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Home My WebLink AboutPAIN D'AVIGNON - FOOD PAIN VAVIGNO 'ri' , 15 HinckleyRoad Hyannis t _ WWI BOARD OF HEALTH Town of Barnstable John T.Norman Board of Health Donald A.Gaudagnoli,M.D. = BARNrrADLE, F.P.(Thomas)Lee,. �A 200 Main Street, Hyannis, MA 02601 IDaniel Luczkow,M.D. Alt. �639• 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: 852 Issue Date: 01/01/2022 DBA: PAIN WAVIGNON OWNER: VOJIN VUJOSEVIC Location of Establishment: 15 HINCKLEY ROAD, UNIT B HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 91 OutdoorSeating: 20 Total Seating: 111 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 2014 Approved Food Variance permitted to use air curtains w/o screen doors for outside dining and allowed to hold food out of temperature. I L BIKE For Office Use Only: Initials: Town of Barnstable Date Paid d tAmt Pd$ * BA ATABI£, : - Inspectional Services _ v$ MASS. °rFnrax�" Public Health Division Thomas McKean,Director 200 Main Street, Hyannis;MA 02601 _ Office: 508-862-4644 Fax: 508-790-6304 ^,A,P,PLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE, NEW OWNERSHIP RENEWAL i/ -NAME OF FOOD ESTABLISHMENT: %L) P I� , (7 ADDRESS OF FOOD ESTABLISHMENT: pq4 a 6o 1 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: (\ I�Vl QLA , C64^ a `pg V60 OA CO✓ A TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO '" (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: v SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: 0 OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? (/� TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY ELOW) ✓ F OD SERVICE TAIL 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 Q'Application FonnsTOODAPP 2020.doc a OWNER INFORMATION: �k�c4�,Q, FULL NAME OF APPLICANT V�`lo SOLE OWNER: YES'/i�D D.O.B %* . OWNER PHONE# O) Ii,3 ADDRESSOHk-�\- Uj6 of (U- CORPORATE OWNER: J S�J u t ND� CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date SIGNATUR PP ICANT 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 508-8624644 to schedule your inspection. Please call at least(7)days in advance. J 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.townofbarnsta6le.us/healthdivision/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 1 st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q'Application Forms\FOODAPP REV3-2019.doc I BOARD OF HEALTH IVAT, Town of Barnstable John T.Norman Board of Health Donald A.Gaudagnoli,M.D. nan.Ns ABLE, Paul J.Canniff,D.M.D. MASS. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate ffQ'" R 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: 852 Issue Date: 01/01/2021 DBA: PAIN WAVIGNON OWNER: VOJIN VUJOSEVIC �I Location of Establishment: 15 HINCKLEY ROAD, UNIT B HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 91 OutdoorSeating: 20 Total Seating: 111 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - ------ MOBILE-FOOD: MOBILE- ICE CREAM: Q� 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: 2014 Approved Food Variance permitted to use air curtains w/o screen doors for outside dining and allowed to hold food out of temperature. Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. rSTABL 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, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 852 Issue Date: 01/01/2021 DBA: PAIN WAVIGNON OWNER: VOJIN VUJOSEVIC Location of Establishment: 15 HINCKLEY ROAD, UNIT B HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 63 OutdoorSeating: 19 Total Seating: 82 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 2014 Approved Food Variance permitted to use air curtains w/o screen doors for outside dining and allowed to hold food out of temperature. �I t For Offi • Initials: � Town of Barnstable Date-Mil r I la�Amt Pd$ : . M. Inspectional Services Check# O��IS p •�o� �.. Mp � 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 DI I NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: b)%is yj ADDRESS OF FOOD ESTABLISHMENT: �� \�L � (� t�1^'bvis , D��q UUDo I MAILING ADDRESS(IF DIFFERENT FROM ABOVE): ((�� (^• E-MAIL ADDRESS: �` � IW"� ✓i X�'xi ,emu/' TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( �b ��- X TOTAL NUMBER OF BATHROOMS: WELL WATER: Y S NO (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: v SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: q OUTSIDE: 2,0 TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. 1pD 5 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) _/OOD 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 Q:Wpplication FormsTOODAPP 2020.doc I . v OWNER INFORMATION: FULL NAME OF APPLICANT 1 SOLE OWNER: YES/ 1 D.O.B t I OWNER PHONE # I W b ADDRESS V O �1�,, A d tO CORPORATE OWNER: ,� \lIJ �, �� P ►lid b ( 01-J CORPORATE ADDRESS: �C/ ►� o'�I S ' `� 0 PERSON IN CHARGE OF DAILY OPERATIONS: r 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 3} ftr-id qbO W' t 3 6-T-ap, fifl6a, ldko 2. S . / / Z� SIGNATU E O CANT 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://www.townofbarnstable.us/healthdivision/applications.asi). 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 1st. Q:\Application FormsT00DAPP REV3-2019.doc r.> p4S Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BA 1F�T t Paul J.Canniff,D.M.D. 8 200 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: 852 Issue Date: 12/10/2019 DBA: PAIN WAVIGNON OWNER: VOJIN VUJOSEVIC Location of Establishment: 15 HINCKLEY ROAD, UNIT B HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 63 OutdoorSeating: 19 Total Seating: 82 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 2014 Approved Food Variance permitted to use air curtains w/o screen doors for outside dining and allowed to hold food out of temperature. For Office Use 0 X� Initials: LAO Town of Barnstable yy � Date Paid 19 Amt Pd$Z"'�-' NRNS[ABLE, : Inspectional Services '°9. `°� Public Health Division Check# j Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-E62-4644 Fax: 508-790-6304 h4, r,7 ` APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE �I NEW OWNERSHIP RENEWAL_ NAME OF FOOD ESTABLISHMENT: q06 1,j Yh4 ADDRESS OF FOOD ESTABLISHMENT: (J l�l�w� J E �T11/ut" rf d'1k MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: l i� L-ACG V( A �O C� I f TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 99 - TOTAL NUMBER OF BATHROOMS: —� WELL WATER: Y S NO . (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: 41-LOUTSIDE: TOTAL: Z 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 SERV CE DOOR(S)?4 TYPE OF ESTABLISHMENT: (PEASE CHECK ALL THAT APPLY BELOW) ,POOD 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 MACHIiNES ... (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 Q:\Application FormsTOODAPP 2020.doc I - OWNER INFORMATION: 1 FULL NAME OF APPLICANT �J Uj .l�`,�v i c SOLE OWNER: YES! D.O.B OWNER PHONE # �CT ® 3 ADDRESS rk i ^ MA OIL�,, CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least(1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date P -7 Wit 2. SIGNATU OF LI ANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/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 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.doc r � Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. �'. DAMNISrAaL& John T.Norman 1�1619. 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: 852 Issue Date: 01/03/2019 DBA: PAIN WAVIGNON OWNER: VOJIN VUJOSEVIC Location of Establishment: 15 HINCKLEY ROAD, UNIT B HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 63 OutdoorSeating: 19 Total Seating: 82 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: — MOBILE-FOOD: MOBILE-ICE CREAM: G�n FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 2014 Approved Food Variance permitted to use air curtains w/o screen doors for outside dining and allowed to hold food out of temperature. ;,; �F�*oyti Town of Barnstable For Off Initials: o� t aY- Date Paid Amt Pd$ „�BAMWA $ Inspectional Services �prEO 39. Public Health Division Thomas McKean,Director a �Q 200 Main am Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE I NEW OWNERSHIP RENEWAL ✓ NAME OF FOOD ESTABLISHMENT:_' !/ .\1a of ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: to P C&Ak'& 0 ZAP TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO " ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: (01— OUTSIDE: _TOTAL: yJ�--- 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) OOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST C" ONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES .., (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FormsTOODAPPREV2018.doc ?. -- -- PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT qA,-)0 ,SCV ( C, SOLE OWNER: YES/CN0 D.O.B lJ 4C y OWNER PHONE # � (�� ADDRESS S c'V�tC( � � 1 HA Ulf CORPORATE OWNER: )1,-1 yo i'S�,ViC FEDERAL ID NO. : OLl lI q /L CORPORATE ADDRESS: K K fi) PERSON IN CHARGE OF DAILY OPERATIONS: �l �? �~0 /1, t� I i\J VA 30 C v I c_ 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 Aller en Awareness Expiration Date 1. krj- �(,kj ra L-� t�k / 1 / 2-0 SIGNAT OF PLIC"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://www.townofbarnstable.us/healthdivision/applications.asi). 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 1st to Dec. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Application FormsTOODAPPREV2018.doc HEALTH INSPECTOR'S Establishment Name: �/ cl P`OFTNE Tp TOWN OF BARNSTABLE HE OFFICE HOURS ��tY ` (" '" i n�� Date: 62-11 Page:g 1. of TH BAR E, PUBLIC 0 MAIN LSTREEET 3:30-4:30 P.M. SION : 0- :30 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified M639• 00� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY,,r fD Mpy s 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name o Date�"1 f(Q Zf Tyne of Type of Inspection Irl i Routine Address is WA Risk Food Servic Re-inspection Level Previous Inspection Telephone Residential Kitchen Date: V ato- ct Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness j4e-4.S' f `,/) r ^ Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast �1, ,m In:3 :l5 otn J I�'V7 ` Inspector U Out:a%11}- 1 KIT ilue Each violation checked re wires an explanation on the narrative page(s)and a citation of specific provision(s)violated. pl�,(LS Q _ � p Cam"' 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 &OI1 lvFcD R EMPLOYEE HEALTH PROTECTION FROM CHEMICALS r`0Z- V ❑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) ) L ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ,Q iS Ol ( �'1 O ❑ 5.Receiving/Condition ❑ 17.Reheating 'A A-ze (Q ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ' r / f- > / be 1717.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding (/✓�/ t Jk- PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ,) ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ` \ CAA.., 0, 6 S'-q ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ;C ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY a n ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories (� kC I.P J Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations tilLIA11 Critical(C)violations marked must be corrected immediately. (blue&red items) a,� oz� Corrective Action Required: ❑ No ® YLS, 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 checked indicate violations of 105 CMR 590.000/Federal Food Code. ® g ❑ Emergency Closure El Voluntary Disposal F] 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 (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C= Seriously Critical Violation=F is scored automatically la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 2 critical violations and less than 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) g violation,4 to 8npn-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Sign re Print: 31.Dumpster screened from public view 4!tz't 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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each * 590.004(F) 7-101.11 Identifying Information-Original Containers 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.1 I Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.1 I(A) Food Protection* 7-201.11 Separation-Storage* 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 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(l I) Variance Requirements 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* ( 3-306.14(A)(B)Returned Food and Reservice of Food* REQUIREMENTS FOR 590.003(E) I Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* _ 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* 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 * Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water 3-401.11 A(1)(2) Eggs-155°F I5 sec 4 601.I I(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F I S sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* hffe°"°e tnrzva 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 o 3-401.11(B)(I)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency rf cesSanitizationEquipment* of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Poultry or Meat, 3-20L Stuffing Containing Fish, 15 Molluscan Shellfish from NSSP Listed Chemical* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* ° 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* s 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* Fill Good Hygienic Practices 17 Reheating for Hot Holding practices should he 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 03. * 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-411.(13;t ' Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* (Blue Items 23-30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F* Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.1 I E Remaining Unsliced Portions of Beef Roasts* 3-]01.11 Food Safe and Unadulterated � O g illness interventions and risk factors listed above,can be found in the -6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16. Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590XWO 3-203.12 Shellstock Identification Maintained* 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 Hand Drying Provision 129. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 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 ) oFiKE TOWN OF BARNSTABLE HEALTH wsPEcroRs Establishment Name: �0 Date: 11 ��[ Page: of P.• 'D OFFICE HOURS BARN STABLE. PUBLIC 0 MAN STREET 3:30-4:30 P.M. N DIVISION : 0- :30A.M. Item Code C-Critical Item DESCRIPTIO OF VIOLATION/PLAN OF CORRECTION Date Verified MONM67 q• �0� HYANNIS,MA 02601 -FRI" 508-862-4644 NO Reference R-Red Item PLEASE INT CLEARLY 8-8 p'FDN1�`p FOOD ESTABLISHMENT INSPECTION REPORT OperatMName f �•� Date )� Type of fInspection j g Routin Address ), Risk Food Serv' spection Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Cb Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Other In: Inspector 1 Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating SIN 4 ❑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 U ❑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: To No Yes Non-critical(N)violations must be corrected immediately or A within 90 da s as determined b the Board of Health. Overall Rating ` 1 -t Volunta Compliance Y y ry p F] Employee Restriction/Exclusion ❑ Re-inspection Scheduled ® Emergency Suspension C N Official Order for Correction: Based on an inspection today,t I ems 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. FC-4 590.005 B=One critical violation and less than 4non-critical violations g 25.Equipment and Utensils ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i cal violations. If f critical icwater,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 8 non critical violations=C. 29.Special equirements (590.009) y p Inspec na Pri 30.Other DATE OF RE-INSPECTION: 31.D ster 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) +Dem, sgnment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45`F Within 4 Hours* 590.003(B) nstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 5 590.004(F) 590.003(C) Responsibility of the Person-in-Charge[0 7-]02.11 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* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* P g 2 Require Reporting by Food Employees and y`+ 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(17 7-202.11 Restriction-Presence and Use*) 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 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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 Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* _ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 6 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* Elf°nve uriaoor 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* 4-703.11 Methods of Sanitization-Ho[Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g. P mr3' �p 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 practiceRequues rhos ld be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3403.11(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* 3-03.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F �2 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 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 * '13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.12 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*a 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 1.008 HACCP Plans 1 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. 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. `gyp THE row TOWN OF BARNSTABLE HEALTH INSPECTOR's Establishment Name: Date: Page: of •y"p'`"y��i(�W PUBLIC OFFICE HOURS • BARNSTABLE.O 2 0 MAN ST EE 3:30-4:30 P.M. VISION : 0- :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,639. �0� HYANNIS, MA 02601 MON.-FRI. No Reference R Red Item PLEASE PRINT CLEARLY i0rF0 MP'�° 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Date De of TvDe of IpjagfiUon er Ro } Address Risk iF.d Service Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation S� Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other �<�� Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ L- Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 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) Non-critical(N)violations must be corrected immediately or Corrective Action Required: ❑ No Yes within 90 days as determined b the Board of Health. Overall Rating y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items o 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 6=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 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view 4 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N s Sig r Pri r Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N 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* $ Cross-contamination 1 q 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 Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to P g * 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 * 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* 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* ( ) q ContaMination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP v fExclusions and Restrictions g 590.003(E) Removal o Disposition of Adulterated or Contaminated Drying Agents,Criteria* 21 3-801.11 A Unpasteurized Pre-Packaged Juices and Food 7.204.14 rY g g ( ) P g FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* q Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Warewashin 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 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens 590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game * Effective inrzooi 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) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004 C Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( ) 11 Good Hygienic Practices practices should be debited under#29-Special 3-201.17 Game Animals* 17 Reheating for Hot Holding Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(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* on ( ) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the $ Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Liv 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 FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 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: ��"\ `�� Date: 513 Page: of OFFICE HOURS PUBLIC HEALTH DIVISION e:00-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-430 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 M-8 -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 'EDN1P` FOOD ESTABLISHMENT.INSPECTION REPORT sossz asaa Name , r1 Date Type of jynp f Inspection O s ou in Address Risk Service Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: IN �� I o, Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness ,�j Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other t Inspector ^� � Out: q> Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. r Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ -3h 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 A, 7� ❑ 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 ►L1L1' �� Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) 5 (� Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or �v within 90 days as determined by the Board of Health. Overall'Rating Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today h 'items V❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal ood 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.E• Equipment aiid Utensils (FC:-4 590.005 B=One critical violation and less than 4non-critical violations 9 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 (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 Bnon-critical violations. If 1 critical refrigeration. within 10 days of receipt violation,4 to 8 I violations C. t of this order. 29.Special Requirements (590.009) Y P 30.Other DATE OF RE-INSPECTION: Inspector Si n e Pri 31.Du ster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N , h 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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) ' 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 1 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* P g Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* i 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food andReservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) i 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 17.206.12 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* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 1 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 dness* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.1.1(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef/ecriw 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* 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 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009 A D Violations of Section 590.009 A Chemical ( )-( ) O-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen operations should be debited under 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. 5 Receiving/Condition g. g 8 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 Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* y Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* ocation an acement 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 Hand Drying Provision a 29. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 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. N h7 of W rop r TOWN OF BARNSTABLE U��_ HEALTH INSPECTOR'S Establishment Name: � 2 Date: Page: of ti D OFFICE HOURS P ° PUBLIC HEALTH DIVISION O 8:00-9:30 A.M. BARE. 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTIONtDate/Verified HYANNIS, MA 02601 MON.-FRI.� sob-862-asaa No Reference R-Red Item PLEASE PRINT CLEARLY. 'FDMP+ FOO ESTABLI HMENT INSPE T N EPORT IIIJJJ��` V . Name Date 'TvDe of section p Routine �' Address Risk Rod Se vi Aspet fi n , /all Level Re Previou�j p o Telephone Residential Kitchen Date: Jj 1 y Mobile Pre-op t n Owner HACCP YIN Temporary Suspect III ass Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Other Inspector 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 M� ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation./Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate.Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices- ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Q 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 rel within 90 days as determined by the Board of Health. Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,th ite s 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 noncritical 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 4 non-critical violations 9 ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-crit cal.vi lations. If 1 critical refrigeration. 29.Special Requirements, (590.009) within 10 days of receipt of this order. vi 4 to 8 non-critical viola' ns- 30.Other DATE OF RE-INSPECTION: Ins a is ' t jMi : 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 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 1q 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* * 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 b Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* � P g Y7-201.11 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* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person Id 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* 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 g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual 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* 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* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3 401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff-me 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 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* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' P �Y 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. 44 When to Wash* 3-401.1l(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 Not Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(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 foodbome 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 * 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 I 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. 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. PA °p ME Tp , L TOWN OF BARN_STABLE HEALTH INSPECTOR'S Establishment Name: / V/<<3' � Date: , Page: f OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE 200 MAIN STREET 3:30-a:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,639- �0� HYANNIS,MA 02601 M 508 8- -FRI.s2-asaa No Reference R-Red.Item PLEASE PRINT CLEARLY PTFD MP'�A F O> ESTABLISIMJMENT INSP ION REPORT Name Date -Tx of Type of Inspection It Operation(s) Routine Address Risk Food Service Re-inspection 02 Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary. Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector:22 Out: Each violation checked requires n exp atibn 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 907 ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑.3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 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 ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating ❑ 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 6=One critical violation and less than 4non-critical violations g ) 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 FacilityFC-6 590.007 aggrieved by this order,you have a right to a hearing. Your request must Y ( )( ) 9 q 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critics =C. violations. If 1 critical refrigeration. violation,4 to 8 no latio ns 29.Special Requirements (590.009) within 10 days of receipt of this order. -critical vio 30.Other DATE OF RE-INSPECTION: Inspe s Sig a r Print: 31.Dumpster screened from public view Permit Posted? y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC s Signa r Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N / Dumpster Screen Y N S 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 15 590.004(F) 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 * 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Se 3-501.16(A) Roasts Held At or Above 130'F* 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 * ( ) q 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 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 17.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* y Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 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* TIMEITEMPERATURE CONTROLS 3-202.14 1 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* 3401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.1](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* 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-Hat Water and 009 Stuffing Containing Fish,Meat,Poultry or 590. A)-(D) Violations of Section 590.009 A 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( ( )-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 90 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen o erations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* P 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* * Other 590.009 violations relating to good retail ( ) 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under k29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(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) 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands ( ) 8 * Critical and non-critical violations,which do not relate to then the me 3�03.11 E Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock [5-203.11 .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 ConvenientlyLocated and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Tags/Records:Fish Products Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 04.11 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 1 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .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 - + BARN9TABLE, . Board of Health 9 MASS. g `bAT fo 39. p.� 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D.. FAX: 508-790-6304 John Norman Donald A.Guadagnoli,M.D. March 5, 2019 Mr. Mario Mariani 15 Hinckley Road Hyannis, MA 02601 RE: Grease Trap Variance Request Decision,.Pain b'Avignon, f$ Hinckley Road, Hyannis', Dear Mr. Mariani, Your request for a variance from Section 322-3 of the Town of Barnstable Code, to operate a food service establishment with 82 seats at 15 Hinckley Road, Hyannis, without a sufficiently sized grease trap designed to handle the established kitchen flow rate of 15 gallons per seat, is not granted. Mr. Brian Yergatian, P.E. testified the food establishment will be renovated and the outside seating area will become enclosed. Therefore these seats will be used year-round. Based upon the kitchen flow rate of 15 gallons per seat, the existing 1,000 gallon capacity grease trap is designed for only 67 seats maximum. This grease trap is undersized for the proposed kitchen . flow rate for 82 seats, which calculates to 1,230 gallons per day. The Department of Public Works informed the Board of Health, in a letter dated February 25, 2019 from Interim Town Engineer Amanda Ruggiero, that an external 1,500 gallon grease trap is recommended as per Section 322-3 of the Town of Barnstable Code which reads as follows: 'Grease traps must be provided at restaurants, nursing homes, schools, hospitals, bakeries, or similar establishments as determined by the Board of Health. The capacity of the grease trap shall be calculated by the kitchen flow rate of 15 gallons per seat or chair, per day, but in no case shall be less than 1,000 gallons. This applies to establishments connecting to Town sewer, or establishments with on-site sewage systems.' Variances may only be granted when, in the opinion of the Board of Health, the applicant has demonstrated that (a) enforcement of the particular provision would be manifestly unjust and (b) the same degree.of protection could be achieved without strictly adherence to a particular provision or regulation. You did not demonstrate manifest injustice and you did not provide sufficient information relative to how you would or could provide the same degree of protection to the municipally-owned sewer lines and the Town's Wastewater Facilities Plant. Therefore your request for a variance is not granted. Sincerely yours, au .�Ca i , D. QA FILESTai vignon GreaseTrapVariance enial20l9.docx l 1 THE Tom_ DATE: „ $95.00 FEE*: �r BARNSTABLB, MASS. $ REC.BY: sCA�m� LJ� r '6'� Town of Barnstable . 1: '�Fo Mar a SCHED.DATE: Q a(Q -0 Board of Health 200 Main Street, Hyannis MA 02601 ' k-A Office: 508-862-4644 Paul J.Canniff,D.M.D. T, FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi VARIANCE REQUEST FORM LOCATION ,/ Property Address: 15 Hinckley Road AF u [ Assessor's Map and Parcel Number: Map 311, Parcel 020 Size of Lot: 36,355±sq. ft. Wetlands Within 300 Ft. Yes Business Name: Pain D'Avignon No X Subdivision Name: APPLICANT'S NAME: Pain D'Avignon Phone (508) 778-8588 Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: Lion LLC Name: Mario Mariani Address: 15 Hinckley Road, Hyannis, MA 02601 Address: 15 Hinckley Road, Hyannis, MA 02601 Phone: (508) 771-9771 Phone: (508) 771-9771 EMAIL: mario@paindavignon.com VARIANCE FROM REGULATION(Incl.Reg.Code a) REASON FOR VARIANCE(May attach separate sheet if more space needed) Sec. 322-3 Grease traps To allow continued use of the existing 1,000 gallon grease trap, with 25% additional seating. NATURE OF WORK: House Addition House Renovation El Repair of Failed Septic System LJ Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as S collated packets. A. Five(5)copies of the completed variance request form B. Five(5)copies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an I/A system or secondary treatment unit(S.T.U.). C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health@town.barnstable.ma.us D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version. A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or R.S. Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). . Fee Submitted*$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance"). Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Donald A.Guadagnoli,M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\QDLJENHC\VARIREQ Rev APR 4- 2018.docx PARKING SEATING: 1 9 OUTDOOR 63 INDOOR (ED 52 TOTAL PATIO PARKING EXIT EXIT 0 00 � � J � o RESTAURANT WINE RED BAR BOULANGERIE KITCHEN O CL. WOMEN MEN O HCP. O BREAD PRODUCTION N Chris Warner Architect SK-PI Seating & Egress Plan scale: v8°=1'-0" 208 Quissett Ave. Woods Hole MA 02543 Existing Conditions Date: 01/14/19 phone.508 -274 -0421 Pain D-Avignon email.-chriswarnerarch@gmail.com Project No.t807 15 Hinckley Rd. H annis i January 15, 2019 Thomas A. McKean, Director Barnstable Health Division 200 Main Street Hyannis, MA 02601 RE: Variance Application for 15 Hinckley Road, Hyannis, MA Dear Members of the Board: As an officer of Pain D'Avignon, I hereby authorize BSC Group, Inc. to represent our business in this request for a variance. If you have further questions, please do not hesitate to contact me. Sincerely, ~ P Mario Mariani, General Manager Pain D'Avignon I' BSC GROUP ' TIt NSMITTAL 349 MAIN STREET,UNIT D,WEST YARMOUTH,MA 02673-www.bscgroup.com TEL 508-778-8919-800-288-8123,...; CT To: Thomas A. McKean,Director Date: January 15, 2019 041; Barnstable Health Division Proj.No.: 50253.00 ti 200 Main Street Project: Pain D'Avignon : Hyannis,MA 02601 15 Hinckley Road 1-T1 We are sending you: ®Attached ❑ Under Separate Cover Via: Delivery Tracking No.: ❑ Overnight Delivery ❑ Picked Up By Recipient ❑ Regular Mail ❑ Taxi ❑ Messenger ❑ Direct From Printer ® Other: The following item(s): ❑ Change Order ❑ Drawings ❑ Prints ❑ Samples ❑ Copy of Letter ❑ Photocopies ❑ Reports ❑ Specifications ❑ Digital Media ❑ Plans ❑ Other: Date or No.of Copies Drawing No. Revision Description 1 1/11/19 Check No. 30668 5 Board of Health Variance Request Form 5 1/14/19 Seating&Egress Plan 5 1/14/19 Site Plan This information is: ❑ For Your Information ❑ No Exceptions Taken ❑ Resubmit copies for approval ❑ Unchecked ❑ Furnish as Corrected ❑ Return corrected prints ❑ Preliminary ❑ Rejected ❑ Submit copies for distribution ❑ Revised Plans ❑ Revise&Resubmit ❑ Final Plans ❑ Sent for Your Review&Comment Remarks: Signed: From: Brian G. Yergatian, .E.,LEED AP cc: G. Beaudoin,Dept. of Public Works M. Mariani,Pain D'Avignon Note:If enclosures are not as noted,please contact us immediately. Rev.2015-11-16 Page 1 of 2 l Town of Barnstable Barnstable anxrisrns�, Board of Health MASS. j"' V y i679• .m� 200 Main Street,Hyannis MA 02601 ��ED MA'S s 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi October 30, 2014 Mr. Mario Mariani Pain D'Avignon Cafe 15 Hinckley Road Hyannis, MA 02601 RE: Variance Decision Regarding Use of Air Curtains Without Screens/Variance from Section 322 5 (6) of the Town of Barnstable Code Dear Mr. Mariani, You are granted a variance from Section 322-5 (6) of the Town of Barnstable Code, in order to utilize only the existing electronic air curtains, without providing screens at the front doorway of the restaurant. This variance is granted with the following conditions: (1) Foods shall be prepared and stored within the enclosed kitchen area. No foods shall be prepared within the dining room. (2) The electronic air curtains shall be turned-on all times this food establishment is open for business and whenever the doors and screen doors are left open and/ or removed. (3) This variance may be revoked anytime the applicant fails to comply with.the conditions of this decision letter. (4) This decision letter shall be posted on the wall adjacent to the food establishment permit in a location which is easily viewable to a health inspector anytime an inspection is conducted. (5) This variance is not transferable to another owner or leasee of this food establishment. Section 322-5 (6) of the Town of Barnstable Code specifically requires both electronic air curtains and screens at all window and door openings at restaurants with outdoor dining, Q:\WPFILES\PainD'avignon2014.doc where food is transferred. This variance is granted because the food preparation area/food storage area is enclosed and is physically separated from the dining area. Also, electronic air curtains are provided at the front entrance doorways to prevent the entrance of flies and other insects into the establishment; thus providing a "double barrier" of protection. It is the opinion of the Board that this double barrier of protection should be sufficient to prevent insects from entering the food preparation area. S in e , M.D. i Q:\WPFILES\PainD'avignon20 l 4.3oc Joe Henderson explained his purpose for returning.to the Board was to clarify the actual extra capacity in the system. Last meeting, the extra capacity per square foot was incorrectly referenced as 2 gallons. The actual extra capacity is 129 gallons per day. With this in mind, Mr. Henderson 15 hosing the Board will revise the conditions put on the variance approval to eliminate the monitoring of the water use and to reconsider the `use'.stipulation. Mr. Henderson said the total required flow is 2;751 gallons. The breakout is as follows: 200 parking spaces/2 people per car equals 400 people at 5 gal/day/person. The 413 s.f. lifeguard room based at office use of 75 gal/day/1000 s.f., equals 31 gal/day. And the snack bar/restaurant use is at 20 gal/day x 36 seats and equals 720 gal/day. The design flow is 2,880 gallons/day. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to revise the conditions of the variance approval of March 8; 2011 to now state there are no restrictions in use of the accessory building during the period outside of the dates between and including Memorial Day to Labor Day. The water monitoring condition will remain. The Board will revisit the conditions after receiving the first year's readings of water usage. (Unanimously, voted in favor. VII. Variance — Food (Cont): �= A. Mario Mariani representing 'rain DAvignon Cafe — 15 Hinckley Roa Hyannis, outdoor dining, air curtain variance (continued from December 2010). Mario Mariani was present. There are three openings, one at 36" wide, and two French doors at 72" wide/each. Mr. McKean stated the staff has no objections to trying this. Fluctuations of complaints would identify any issues, as well. Mario stated they would, of course, not be interested in causing any complaints to arise. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to temporarily approve the variance of air curtains, permitting the establishment to operate without requiring a screen used in conjunction with the aii curia:ins wr.iie. roviosr�; �a,ie serti:ce t taEifes ciaisio witi�"ii�eiuiiiwi�in p 9 g. conditions: 1) all openings will have air curtains constantly on during this time —the three openings are the 32" wide entrance door, and two French doors, each at 72" wide, 2) no table will be billowed within 6 inches of the air curtain as this will disrupt the function of it, and 3) they must appear before the Board of Health, after the season, at the Oct 11, 2011 meeting to revisit the situation. (Two voted in favor. Dr. Canniff voted to deny. Board approved.) ing ichae!'s Creative Baking — 424 Main Street, Hyannis (formerly, Center News), grease trap variance. Page 5 of 6 BOH 3/08/2011 I f Town of Barnstable Barnstable THE T 01 w �o�0, : Al�fUndicaCitB �� ; Board of Health p IIAnNSA AgS6 ,0'I 200 Main Street, Hyannis MA 02601 39 °'t �p�� 2007 OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Mario Mariani, Pain D'Avignon Cafe, 15 Hinckley Road, Hy ATTENDANCE REQUIRED. October 3, 2014 The Board of ifealth requests you attend the Board of Yfealth meeting re: Wain D Ayi non Ca Le 15 Yfinckey &ad, gjannis. Conclusion forAir Curtains/Open Entrance (continued from March 8, 2011 meeting. Thankyou for your cooperation. HEALTH Phone 508-862-4644 Your item will be heard at the Board of Health Meeting on the: Date of: Tuesday, October 14„ 2014 You, or a representative for you, is expected to be present to answer questions the Board may have. Meeting Location: . Town Hall, 367 Main St, Hyannis Hearing Room, Second Floor Time: 3:00— 6:00 P.M. Approximately three days prior to meeting, an agenda will be sent out to you— once it is available. It will also be available on line at the town website: www.town.barnstable.ma.us Go to :.."Boards & Committees > Board of Health - or- Go to Official Agendas QAIAGEI\DAS BOH\let Receipt of BOH Submission 15 Hinckley Rd Hy.doc f FINE 1 Town of Barnstable Regulatory Services Barnstable $i BARNSTABLE, Richard V. Scali, Director A*Amevica City MASS. i63q. Public Health Division �0 ATED MA'1 a Thomas McKean, Director 2007 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 16, 2016 Mr. Vojin Vujosevic Pain D' Avignon Cafe 15 Hinckley Road Hyannis, MA 02601 The General Manager of Pain D'Avignon Caf6, Mario Mariani, has requested a variance for using Time as a Public Health Control Variance Procedure:2012-004 for the following foods listed to be held with a discard time of two hours after preparing the five foods mentioned below: Grab and Go Sandwiches are displayed un-refrigerated, behind sneeze guards, with expiration times labeled as follows: 2 hours after preparation, then the products listed will be discarded. 1. Ham & Brie with Butter on Demi Ficelle & Simply White Roll 2. Sopresatta & Butter on Demi Ficelle 3. Arugula, Hummus, Roasted Red Peppers & Hummus (Contains: Chick Peas, Lemon Juice, E.V.O.O, and Cayenne Pepper) 4. Turkey & Brie on Croissant with Dijon Aioli (Contains: Mayonnaise, Dijon Mustard) 5. Smoked Salmon on Sesame Croissant with Creme Fraiche Sauce (Contains: Red Onion, Lemon Juice, fresh cream) The applicant, with acceptance of this variance, has reviewed and understands all the criteria regarding Time as a Public Health Control Variance Procedure:2012-004. A copy of the policy has been provided to the applicant... gAfood&food handlers instructors\pain d avignon cafe variance 15 hinckley road 11-16-16.doc1 i This variance is granted to this establishment with the acknowledgement that this facility must meet the requirements and that this variance is not transferable. The TPHC variance decision statement shall be posted immediately adjacent to and/or included onto the food establishment permit, in a location which is easily viewable by a health inspector during inspections. Thomas A. McKean, R.S., C.H.O. Director of Public Health Town of Barnstable Applicant's Signature Date r gAfood&food handlers instructors\pain d avignon cafe variance 15 hinckley road 11-16-16.doc2 Joe Henderson explained his purpose for returning to the Board was to clarify he actual extra capacity in the system. Last meeting, the extra capacity per sluare foot was incorrectly referenced as 2 gallons. The actual extra capacity is 129 gallons per day. With this in mind, Mr. Henderson is hoping the Board will revise the conditions put on the variance approval to eliminate the monitoring of the water use and to reconsider the `use' stipulation. Mr. Henderson said the total required flow is 2;751 gallons. The breakout is as follows: 200 parking spaces/2 people per car equals 400 people at 5 gal/day/person. The 413 s.f. lifeguard room based at office use of 75 gal/day/1000 s.f., equals 31 gal/day. And the snack bar/restaurant use is at 20 gal/day x 36 seats and equals 720 gal/day. The design flow is 2,880 gallons/day. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to revise the conditions of the variance approval of March 8, 2011 to now state there are no restrictions in use of the accessory building during the period outside of the dates between and including Memorial Day to Labor Day. The water monitoring condition will remain. The Board will revisit the conditions after receiving the first year's readings of water usage. (Unanimously, voted in favor. VII. Variance — Food (Cont): i A. Mario Mariani representing Pain D'Avignon Caf6 — 15 Hinckley Roa Hyannis, outdoor dining, air curtain variance (continued from December 2010). Mario Mariani was present. There are three openings, one at 36" wide, and two French doors at 72" wide/each. Mr. McKean stated the staff has no objections to trying this. Fluctuations,of complaints would identify any issues, as well. Mario stated they would, of course, not be interested in causing any complaints to arise. Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Canniff, the Board voted to temporarily approve the variance of air curtains, permitting the establishment to operate without requiring a screen used in conjunction with the air curtains while providing table service to tables outside with the following conditions: 1) all openings will have air curtains constantly on during this time — the three openings are the 32" wide entrance door, and two French doors, each at 72" wide, 2) no table will be allowed within 6 inches of the air curtain as this will disrupt the function of it, and 3) they must appear before the Board of Health, after the season, at the Oct 11, 2011 meeting to revisit the situation. (Two voted in favor. Dr. Canniff voted to deny. Board approved.) ng ichael's Creative Baking —424 Main Street, Hyannis (formerly, Center News), grease trap variance. Page 5 of 6 BOH 3/08/2011 P . . 0 f b a k e r y Mario Mariani 15 Hi'nckley Road ' mario@paindavignon.com Hyannis, MA 02601 508.771.9771 wholesale 508.778.8588 cafe 818.389.3545 cell 508.778.6778 fax i 1 S V t Nr i WWW.PAINDA.VIGNON.COM i ' M EXCERPT OF BOARD OF HEALTH MEETING MINUTES— 12/14/10 A. Mario Mariani representing Pain D'Avignon Cafe — 15 Hinckley Road, Hyannis, outdoor dining, air curtain variance. Mario Mariani was present and expressed that the 19 seat outside receive full service, along with 63 seats indoors. The Board requires both screens and air curtains for outside dining. Pain D'Avignon Cafe is applying for a variance so that they do not need the screen as well as an air curtain. If the owner is able to locate models reasonable priced and which create low noise-levels, Mario asked the Board to consider approval of the air curtain (allowing them to operate without a screen). The Board expressed being comfortable in using the air curtain alone provided it is on all the time the door is open. (The drawback is that it does not help with keeping animals out.) Mario stated the building has people at it for the majority of the day (average of 21 hours which keeps the animals out). The owner will get pricing on air curtains. They would need five air curtains. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to continue until Feb 8, 2011. (Unanimously, voted in favor.) 02/08/2011 11:30 FAX IM001 F®-08-2011 12:2O From:9AWST�l�EFILTF1�j '1509r906M4 To:S15087710342 p.2"2 Town of Barnstable t Beard of Health # 200 Mairl Street -Hyarmis MA 02601 03 . Agreement to Extend 7irne Limit for Acting Upon a Variance Request In the Matter of a varlanos request form rw4tved on the Petttloner(s), regarding*the property at the petitloner(s)and the Board of Healtti agree that the Sward of Aealth ha e until (Insert date)to act upon the Petitioners'completed applicsrtiw for a variance, In executing tnls Agroement.the Petitioners)hereto specifically waive any claim for a constructive grant of relief based upon time limits applicabla prior to the execution of this Agreement. petltianar(s): hoard of Health: Signature: Signature: P6do w4a)or PetltloiW'a Representative Dh8lrmon Print: 14wio 4,0 ( Print: Wuyne Miller,M.D. Date: Mdrms of PeOttoner(e)or P tkionpes flop ae ova - Town of Barnstable Board of Health Public Health Division 200 Mein Street - Hyannis, MA 02601 Phone: (508)862-4W Fax: (508)790-6304 fire q�oxtenddor. Town bf Barnstable �pF THE)p�� Board of Health BARNSTABLE, s 200 Main Street - Hyannis MA 02 601 MASS. g %63g. HIED MAC A Agreement to Extend Time Limit for Acting Upon a Variance Request In the Matter of a variance request form received on �� the Petitioner(s), r r regarding the property at 1 t p the petitioner(s)and the Board of Health agree that the Board of ealth has until /6t 4 �� (insert date)to act upon the Petitioners' completed application for a variance. In executing this Agreement,the Petitioner(s) hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s): Board of Health: Signature: Signature: 'Petitioner(s)or Petitioner's Representative Chairman Print: /Okl0 lVak/e` Print: Wayne Miller, M.D. Date Date: Address of Petitioner(s)or Petitioner's Representative�� Town of Barnstable Board of Health Public Health Division 200 Main Street Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508) 790-6304 file q:extend.doc I d +t K Jti _ I. pi' � M ;.�, ..�"'r''_._.'�.l!_mil sks•-�•# t.33�t'�t�A .M jt K • L� .&'`�, _ ^-ems I j� •,.�: Jill Ili. ti. 'M .. � ,ram . :!.kSFY`.�6i•YAA,/J r,.., '� � ^�' �\ ��5�# 1p( oil r Town -of Barnstable �pf IME Tp�� Board of Health * sAxxszABLE. * 200 Main Street - Hyannis MA 02601 � MASS. i639• Agreement to Extend Time Limit for Acting Upon a Variance Request In the Matter of a variance request form received on �7 2 41)JC� the Petitioner(s), dJL f D `» f 1 6/i regarding the property at �S ` ��' J the petitioner(s)and the Board of Health agree that the Boar of Health has int, jl (insert date)to act upon the Petitioners' completed application for a variance. In executing this Agreement,the Petitioner(s)hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s)YnerZ(s) Board of Health: Signature: Signature: Pertltl Peo Representative Chairman �a v Print: Wayne Miller, M.D. Print: �V' y (�"'L Date: Date: Address of Petitioner(s)or Petitioner's Representative Town of Barnstable Board of Health Public Health Division 200 Main Street Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508) 790-6304 file q:extend.doc I ppIHE Tp� DATE: FEE 9. * BARNSTABLE, y MASS. 0� ap 019. ��°i REC.BY: "`A�A' Town of Barnstable SCHED.DATE: I �0 Board of Health 200 Main Street, Hyannis MA 02601 Office: 5,08-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 JUniChl Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION , Property Address: LL V-.C- © a—cn 4 S Assessor's Map and Parcel Number. Size of Lot: c r Wetlands Within 300 Ft. Yes Business Name: Ci IV& No w Subdivision Name: ;/ A y� fit-/v APPLICANT'S NAME: V61%t'kVJ, Phone ��' I `T-1-7 Did the owner of the property au orize you represent him or her? Yes. �� No PROPERTY OWNER'S NAME CONTACT PERSON , fv,,Ckvt r v v-\ckV�! 'a-� Name: 1 ^ �( C Name: t/ u_ O� 1f 10 StnV(L Jllj� Address: - —f, C%—A& AkA 0 a n i Address: Phone: `7 �] '� �,�� Phone: ® - VARIANCE FROM REGULATION(List Res.) REASON FOR VARIANCE(M y attach if mores ce needed) �iZ-"-' S vtd-� NATURE OF WORK: House Addition ❑ . House Renovation ❑ Repair of Failed Septic.System El Checklist ,(to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. . Four(4)copies of the completed,variance request form Four 4 copies of en meered plan submitted(e.g.septic s stemplans) n _ Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineeror'registered sanitarian Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request CD Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's eg se(for hide V and/or local sewage regulation variances only) , Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner`/,lessee of ly], , outside diningvariance renewals same owner/leasee only],[ y],and variances to repair failed sewage disposal system [only-if no expansion-to;the building proposed]) - Variance i ecnest submitted at least 15 days prior to meeting date Uj rfig VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. Q:\Application Forms\VARiREQ.DOC Vt-IC�- - Tr if 4-� `"4* tor C"4 0 4tf _ Ua -book � C Se s W'60c;.- C) --� ,ram a - AAA4kff VS EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES ON 8/26/2008: D. David Lawley represented Vojin Vujoseic, owner ©f.=Pa-� in D'Avi n--&h It 15-Hinckley,Road,;rtHyannis,-Map/Parcel 311-020, variance for bathroom facilities. David Lawley and Mario were present for the owner. Two bathrooms already exist but require some additional work to make them accessible. The Board needs to review the permits of the Building department and the Common Victual License. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to approve a Continuance until October 14, 2008, and the business will be allowed to continue operating in the caf6 until then, as the other permits are in place by the other departments. (Unanimously voted in favor.) EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES ON 10/14/2008: G. Pain D'Avignon - Status of toilet facilities, seats and permits. Mario stated that the original bathrooms are now accessible to the restaurant. The wall was removed. This brings the total amount of bathrooms to three (including one for handicap) and meets the requirements. No further issue. r \ DATE• FEE: rl Q � a v • BARNSTABLE, y MASS. o 1639• �C REC. BY ArfDMA'�A Town of Barnstable `��"�J--- SCHED. DATE: a Z 0Q e G Board of Health Q 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6'04 Paul J.Canniff,D.M.D. eV Junichi Sawayanagi VARIANCE REQUEST FORM LOCATION ,+ Property Address: Assessor's Map and Parcel Number: j !/ Size of Lot:-- -- -- Wetlands Within 300 Ft. Yes Business Name: rAL ID AV/C N 0 AJ No Subdivision Name: APPLICANT'S NADIE: A(b !�, Phone .5 09 7 78- Eir Did the owner of the property authorize you to represent him or her? Yes No PhOPE10-Y OWNER'S N,"IE CONTACT PERSON Name: � L� 9'a4o Imo !' U--C. Name: ' P i Lkw�. 0�er-tlt Address:P-®, '-Ro AWL 7 h ij A tyd;l e _ Address:_j V 0 Dd-- .4 Phone: °- 3 ---- Phone: ��Lf,J 7 VARIANCE -FFR�.[OgA�'�I,,REGULATION(List Reg.) REAS pO /�N F]O/R VARIANCE(May attach•if mores ace needed) v's - CD NATURE,OF WORK: House Addition ❑FIX1 0 House Renovation ❑ Repair of Failed Sept ystem El '`' Checklist (to be completed by office staff-person receiving variance request application) �o Please submit copies in 4 separate completer)sets. W co Four(4)copies of the completed variance request form -J m _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional(lour plans submitted(e.g.house plans or restaurant kitchen plans) Sir ted letter slating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title.V and/or local sewage regulation variances only) _ huff nicnu submitted(for grease trap variance requests only) _ Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee. only], outside dining variance renewals [same owner/leasee only], and variances to repair failed sewage disposal systems ]only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED_ Wayne Miller,Chairman NO"r APPROVED _ Paul J.Canniff,D.M.D. REASON FOR DISAPPROVAL_ Junichi Sawayanagi �V Q:\Application Fours\VARIREQ.DOC t_ Avgly\o V\ elose @otireo«y . i 4 ,. O 40° O tLh�1r' T 4 p ti b� . 0 io OY 0 0 O O r►, . p oo • o � �. o e o �' I Late September LLC P.O. Box 2427 Hyannis , Ma 02601 July 15, 2008 TO: Town of Barnstable Board of Health 200 Main Street Hyannis , Ma 02601 RE: Pain D'Avignon 15 Hinckley Road Unit A Retail Cafe Hyannis, Ma 02601 Dear Sir: I Late September LLC as property owner of 15 Hinckley Road, Hyannis authorizes Pain D' Avignon to represent me in this request for a variance. Aames yours, Burke, Manager epember LLC N d b . �J c v rn Crocker Sharon From: McKean, Thomas Sent: Wednesday, October 08, 2008 3:34 PM To: wamdoc@verizon.net; Jimmy Sawayanagi (exit5ga Ile ry@com cast.net); Paul Canniff (canniff.paul@gmail.com) Cc: Crocker, Sharon Subject: FW: Pain D'Avignon seating -----Original Message----- From: Stanton, David Sent: Wednesday,October 08,2008 3:31 PM To: McKean,Thomas Subject: Pain D'Avignon seating Tom, I stopped by today. They had 18 seats set up on the outside patio. Inside the establishment there were 22 seats set up. So the total number of seats present inside + outside was 40. They are installing 2 more bathrooms for the public to use on top of the existing 1 handicap accessible one. They stated that Dr. C had also done a site visit there recently as well. Thanks, David 1 r Town of Barnstable of THE Tp� " Board of Health ' MASS. ' 200 Main Street - Hyannis MA 02601 9Qj i639. ArFD MA't A Agreement to Extend Time Limit for Acting Upon a Variance Request In the Matter of a variance request form received on_ c�U� O the Petitioner(s), O I-Y\ � U I` � regarding the property at fIeAA the petitioner(s)and the Board of Health agree that the and of Healt has until © y be, (insert date) to act upon the Petitioners'completed application for a variance. i In executing this Agreement, the Petitioner(s) hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s): Board of Health: Signatu l Signature: Petitioner/ etitione/r'ss Representative Chairman Print: ` � �� Print: Wayne Miller,-M.D. 7KDate: Date: Address/oPetiticner(s)or Petitioner's Representative Town of Barnstable Board of Health Public Health Division 200 Main Street Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508) 790-6304 file q:extend.doc Ai, - A v i G*N 0 N B 4 u l a ng e r i e - C a f 6 � WN ER Soupes du jour: Priced Daily Les Hu tres Mignonette, cocktail sauce&lemons Coquille du Wellfleet: 3 each Coquille du Jour: 3 each Carpaccio de Thon AN Pickled shallots &roasted garlic-soy sauce 12 La Salade Locale Lemon zest, olive oil, thyme&crispy shallots 7 La Salade Caprese Mozzarella di buffalo, farm tomatoes &fresh basil 12. Moules Reisling Marcona almonds &grilled baguette 11 ' Ricotta Housemade with crudites &grilled baguette 9 Pommes Frites aux Herbes Spicy&garlic aiolis 7 Petite Pizza du jour Chef Hill's daily musing Priced Daily Tartare de Boeuf Crispy Shallots, caperberries &pink pepper crackers 13 Mangez a Trois Sliders of truffled kobe burger, lobster salad&grilled eggplant 14 Ricotta Gnocchi Housemade with peas, carrots, morels &parmesan 9 small/18 large Salade de Crevettes grillees Greens,avocado, tomato, red onion&creamy dressing 19 Salade de confit de Canard Frisee,poached farm egg&parmesan 17 Prosciutto et Monkfish a la Nage Pom mes robuchon &roasted tomatoes 25 Melange grille du jour Three artisan meats &farmed vegetables Priced Daily Demi-Poulet roti aux herbes Mashed potatoes &asparagus 23 Sole au beurre brun Herbed bread pudding&haricot verts 22 "Hangar" Boeuf Frites Watercress &blue cheese butter 24 Crepes Boeuf, braise Short Rib Blue cheese fondue 21 PATISSERIE Creme Fraiche Panna Cotta Raspberries, raspberry gelee&basil 7 Les Tartes de Saison Pain D'Avignon Fresh whipped cream 8 Crepes du Jour Whimsically sweet concoctions Pricd Daily Fraises Balsamique Mint, biscotti crumbs&whipped cream 7 ;Pudding a la Brioche au sucre Fresh whipped cream 8 Le Brownie a la Mode Housemade vanilla ice cream 7 Plateau de Fromages Chef s daily selection with Marcona almonds, jams&housemade.crackers 5 (per cheese) Our.Chef, Toby Hill, has created a menu designed for you and your guests to share and enjoy several dishes family style. "The menu is a bit French, so please ask your server." Bon Appetit! PAIN D"AVIGNON Boa l a n g e r i e - C a f 6 �Q s �TNE DATE: � - $ 5.00 FEE*: + BARNSTABLE, 169. 10� ,✓,A Town o -v REC.BY: �EDMpis BN stable ' 1 SCHED.DATE: Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-8624644 Paul J.Cannif�D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi VARIANCE REQUEST FORM LOCATION Property Address: 15 Hinckley Road Assessor's Map and Parcel Number: Map-311, Parcel 020 Size of Lot: 36,355± sq. ft. Wetlands Within 300 Ft. Yes Business Name: Pain D'Avignon No X Subdivision Name: APPLICANT'S NAME: Pain D'Avignon Phone (508) 778-8588 Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: Lion LLC Name: Mario Mariani Address: 15 Hinckley Road, Hyannis, MA 02601 Address: 15 Hinckley Road, Hyannis, MA 02601 Phone: (508)771-9771 Phone: (508) 771-9771 EMAIL: mario@paindavignon.com VARIANCE FROM REGULATION(Incl.Reg.Code#) REASON FOR VARIANCE(May attach separate sheet if more space needed) Sec. 322-3 Grease traps To allow continued use of the existing 1,000 gallon grease trap, with 25% additional seating. NATURE OF WORK: _House Addition_ House Renovation___ ___Repair of Failed Septic System LJ Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as 5 collated packets. A. Five(5)copies of the completed variance request form B. Five(5)copies of MA DEP approval letters for Innovative/Altemative septic system(when proposing an I/A system or secondary treatment unit(S.T.U.). _ C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health@town.bamstable.ma.us _ D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version. A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or R.S. Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). Fee Submitted*$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance"). Variance request submitted at least 15 days prior to meeting date _—_ ._ . _ . -. . __ VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Donald A.Guadagnoli,M.D. C:\Users\decol1ik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\QDLJENHC\VARIREQ Rev APR 4- 2018.docx. b l 1' PARKING SEATING: 1 9 OUTDOOR(6 (1.� 3 IND-OOR 52 TOTAL 0 0 PATIO PARKING EXIT EXIT O O O O LJ U LJ �D RESTAURANT WINE RED BAR BOULANGERIE KITCHEN LU- CL. — - — -WOMEN — -- MEN O HGP. 01 BREAD PRODUCTION N (@ Chris Warner Architect SK-Pl Seating & Egress Plan Scale:1/8"=1'-O" 208 Quissett Ave. Woods Hole MA 02543 Existing Conditions Date: O1/14/19 phone.508 -274 -0421 Pain D'Avignon email.-chriswarnerarch@gmail.com 15 Hinckley Rd., Hyannis Project No.18o7 BSC GROUP TRANSMITTAL 349 MAIN STREET,UNIT D,WEST YARMOUTH,MA 02673-www.bscgroup.com TEL 508-778-8919-800-288-8123 To: Thomas A.McKean,Director Date: January 15, 2019 Barnstable Health Division Proj.No.: 50253.00 200 Main Street Project: Pain D'Avignon Hyannis,MA 02601 15 Hinckley Road We are sending you: NAttached ❑ Under Separate Cover Via: Delivery Tracking No.: ❑ Overnight Delivery ❑ Picked Up By Recipient ❑ Regular Mail ❑ Taxi ❑ Messenger ❑ Direct From Printer N Other: The following item(s): ❑ Change Order ❑ Drawings ❑ Prints ❑ Samples ❑ Copy of Letter ❑ Photocopies ❑ Reports ❑ Specifications ❑ Digital Media ❑ Plans ❑ Other: Date or No.of Copies Drawing No. Revision Description 1 1/11/19 Check No. 30668 5 Board of Health Variance Request Form 5 1/14/19 Seating&Egress Plan 5 1/14/19 Site Plan This information is: ❑ For Your Information ❑ No Exceptions Taken ❑ Resubmit _copies for approval ❑ Unchecked ❑ Furnish as Corrected ❑ Return corrected prints ❑ Preliminary ❑ Rejected ❑ Submit _copies for distribution ❑ Revised Plans ❑ Revise&Resubmit ❑ Final Plans ❑ Sent for Your Review&Comment Remarks: Signed: From: Brian G.Yergatian, .E.,LEED AP cc: G.Beaudoin,Dept. of Public Works M.Mariani,Pain D'Avignon Note:If enclosures are not as noted,please contact us immediately. Rev.2015-11-16 Page 1 of 2 a i January 15, 2019 Thomas A. McKean, Director Barnstable Health Division 200 Main Street Hyannis, MA 02601 RE: Variance Application for 15 Hinckley Road, Hyannis, MA Dear Members of the Board:As an officer of Pain D'Avignon, I hereby authorize BSC Group, Inc. to represent our business in this request for a variance. If you have further questions, please do not hesitate to contact me. Sincerely, P Mario Marian, General Manager Pain D'Avignon i �oFVE rQ�aBarnstable a $nR�, The. w ar�nst b e Department of ftb is Works * BARNSTARrz, MASS. 382 Fahnouth Road,Hyann s,MA 02601 508.790 6400 Daniel W. Santos,P.E. Robert R.Steen,P.E. D recto.r Assistant 10ireetor February l% 2018 Town of Barnstable Board of Health 200 Main Street Hyannis,Massachusetts 02601 1 RE- Paui D'Avignon,15 Hinckley Road.,Hyannis DPW Recommendation for Grease Trap Variance Request Dear Board Members, DPIN.has reviewed the applicant's request for a grease trap variance at the above referenced property. Based upon the information provided,. DPW does not recorninend approval of the variance as proposed. The.applicant is.requesting"to allow continued use of the.existing J;;000 gallon grease;trap,with 25% additional seating" (82 seats total). The restaurant is tied to.municipal :sewer and has an existing 1000 gallon grease trap. However; the existing 1,000 gallon grease. trap can only support 66 seats based upon the sizing requirement of lS gallons per seat per day as specified' ri Chapter 322=3 of the Town Code. It is DI'W's recommendation that a 1,500 gallon in-ground. grease trap be installed for this restaurant to:operate with&2 seats. S.inCerely; a Amanda Ruggiero,P. . Interim Town Engineer 3 cc: Thomas Mclean,Director, Barnstable Health Division Dr.Paul.Carniiff,Chairman,Board of Health Andrew B"oule, Supervisor, Water Pollution Control Division �g 1 r Town of Barnstable Regulatory Services Thomas F. Geiler,Director BEAM+ BARNSfABLE, �Q Public Health Division per s6�.q. �0 Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: `P� I Q to Designer:7�Ce (� , f/Sxx °� Installer: �G/ Address: . (lSl .4 Address: 33 A?w Gm J) / �� r 1� On � �4� �rz; was issued a permit to install a (date) (installer) septic system at based on a design drawn by /f address) e •� '�fl dated %(desijaer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. N of EDWARD L. y� (¢'• PESCE (P`, (Installer's Signature) /� ; CIVIL y ��2Ct��zS ��nho2S' No.32001 Bay 6,1erl 6yk. 30 9F �a �Q �oISTEQ` S/ONAL� esigner s Si afar (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form R. Town of Barnstable CF ZHE T Regulatory Services Barnstable Richard V. Scali, Director AN-America City Public Health Division BARNSTABLE, . I I 11. MASS. Thomas McKean Director 9�pr 1639- A`�g 200 Main Street 20e7 FD Mpl Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 9, 2016 Mr. Vojin Vujosevic Pain D' Avignon Cafe 15 Hinckley Road Hyannis, MA 02601 , The restaurant owned by you that is located at 15 Hinckley Road, Hyannis, MA doing business as Pain D' Avignon Cafe, has been operating without a required HACCP plan as required by FC 3-502.12(B), FC 8-201.13 and FC 8-201.14(D). Federal Food Code 3-502.12 (B): Reduced Oxygen Packaging, Criteria. A food establishment that packages FOOD using a reduced oxygen packaging method and Clostridium botulinum is identified as a microbiological hazard in the final packaged form shall have a HACCP plan... Federal Food Code 8-201.13: When a HACCP Plan is Required. Before engaging in an activity that requires a HACCP plan, a permit applicant or permit holder shall submit to the regulatory authority for approval a properly prepared HACCP plan as specified under FC 8-201.14. Federal Food Code 8-201.14 (D): For a food establishment that is required under FC 8-201.13 to have a HACCP plan, the plan and specifications shall indicate: (A) A categorization of the types of potentially hazardous foods that are specified in the menu..... (B) A flow diagram by specific food or category type identifying critical control points and providing information on the following (1) Ingredients, materials, and equipment used...(2) Formulations or recipes that delineate methods and procedural control measures that address the food safety concerns involved; (C) food employee and supervisory training plan that addresses the food safety issues of concern; (D) A statement of standard operating procedures for the plan under consideration clearly identifying:. (1) Each critical control point, (2) The critical limits for each critical control point, (3) Q:\Order IettersTood Viol ationsO Avignon Cafe 15 Hinckley Road 11-9-16.doc f f The method and frequency for monitoring and controlling each critical control point....(4) Tne method .and frequency for the person in charge to routinely verify that the food employee is following SOP's and monitoring critical control points, (5) Action to be taken by the PIC if the critical limits for each critical control point are not met, and (6) Records to be maintained by the PIC to demonstrate that the HACCP plan is properly operated and managed; and (E) Additional scientific data or other information, as required by the regulatory authority, supporting that food safety is not compromised by the proposal. You are hereby ordered to IMMEDIATLEY CEASE AND DESIST all operations requiring a HACCP plan. Any questions or problems please feel free to contact me at this office. Thomas A. McKean, R.S., C.H.O. Director of Public Health Town of Barnstable Hand Del' d: Received Date: Q:\Order lettersTood Violations\D'Avignon Cafe 15 Hinckley Road 11-9-16.doc 1 f Town of Barnstable . Yq Department of Public Works Permit Number Sewer and Trench Permit_ Connection : Disconnect Mod or Repair Map Et Parcel# : ��/ �Q Water Supplier Street : l,S— hC�lF �Gv Sewer Account# Village ' _ G G�hh !S Permit Fee Et Check# : � � t! C/c 3l23 t. Residential Bldg Fee-$420.00 ; Commercial Bldg Fee-$875.00 Septic Abandonment Permit# : 2. Surcharge for Each Additional Bldg on Same Service-$200.00 3. Surcharge for Pump Station-$300.00 4. Minor Repair or Disconnect of Existing Service-$50.00 Project Contact Information Contractor Name SC�iI 1-/2e h Owner Name y 6rx L L� Contact Name , Mailing Address l 9/7 /P� �� ` Business Address h l�I rio1 Contact Phone Telephone Contact Fax Property Use Information Residential : Commercial : Commercial Use : II ky;„ hl-e Industrial F-1 Standard Industrial Code : Number of Bldgs Size of Parcel (acres) �, uC co Pipe Diift Material :L &Fitr c _ / Pipe Length � c�(tiri��i/ pg i Before'excavating in a Town Way or on Town owned property, the sewer installer must obtain a Road Opening/Trench Permit and comply with the Construction Standards ft Specifications outlined therein. Applicant must notify DPW 48 hours prior to installation. Failure to comply with the regulations shall be grounds to revoke this permit. The Sewer Et Trench Permit is valid for 180 calendar days from DPW approval and the installation must be completed within that time period. Engineered drawings must be submitted, with this application form, to the DPW for all commercial or industrial installations. The drawings must be approved before a permit will be issued. Contractor Signature Et Date 3bCl/ DPW Approval Signature li DateS/�ez-1,0J/a21.2 1c2(,7)2 V Sewer Permit Expires _-,2(j) ? r 4' IKE Town of Barnstable Regulatory Services t aAaNsrAEM q MAB& g Thomas F.Geller,Director Eo;a►.gym Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: S08-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, -14w6s lel- Al/a&e , as Owner of the subject property hereby authorize eb— 8o to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) e of Owner ate Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:F0RMS:0 WNERPERMISSION REMOVE 3 GUT EXISTING PARKING 2 SEATING: PARKIVO 1 RETAINING 5K-E OUTDOOR - 18 SPOTS K-S WALL AS INDOOR - Sci READ. BOLLARD TOTAL - 10 1 BIG TV 0 THIS PART OF EXISTING 'v SERVER EXIT PATIO AND 1/2 WALLS STATION ENTRY TO REMAIN 7 HOSTESS CT � 1 p 5K-E tV MULTI- FUNCTION ROOM PATIO 2 5K-5 ALIGN EXIT CO) EXIT 1/2 WALL GUT AND PATCH WALL TO MATCH J r MILK i EXI5TIN& RESTAURANT `OD SUGAR REMOVE COS COOLERS, SHELVES, ETC. WINE Co RED BAR BOULANOERIE KITCHEN m F1 CE GL. WOMEN SERVERS MEN O HGP. O KITCHEN N® SK-P1 Seating Plan with Chris Warner Architect Addition scale:1/8 =1-0 293 Gifford St. Falmouth MA 02540 Preliminary Design Date: 05/28/19 phone.-508 -274 -0421 Pain D'Avignon emal]:chriswarnerarch@gmail.com Project No. 15 HinckleyRd. H annis I I ti A� All It d tz_—.... . i Ir I � il. I ' I I I ' s No g000 / THE COMMONWEAL OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for aigponl *pgtem Cougtructiou. Verrmtt Application for a Permit to Construct X Repair( ) Upgrade( ) Abandon( ) ❑ Complete System U Individual Components Location A dress or Lot No. Owner's Name,Address,and Tel.No. $f 191—6`33 Assessor's Map/parcel 3(I ;LV 5 Hln Rat br-. 8- 4�8Fo Instal is Name,A dress,and Tel o. Designer's Name,Address and Tel.No. �A� �rnnc�, - �y Type of Building: 06RH e.2& Z 3�� wn 5e"e-f A c(u Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) N w gpd Design flow provided �Y9 gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) q) w o, cae J-g" AaacIno man Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H lth. L�iC�2f< s C:c*nr�o/L Signed Date Jr Application Approved by JV Alv. (4 Date Application Disapproved by: Date for the following reasons Permit No. )-00 o—oa9 Date Issued I v ----No w Fee ^ Entered in computer: � _. THE COMMONWEALTH OF MASSACHUSETTS . PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIPPrication for lb.i!6pogaY (tors.5tructton Verm t Application for a Permit to Construct A0 Repair O Upgrade( ) Abandon O ❑ Complete System E Individual Components Location Address or Lot No. Owner's Name,Address,and Tel No. �7/-�6,J j l5 141 r?C kk-�.� / � �� ✓� `J 7qh�s 73 Assessor's Map/Parcel / ' _D � /c,H,1)C10,-,1 RU Install�ei's Name,Address,and Tel_. vo. Designer's Name,Address and Tel.No. �i 3T71�i9C/71 I L Q- Sia,1/Ltl/(/7 Type of Building: (76 H P,2ei/q/ ? 3 qq . `�uvr $�we r^ c,cC��.,1 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria,(. ) Other Fixtures Design Flow(min.required) 4114 gpd Design flow provided /y 13 and Plan Date Number of sheets Revision Date Title J jSizeof Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 16av on (-elde Date last inspected: w Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewagedisposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H alth./� q fZ Signed Date Application Approved-by�" = � .' l?: _ Date, 1 Application Disapproved by: 4` Date for the following reasons Permit No. �00�0 - Ua 9• Date Issued 1 THE COMMONWEALTH OF MASSACHUSETTS pf BARNSTABLE, MASSACHUSETTS rp wPY' Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired ( ) Upgraded ( ) Abandoned( )by C L , 1r f (o✓,,o�` at /. AZ„�k r a /7 {-��,,,'4 has been constructed in accordance i with the provisions of Title 5 and the for Disposal System Construction Permit No. Q00&-0.?9 dated i)2746 l Installer arylY-, - t_ Designer PIWS IJ I #bedrooms K) )Q -4 u vn C.o wP f — G J/ 'tiSP T uD Approved design flow Md gpd The issuance of this permits all not bb,construe'd as a guarantee that the systen �l� 1 f n ti,.n as-d Pled. Date � �.�/ (/ Inspector� � �� .-� ———————————————————————————————————————————— - No. -)00 -o.�q Fee /5 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS Mi5po5a ,,*pgtem Construction Permit Permission is hereby granted to Construct ( )) Repair ( ) Upgrade ( ) Abandon ( ) System located at / ' l �n Cklev 12Cl', and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this-permit� Date I 'Z '4, / Approved by „! V,_. r- r .irh"on AP-2-3 1-SS Air Pro Air Curtain lose ct 36"; 120V ; bttp://www.webstaur .com/cu tron-ap-2-36-1-ss-air-pro-air-c... -,,,--- —�1*r tjIt%�l�+t]y f rP 1 jQMcAfee5ECURE"j ftla �caa t W LB S C.1�u1 G�11t s I.V�V� TESTEQ D?1l.Y Oi-FEB ��°k�0' �#�r�r� Mon-Fri&MWM EST _ Chat Wfth The WEBstaurant Store HOME I MY ACCOUNT I FOOD SERVICE HELP I ABOUT US ` BLOG U, f Policies Help FAGs Track Order 1 Your shopping Cart: The WEBstaurant Store>Convenience Store>Air Curtains>Curtron AP-2.36-1-SS Air Pro Air Your Cart Is Empty Curtain Insect Door 36"-120V ......................................... i _ - You are rtot currently logged in. T_.- Each Only: Login I Register Curtron.AP-2-36-1-SS Air Pro-Air - $458.99 EA Product search � Curtain Insect.Door'-361-_120V Quantity: iOur Item#:517AP2361SS Browse by Category I _ FREE Freight on this iteml Restaurant Egulpmerlt ` ` W Units:EA Smallwares } ;Usually Ships In 1-2 Business Storage I Transcork Days Tabletop Manufacturer's Item#: Disposables ; Fumlture `~ - AP-2-36-1-SS t Were WashinalLaundry I Restaurant Dinnerware " Consumables Janitorial Supplies Equipment Parts Curtron Browse by Business Type White Glove Asian Restaurant s Delivery Available Bakery Supplies - Bar Supplies - - - j0 Erna!I this item to a friend; Buffet Supplies Er-3ai to-„friend Catarina Supplies _ tf I�sk us auouf this item Coffee Shop Supplies I Uke Concession Supplies Food Safety.Supplies • Ships In 1 to 2 business Grocery I Dell Supplies ' 113 hp,2 speed motor days This item qualifies for Pizza Supplies ; .; : Free Sandwich Shop • For interior mounting only • Door trigger switch :,� Shipping. Additional Businesses Included _� .:- :'. rflli�s to tr�ttlnertal i1.S. • Maximum door height 8' • UL and NSF Listed e Go ahead and try to Have you used this stump usi i product? { Login to write your own 1 Ask Us ^ � re ' and eam$2.001 i Or tow Wei MEN= Enter your email to receive email speaals! Enter We Securely Accept a�czvr Ipa ym of 3 2/7/2011 1:24 PM rtron AP-2-.--, 4-SS Air Pro Air Curtain Insect r 36"- 120V, hrip://www.websandtaur com/curtron-ap-2-36-1-ss-air-pro-air-c... .�° .— for all your restaurant supply needs! Details Spec Sheet Warranty .The 9urtro6 AP-2-36-1-SS Air Pro 36"air curtain keeps interior- I emriron►nerits clean and comfortable,while keeping outdoor,nuisances like flying bugs,dust,and odors out.The small, N'wide Air Pro air, curtain is great for take-out service windows,employee and customer*_` entrances, or even above walk-in doorways. m I Its 2 speed, 1/3 hp motor and dual blowers can stop winds up to 25 i mph, helping you maintain a consistent internal temperature even with l the door open.The air curtains motor has a low noise output, so it 1 won't to bother your customers. i If used with its included door plunger switch,the Curtron i AP-2-36-1-SS Air Pro 36"air curtain only triggers when the door is opened and shuts off when the door doses,which helps to conserve energy. 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REDUCES HUMIDITY&LOSS OF COLD C, CH and CHS Series air curtains, which AIR FROM OPEN FREEZER AND COOLER 7A11 � are siilar in design and construction except for DOORS � '" — ' 0 LOWERS BUILDING HEATING AND differences in outlet air flow COOLING COSTS and motor capacity.All of these commercial grade air jUiAIWAIN5CL AN-SANETAkY-PREMISES - -in the eight or nine years curtains provide dependable climate, insect that we've been working and energy control for a variety of settings, f13'ALLOW5 DOORS ToREMAIN OPEN- with Mars Air Door for WHICH IS'Cf7NDUCIVE TO AT tfWCTING from receiving doors and cold storage doors4 , , CUSTOMERS installations throughout to entrances for office buildings, depart- /r ob 6 Mew England,we've been ment stores and supermarkets. Depending O ELIMINATES NUISANCE OF OPENING iil� very pleased with the upon the height of your doorway and the AND CLOSING DOORS,WHICH CAN quality of the product,the fast delivery,the price and air flow required, one of these three series HAMPER PRODUCTIVITY the company's eagerness of models will provide a solid solution. o PROVIDES EASIER FLOW OF CUSTOMERS to help In every way. The C Model, designed to mount over OR PERSONNEL TRAFFIC Its no wonder they're the customer entrances, creates a mild, curtain a INSTALLS EASILY industry leader." of air undetected by customers walking —Steve Ginns,President through the doorway. It acts as a continual O FOUR DIFFERENT MODELS ADAPT TO SJ.Ginns&Associates,Boston,MA YOUR SPECIFIC ENVIRONMENT barrier against outside climate to maintain the desired interior temperature. n STANDARD WHITE OR CUSTOM COLORS The unit also prevents loss of refrigerated AVAILABLE air and reduces humidity or ice buildup I when installed over doors on freezer or 0 ELECTRICALLY HEATED MODELS AVAILABLE IN C,CH AND CHS • cooler rooms. 4 - The CH and CHS Models produce a greater the cold storage room.The medium 1(upit' velocity of air flow. Recommended for speed setting is used for the same above average insect conditions, the CH applications and provides the same j and CHS Models are highly effective in benefits as the low speed setting, large markets, restaurants, hospitals, food but for slightly taller door openings. l h d t l i processng pans an schools. 1 4V The high speed setting, utilized The C,CH and CHS are offered in heated for applications such as receiving or `P and unheated versions. Adjustable vanes at service doors, works especially well the outlet nozzle make it possible to direct for extreme insect conditions or ,. the air where needed most and to where large openings enable compensate for possible draft conditions substantial amounts of air to enter. through open doorways.These The Combi Models have proven easy-to-install units create productive themselves in a diversity of environments in so many important ways. situations, including restaurants, The ultimate in application flexibility, the shopping malls, drug stores, Mars Combi°series of unheated air curtains hospitals, office buildings, hotels, is actually, as the name implies, a food processing plants and storage #: combination of the C and CH or the CH and areas,to name just a few.When you CHS models. It provides different applica- need to combine the performance ' tions at the turn of a switch for customer of single speed models into one entrance doors, its flexibility compensates unit,the Combi series provides for varying wind conditions and prevents excellent flexibility for installing in loss of conditioned air, controls flying insects various locations. ' and protects against dust.fumes and odors. When installed above a cooler/freezer cold 800-421 -1266 storage door, its flexibility is effective in i4714 S.B SAD' 04,RNhA t 9024. preventing the loss of refrigerated air and =! 310 '2-1`" -h'X:3i0 2' FOR es AIR CURTAINS SEE PAGE 6 reducing humidity and ice buildup inside 3 Mars is Committed to Better Products 'The people at Kwikset are ecstatic about the Mars Air Doors builds solid products and also solid relationships. temperature control from the Mars system. Its improved their comfort level, Increased Since 1962 when Martin Smilo introduced his air curtain design productivity and reduced absenteeism.As for and opened the doors for business, Mars has taken a leadership me,I wouldn't go to any other manufacturer. position by listening to customers like you and responding with The Mars people are true professionals." solutions.The largest manufacturer of air curtains in the world,we —Dennis Starr Starr State Air,installer of Mars air curtains for represent,distribute,service and sell our products on a global Kwikset Corp.,Anaheim,CA scale for all climates and environmental conditions. Should you have special requirements for unique or custom GaikE eWc,Hot Wdw or sum? applications,we have the capability to meet your needs. poWerealty need a heated air curtain? li:The answer is maybe not.Your Mari Air Doors effectively , creates an efficient insulation barrier between two "' i = • environments.it's approximately 80%-90%efficient.it does so by creating a stiff blast of air blowing down from the unit I towards the floor.This blast of,air creates an invisible barrier i '; _ f separating the two environments. t91 = If you have people working near or walldng through this moving ` r_ . air,they may feel a breeze.This mould cause a wind chill effect, similar to the cooling effects of a blowing fan.during the summer. Adding a'heated air curtain unit wili.minimize this effect and make fora comfortable and more productive work Mars Quick Ship Program place for your employees and customers. Should your facility be located in a cold weather environment For your convenience we stock a huge quantity of Mars Air Doors. creating significant temperature differences between the The bulk of orders ship out rapidly,normally within 3-5 working days. outside versus the inside temperature, a Mars®Air Doors However,under most circumstances,we can ship same day should you heated.unit will significantly improve the work environment need such service.Please make sure to ask your Mars Customer Service comfort level and help maintain.consistent temperature` Representative for details. control. In addition, it. will reduce'.overall utility and Mars Air Doors has the longest parts guarantee in the industry. maintenance costs by providing a more constant inside This attests to our faith that you will have trouble-free temperature. performance for many years. III: We've decided that we need a heated unit;which one do we choose;gas,electric,hot water or steam? "Mow all 24 dock doors have a Mars® A.The general rule of thumb Is to choose the same type of ' air curtain.This makes the system very flexible and versatile. heat used to heat your facility; however,there may be some We now maintain steady temperatures,even on the hottest and exceptions.For example;should your facility be steam heated, coldest days.Before this installation,one of our shipping but connecting to the steam lines is too far,inconvenient or too department's computers literally froze.TbiWs not a problem expensive,it may be-more feasible to choose gas or electric. anymore.An unexpected benefit was the measureable improved -To assure installing the correct heating method and proper quality at our finished laminate products." —Tim Shay heating outputs for you,we highly recommend consulting with Mgr.Manufacturing Engineering, your Mars factory representatives first for proper selection. Shrock Cabinet Co.,Arthur IL iatiRnf o�Ya s 1 Panels' Mars products meet the stringent listing or certification requirements CAntre, of many organizations.The specifics vary depending on the model, I Available options installed or application usage. 1 UL Listed and CSA certified O10us Q. O electrical control panels for c c � � °�' '� . : .� � air curtain applications ensure easy installation, long life and safe operation. Mars reserves the right to make improvements and changes to specifications without notice. 02002 MARS SALES COMPANY,GARDENA,CALIFORNIA.ALL RIGHTS RESERVED. 800421 m 1266 A World of Smart Choices From (EjRDS� 14113 S.BROA555 FAX:31 CA -3030 TEL• 310.532•t555 FAX: 310-324.3030 WWW . MARSAIR . 00M AIR SYSTEMS HYANNIS FIRE DEPARTMENT '95.HIGH.SCHOOL FRD. EXT HYANNIS, MA.02601 HAROLD S. BRUNELLE, CHIEF I ` PAAfAyEb STUDENT AWAAENEIN OF FIRE EDIPUTION PREVENTID:N.BUREAU BU5INESS PHONE:(5b$)775=i300 FACSIMILE PHONE: (508)778-6448 LT. UN9LD I3: CiET<,5_E;_JR., CFI LT. ERIC F.RuBLER, CFI i F)IL E P.,2EVkNTION OFFI $ FIRE PREVENTION OFFICER BUILDING. G.4DE COMPLIANCE FORM THIS FILE PREVENTION CUREAU.HAS REVIEWEDTHE PLANS DATED -i J 4 15 "rOR THE PROI?EP.TI�`:-LOCATED AL50 KN(�VJiv A.S. ,:.. `f - THE .CHART BELOW INWC' ES: THE STATUS OF OUR REVIEW. TYP'OF:CONSTl�UCtION d:y"C :,..•,. _. .. U.IvIEN' RECEIVED REVIEWED _„ -.1..;NARR�IT(WE:REF'OF�F \/ _; - 2FI'RE ICI tTITJ�x RESCUE:ACCSS •:• $=HYDBANTLC9C 'TION'•/iiyAi Sf1PP'L1F, .: mRINKLER'SYSfi {S.SI'R)f�iKLER C©NTROL EQUIPMENT r pJ '' Ea= TAN R .�>=;•i :a R .IP:E>SY�'TE'[ih:5�` F ';7STQIVI3PIPE.vALWE"L`OCA7IQNS_ try 8.FIRE DEPIRTI1lIENT COI�INECTION 9 fIREPROTECTIVESIGNQ�IINOSYST Y` j�,1j/ < �•r` p — ,. J.O=F F �:S &ANNUNCIATOR;LOCATION': '" 1 i-SMOKE"CONTROE%EXHAUST r t� SMOKE CONTROLYEQU:IF LOCATION 13=LIFE SAFETY SYSI EM FEATURES ,AN.. t .• o.` 14=FIRE EXTINGUfSHIhJG SYSTEMS ,J � ` 15- F.F:S.'CO_NTHOL'EQUIP LOCATION y. Iry 1 -FIREPf OTECTII N'-Q QtJ(P s1, NAGE ARM:TA M15SIOON`M-THOb' om is=sE.QUE : - NNIS FIRE PR VENTION ) NCESF,'O[? FATIO::RI REPQ.FiT HYANNIS lift DFpAf31 MENI r 2G.-ACCEPTANCE TESTING Cf ITEf�1A , ;t ,. HYANNIS Mft ` T WE-8 L1 VE::TNE D000MrN1S TO BE TE A. b.0 MP IANT FOR THE ISSUAHbE OF A BUILDING PERMIT •'T6 2- W A'1.1.5 L :• ;. V1/t=HAVE COMPLETED:THE`ACCEPTANCE TESTING:FOF.THE OCCUPANCY PERMIT AND BELIEVE THAT WITHIN THE SCOPE'OF THE BUILDING PEFfMIT,'THE'A80VE ISSl1ES ARE IN COMPLIANCE. All SBONGARD THE$NEST bmw MACH➢NES&OVENS * * * * * Jun-06 RONGARD HEARTH DECK OVEN "CERVAP" SERIES FLOOR CONSTRUCTION REQUIREMENTS ------ - OUTSIDE FRAME -- ---- --------- rn t .:' ...�.rx se- --'--- - •`:-..�,_ mom.- ., :..: ...::_. ..: .. •k34.+�'tx,.,�'Lt4.' 4 .-v_:d2'�•'+.) ..�°;"+�v:,.��.N`.'� 'v_`a�3 e " .+.F9'.Kc✓'nx c."."-Y ...:S r 4 �• 5a 4S OVEN FIRE CHAMBER i B _ _ A MINIMUM 4"THICK CONCRETE 4" 30" - ---® 101,— { �----�-- 24„ �- - 112" FIRE BOARD OVERALL WIDTH OF CONCRETE AREA 1 SLAB IS THE OVERALL WIDTH 01=THE APPLICABLE OVEN AS LISTED ON PAGE 5 PLUS I"ON EACH SIDE FBM BAKING MACHINES,2666 RT 130,CRANBURY,NJ 08512 USA Tel:609-860 0577 Fax:609-860 0576 fbmbak-mg@aol-com 9 j � r BONGARD THE fINEST bAIONG ffiACHINES&OVENS * Jun-06 BONGARD HEARTH DECK OVEN "CERVAP" SERIES FLOOR CONSTRUCTION REQUIREMENTS -THE FLOOR AREA UNDER THE OVEN MUST BE SOLID,LEVEL, HEAT RESISTANT,AND DRY, SUCH AS CONCRETE SLAB. -A MINIMUM 4"THICK CONCRETE SLAB IS RECOMMENDED FOR THE OVERALL AREA. -PRIOR TO ASSEMBLY, CUSTOMER MUST REMOVE FLOOR COVERINGS SUCH AS CARPET,LINOLEUM, VINYL TILES,EPDXY OR SIMILAR MATERIALS. THE CUSTOMER SHALL BE RESPONSIBLE TO ASSURE COMPLIANCE WITH APPLICABLE LOCAL,STATE AND FEDERAL FIRE AND BUILDING CODES. IN THE EVENT OF A WOODEN FLOOR: -A WOODEN FLOOR REQUIRES FIRE PROOF MATERIAL ON TOP, SUCH AS 1/2 " CERAMIC FIRE BOARD PLUS GEOBOND MATERIALS AS PER MANUFACTURER'S REQUIREMENTS. -A TOTAL OF 4"THICK CONCRETE SLAB IS RECOMMENDED FOR THE OVERALL AREA IN LIEU OF THE WOODEN FLOOR. PLEASE REFER TO PAGE 9 FOR CROSS SECTION DRAWING SHOWING FLOOR CONSTRUCTION REQUIREMENTS A: FOOTING—LEFT SIDE TEMPERATURE: UP TO 1,200 OF WEIGHT: 45%OF TOTAL WEIGHT-OF APPLICABLE OVEN* SIZE OF AREA A: 30"WIDE x OVERALL DEPTH-OF APPLICABLE OVEN" B: OUTSIDE FRAME—LEFT SIDE TEMPERATURE: NOT AN ISSUE WEIGHT: 5%OF TOTAL WEIGHT-OF APPLICABLE OVEN* SIZE OF AREA B: 4"WIDE x OVERALL DEPTH-OF APPLICABLE OVEN* C: FOOTING+OUTSIDE FRAME—RIGHT SIDE TEMPERATURE: NOT AN ISSUE WEIGHT: 50%OF TOTAL WEIGHT-OF APPLICABLE OVEN* SIZE OF AREA C: 10"WIDE x OVERALL DEPTH- OF APPLICABLE OVEN* *REFER TO PAGE 5 FOR THE WEIGHT OF THE APPLICABLE OVEN FBM BAKING MACHINES,2666 RT 130,CRANBURY,NJ 08512 USA Tel:609-860 0577 Fax:609-860 0576 fbmbaking@aol.com g ~ ~ ® 3®NGARD THE FINEST bAIONG MACHINES&OVENS Jun-06 BONGARD HEARTH DECK OVEN "CERVAP" SERIES STEAM EXHAUST " RECOMMENDE D INSTALLATION A B DETAIL OF ROOF INSTALLATION OPTION"A": RAIN CAP WITH IN-LINE EXHAUST FAN OPTION"B": MUSHROOM TYPE EXHAUST FAN BAKERY TO ROOF EkIIAUST FAN(NOT SUPPLIED) MINIMUM RATING FOR EXHAUSTFAN 1000 CFM d— 8"STEAM EXHAUST PIPE SS.OR ALUMINUM RECOMMENq)ED HOOD 8"1.BOWS 3/4"COPPERLINE PIPED INTO OVEN DRAIN LIN DOUBT-PLEASE ASK! SIDE VIEW FBM BAKING MACHINES,2666 RT 130,CRANBURY,NJ 08512 USA Tel:609-860 0577 Fax:609-860 0576 fbmbaking@aol.com _ 7 l ',J . • ' ®BONGAR® THE fINEST bA10NG MACHINES&OMENS * * * Jun-06 BONiGARD HEARTH DECK OVEN "CERVAP" SERIES CHIMNEY AND FRESH AIR INSTALLATION REQUIREMENT RAIN CAP 3'MINI DOUBLE WdALL DUCT 25'MINI 6' ROOF I�0, MNI 8'MINI BAKERY BAKERY FRESH AIR INLET INSTALLATION = MINI. DETAIL OF FRESH AIR INLET PIPE REQUIRED AS PER PAGE#2&3 6"GALVANIZED PIPE REQUIRED FOR FRESH AIR INLET SCREEN I - PROTECTION NO MINI HEIGHT REQ1uII2ED E BAKERY BAKERY OVEN OVEN FRONT IF IN DOUBT -- PLEASE ASK! FBM BAKING MACHINES,2666 RT 130,CRANBURY,NJ 08512 USA Tel:609-860 0577 Fax:609-860 0576 fbmhaking@aol.com 6 f MMINBONGARD THE FINEST bAK1NG InACHINES&OVENS Jun-06 OVEN CODIFICATION BONSGARD HEARTH DECK OVEN "CERV AP" SERIES MODEL REFERENCE- X . Y . Z IE. 750.6.222 X DOOR WIDTH(in mm) TECHNICAL SPECIFICATIONS Y NUMBER OF DOORS OF AVAILABLE OVEN MODELS Z ) BAKING CHAMBER DEPTH(in cm) IN ADDITION TO THE WEIGHT INFORMATION,PLEASE REFER TO PAGES 7 & 8 FOR THE LOCATIONS OF THE PRIMARY SUPPORT POINTS ON THE CERYAP OVEN. BAKING MODELS CAPACITY TOTAL • INSIDE 'OVERALL OVERALL MINIMUM NkJMBER NUMBER WEIGHT GAS 18''X26 BAKING DEPTH WITH DEPTH OPERATING. ,::OF DECKS OF DOORS IN LBS. B.T.U./HOUR PANS. AREA .ft. DEPTH. 600.6.164 15 65 65" 80" 102" 186" 3 6 6200 163000' 600.6.186 18 74 73" 80" 112" 195" 3 6 6900 195000 600.6.201 18 80 79" 1 80" 117" 216" 3 6 7500 205000 600.6.222 24 89 87" 80" 126' 224" 3 6 7800 219000 600.6.259 24 104 102" 80" 141" 254" 3 6 8800 243000 600.8.164 20 87 65" 80" 102" 186" 4 8 7900 219000 600.8.186 24 99 73" 80" 112" 195" 4 8 8800 243000 600.8.201 24 107 79" 1 80" 11T' 216" 4 8 9500 250000 600.8.222 28 118 87" 1 80" 126" 224" 4 8 9900 266000 600.8.259 32 138 102" 1 80" 141" 254" 4 8 11000 282000 750.6.186 24 91 73" 91" 112" 195" 3 6 9000 243000 750.6.222 30 109 87" 91" 126' 224" 3 6 10100 266000 750.6.259 33 127 102" 91" 141" 254" 3 6 11500 282000 750.8.186 32 122 73' 91" 112" 195" 4 8 10600 266000 750.8.222 40 146 87" 91" 126" 224" 4 8 11700 298000 75 0.8.259 14 170 102" 91" 141" 254" 4 8 13200 326000 FB M BAKING MACHINES,2666 RT 130,CRANBURY,NJ 08512 USA Tel:609-860 0577 Fax:609-860 0576 fbmbaking@aol.com BONGARD THE ANEST bAI m InACHINES&OVENS Jun-06 BONGARD HEARTH DECK OVEN "CERVAP" SERIES TECHNICAL DATA SHEET(6& 8 Door Models Only!) MEASUREMENTS FOR CONNECTIONS Overall Width OF DUCT WORK i 3 1/2 of Overall Width For overall depth and width of corresponding oven,please refer to: "Cervap Technical Data Sheet", page 4. BONGARD .0 CERVAP 10in."T'+Barometric Damper o must be installed Horizontally! L (See"Cervap Technical Data Sheet"page 1) 9.50in. > BAROMETRIC DAMPER INSTALLATION REQUIREMENT 0 "T"can point in any direction, 8in.dia.S.S.Collar as indicated by dotted circle. ;' ` \ (For connection of oven hood ' steam exhaus duct.) r � I � 1/2 of Overall Width No utility connection within shaded area to both sides o \ and front of oven. 2 C LO Damper ' Oven Hood Item 1 =Gas Combustion Exhaust,also referred to as"Chimney" Y 8in. dia.connection. Requires 8-to-10in. adaptor for 10in.7'+Barometric Damper and 10in.dia.double wall duct -Ducting to be supplied by customer. (Please see"Cervap Technical Data Sheet"page 1 ;2&6) Item 2=Steam Exhaust from Oven hood-8in.dia.duct-ducting to be supplied by customer. (Please see"Cervap Technical Data Sheet"page 1 ;2&6) Item 3=Fresh Air Inlet-6in.dia. duct.Requires 6-to-4in. adaptor-Ducting to be supplied by customer. (Please see"Cervap Technical Data Sheet"page 2&5) IMPORTANT: Venting contractor shall NOT start the erection of smoke and steam exhaust ductwork before assembly of oven has begun. Drawing Not Contractual If in doubt,please call our office. FBM BAKING MACHINES,2666 RT 130,C> RANBLTRY,NI 08512 USA Tel:609-860 0577 Fax:609-860 0576 flimbaking@aol.cum 4 i s®NGAR® THE FINEST bAIQNG MACHINES&OVENS Jun-06 BONGAR®HEARTH DECK OVEN "CERVAP" SERIES TECHNICAL DATA SHEET(6&8 Door Models Only!) TOP VIEW 6"FRESH AIR INLET(GALVANIZED) 3/4°WATER SUPPLY LINE INSULATION 10"� 8° Al STEAM EXHAUST(SS COLLAR COLLAR) FLOOR DRAIN BACK OF OVEN 8"GAS COMBUSTION EXHAUST INSULATION BURNER ELECTRIC LINE o MAIN GAS LINE (FROM RIGHT OR LEFT SIDE) ETL Listed and BISSC Certified -GAS SUPPLY LINE: PRESSURE OF A MINIMUM OF 6"OF WATER COLUMN IS REQUIRED. PIPE SIZE SHALL BE DETERMINED BY CONTRACTOR BASED ON OVEN MODEL AND THE DISTANCE FROM THE GAS SUPPLY TO THE BURNER. -ELECTRIC: 20.8 VOLT-1 PHASE-+N.+Ground / 20 AMP CIRCUIT (ALL MODELS) -WATER SUPPLY: 3/4"TAP WATER SUPPLY LINE REQUIRED @ 40 PSI MINIMUM WATER PRESSURE. -FRESH AIR INLET: SEE ADDITIONAL DETAILS ON PAGE 5 NOTE: ELECTRIC,GAS SUPPLY AND WATER LINE CAN BE DROPPED FROM THE CEILING,EITHER FROM THE FRONT RIGHT OR FRONT LEFT SIDE OF THE OVEN. -CLEARANCE: A MINIMUM OF 18"CLEARANCE IS RECOMMENDED ON BACK AND SIDES OF THE OVEN. FBM BAKING MACHINES,2666 RT 130,CRANBURY,NJ 08512 USA Tel:609-860 0577 Fax:609-860 0576 fbmbaking@aol.com 3 ' ®BONGARD THE fINEST bAriNG MACHINES&OVENS * * * * * Jun-06 BONGARD HEARTH DECK OVEN "CERVAP" SERIES TECHNICAL DATA SHEET(6& 8 Door Models Only!) 8"STAIIILESSSTEEL COLLARFOR STEAMEXHAUST PIPE REFER TO ADDITIONAL INFORMAMON ON PAGE#6. 8"or 10"DOUBLE WALL DUCT 10"T AND BARONET RC D.4&FR (FOR GAS COMBWMN EXHZiS REQUIRED BUT NOT SUPPLIED RATED FOR UP TO 750°F CEILING FOR THE FIRST 5 OF RUN "T'MUST BE INSTALLEDHORMONTALLY f-- AS PER DRAWING BELOW ALSO,REFER TO CHUTNEY INSTALLATION BONOARD — HOOD REQUUUMENT ON PAGE#5 100 MINIMUM 87 LOADING AREA i A T-�7 R IMPORTANT -FLOOR SIDE VIEW HEAT RESISTANT DRY NON-COMBUSTIBLE MAEA UNDER THE OVEN MUST BE TERIAL-LEVEL ]FRONT VIEW PRIOR TO ASSEMBLY,CUSTOMER MUST REMOVE FLOOR COVIERINGS SUCH AS CARPET,LINOLEUM,VINYL TILES, EPDXY OR SIMILAR MATERIALS. BAROMETRIC DAMPER INSTALLATION REQUIREMENT ------ -`-----`? 8"or 10"DOUBLE WALL DUCT 10"BAROMETRIC DAMPER 10 --7 " T VERY IMPORTANT: 10" 10" T MUST BE INSTALLED HORIZONTALLY, DO NOT INSTALL T IN VERTICAL POSITION 18" ADAPTER(8"TO 10") 8" 10" FBM BAKING MACHINES,2666 RT 130,CRANBURY,NJ 08512 USA Tel:609-860 0577 Fax:609-860 0576 fbmbaking@aol.com yk RVAP" TECH TA : 19BONGARD THE ANEST IbAKING MACHINES &OVENS FBM BAKING MACHINES, INC. 2666 ROUTE 130 CRANBURY,NJ 08512 TEL: 609-860-0577 FAX: 609-860-0576 fbmbakinggaol_com FBM BAKING MACHINES,2666 RT 130,CRANBURY,NJ 08512 USA Tel:609-860 0577 Fax:609-860 0576 fbmbaking@aol.com l f I a s \. \ r ` Q 4' y R I rO -02 r Four Points by Sheraton Hyannis Resort 35 Scudder Avenue,Hyannis,MA 02601 Tel: (508) 77 775 F .(50 778-6423 r fourpoints.com/hyannis l r 1 P f Bellaire, Dianna POJ� From: Stanton, David Sent: Thursday, November 01, 2018 9:00 AM To: Bellaire, Dianna Subject: Wholesale retail gray areas Hi Dianna, For these gray areas, we have concluded the following: -Kayak cookies and.Cape Cod chips can be dropped off from our permitting (they get a wholesale license from the State and so we are going with the open foods are packaged under their wholesale license, not the retail license and the foods are not TCS.) -We will keep Pain D\Avignon on with their full food permit (they have a wholesale license, but also sell retail which falls under their full food permit.) Thanks, Dave 1 Bellaire, Dianna From: Stanton, David Sent: Tuesday, August 28, 2018 9:40 AM To: Bellaire, Dianna Subject: Sorry, another one, pain D'Avignon Sorry, I need to stop getting request to review files, this time it is on site plan review for this afternoon. It has the wrong number of seats listed, but I would hold off for now, maybe make a note for the future,they are looking to add seating at this establishment,thus the site plan review this afternoon. They have no variances listed on their permit, but they have 2 variances: 1. Air curtains without screen doors for outside dining 2. Allowed to hold food out of temperature. Thanks, Dave 1 z: Ilk BSC GROUP: Transportation■EtSE:<:y s i.0i?d t)t?*+eEapment "Vxs- 349 Main Street (Route z8), Unit D May 17,2019 West Yarmouth n t- MA oz673 Ms.Ellen Swiniarski Site Plan Review Coordinato Tel: 508-778-89T9 Town of Barnstable 800-288-8E23 200 Main Street Hyannis,MA 02601 w%iv.bscgroup.com RE: Site Plan Modification,Pain D'Avignon, 15 Hinckley Road BSC Project No.50253.00 Dear Ellen: On behalf of the Applicant,BSC Group,Inc. (BSC)is seeking to modify the previously approved Site Plan for Pain D'Avignon(PDA), located at 15 Hinckley Road in Hyannis, Massachusetts. The Site Plan,previously approved by the Site Plan Review Committee,permitted the annexation of the existing outdoor patio into the existing restaurant. This would have resulted in an increase of 6001 square feet of gross floor space. However, after speaking with a general contractor,the applicant has come to the realization that the restaurant would have to close for several days if not longer,in order to construct the improvements. In light of this,Pain D'Avignon has decided to revisit an old idea,which they had previously explored,but never acted on. Pain D'Avignon is currently proposing to construct a small addition(663t sq.ft.)onto the existing building, and leave the patio unchanged. The additional floor space would be utilized as a multi-function room with large screen television and fireplace, and a new entry area with hostess station. These improvements would enable PDA to increase its seating capacity to 133 people(see enclosed seating plan)and would also provide its customers with a higher quality experience. Pain D'Avignon has recently installed a new 2,000 grease trap,replacing its prior.1,000 gallon grease trap. The added size enables the restaurant to have up to 133 seats (15 gallons per seat). The added seating capacity would also increase the required number of parking spaces. Engineers PDA proposes to increase its seating capacity from 82 to 133,thereby increasing the parking requirement from 37 to 54 parking spaces. The proposed Site Plan provides a total of 68 Environmental parking spaces,which exceeds the local requirement. Scientists Custom Software As part of the recent Site Plan Review process, it was brought to light that PDA was Developers maintaining several parking spaces, either partially or completely within the layout of Hinckley Road. To correct this situation,PDA sought and obtained a Town Manager's Landscape License. As a result of this process,PDF is required to make several improvements within Architects the right-of-way as well as on private property(signage,paint striping,etc.). The proposed Planners Surveyors Ms.Ellen Swiniarski May 13,2019 Page 2 modifications to the Site Plan will not require any changes to the work associated with the Town Manager's License. This will proceed regardless of the outcome. Please do not hesitate to contact our office with any inquiries you may have. Very truly yours, BSC GROUP,INC. Brian G.Yergatian,P.E.,LEED AP Project Manager/Associate \\bscbos\yar\Projects-YAR\5025300\_PriCtrl\Correspondence\Outgoing\Town of Bamstable\2019-05-17 bgy LT Site Plan Modification.docx i REMOVE 3 GUT EXISTING PARKING 2 } PARKING 1 RETAINING SK-E SPOTS SK-S WALL AS READ. BOLLARD BIG TV O ENTRY EXISTING PATIO 77 SERVER AND 1/2 WALLS STATION TO REMAIN HOSTE55 1 O SK-E LA FIRE- MULTI PLACE CD FUNCTION 0 ROOM PATIO 460 Sa.FT. HALL C 0 0 2 SK-S ALIGN EXIT CO) MILK & EXIT 000 gr SUGAR GUT AND PATCH COD WALL TO MATCH 12'-0" 10'- 1 O'- 1 O" EXISTING RESTAURANT 1/2 WALL REMOVE Cu) COOLERS, SHELVES, ETG. ET- WINE Co. RED BAR .4 BOULANOF-RIE KITCHEN m O GL. WOMEN I MEN HGP. O KITCHEN n � N® SK-P2 Addition Plan for Chris Warner Architect off season gaming Scale:1/8"=1'-0" 208 Quissett Ave. Indl Woods Hole MA 02543 Preliminary Design Date: 05/10/19 phone.-508 -274 -0421 Pain D'Avignon email.chriswarnerarch@gmail.com 15 Hinckley Rd. Hyannis Project No.1807 3 1aa1 za2a Pv� �— Vote to accept Minutes: 1. Vote to accept minutes of the 3/09/2020 meeting. New Business: 1. Consent Agenda: Public Hearings: 1. APPLICATION OF A NEW ANNUAL ALL ALCOHOL COMMON VICTUALLER LICENSE AND NON-LIVE ENTERTAINMENT LICENSE Application of Hyannis Harbor Tours Inc. d/b/a The Landing Cafe, 230 Ocean Street, Hyannis, Kathleen M. Murray, manager for an Annual All Alcohol Common Victualler License and Non-live Entertainment license. Premise Description: Two story building containing approximately 4396 sq. ft. The Landing Cafe will serve breakfast, lunch and dinner. Hours of operation will be 6:30am to 10:00pm. The Cafe customer area includes a first floor with interior seating for 32 and an outside brick patio that seats 26. The second floor deck seats 34, making the total customer seating for the Cafe 92 persons. A separate meeting room on the second floor containing 49 seats will be used exclusively for Hy-Line Administration and Operations. No alcohol will be served in this space. All approved by the Building Commissioner on 3/3/20. Entertainment to include recorded music below conversation level and 2 TV's. Hours of operation and entertainment are 6:30am to 10:00pm, Daily 2. ALTERATION OF PREMISES ON AN ALL ALCOHOL COMMON VICTUALLER LICENSE Application of Pain D'Avignon II Inc.,d/b/a-Pain D'Avignon Cafe - Boulangerie, 15 Hinckley Road, Hyannis, Mario Mariani, Manager for an Alteration of Premises description of the existing premises. Alteration of premise is to include a new dining area with 40 seats with one additional seat in patio area. New Description: Single story building at 15 A, B, & C Hinckley Road, Hyannis. Approximately 8211 Sq. Ft. Cafe/Bakery serving breakfast, lunch, dinner and take out. 11 seat full bar, dining seats 80 and outdoor patio seats 20. Total inside seating 91; outside seating 20. Main entrance plus two French doors leading to outdoor patio and parking area, containing three exits. Additional exit into connecting bakery warehouse and several garage doors and side exits. Ali changes approved by the Building Department on 2/21/20 • 2 Y2, ��s I 3. NEW LODGING HOUSE LICENSE Application of American Youth Hostels Inc. d/b/a/ HI- Hyannis Hostel, 111 Ocean Street, Hyannis. Javier Bujanda, Manager for a New Lodging House License for 3 Buildings with 13 bedrooms and 47 lodgers 4. NEW LODGING HOUSE LICENSE Application of Karla Taylor LLC, d/b/a Lamb & Lion Inn, 2504 Main Street, West Barnstable, Lauren Wendelowski, Manager for a New Lodging House License for 10 units. 5. AMEND EXISTING CLASS II AUTO DEALER LICENSE Application of Cape Cod Carz LLC. d/b/a/ Cape Cod Carz, 153 Corporation Road, Hyannis to amend a Class II Auto Dealer License to include the location of 740 Bearses Way, Hyannis, for a maximum of 19 total spaces, inclusive of 16 display spaces, one Handicap space and 2 customer spaces per approval of the Building Commissioner 2/24/2020. Licensing Division Updates: 1. Licensing Department updates — 2. Police Department updates- • Matters not reasonably anticipated by the Chair The list of matters, are those reasonably anticipated by the president/chair,which may be discussed at the meeting. Not all items listed may in fact be discussed and other items not listed may in fact be discussed and other items not listed may also be brought up for discussion to the extent permitted by law. It is possible that if it so votes, the sub-committee may go into executive session. For your information the section of the M.G.L. that pertains to postings of meetings is as follows: Except in an emergency, in addition to any notice otherwise required by law, a public body shall post notice of every meeting at least 48 hours prior to such meeting, excluding Saturdays, Sundays and legal holidays. In an emergency, a public body shall post notice as soon as reasonably possible prior to such meeting. Notice shall be printed in a legible, easily understandable format and shall contain: the date, time and place of such meeting and a listing of topics that the chair reasonably anticipates will be discussed at the meeting. Meetings of a local public body,notice shall be filed with the municipal clerk, and posted in a manner conspicuously visible to the public at all hours 3 (clock in stamp) (TIMESTAMP ALL 3 COPIES IN TOWN CLERK'S OFFICE— LEAVE ONE TO FILE FOR OUR RECORDS-ONE TO POST IN TOWN HALL-KEEP ONE COPY FOR YOUR RECORDS). TOWN OF BARNSTABLE NOTICE OF MEETINGS OF TOWN DEPARTMENT AND ALL TOWN BOARDS As Required by Chapter 28 of the Acts of 2009 which amends MGL Chapter 30 A Licensing Authority Agenda In accordance with the Governor's Order Prohibiting Gatherings of More Than 25 People, issued on March 15,2020,and effective through April 5,2020,unless further extended the March 23,2020 public meeting of the Licensing Authority shall be physically closed to the public to avoid group congregation. Alternative public access to this meeting shall be provided in the following manner: 1.The meeting will be televised via Channel 18 rand may be accessed the Channel 18 website at http://streamiing85.townofbarnstable.us/CablecastPu blicSite/watch/l?channel=l 2. Real-time public comment can be addressed to the Licensing Authority utilizing the Zoom link or telephone number and access code for remote access below. Link: https://zoom.us/i/289421680 Telephone Number: 888-475-4499 US Toll-free, Meeting ID: 289 421 680 3. Applicants,their representatives and individuals required or entitled to appear before the Licensing Authority may appear remotely and are not permitted to be physically present at the meeting,and may participate through the link or telephone number provide above.Documentary exhibits and/or visual presentations should be submitted in advance of the meeting to Richard.scalintown.barnstable.ma.us,so that — , they may be displayed for remote public access viewing. DATE OF MEETING: March 23, 2020 Check below which one applies The Clerk's office has this meeting date already posted X This is a special meeting which has not been posted TIME: 9:30 a.m. PLACE: Selectman's Conference Room, 2nd Floor, 367 Main Street, Hyannis, MA r -A�l - .r•t'C V CCC��. - • �,y[F1z� �eri,�r�e� -.. • 7,q`/ - mE no do �. $ - LL 1raq� pit t - 5N � ) 1 S Sk 6'i9 l.Fi J Jt•� 1 ' � L➢/�ELtJfffC,rrP.�1F� \ � I ,, _.i �-y� I 1 Ll-p �- �a2-Eft r'f��• •'1—�"1J� � � , 7 11 6 C^ W L A, . a vv a j PAIN DAviGNON ARTISAN BREAD MENU BAGELS KALAMATA OLIVE - .. B O U 1 a n e r l E - C a f 2 Assorad each $0.80 1 di.$9.10 Rustic 1 Ib $4.95 Rustic $12_00._-- BRIOCHE Rolls - _ -_-_,-_- each $0.70 -1 dz.$7 95 SOUPf DU DOUR Pullman - - -- -- 11G. $5 25 _.. - Pulhnai� MARBLE RYE Seasonal4.50 Bul}... ........ . ... . ... each. $1.20 Lobster Roll -- - - - - - each $0.90 _....... .. Sandwich_. - - - 3 Ib - Dinner Roll each _. ._. $0 65 ... .... l.dz $7 40 LES SflNDWICfltSCHEESE MULTI GRAIN - .. - - _..._.._ _ unman ] 5 lb $4 75_...._-.. .. P SEW FPOID(served cold) SEW Ct1AUD(served hot) Rustic _ -- l lb_ - $47o Pullman - ----- l--.__- 25b 725 _-- ._-._ N � �� Rustic Loaf 2.5 6 $7 25 CHOCOLATE HAZELNUT Rolls each $0.70 1 dz$7 95 Rustic RoaLid l lb. $7,75(Fri,&Sat.Only) VEGETARIAN With your choice of.lettuce,cucumber, CROQUf MONSIEUR Black forest ham&gruyere baked on country bread. - Y) MULTI GRAIN LIGHT tomato,roasted eggplant,red onion,roasted red pepper, Served open-face.6.95 - - P CIABATTA .- _.. Pulhna.n _ 151b $475 porn ello mushrooms,avocado(seasonal), Gabatta _ _ l lb. $3.50 Pullman _ 2 516 $7 25 fresh mozzarella,feta&hummus, CROQUE MADAME Black forest ham,gruyere&egg baked on country bread. Ciabatta 3 l6. $9,00_ Ba ette each $400 __- Served open-faced.7.25 as _ - served onmulti-grain. 8.25 p C batta Pockets each $1.00 Ro Is each $0.70 1 dz.$7 95 .. P_ocket .....,. eac_h 1.00 ROASTED PROSCIUTTO Aru la&aioli mayonnaise on brioche 8.50 COUNTRY Bun each SOPRESSATA&FRENCH BUTTER gu y -._ _.. _ _ _- _ _ $1.00 Served on a demi-ficelle 6.75 Rolls each $-0.50 1 d_z$5.70 --- - GRILLED MARINATED CHICKEN Fresh tomato EV olive oil- Ruutc 1 lb. $3.50 PICHOLINf(GREE_N OLIV_f) _ _ WHITE ALBACORE TUNA With lettuce,tomato& &goat cheese served on a ciabatta pocket 8.25 Rustic 316. $9.00 Rustic TIE $4.95 Round __, 21b $6.06 Baguette.___ each $4 00 -- _ aioli mayonnaise served on multi-grain light 7.75 ROASTED EGGPLANT Arugula,shaved parmesan&garlic aioli Pullman _ - l lb. $3.50 Pocket _ each $150 Pullman 2lb. 6,00 S uare Rolls.- each $0.60 1 dz.$6.85 CURRIED CHICKEN Chunks ofgrilled chicken served on a simply white pocket 8.25 - - -- - - $- - a Long Salt Rolls __-_each $0.65_ 1 tossed with cashews,raisins,mayonnaise&curry KOBE BEEF BURGER With your choice of tomato,lettuce, served on a hand-made croissant 8.95 CRACKERS_,,_. __.,_ _ PIES _ onion, ru ere,feta,horseradish sauce&aioli mayonnaise, - _._ g Y Y Sesame _per 1 Ib $14.00 _Assorted,Seasonal _ each _ Market Price CHATEAU BRIAND Sliced tenderloin of beef, served on a brioche bun 11.00 PepperKoipj Thyme_ ..-..._- _.. per 1 l6, $14.00 served on a French roll with PUGLIfSE - PROSCIU170&MOZZARELLA Fresh basil,tomato& CRANBERRY PECAN _-_ Rustic __ _ 1 I6 $3_50 _ ahorseradish&green onion sauce Rustic 1 Ib. _ $6.00 Rustic - 3 lb. $9.00 EVolive oil served on focaccia 8.25 _._. .-... _.. __.. _._ _... _-- _ ---- Rustic ____ 3I6. $15.00 _ Rustic with Onion 116. $3.50 Rolls._ each $0.80 1 dz.$910 Pugliese DiSesamo 1 lb $3.50 n .- - _...._._. Lf S SA L�Df S plZZti Rolls no pecans-) -------- -- each $0.70 l d_z_ $7 95 PUMPERNICKEL _ Baked on our stone hearth ovens 3.95/SLICE FICELLE Pullman - --------- ------ - _ - Plain_ $2.80 Pullman -- - ---- 2(b _ _ ARUGULA With roasted pecans,cranberries,homemade DAILY: Margherita-tomato,mozzarella&basil Salt - $3.00 Pullman ___ _ 3 Ib $9 25 goat cheese crostini&aged balsamic 7.75 MONDAY: Diavolo So ressata-s is So ressata, Three Seed $3.00 Sandwich..... 3 I6_ ....... _.. P P Y P Onion $3,00. .._..._. _ .. .. CAESARCrisp romaine lettuce with homemade croutons tomato&mozzare a' Cheese $3.60 RAISIN PECAN ....... . Pum r-nickel $3.10 Rustic 1 lb $4 95 &shavedparmesancheese 5.95 TUESDAY: QuattroFonnaggi-pecorino, - P - mozzarella,asia o&bufalo mozzarella Rustic _ 3 lb. MEDITfRRANfAN With roasted tomato,cucumber,baby artichokes, g fOCACCIA Rolls each $0.75_ 1 dz.$8.55 roasted shallots,nicoise olives&feta cheese. 8.75 WEDNESDAY: Capricciosa-tomato,ham, Half Sheet(herb garlic, olive)_.,. _ 616 $27,.00 Pullman 1_5 lb. - - _ mushroom&mozzarella Sgld b pound.. . 116 $4.50 -Pullman 2lb. $9.00 GRILLED CHICKEN ADDED TO YOUR SALAD 2.95 Herb_Bun each $125 _..... ASSIETTEDEfROMAGfS Selection ofcheesesof the da served with THURSDAY: Prosciutto-prosciutto, Onion Bun _ each $1.30 RYE Y 316 Round(herb garlic,onion olive) each $15.00 Round(Caraway Seeds) 116. $3.50 cranberry pecan crostini . 5 roasted red pepper&goat cheese S • Y P Rolls(Caraway eeda) each $OSO__-1 dz.$5 70 fRIDAY' Carciofi-artichokes,asia o, fRENCH -- __ g - _ _ ___ _"- Pullman 21b. picholine olives&red onion Rolls.._. _. ..._.... . ........_._ . . each $0.50 1 dz$5:70 - -- - Point _ each $0.60 1 d_z.$6.8.5 _ Petite Baguette. each $2.80 SO Tl RISOZTGI� - .._ _.. PATISSERIE� LfS 801SSONS fROIDfS -LfS BOISSONS CtiAUDfS� Double Petite Baguette_ - - -each Round 11b. $3.50 Baguette __ 1 lb. $3.50 Rustic _ l lb. $3.50 Baguette 15lb. $4.00 Rustic 21b. $6.00 CROISSANT:(SMALL)1.95 (LARGE)2.50 SAN PELLIGRINO SM 2.00 COffff: - - Ba uette 2lb $4.50 Rustic 316. $9 25 TOASTED BAGEL W/CREAM CHEESE 1.95 SAN PELLIGRINO LG 3.00 SMALL 2.00 LARG 2.50 - - ... - --- - - ( ) ( q Pu hnan - _ 1 lb. _ $3.50 Rolls plain each $0 50 ]_dz. 5.70 - - PAIN AU CHOCOLATE:(SMALL)2.25 (LARGE)2.50 ACQUA PANNA 2.75 HOT CHOCOLATE: Pullman__, _.-- 2 l6. $6.60 Rolls(onion) each $0.55_--1 dz.$6.25 ALMOND CROISSANT:(SMALL)2.25 (LARGE)2.95 UMONATA 2.25 (SMALL)2.75 (LARGE)3.25 CINNAMON PECAN BUN 2.95 CHINOTTO 2.00 ESPRESSO 2.25 HAMBI IPGfR BUNS-- WHOLE WHEAT_ i _Plain _ __ _ ___ ___ ___ $0:85 Rustic _ _ _1 Ib. $3 7S_----- SCONES HAM 8 CHEESE CROISSANT 3..75 ORANGINA 2.75 CAPPUCCINO 3.75 Poppy Seed each $0.90 Pullman 2 lb. $6 00_. _ _ -_ - _ 2.25 COCA COLA 2.00 CAff LATTf 3.75 Sesame Seed _ each $0.90 Pullman 3 lb. -_. .. ---- ..._.. ._.. -- - SPINACH PIE 2.50 REPUBLIC Of TEAS(fLAVORS)$4.25 ICED COffff 2.75 Onto❑ __each $090 fPESH SQUEEZED JUICE 3.95 SELECTION Of TEAS: Hot doh _ each $0.65 (SMALL)2.00(LARGE)2.50 Sub RoII each _ $0.70 - Sandwich Pocket _ each $1.00 15 Hinckley Road, Hyannis, MA 508.778.8588 - www.paindavignon.com Counter: Monday through Saturday 7:99AM to 5:00PM Sunday 8:90AM to 5:9OPM Call ahead for large quantities , mail orders , and specialty items. Orders must be placed by 11 am .for next day pick-up 508.778.8588 www.paindavignon.com W r PAIN uAVIGNON rl - _. .._ _.- 6 o u I a n g e r i e - C d i e t _ -- - — - _rn 4 y ...rt _1 i •_ ; - AT Y:GNOCI I�AKCRY ` 1� y v fp - ~• I u .,s 1. 1J e snra,paaStnlrpynxu'.ouc�a,r'raijannznsasaxdspnpoxiixno3o ale$wx�o ox Pau!uitnoa axe a su"Ao yvsay a1101s u,irt,ep P7149 f Nraatg pue xn. °}l i — iFes eas 3o y esrq a nm ne pile a1HW'4 3sotu sn ut paAoCeu vac�m�iraq st pcaxq Styx 3a�q xno sc g•papadsax Puce 1 u T 7 } r RaxanR. VW peaxgjo�it'ssajaum'iayx aou$fAYQ uiyd xy Nr x i r +� `. .,— ' ( t@9L9 tlF1 s�uueSN F 3 ode ] a F' NONIJ` Iil; - t _ a Pain D'Avignon Bakery is located at 15 Hinckley Road, steps away from the airport rotary in Hyannis, PAINT�,7D*AvIGNONMassachusetts.Every day in our 15,000 sq.ft.,state of the art facility,we bake our Artisan breads,croissants,pies and rl, k'+Ipastries for many of New England's finest hotels,.restaurants, and specialty shops, including the.Foxwoods Resorts, B o u l a n g e r i e - C a f e Whole Foods, and The Market at Pine Hills. Over the years our dedication to old world values of Artisan bread baking has been recognized by both the regional and national media. However, we are most proud of our long term Directions from Boston : commitment to the community of Hyannis and to our loyal customers all over Cape Cod. Take Route 6 to exit 6,turn right on Route 132(towards Hyannis), 6 4-'..4t' and proceed approximately 6.5{Hiles(past the w� Cape Cod Mall and nearly into the Airport Rotary). It is with the same pride and commitment that we —Special Occasion?— .........$os PAIN D IGNON Turn left at the Chicago Uno's Restaurant onto Hinckley Road. � �•-�•�t g Y announce the opening of the Pain D'Avignon Cafe and V�Ie offer catering for our office events and for �oVt Pain D'Avignon will be the last building on your left. Boulan eie. In keeping with our commitment to g Y g P g private home parties;or rent our cafe with indoor and Directions from P r o v i n c e t o w n : excellence,our cafe is open 7 days a week,offering European outdoor seating,42"plasma TV,and stereo system for ¢� Take Route 6 to exit 7(Willow Street),take a left and proceed style breakfasts and gourmet lunches, as well as early straight to the first traffic light.Take a right on to Iyannough Rd(Route 28). your office parties,business meetings,holiday fare and take-away.� y.otyce2a When you reach the rotary take Route 132 and turn right onto evening parties,dinner parties, and networking events. � Hinckley Road(just after Chicago Uno's Restaurant). Pain D'Avignon will be the last building on your left. In addition, we offer an amazing selection of imported We welcome advanced phone orders for next day 15 Hinckley Road cheeses, pates, olive oils, and various gourmet retail items. pick-up of our breads,croissants and pies. We will Hyannis, MA .02601 508.778.8588 Take-away orders : even take our hone order and it UPS or Please call: 508.778.8588 Enjoy your food and beverages at one of our intimate.cafe Y P P Y www.paindavignon.com Wholesale inquiries and orders : . tables inside or outside. Or, have a seat at our communal FedEx to anywhere. Please call: 508.771.9771 table, and catch up on today's news and sports scores with Now serving Dinner! our 42"plasma TV...and bring your laptop;we are WIFI We look forward to serving you! 7 days a week: 6 PM to 11 PM BonAppetit! Wine — Beer & Entertainment ---- RIM=50.t �, 50.2 (�:_�_-�--_ __^ - � \ I, ARNST E RD AIRPORT r ---..� ----- �_ __-:;-----.. BAf?NS FABLE ROAD �-----" BLlp T LOCUS INFORMATION (50-W/DE-D/SCONT/NUEDCOUNTVWAY) f SMH LOCUS p 49.5 ZS� .-.. _ � _ \\ RIA9=46.7 } 9�� N C �E) CURRENT OWNER: DON LLC U PO RIM=48.3 S - - TITLE REFERENCE CERT 210561 . --..-.- 83?011_._E 67.56' (235't By DEED) �.w-_'T_- =- -a h SIGYJ <:h \�� WG a VC \\\ WG PLAN REFERENCE: LLCPP 11519PLAN BOOK 58, PAGE 75 132 `- 49.5 X "mTI111�;n1111 / CRASS - p h "pZ BIT. ilirll? PIlTi1'� .-- - `^„--- \ ASSESSORS MAP: 311 28 J+� h 1�1TiTITR I O O .-- 20 1 1_may__-16�.44. 2.2' �� EfJD OF PARCEL' 020 �! PARh�NSPACES CONC. __ METER 4i'i. a TR7\ll GRnss lil'1,Tiii It1 t t 1. gIlTR a - -' ��N��ALK _ 9 COUNTY N ^ (/JOT SURVEYED) \ \ IT41 11 TTRAIT IRR 1 Pr�pT `� I i CA POUT ZONING DISTRICT: B �O �\p� �111T,T1T� l�- �- �.` / SETBACKS: DENT 20' NOT TO SCALE LOCUS MAP \ Q ` r G, E)•"I�T�NG' ..^RAMP REAR 0' 2.0D0 CAL. t m _ 1 / 1 W 49 0 c:--5E TRAP 1�� OVERLAY DISTRICT: IMP a1DF GRAVEL 600-GALLON DRYWELL - t" (BURIED ACCESS) v` $_�N w II ( I NITROGEN SENSITIVEPROPO po4' O\ PAINT STRIPING INSIDE B'Xe'BED OF )V N �^qSo v`M ZONE: ZONE II s YERWMN PARKING AREA IN USE STONE CBS - / `n+1 �T FEMA FLOOD " CIVIL i I SPACES O BIM SIRUCTUREa44.0 RRd=47.1 .£ /V g REMOVE IXISTINC _ / ZONE DISTRICT: "X", DATED 7-16-2014 g•AF E� (Nar suRt�Ytro) _ PAINT STRIPING BTM STONEm93.3 PANEL 25001 C566 J OI _ INTERIOR LOT \ ullll _z VAL�b GRAVEL 2 =NES 1-y1pt�',�r 11,t11111 t 1',1 Itt t••`.: PROPOSED PpRISciN°Nc -=-(hby /RF=.� i ..-7(49 p MINIMUM LOT SIZE 0 S.F. ro J \ 1--L .Inrl Illlulll 1 Blr. % 47.6 1 6in c•"� .. ELE. �Lt-,tt,to ZD IXISTING LOT SIZE: 36,355f S.F. METER: \I--7/,- - RArr.F q _ � \ MAXIMUM LOT COVERAGE: NONE 1_!L., '�/I-�_ Sta•Z (� ANK\� Y ' ' L._ 3, ` 48. _�J 6'HOSE T - i 1)711iE uNE �m \ LANDSCAPE BUFFER ALONG STREET: 10' �{ I D OF SOLID C- v �- S-2.Ox V GB ,T I�1�J RIM=47.3 / q� m \ BRIAN G. YERGATIAN DATE . ' 31t355t`SF. / SED PROFESSIONAL ENGINEER PROPOSED _ PAINT STRIP/C O EXISTING PAINT STRIPING CB \ �CB (TYPE) D 1-STORY (TYP) IM=47 [] LOADflJG AREA METAL BUILDING -.:y kIM=48.3 /t nrsrFLOOREL. 51.2 �\ cwi ^' mcEofo6sn"cKD / PAIN DAVIGNON i 1J0T SURVEYED)- ,. � T -_ "- MH C\ TRAVEL IANE - / ` PROPOSED.a ' RIM=48.4 \2s (TIP.) I BUILDING ADDITION RETAINING .6633 SFf / PROPPOSED FtANDICAP WG -------J� IMPROVEMENTS 1TALL NIF .��q t PARKING SION(TYP. U \CFJ a l \i HYD RIfA=�9.1 TOWN A OUCH ROAD -=``?w / / l i' 606 IYANNOUGH ROAD ASSESSORS MAP 311 PARCEL 015 - �:=-/ f i PROPOSED 15 HINCKLEY ROAD PATIO 11 / \ / / PAINT SIR/PING .. / (TIP.) f zD• ,y IN 8I7 PROPOSEDYACONIC. 50.2 LINE N NIS OFF EDGE Q�TRAVEL LANE MASSACHUSE TTS 71i -'L,n'101 I t nl'Ilnll Lp�,,I CAR �..`!/ (BARNSTABLE COUNTY) 51.i 49.4 S 7D Oj -� EMO E%IS,IN CONC. ` V i C'aP sYMBo( i SITE PLAN PROPOSED SIGN NO PARKING ALONG EITHER GRAVEL I GRAVEL NAF / SIDE OF ROADWAY _ / JOHATHAN J. CARLSON 0' / NOVEMBER 28,2018 27 HINCKLEY ROAD / ASSESSORS MAP 311 PARCEL 019 I BEGINNING OF PARKING AREA X 50.1 6'6"O OFF ED WH DDE OF GE 4 SPACES TRAVEL TANS REVISIONS: (NOT SURVEYED) PAR.'G S AREA 1 SPACES / / (NOT SURVEYED) / N0. DATE DESC. 8 1 /1 /19 PER STAFF COMMENTS 0 ,# 2 3/13/19 GREASE TRAP &PARKING 3 5/17/19 NEW ADDITION GALVANIZED ALUMINUM REFLECTIVE SIGN PANEL WITH 4 5/28/19 PARKING REQUIREMENTS SELF ADHESIVE,ENGINEER-GRADE,REFLECTIVE VINYL SHEETING.EDGES TO BE DRESSED.PROVIDE SIGN PANEL&PRE-PUNCHED MOUNTING HOLES IMAGE TO BE SURFACE INSTALLED.SELF-ADHESIVE 12" BIT.CONG ENGINEER-GRADE,NON-REFLECTIVE VINYL 3•-z" 0 HANDICAP ACCESSIBLE NI GRAD ZONING SUMMARY.'(Barnstable,MA) PAMP(TIP.) PRECAST TONG DRYWELL H-2-20 N TO MEET VAN ACCESSIBLE LOADING CLEAOUT - ZONING CLASSIFICATION: B PARKING SIGN(TIP.) SIDEWALK FILTER FABRIC SPECIAL PLATE - WIDE o 0 - 0 INLET "� REQUIRED DIMENSIONAL REQUIREMENTS: REouIRED EXISTING PROPOSED • TRAFFl PLANS WHITE YP.) o o - - 0 MINIMUM LOT AREA(CONTIGUOUS UPLAND) N/A 36,355t SF 36,355t SF PREPARED FOR: ONES WIP , .o UNAUTHORIZED MINIMUM LOT FRONTAGE 20' 419.4t' 419.4:t' PAIN D'AVIGNON VEHICLES MAY BE MINIMUM FRONT YARD 20' 2.2' 2.2' a o 0 0 1-1/2'CRUSHED STONE _ REM°VIXPA�TT�WNETtS 15 HINCKLEY ROAD EHVELO UE IN PERMEABLE MAXIMUM BUILDING HEIGHT 30' <30' <30' HYANNIS, MA 02601 ACCESS PAINT 3_O. ) S OR APPROVED D EQUIVALENT 140N, •t ATCESSIBLL � o 0 0 OR APPROVED EWIVALFNT PARKING O S o3 0 0 0 0 o FRONT LANDSCAPE BUFFER 10' 0' 0' SYMBOL(IYPJ I`-� ei o 0 0 0 2"x2"GALV.STEEL 4•TO END NBE SET IN PARKING SPACES SEE PARKING TABLE BELOW C (/�" OF PARKING APPROX 126DAK B.Y� T�� SPACE(TIP.) 36"DEPTH PARKING REQUIREMENTS: V V 6'of CRUSHED FINISHED GRADE REQUIRED EXISTING PROPOSED 349 Main Street-Route 28 _ STONE BELOW DRY CURB MN e'-o'--- MIN WELL "ON-SITE" PARKING LOT 24 21 (VAN SPACE) (MIN) (VAN SPACE) ' ` West Yarmouth,Massachusetts 12' s'-6" 12- VAN ACCESSIBLE "OFF-SITE" PARKING SPACES 12 7 02673 ACCESSIBLE PARKING PAVEMENT LEASED PARKING SPACES(ADJ. TO SITE) 39 39 508 778 8919 MARKING SYMBOL 12" ACCESSIBLE PARKING SPACES 12(1 VAN) 1 (0 VAN) 2 (2 VAN) ©2019 TI,,BSC Group,Inc. NOTE: ACCESSIBLE SIGN & POST TOTAL PARKING SPACES 45 76 67 SCALE: 1" 20' PAINTED PAVEMENT MARKINGS DRY WELL (SMALL WITH BURIED ACCESSZ ACCESSIBLE SYMBOL SHALL BE TRAFFIC PANT AND (VISITOR SIGN & POST NP.) ' CENTERED IN STALL REQUIRED PARKING= 1/3 SEATS+1/2 EMPLOYEES+ 5/TAKE-OUT AREA ACCESSIBLE VAN PARKING SPACES SCAT F•"°"E PAINTED PAVEMENT MARKINGS ACCESSIBLE 107 SEATS, B EMPLOYEES, &1 TAKE-OUT AREAS= 36 + 4+ 5= 45 0 10 20 40 m SCALE NONE FILE P:\5025300\CiMI\-DraMngs\5025300-SP.deq PARKING SYMBOL & ACCESSIBLE PARKING SIGN DWG.:6553-01 SHEET OF , SCALE:NONE JOB. NO:5-0253.00 S _ i h�'/U �Ov✓ LInji 44 I r +� $A4. — _ Poll, Lou ViJ LJ LJ U LJ / 1 I 40 j l I I a I . . I L. `y [ j I -,�p(^�'�,� ,off -��Q. ��Q I , , q I. u ,I T.1, SN�iL'9�t+QE AIN Lr C� � C�91/N7Ei2� 1 � ca 9(GI�f - 1 • 1 . . .. 117 Owl Lou L Li Li U , 1 - - a 1 I 1 _ I I 1 e _ - T (1. i It 11 q 1. • tiv, fv�aI"/ 44lk Cpl. cs,fi r,de do 4y - c�• o ,p, �QToP 8�- - � yj09 y � � Y � 'j ' .. - ' IT,R?'� J I 11 qk 'i° � I •off � AW4 �I _ J_. 1 EL.= 100.0 (ASSUMED) ENLARGED VIEW BELOW 7VP OF PoUNDAT/ON RISERS fY/TH CAST IRON n RING AND COVER 717 GRADE _ PROPOSED 1000 GAL GREASE TRAP PA VED XA V APPROX LOCATION 98.11 tEL, 98.1 67 60' i OF EXISTING MANHOLA , , A K'AY PROPOSED 4" PVC SEWER PROPOSED CLEAN OUT EL,=97.4 PROPOSED 4" PVC 4" CAST IRON PIPE 0 0 O X 98.1 SEWER CO NECTION (OR EQUAL) MINIMUM PITCH 114 PER FT '6 ;4" SCH. 40 PVC SLOPE = 29TINOg4" SCH. 40-PVCMlN.EXISTING BLDG. 719P OF FND.= 100.0 (ASSUMED) g , � P� SO. IN� 7 0 MNEL- ___ 45 SCH 40 PVC ELBOWS CR\ 97.4' bo INVERT EL.=95.7 EL.=91.9 12" Y CONNECTION o EL.=_9_6.0_ (M BE PLACED ON,""BASE) TO EXISTING 6" PVC SEWER LJ1 MECHANICALLY COMPACTED OR B" OF S7VNE __jQ00__GALLONS BLD 0,15 \STEPS PROFILE OF GREASE TRAP \\ STEPS PROPOSED SYSTEM SEVERAL BUSINESS UNITS \ ASSESSORS MAP 311 NOT To SC \\ PARCEL 20 99 �O �P��N OF 4f,4 EDWARD L. o�G ASSESSORS MAP 311 PARCEL 20 PESCE t PLAN REF L.C.P. 11519 SHEET H o CIVIL PLAN BOOK 58 PAGE 75 No.32001 ;; DEED REF 178088 STEPS \ 4 A90 9 Q/8 EA�� ZONE: "B" AL GROUNDWATER PROTECTION \\ �� 0 VERLA Y DISTRICT GP 06 y� NOTE: THIS PLAN BASED ON MORTGAGE PLAN OF IN,��PECTION PLAN 9127105 PROPOSED GREASE TRAP AT v' 15 HINCKLEY ROAD, UNIT B ' HYANNIS, MA. ENLARGED VIEW PREPARED FOR., SITE PLA N NOT TO SCALE LATE JUL Y ORGANIC SNACKS SCALE: 1 "=40' PA VED WAY LOCATION APPROX MANHOLE JANUARY 25, 2006 EASE TRAP OF EXISTING REV 1000 GAL GREASE C SEWER 4 PVC REV PROPOSED OSED 4 PV PROPOSED WALK WAY PROP CONNECTION - ------------------------------------------ ----------------------------SEWER TINGVjf REV --------------------- _ _ - - ------------------- 97• Ex�C S PESCE ENGINEERING & ASSOCIATES ------------------------------- --- ---� , iii o0o i .! , . ii / ' '.! . . ii / 7 '.!;`. iii � '.'.! 451 RAYMOND ROAD _o x_ se.l AMP ASSUMED PLYMOUTH, MA 02360 ! p OF FND - IO0 0 ( % ' ' EPESCE@ADELPHIA.NET EXISTING BLDG• TO PH.(508)743-9206 SHEET 1 OF I J# 54030 i -114 Z4 / f J-1 ":l�r1 •� Y-� mp n o a oD Q toC"hFE 5e4�.1c , � � � yme:5� ' • -vi N9�''/1 ft` , y 1 iYl . `,`1 Ar—_ 5 N: CR, co t 1101- 1 _ 1 , + ' t- ➢ Tw tv ley t t ' L t c) ve-�d-t L ce V-\s fek�Cll � � ' / r k � co Lr VE i, �c N Q i"ee SA f, t� - � 1 oil lin Lou 1 ► . . is oc# 1 ,. -� 77 M _ , 1 REVISIONS— BY i i L41�t-tpv Gr, (),410 v r - - f0"� `9 z .c.1N ja?,j&f(6fj&L- 91(,1gtfoC-T P?>°UI LD1"Ci COPE_ .. au -a,-�tA brie iv Nr c. ��•{Eo n(�1, - tZacb Goy Qt t►1 Cy 20010 — r —LoofZ 16 4NDI41r^Cc�55igiL+"vto it A LAP-bA /.Y,e-rt-M. I ( tub 5a-2� � `o ( LUM.pc;t_L r ru° 2 lyp gM �I �iy,�fi f G�i�R c w - i L_ _.._ ' I i Cow, r a 7�6 - �� s CA55d fi� OF LAR YpUN At_uMjNuwi - - 6 tM Fob NO. f Zo t7. sew ASJob f19 �J p A-2 _ Of "> Shoats MRM IAno0111"0..0001 CIfW1rMt- REVISIONS BY Gmrc Amp 1)0")d5Paa1- RkfaG3R R-�uG Jr�y,.tic - --- t Z�c� Mt .L �+ cy-t Oct s �. 112 t,, i -2Xlo rRE L�I�rGTRfA,'r�I)121L(. v { z r-L 3c CE u 12 ou -10 ,;fit cI: r>ov�D a z ��A' "w f�u Av l tod,fz7pfr' tCt trou '1 at o i =7t3 _... O ' LOW 1,wq- f5u GlVICrK)04 t is d 114aLq Q�M OF aA�W vo N ow �i 2ot7 NO. 8 AG r'- tcs�skAo.+` Drawn L euq Job shoot m.3 s i REVISIONS BY i GT j t rti 4 r f t: i 111 .'._ _'_- - a` W _. s uil �UN(y=kfi}oK�. ° t LL t. ¢ ¢ riL,i_ Ikj c \jc11,, r, J�tHOF Dab?� ,. ,...,.,. .-.. - -__• _. _.,--....._ - - ._...�4J_L.hUGI� orb LARRY 2Cf YOU SWaL) I.9ur�D Drawn t ONa� i Job i 8baaf Or 3 8Mab • a ,4sIN4 1601 -01 1 , Aten,gegfe�- f 161 DOUCE SHTRRj I PROD R 4VXI 16'-� PAST � rreezer cooler p 8X 12 LOADER 4X1 `p H x 9 Q Y 18' 54' CQOLE 7 . 8X 12 LOADER 4X1 + 5"�$ oV 0 LOADER4X1 MIXING 8X 12 LOADER 4X1 - OVEN 41 WC kML itchen 14.5' o 4 l 30 -0°° �. OFFICEIJ � J � l� ! . i i f __________ :I SMH _____________. - BARNSTABLE RD AIRPORT _ LOCUS INFORMATION BARNSTA-BL-&-H--DAD (50"WIDE-DISCONTINUED COUNTYWq Y) �,7 5 P _ SMH LOCUS 49.5 o ys __ % �\Rt�4B.3 / CURRENT OWNER: LION LLC F" .. S 83'2 twl� _ _—_-- ___ ® TITLE REFERENCE:.. -- 0.1_11"E_.._67.56, (235'a By DEED) _ -----9 p SIGN •h<.p \ WG ® IVG CERT. 210861 _ --._._ G PLAN REFERENCE: PLANT BOOK 58, PAGE 75 09,P O 132 28 BIT. �. n1Tl'(>m cm O _.-._N 83'20'11" I \ \ ASSESSORS MAP: 311 28 ysT PARKING AREA CONIC. I GA_ TTDTM O TR1�111 �--' � �+ 13 SPACES 2 mI• GRA55 1 \ \\,\ \, 16--"/-- CONC. WA 2Z \ CI, HTY PARCEL 020 ME TER, ''RT\il 11T111 \\\ \ WALK 9 (NOT SURVEYED)- J Tlil \ '1\ \.\p /\A LI YOUT LOCUS MAP PO N _ \ 11\ 1 1 / \ I ZONING DISTRICT: B NOT T°SCALE / I v \ SETBACKS: FRONT 0' SIDE 0' Gt E:i S71iv'G RAMP REAR 0' _� 49 O U� Cic'A_E TRAP \\ iA\ L'---r — '_ I OVERLAY DISTRICT: WP p /n 600-GALLON DRYWELL � �p � lOF GRAVEL _ O\� PROPOSED (BURIED ACCESS) - g�N - I NITROGEN SENSITIVE Ot PAINT STRIPING INSIDE B'XS'BED OF �j A_S ( w ZONE: ZONE II ORNN G „ PARKING AREA !g CRUSHED STONE I SPACES o\O (�.) STM S6.0 _ Cam - I -D� \i1 I D FEMA FLOOD o YEN NTWV REMOVE EXISTING BIM SIR CTURE=44.0 P.lM-4/.i 1 (NOT SURVEYED) BTM 51QNE=4a5 - J 0�.,/ 4' ZONE DISTRICT: "X", DATED OIC566 J PAINT STRIPING ANTERIOR \ 1 p8 PANEL25001C566 J GRAVEL a ti - �O�DNES — W\-L,L mall'\ \D\p PROPOSED SIGN g� ZCB Ia (n �s•T/oNAI�� \ --L\\ \ILIW—, �_' /� \ 9 0-4 MINIMUM LOT SIZE: D S.F. J � NNtT�O NO PARKING RIId= �" WG6 `�\\ \1\\,\'1\ u\I' \ \" CONa 47.6 7 .'U"A—" iD \ EXISTING LOT SIZE: 36,355t S.F. g METER _ \ Q] \ MAXIMUM LOT COVERAGE: NONE BANK ,� y F= .).a 48, y� END aF souD j 6•HDPE v ITE uNE m LANDSCAPE BUFFER ALONG STREET: 10' a 5 2oz CB I� A� E°F ^.S \ BRIAN G. YERGATIAN DATE _ 7? p,)M=47.3 \ 36.355xIS I _ PROPOSED PROFESSIONAL ENGINEER eP.^ EXISTING PAINT RSiRIP/N�G CB I PAINT sTRIP1 1; OCB (TYP.) 1-STORY (TYP) IM=47 [t9f RIM=48.3 LOADING AREA = METAL BUILDING FIRST FLOOR EL. 51.2 y �• a, /� c c t�'� EDGE OF EXISTING (NOT SURVEYED) � •,•r —4t3""� FA,H�i� S TRAVEL.LANE I �� PAIN DAVIGNON =..I LNG 5ED9 ,.- kRA=48.4� (Ti'P.) _--_ suILDWc ADDrnDH / �� RETMNlNC -683t SF� PROPOSED XAN DICAP +' PARKING SIGN(TYP. WGm-��' 5� IMPROVEMENTS N/F ;"^ .� ..�>ti. ) 48.7 �, SMH 4 f\eJ TOWN OF BARNSTABLE -::, / HYD R1Ai=49.t 606 IYANNOUGH ROAD J - �- O ASSESSORS MAP 311 PARCEL 015 PROPOSED 15 HINCKLEY ROAD PA TiO O / PAINT STRIPING !�� (�) IN Ci `� :.' �� f ,L HYANNIS W L?;1 �po f . BIT. 8.@• \ r�lDV` / PROPOSED Wf CONC. 1 1 ll l 1 11 v / 6'O EDGE E OF D2 _ &°' 9.6• G / 6"OFF LANE OF TRAVEL LANE MASSACHUSETTS II IIII I;f ll1' J3 � 1 _ (BARNSTABLE COUNTY) I 51� 5i.'r..',' Ul\I;11'.,ull I\III ETEP^ ��'� I� 49.4 � f Blr. 1 ._ 3 7p 0737.Eq� EsnN/ " HAd AP SYMBQL // ` SITE PLAN PROPOSED SIGN / NO PARKING ALONG EITHER GRA VEL GRAVEL N `--- / / SIDE OF ROADWAY - - JOHATHAN. CARLSON ''/C / / .. 27 HINCKLEY ROAD NOVEMBER 28,2018 ASSESSORS MAP 311 _ PARCEL 019 L try �. /, II / BEGINNING OF PARKING AREA ! (o // SCUD N};ITE LINE X 50.1 6.OFF EDGE OF 4 SPACES PARKING AREA TRAVEL LA REVISIONS: NE RE DATE DESC. (NOT SURVEYED) 6 SPACES / (NOT SURVEYED) 1 1 01/14/19 PER STAFF COMMENTS 14 f - 2 03/13/19 GREASE TRAP &PARKING 1 3 5/17/19 NEW ADDITION GALVANIZED ALUMINUM REFLECTIVE SIGN PANEL WITH SELF ADHESIVE,ENGINEER-GRADE,REFLECTIVE VINYL SHEETING.EDGES TO BE DRESSED.PROVIDE SIGN PANEL&PRE-PUNCHED MOUNTING HOLES IMAGE 10 BE SURFACE INSTALiFDJ SELF-ADHESIVE 1Y ENGINEER-GRADE,NON--REFLECTIVE VINYL BIT.CONG HANDICAP ACCESSIBLE FIN( AD 1 Q RAMP(TYP.) PRECAST LONG ZONING SUMMARY.-(Barnstable,MA) DRYWEII TO VAN ACCESSIBLE MEET H-20 ZONING CLASSIFICATION: B PARI(INC SIGN(TYPJ SIOEWMX LOADING CIFANOUT I FILTER FABRIC I SPECIAL PLATE o 0 0 o INLET REQUIRED DIMENSIONAL REQUIREMENTS: •WIDE TRAFR ) REQUIRED EXISi1NG - PROPOSED PAINTWHITE UNES o 0 0 0 MINIMUM LOT AREA(CONTIGUOUS UPLAND) N/A 36,355E SF 36,355t SF PREPARED FOR: ES HITE o •i UNAUTHORIZED MINIMUM LOT FRONTAGE 20' 419.4t' 419.4t' PAIN D'AVIGNON I V6iICLES MAY BE o 0 0 0 0 1-1/2• R SHED STONE REMDVED AT OWNERS MINIMUM FRONT YARD 20' 2.2' 2.2' 15 HINCKLEY ROAD 3'-0•(TYP) •I o 0 0 0 o ENVELOPED IN PERMEABLE ') TRAFFIC PM NT GEOTEX,ILE MIRAR 140N, '� EXPENSE MAXIMUM BUILDING HEIGHT 30, <30' <30' HYANNIS, MA 02601 ACCESSIBLE • O o o a o OR APPROVED EQUIVALENT PARKING 3 3• ) Q FRONT LANDSCAPE BUFFER 10' 0' 0' SYMBOL OYPJ PRO 2"x2"GALV.STEEL I PARKING SPACES SEE PARKING TABLE BELOW 4'TO END - o 0 0 0 •( CONCRETE IN - C(/'�' (/'q"�/� OF PARIONO I i1 36"DEPTH 1Y DIA.x Y BSA GROUP )UP SPACE(TYP.) III 36"DEPTH PARKING REQUIREMENTS: 11JJ V iYlOZ�J 6"OF BRUSHED FINISHED GRADE REQUIRED EXISTING PROPOSED B'-0• B'-0• — STONE BELOW DRY 349 Main Street-Route 28 B'-O WELL I� "ON-SITE"PARKING LOT 24 22 CURB MIN. (MIN MIN. (VAN SPACE) (VAN SPACE) \12• S'-6• 12" West Yarmouth,Massachusetts `, VAN ACCESSIBLE "OFF-SITE" PARKING SPACES 1 12 7 02673 ACCESSIBLE PARKING PAV Mrnn' 12" LEASED PARKING SPACES(ADJ. TO SITE) 39 39 508 778 8919 MARKING B� •./ ACCESSIBLE PARKING SPACES 2(, VAN) 1 (0 VAN) 2(2 VAN) ©2019 The BSC G—P,Inc. \ NOTE: / ACCESSIBLE SIGN & POST TOTAL PARKING SPACES 54 76 68 PAINTED PAVEMENT MARKINGS DRY WELL (SMALL WITH BURIED ACCESS ACCESSIBLE SYMBOL SHALL BE 7RgFT C:PNNT AND �Q$ITOR SIGN & POST TYP.1 SCALE: 20 cEP17FRED IN STALL REQUIRED PARKING= 1/3 SEATS+ 1/2 EMPLOYEES+ 5/TAKE-OUT AREA ACCESSIBLE VAN PARKING SPACES :"°"E D40 SCALE:NONE PAINTED PAVEMENT MARKINGS ACCESSIBLE 133 SEATS, 8 EMPLOYEES, &, TAKE-OUT AREAS 45+ 4+ 5 54 O lO zo ' FILE P:\502530D\CiN�lraxings\50502530300-SP.dng PARKING SYMBOL & ACCESSIBLE PARKING SIGN DWGSCALE- .:6553-01 SHEET I of , JOB.To.5-0253.00 50.2. 0 SMH RIM=50.1 BARNSTABLEROAD O BARNSTABLE RD AIRPORT 49.5 (50"W/DE-D/SCONTWNUED COUNTYWAYJ �y� SMH LOCUS INFORMATION 9 RIM=48.7 �2 CB :. LOCUS � 48.5 RIM=48.3 @W 9�` N oHw------ � oHw------- CURRENT OWNER: LION LLC F S 83•20 11" E 67.56' (23t Ely DEED v oHw----_._ SIGN �y��' WG ® WG �' WG TITLE REFERENCE: CERT. 210861 ?_ 49.5 GRASS p 132 28 PLAN REFERENCE: LCP 11519—H BIT. $3'20 11 PLAN BOOK 58, PAGE 75 �9 PARKING AREA CONC. y. GAS GRASS W 167.44, 2.2 END OF 28 �ys� 18 SPACES METER CONC. WAS oy 9 COUNTY ASSESSORS MAP: 311 y (NOT SURVEYED) / ,-LAYOUT PARCEL: 020 <1% -_. _ ZONING DISTRICT. 13 LOCUS MAP �� w SETBACKS. FRONT 20 NOT TO SCALE a 0 N RAMP SIDE 0 X 49.0 �`N � �y� ? REAR 0' GRAVEL OVERLAY 'DISTRICT: WP OF JW4 PARKING AREA �Zrz CBS cry\ NITROGEN SENSITIVE 11 SPACES O` '� ZONE: ZONE II (NOT SURVEYED) RlM=47.1 J YERGATIAN : A BRIAN G. 1 2 ti FEMA FLOOD Io N "'� ••.... , ERIOR LOT �`$ o ZONE DISTRICT• "X", DATED 7-16-2014 v CIJIL LINES /CB ✓ (f No.46206 GRA-VEL •. �- •.... ` �'"^k8 BIT RIM= �---49 O PANEL #250010566 J o��FGIsTP�,\a``w/ •.. cp J " O / 47.6 ONW C� �'�sSl4NA1-F � 3 V, EXISTING ELE. WG CONC. Z�, MINIMUM LOT SIZE: 0 S.F. 1-STORY METER RAMP �' ___ -�' M EXISTING LOT SIZE: 36,355t S.F. A Q METAL BUILDING BANK o\��t 48.8 M FIRST FLOOR EL. 51.2 �. : . . .•: • . • - - MAXIMUM .LOT COVERAGE: NONE CB l,� rn LANDSCAPE BUFFER ALONG STREET: 10' t A RIM=47.3 36,355t S.F. BRIAN G. YERGATIAN DATE PROFESSIONAL ENGINEER EXISTING • CB ZRIM=48.31 B 1-STORY _ • RIM-47.4 � -- ©METAL BUILDINGQ ` •,. -. LOADING AREA PROPOSED HANDICAP BIT. FIRST FLOOR EL. 51.2 0 .. PARKING .SIGN (TYP.) GONG. .; . (NOT SURVEYED) . .�-- 48 - MH � -� RIM=48.4 00 WG PAIN DAVIGNON RETAINING 48.7 ® SMH 91 IMPROVEMENTS NIF WALL ,: HYD RIM=49.1 , .TOWN. OF BARNSTABLE • . •, _ ' 606 I YANNOUGH ROAD PROPOSED . BUILDING ADDITION ," �L�'. 00 ASSESSORS MAP 311 t D ._ �4 20' X 30' P PARCEL 015 ME � m$ TR ` n 600-GALLON DRYWELL 5 r f ) 5 HINCKLEY ROAD (BURIED ACCESS) 6" HDPE o �� ZONING SUMMARY- Barnstable MA 2.0 INSIDE $'X8' BED OF L=10' � � � � � ' ) 1N BIT. CRUSHED STONE S=2.07r y> � INV.-48.0 k � g s, ' CONC. � � , 50.2 BTM STRUCTURE=44.0 �o 9.68` `►� ZONING CLASSIFICATION: B BTM STONE=43.5G HYAN N I S DIMENSIONAL REQUIREMENTS: MAS SACH U S ETTS GAS REQUIRED EXISTING PROPOSED 5� 51.1 '''- METER BIT. X 49.4 MINIMUM LOT AREA (CONTIGU(OUS UPLAND) N/A 36,355f SF 36,355f SF (BARNSTABLE COUNTY) S )0 C MINIMUM LOT FRONTAGE 20' 419.4t' 419.4t' a 4� s� MINIMUM FRONT YARD 20' - 2.2' 2.2' OVE EXISTING - 2� HANDICAP SYMBOL MAXIMUM BUILDING HEIGHT 30' <30' <30' SITE pN FRONT LANDSCAPE BUFFER 10' 0' 0' GRAVEL'.' - GRAVEL N/F G, PARKING SPACES SEE PARKING TABLE BELOW JOHA THAN J. CARLSON 27 HINCKLEY ROAD' ASSESSORS MAP 311 �, PARKING REQUIREMENTS: NOVEMBER 28, 2018 PARCEL 019 co n REQUIREDX� PROPOSED "ON—SITE" PARKING LOT 20 19 Q p "OFF—SITE" PARKING SPACES 12 12 o�5 LEASED PARKING SPACES (ADJ. TO SITE) 39 39 PARKING AREA 50.1 4 SPACES ACCESSIBLE PARKING SPACES 2 (1 VAN 1 (0 VAN) 2 (2 VAN) (NOT SURVEYED) PARKING AREA ) 6 SPACES REVISIONS: (NOT SURVEYED) TOTAL PARKING SPACES 37 72 70 REQUIRED PARKING = 1/3 SEATS + 1/2 EMPLOYEES + 5/TAKE—OUT AREA NO. DATE DESC. o� 1 01/14/19 PER STAFF COMMENTS 82 SEATS, 8 EMPLOYEES, & 1 TAKE—OUT AREAS 28 + 4 + 5 = 37 GALVANIZED ALUMINUM REFLECTIVE SIGN PANEL WITH SELF ADHESIVE. ENGINEER-GRADE. REFLECTIVE VINYL SHEETING. EDGES TO BE'`DRESSED. PROVIDE_SIGN PANEL & PRE-PUNCHED MOUNTING HOLES. IMAGE TO BE `SURFACE INSTALLED, SELF-ADHESIVE 12» ENGINEER-GRADE, NON-REFLECTIVE VINYL BIT. CONC. « 3-2 O HANDICAP ACCESSIBLE NI GR RAMP (TYP.) PRECAST CONC.; Z - �) DRYWELL TO VAN ACCESSIBLE MEET H-20 » PARKING SIGN (TYP.) SIDEWALK LOADING a �CLEANOUT . FILTER FABRIC SPECIAL REQUIRED " WIDE TRAFFl - o o Q o o ('� NLET °° PAINT WHITE ` PREPARED FOR: LINES , . o 0 o a , UNAUTHORIZED PAIN D AVIGNON o ca Q o n o zo VEHICLES MAY BE 1-1/2" CRUSHED STONE REMOVED AT OWNERS o. oI o a o 0 0 o ENVELOPED IN PERMEABLE r o EXPENSE 15 HINCKLEY ROAD TRAFFIC PAINT 3-0 �) In ' , GEOTEXTILE MIRAM 140N, I H YA N N I S, MA 02601 o > OR APPROVED EQUIVALENT ACCESSIBLE >- � a o 0 0M o PARKING S 3» - O SYMBOL (IYP.) w o 0 0 0 0 0 2«x2" GALV. STEEL C C TUBE SET IN 4 a o 0 o a o CONCRETE BASE 4' TO END OF PARKING > APPROX. 12 DIA.x BSC SPACE (TYP.) 01 a 6" OF CRUSHED FINISHED GRADE 36 DEPTH 8'-0 8'-0" STONE BELOW DRY 349 Main Street - Route 28 8'-0» WELL (MIN) West Yarmouth, Massachusetts CURB (VANMSPACE) (VANMSPACE) ` 12" 5'-6" 12" VAN ACCESSIBLE 02673 5087788919 ACCESSIBLE PARKING PAVEMENT ,2" MARKING SYMBOL © 2019 The BSC Group, Inc. NOTE: ACCESSIBLE SIGN & POST ACCESSIBLE SYMBOL SHALL BE TRAFFIC PAINT AND VISITOR SIGN & POST TYP.) SCALE: 1" = 20' CENTERED IN STALL PAINTED PAVEMENT MARKINGS PAINTED PAVEMENT MARKINGS ACCESSIBLE ,D 20 40 nxT ACCESSIBLE VAN PARKING SPACES DRY WELL (SMALL WITH BURIED ACCESS PARKING SYMBOL & ACCESSIBLE PARKING SIGN ' DWG.: :\5025300\Civil\drawings\5025300-SP.dwg SCALE: NONE SCALE: NONE SCALE: NONE DWG.:6553-01 " SHEET 1 OF 1 JOB. NO: 5-0253.00 v , E - i � l , t V 0 q ft ...... Pt �- � uj (� af , t Scat. Drawn Job Shoat Ot Shoots N X SS llom oM Na tem crag•