPS FOR EACH CORNER OF FLUORESCENT GRID TROFFERS. 6. PROVIDE ALL REQUIRED MOUNTING OR HANGING HARDWARE. 7. COORDINATE AND VERIFY ALL FIXTURE INFORMATION, TYPES AND FINAL LOCATIONS WITH THE REFLECTED CEILING PLANS. 8. LAMPS SHALL BE AS MANUFACTURED BY SYLVANIA, WESTINGHOUE, GENERAL ELECTRIC, OR APPROVED EQUAL. 9. FIXTURES CAN BE PURCHASED THROUGH A NATIONAL ACCOUNTS PROGRAM WITH VILLA LIGHTING SUPPLY INC- 1218 S. VANDEVENTER, ST. LOUIS, MO 63110. PLEASE CALL NATIONAL ACCOUNTS AT 1-800-370-5050 EXT 169 OR FAX 800-830-5267 FOR PRICING. POS NOTE: GENERAL CONTRACTOR TO PROVIDE FOR P.O.S. SYSTEM AS SHOWN ON ELECTRICAL DRAWINGS OR, AT MINIMUM THE FOLLOWING CONDUITS: A) 2 1/2- I.D. FROM 4x4x3 JUNCTION BOX LOCATED BEHIND OFFICE DESK UP THE WALL TO ABOVE CEILING. B) 2 1/2" I.D. CONDUIT WITH 2'-0" SWEEPS AT ENDS FROM A HUB LOCATED IN THE FRONT LINE CHASE UNDER SLAB TO THE BACK WALL TERMINATE ABOVE CEILING. C) 1" I.D. CONDUIT FROM BEHIND THE DRIVE THRU CASH STATION UP THE WALL TO ABOVE CEILING. D) 2"x4" ELECTRICAL BOX 6'-0" A.F.F. WITH 1" CONDUIT IN WALL TO ABOVE CEILING. CENTER 32"02"0/4" PLYWOOD WALL BLOCKING IN WALL FOR VDU UNIT. THE MAXIMUM CONNECTION LENGTH BETWEEN A VDU AND ITS DEDICATED CPU IN THE FRONT LINE CHASE IS 75'-0". THE CONNECTION THEN GOES TO THE OFFICE. G.C. TO PROVIDE ONE ISDN TELEPHONE JACK IN THE OFFICE. NOTIFY DUNKIN' DONUTS IF ISDN SERVICE IS NOT REGIONALLY AVAILABLE. NOTE: "P.O.S.", ALL POWER OUTLETS FOR P.O.S. DEVICES ARE DEDICATED CIRCUITS WITH THIRD WIRE ISOLATED GROUND. AN IG IS AN INSULATED WIRE, SEPARATED FROM ALL OTHER GROUND WIRES, RUNNING BACK TO THE BUILDING MAIN OR COMPLEX POWER PANEL NEMA STANDARD L5-15R I.G. FOR THE RECEPTACLE AND PLUG, USE OF IG DUPLEX OR QUADPLEX OUTLETS: (I.E., HUBBELL IG-5262, IG-5362 OR EQUIVALENT). s" VERIFY EXISTING CAN SIZE NEW PANELS TO BE MADIE BY DUNKIN fDONUTS SIGN MANUFACTURER PEDALSTAL SIGN SCALE: 1 /2"=1'-0" 6'-8" t♦ DUNKIN �• ooNu�rs. f� �i �1I��IIIiI l Ft�ri�hlllEchristy' p�Z�vF "THRU 00 co ® N c0 0 J� ® mN cn Morn O�� co < I m� O a:3►u'n 0 M O Lo V1 O O V) o W 2 CU - W Q z �Loz • A Z C- LL Z vj 3 Z W C� Q � oZ W �z 3 Z Q n 0 (� o< m �- _ �0 , C..,� po C Of F® 2 F- U LIL JWC _jLL LI`J LLJ SHEET FI LE#: D021 DATE: 7-15-2003 DRAWN BY: BIG C.M. MARK FEUTI 6' X 6' WALK—IN FREEZER HOT & GOLD WATER & GAS PIPING PLAN SCALE: 1 /4"=1'-0" ALL LINES SHOWN ARE TO BE ABOVE SLAB/CEILING U.N.O. SYMBOL LIST -- C.W. — COLD WATER ® H.W. — HOT WATER VENT PIPING BELOW SLAB `—V-- VENT PIPING ABOVE SLAB V.R. VENT RISER }f DOUBLE HAND HOLE BUILDING TRAP F.A.V. FRESH AIR VENT VENT THRU ROOF) I.W. INDIRECT WASTE A.F.F. ABOVE FINISH FLOOR U.N.O. UNLESS NOTED OTHERWISE 9 GENERALNOTES 1. ALL KITCHEN AND SALES AREA EQUIPMENT WILL BE FURNISHED AND INSTALLED EXCEPT AS NOTED, (SEE K2 SHEET, EQUIPMENT SCHEDULE). EQUIPMENT WILL BE FURNISHED WITH TRIM AND FAUCETS, EXCEPT AS NOTED. PLUMBING CONTRACTOR SHALL PROVIDE ALL ROUGH —IN TRAPS AND MAKE ALL FINAL CONNECTIONS. 2. PLUMBING CONTRACTOR SHALL FURNISH AND INSTALL ALL GA3 PIPING AND MAKE ALL FINAL CONNECTIONS. GAS PIPING TO BE SCHEDULE 40 BLACK STEEL PIPE AND BANDED MALLEABLE IRON FITTINGS. 3. ALL PIPING IS SHOWN DIAGRAMMATICALLY, EXACT LOCATIONS SHALL BE DETERMINED IN THE FIELD. EQUIPMENT LOCATIONS ARE APPROXIMATE, COORDINATE EXACT LOCATIONS WITH ALL TRADES BEFORE INSTALLATION. 4. ALL PIPING SHALL BE RUN CONCEALED UNLESS OTHERWISE NOTED. 5. ALL UNDERGROUND WATER LINES SHALL BE TYPE "K" COPPER TUBING WITH 1/2" THICK ARMAFLEX INSULATION. 6. ALL ELEVATIONS SHALL BE VERIFIED AT THE JOB SITE. 7. PROVIDE BACK —FLOW PREVENTER AT THE LOCATIONS REQUIRED BY CODE AND ALL GOVERNING AUTHORITIES. 8. COORDINATE AS REQUIRED TO ASSURE PROPER AND ADEQUATE PROMSIONS IN THE WORK OF THE OTHER TRADES FOR INTERFACE WTH THIS SYSTEM. 9. ALL WORK SHALL BE SUBJECT TO THE APPROVAL OF THE ARCHITECT. 10. SEE 'K' SHEET(S) FOR EQUIPMENT CONNECTION REQUIREMENTS. 11. At]- SANITARY UNDER SLAB PIPING SHALL BE PVC. 12. All. AE30VE SLAB VENT & DRAINAGE PIPING SHALL BE CAST IRON O.F. COPPER. (PVC CAN BE USED IF ALLOWED BY LOCAL CODES). f * S ASTE. & VENT PLAN SCALE: 1 /4"=1'-O" ALL LINES SHOWN ARE TO BE ABOVE SLAB/CEILING U.N.O. PLUMBING FIXTURE SCHEDULE MARK DESCRIPTION WASTE VENT COLD WATER HOT WATER P 1 POT SINK 3" 3" 1/2" 1/2" P 2 BACK BAR SINK 1 1 2" 1 1 2" 11 2" 1 2" * SINK PROVIDED AS PART OF EQUIPMENT PACKAGE — PLUMBER TO MAKE FINAL CONNECTIONS. PLUMBING IN THIS STORE IS EXISTING. REUSE WHERE POSSIBLE. UPGRADE TO MEET ALL APPLICABLE STATE AND LOCAL CODES. CONNECT NEW PLUMBING TO EXISTING. co LJ 04 co N 6� O Q J e!' mN r r` ��00 m� O C3Lo Q z } V) 0� Q U OZ m V �` W m LJ Li 0 /� L.L" V 1 SHEET yED � FILE#: D02 DATE: 7-15-2003 DRAWN BY: BIG C.M. MARK FEUTI