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Home My WebLink AboutGOLS SUPERMARKET - FOOD GOISSUPERMARKE 55 IYtlynciinls d' _ i s o Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. rsen,`�rABM F.P.(Thomas)Lee,. p$ 6 9• 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt. 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: 700 Issue Date: 01/01/2022 DBA: GOL SUPERMARKET OWNER: VE FOODS LLC. Location of Establishment: 55 IYANNOUGH ROAD HYANNIS„ MA 02601 Type of Business Permit: SUPERMARKET Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2022 RETAIL FOOD: $285.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: � Town of Barnstable For Office Use Only: Initials: Date Paid Amt Pd$ Inspectional Services Public Health Division Check# 26( 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 DATEJa Q a\ NEW OWNERSHIP RENEWAL NAME,OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT:SS �� MAILING ADDRESS(IF DIFFERENT FROM ABOVE):" � E-MAIL ADDRESS:_V��Q km�ii V C'jl C9yM p yc,V\ • ('%_c NN TELEPHONE NUMBER OF FOOD ESTABLISHMENT: �%M 9K& TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NOS ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: _ SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? J TYPE OF ESTABLISHMENT:. (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL, MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YES 16 D.O.B OWNER PHONE # gag ADDRESSCj�_ Mk� NV11f\, 1Q\j1\1 P010 mPI\ 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 i.('I��U►�J �� / / i.C��►'�'R�1N1 ��A �Q / a. /aQO�J(p SIGNAT 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 508-862-4644 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/ai)plications.asy. 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 1 st. Q:\Application FormsTOODAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. r r:: -BAWNSTAULF, «' 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, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 700 Issue Date: 01/01/2021 DBA: GOLS SUPERMARKET OWNER: VE FOODS LLC. Location of Establishment: 55 IYANNOUGH ROAD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2021 RETAIL FOOD: $285.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Qh FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 14f, :t,6 1 �pI REFor Office UM �Tp� Initials: y� Town of Barnstable Date Paid Amt Pd$ BA"STABLE, : Inspectional Services 1639. Check# I� „ ArFo3�a Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT:VEJ1&.jA5 Lb:� a6zG , OI— ADDRESS OF FOOD ESTABLISHMENT: r T MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: -� TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO/ ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: / SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE ,RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) ABED& 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 FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT u�w t SOLE OWNER: YES t D.O.B OWNER PHONE# 0 ADDRESS_ CORPORATE OWNER: CORPORATE ADDRESS: R` ` PERSON IN CHARGE OF DAILY OPERATIONS: � 'k �W 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 SIGNATURE PPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: Al: 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/al)plications.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.3I't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.coc Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. vSTABLK : Paul J.Canniff,D.M.D. MAS& �. 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: 700 Issue Date: 12/10/2019 DBA: GOLS SUPERMARKET OWNER: VE FOODS LLC. Location of Establishment: 55 IYANNOUGH ROAD HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2020 RETAIL FOOD: $285.00 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: y . For Off • Initials: Town of Barnstable Date Paid I1 Ic C $a � ,,,�, �,E ; Inspectional Services �'� ►`� Public Health Division f"eC'`# Thomas McKean, Director l °� 200 Main Street,Hyannis,MA 02601 a Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATEA FOOD'ESTABLISHMENT DATE�1�0 NEW OWNERSHIP RENEWAL O NAME OF FOOD ESTABLISHMENT: �vv ��qq V�N:al NVu19--mVn",�'v i ADDRESS OF FOOD ESTABLISHMENT: ss�) Q y�7 "ID MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: ��S'O�� IVIrC� ' W m t- TELEPHONE NUMBER OF FOOD ESTABLISHMENT: )1_�\ TOTAL NUMBER OF BATHROOMS: _ WELL WATER: YES NO (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: _ SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: QQ_ OUTSIDE: TOTAL: oZ€1 SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** ; OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE (_RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** 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 t OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YES CO D.O.B `OWNER PHONE # 1500-?A310��7�r�� ADDRESS S�)M �1�`�S��N� ),-N 1�MAO V�� V�-\ Q CORPORATE OWNER: �C �S LLP—, nq' CORPORATE ADDRESS: 21 PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE.CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. AAEL VS 2- 1. 1;U0W GilomL off/ 2- / 20 24 el rluj 2.AA119AQA 1 07 / -I S /202 . SIGNAT CANT 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.asy. 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.3151 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 Off^T Town of Barnstable BOARD OF HEALTH t�« Paul J Canniff,D.M.D. �� Board of Health Donald A.Gaudagnoli, M.D. r awnasrABM John T. Norman MAWL 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate ar�a�a Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 700 Issue Date: 12/20/18 DBA: GOLS SUPERMARKET OWNER: VIE FOODS, LLC/ELSON GONCALVES Location of Establishment: 55 IYANNOUGH ROAD HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 _ FEES - T FOOD SERVICE ESTABLISHMENT: YEAR: 2019 RETAIL FOOD: $285.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: —-- --- - - - - -- MOBILE-FOOD: MOBILE-ICE CREAM: G�� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: !I FOR ESTABLISHMENTS WITH SEATING: 1 PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE { Restrictions: Town of Barnstable W r Inspectional Services Department AM Public Health Division 659. 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO December 18, 2018 TO: All Food Establishments FROM: Thomas McKean, CHO Director of Public Health RE: New Food Code ------------------------------------------------------------------------------------------------------------------------- The purpose of this memorandum is to announce that the Massachusetts Department of Public Health has adopted the 2013 FDA Food Code with amendments made by FDA in 2015 and additional amendments adopted by DPH in 2018 as the 105 CMR 590: State Sanitary Code, Chapter 10—Minimum Sanitation Standards for Food Establishments. The amendments to 105 CMR 590.000 were published in the Massachusetts register on October 5, 2018 and became effective upon publication.The regulation can be found here: https://www.mass.gov/regulations/105-CM R-59000-state-sanitary-code-chapter-x-minimum-sanitation- sta nd a rds-for-food The 2013 FDA Food Code and FDA's 2015 Supplement to the 2013 Code are available on FDA's website at: https://www.fda.gov/Food/GuidanceRegulation/RetailFoodProtection/FoodCode/ucm374275.htm You may wish to visit the DPH website at: https://www.mass.gov/lists/proposed-amendments-to- regulations-sanitation-standards-for-food-establishments-retail-food for the following resources: • 2013 Food Code Merged with 105 CMR 590:The 2013 FDA Food Code and FDA's 2015 Supplement and the final version of 105 CMR 590 combined into a "merged food code"; and • , Final Redlined Regulation:the final version of 105 CMR 590 with redlined deletions and additions that was filed with the Secretary of the Commonwealth Thank you for your patience and for taking the time to read through the food code changes. .R . F4t+e roy, Initials: Town of Barnstable Date Paid I Amt Pd$ abJ MAS& Inspectional Services s63g. 10 Olk4 nn Public Health Division Check# l! 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 NEW OWNERSHIP RENEWAL X NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: �� ?H 1pow MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: k�, )O 1j TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: _ WELL WATER: YES NOS_ ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL:_ SEASONAL: DATES OF OPERATION: TO NUMBER OF SEATS: INSIDE: - OUTSIDE: _TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICEN FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV. AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL.MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q\Application FormsTOODAPPREV2018.doc PLEASE CALL 508-862-4644 OWNER INFORMATION: ` 1 FULL NAME OF APPLICANT c ZQ VC•�0J j:40 SOLE OWNER: YES/N4V D.O.B OWNER PHONE# SIN �)U��`f ADDRESS_�� ► �. �� VDT CORPORATE OWNER:y L ljk\ , FEDERAL ID NO. : CORPORATE ADDRESS: ss; `D ��`� �� \ �N PERSON IN CHARGE OF DAILY OPERATIONS: W%j Cy L\)0<:; List (2) Certified Food Protection Managers AND at least (1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers _Expiration Date Allergen Awareness Expiration Date 1. ��7Q� SIGNA ANT 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 htti)://www.townofbarnstable.us/bealthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q\Application FormsTOODAPPREV2018.doc `°F,ME ro TOWN OF BARNSTABLE, HEALTH INSPECTOR'S Establishment Name: ( C Date: )c'��J�1 Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARN ABLE, ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,6,59. `0$ HYANNIS,MA 02601 MON.'-FRI.508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Name Da Tvoe of jyippof Inspection O eratio Address - Risk o Re-inspection Level a as Previous Inspection Telephone � � esidential Kitchen Date: p Mobile Pre-operation' o Owner �'e�` 50 9" 60 I 'l LID, HACCP Y/N Temporary ec I Caterer General Complaint Person in Charge(PIC) C,o Time Bed&Breakfast HACCP �V In: Other Inspector Out: eV Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ ` Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating <- ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time Asa 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 WNW n Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations U Critical(C)violations marked must be corrected immediately. (blue&red items) \` Vd Non-critical(N)violations must be corrected immediately or t! Corrective Action Required: ❑ No es within 90 days as determined by the Board of Health. Overall Rating Voluntary Com❑ ry Compliance p ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 9 ardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations re if no critical violations observed,4 too 6 von-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 t 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspe g t re n. r 31.Dum ter screened from public view 1\y \a 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 �,/ l/ ti,...- ..�......-_.-.1--.,-.-._�.�,y...-.---'��+.�.--•--�.-r_--�..�-r�... ,;.. _ ..,-�. •_ � e�. ..;.-_ - ... _� _,,,,,.- � .- r....- ..:.y..r,--.u_ __ _...�-,., .__�_ .°+�..._.«.,.. +.a.:.. +�-.v...-`..n .`.. '--"__:.1.•---•�:.-�-.�.--'. ..-_��_ �- . .- - F � _ -._ ,� � �- .. .�y ,•,•. _ -. 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) JD.-.onstrationof ssignment of Responsibility* 8 Cross-contamination 1 q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* * * 3-501.15 Cooling Methods for PHFs 590.003(B) Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 1 g 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 EachIdentifying * 590.004(F) * ( )O P 7-101.11 Information-Original Containers Other* g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-]02.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130'F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3 304.11 Food Contact with Equipment and Utensils _ 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reted of Food Produce,Criteria* HSP HIGHLY SUSCEPTIBLE POPULATIONS 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or or Contaminated 7-204.12 Chemicals for Washing � ) 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 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 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 3-202.16 Ice Made From Potable Drinking Water* CONSUMER ADVISORY Concentration an 3-401.11A(1)(2) Eggs-155°F 15 sec d Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Equipment* E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Eggs Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg°"°e mnooi 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* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004 C Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 ) Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 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 * 3-30L12 Preventing Contamination When Tasting* 3-403.11 C Commercial) Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 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 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. °F�He r TOWN OF BARNSTABLE. HEALTH NSPECTOR,s Establishment Name: CS'/S Date: age: of ti OFFICE HOURS �ARNSTABLE 2 PUBLIC 0 MAN STREET 3:3030 DIVISION s:00--4:30 P.M. :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MAC, p MON.-FRI. �p .63y,�`q0 HYANNIS,MA 02601 - 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY 'FDA"oa FOOD ESTABLISHMENT INSPECTION REPORT Name Date�J1 Tvoe of of inspection I6 O ion Routine Address Risk ood Sere -inspection Level etall Previous Inspection Telephone Residential Kitchen Date: f� �- Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness �-Y1 C-� Caterer General Complaint - Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector :`-t; Out: T*1.1 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) ❑ 3105.1� r \ v 7 Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ l S 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 b F ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals �\ G FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) C ❑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 L 1 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ®j ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 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. 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, 27.Physical F ility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must g p,infestation of rodents or insects,or lack of 28.Poisono 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. )( ) lion,4 to 8non-critical violations=C. 29.Special equirements (590.009) within 10 days of receipt of this order. Insp ctor's g ur nn 30.Other DATE OF RE-INSPECTION: I 31.D ster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y IN #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: J +,1►� Print:(gip �/'1�-7 Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N �Vr� f/" v1 lj Dumpster Screen o 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 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 7 5 Poisonous or Toxic Substances 590.004(F)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 590.003(C) Responsibility of the Person-in-Charge[0 7-101.11 Identifying Information-Original Containers* * 2 Other* 3-501.16(A) Hot PHFs Maintained At or Above 140'F 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-2.02.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401 A IA(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of Eggs 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaccs of E Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Nut Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff twe 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155'17 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-155'17 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential - 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 PreventingContamination When Tasting* * (Blue Items 23.30) 3-202.15 Package Integrity* g 3�03.11(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 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70'F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70'F to 41'F/45'F Item I Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 . HACCP Plans 6-301.12 Hand Drying Provision ' 29. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. °FIONE TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: age:. of q OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified "'A9' HYANNIS, MA 02601 M-8 -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY � .oyv .0 sos-asz-asaa 'OTpD MPS' FOOD ESTAB ISHMENT INSP T N REPORT I- P ®- is i Name Dat o f I s ection outi i Address Risk ood Serv� spec ion _ Level Previou I s c�ji - Telephone Residential Kitchen Date: $Y Mobile Pre-oa o Owner HACCP Y/N Temporary Suspect III ess Vo Caterer General Complaint Person in Ch r e(PIC) Time Bed&Breakfast HACCP 1 Other 0 Inspector Each violation checked requires an explanation on the narrative pa (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) IV ❑ �. �= 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 I PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) fl ❑ 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 �l/�VI✓� AIM Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results man 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. 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 served,7 to 8 non-cr al violations. If 1 critical refrigeration. . violation, t 8non-critical viol orbs 29.Special Requirements- (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: I sp for In ure t: 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 C's Signatu Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N i ' 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 _ Law Cooled to 41°F/45°F Within 4 Hours* 1 590.003(A) Assignment of Responsibility* _ _ $ Cross-contamination 1q Food or Color Additives .� .. .: 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-20242- Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 - _ PHF Hot and Cold Holding. 2-103.11 Person-in-Charge Dudes - 3-302.14 Protection from�iiappioved 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 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment i 3-501.16(A) Roasts Held At or Above 130°F* * _ _ 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* - 1 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee orCh 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 * ( ) 9 590.003(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 Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g ( ) - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 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 ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 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) 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* 3-00I.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* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eff cri°e rnnom 4-602.11 _ Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 3IQ 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* Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential Authority HE Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and A Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Aut 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 r 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 Requirements. radicsshould be debited under#29-Special 5 Reoeiving/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 ( ) Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* F1S 13 Handwashing Facilities Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°17 hem 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. °FINErow TOWN OF BARNSTABLE HEALTH,NSHECTOR's Establishment Name: �� COeDate: '3 Page: of 4 OFFICE OURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified tb}q• `e� HYANNIS,MA 02601 - MON.-FRI. No Reference R-..Red Item - PLEASE PRINT CLEARLY prFD MPS°' N 508-862-4644 FOOD ESTABLISH M INSPE TI N REPORT Name Date o Tyne of Inspection 9 'o S Routine a Address Risk Food,Serv,c Re-inspect, n Level etail Previou I IC Telephone Res, ential Kitchen Date: Mobile Pre-op¢r t Owner HACCP YIN Temporary Suspect Ilness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACC r I -AN Other Inspector l u n - Each violation checked requires an explanation on the narrative pa e(s)and a citation of specific provision(s)violated. v c� Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items Anti-Choking 590.009(E) ❑ _ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ / FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands 1.PIC Assigned/Knowledgeable/Duties .T ❑ 9 9 ❑ 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 l ` ❑ 10.Proper Adequate Handwashing. CONSUMER.ADVISORY L v_ ❑ 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 8�red items) 3 q 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 ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 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-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violat' 0 8 no ritical violations=C. 29.Special Requirements (590.009) y p y ' 30.Other DATE OF RE-INSPECTION: Inspe re 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 Signatu Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N ` v Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41*F/45*F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41*F/45`F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140*F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130'F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 1 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) 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 Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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 Wazewashing-Hot Water Monitoring* 3-801.11(C) I Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155*F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145*F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* ey crt-innom 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 ShelMsh 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 Stuffing Containing Fish,Meat,Poultry or 590.009 A D Violations of Section 590.009 A D in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-( ) ( )-( ) Ratites-165*F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145*F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165*F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145*F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 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* 3403.11(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 3403.11E Remaining Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated O g Unsticed Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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 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 PFIF's 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 1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 1 Special Requirements 1 .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Fonnback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. p TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: �, �, ellDate: �y 1 Page: of v`of THE r L� a OFFICE HOURS "y r PUBLIC HEALTH DIVISION 8:0a-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item IOLATION/PLAN OF COR Date Verified MASS, q MON.-FRI. HYANNIS,MA 02601 sob-862-4644 No Reference R-Red Ite PLEASE PRINT CLEARLY 0N1P'' FOOD 5S3ABLISIfflENT INSPIECT110)o REPORT Name Date Type o =Ikmeof Insoection �7atj S Routine 7 Address �'7 Risk ood Servi 'ReTinspect'on A Level Retail % Previou spe i n - s Telephone Residential Kitchen Date: i Mobile Pre-o i on Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint y hr Person in Charge(PIC) Time Bed&Breakfast HACCP r- o �y ��R97 Other Inspector ® ►ui Each violatiori checked requires an explanation on the narrative pages)and a citation of specific provisions)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ v v - i 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 I 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) / ' . / 9 i' ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures c - ❑ C ,5.Receiving/Condition ❑ 17.Reheating i ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans 19.Hot and Cold Holding i �f / `/� PROTECTION FROM CONTAMINATION Time As a Public Health Control VyT 1 I • /A( ❑ 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 G' ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 13dAq Critical(C).violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes gNon-critical(N)violations must be corrected immediately.or Overall Ratin 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 s Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ ❑ Emergency Closure ❑ Voluntary Disposal ❑.Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590:005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than Orion-critical violations 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 Snon-critic I violations. If 1 critical refrigeration. violati 4 to 8 non-critical violatio -C 29:Special Requirements (590.009) within 10 days of receipt of this order. o - - a Inspect s-Si• ,atur t 9 , RI9 30.Other DATE OF RE-INSPECTION: 31.Dumpster screened from public view. Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N Iv. r #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 P AC 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 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 2-103.11- Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from-Unapproved Additives* 19- PHF Hot and Cold.Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F - 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003 F Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * O p° h' 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 * � ( ) 9 s 7-203.11 Toxic Containers-Prohibitions 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* J, ( ) - 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* _ 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 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* o 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. Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 183-401.11A(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Eggs Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective!/]2001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155'F 15 sec* te 590.006(B) War 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* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Ho[Water and Stuffing Containing Fish,Meat,Poultry or 590.009 A Violations of Section 590.009(A 3-201.15 Molluscan Shellfish from NSSP Listed .Chemical* ( )-(D) )-(D)in cater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved B _ _ __ 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority Y 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 _ Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g• g 8 3-003.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* - 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne illness interventions and risk factors listed above,can be found in the 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004- 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability - - 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging-Criteria* 8-103.12 Conformance with Approved Procedures* S.590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590:000. °p IME Tpk, ► TOWN OF BARNSTABLE - HEALTH INSPECTORS Establishment Name:��j/ � 1� Date: Page:, Of q OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MAss. MON.-FRI. HYANNIS, MA 02601 No Reference R-Red Item PLEASE PRINT CLEARLY , �p +eS9•ewe - 508-862-4644 'FON1P� FOOD ESTA LISHMENT INSPECTION REPORT Name Date Jype of Type of Inspection 01i . Ooeration(s) Routine Address Risk Food Service Re-inspection Level Ret ail ail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness '- Caterer General Complaint tr �, 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) ❑ - ry ` ) Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ lay I 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 / r ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives A ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals j 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 Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations,and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 6=One critical violation and less than 4non-critical violations _ 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot C= 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 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 Snon-critical violations. If 1 critical refrigeration. )( violati 4 to 8 non-critical violations=C. 29.Special Requirements. (590.009) within 10 days of receipt of this order. i / ) r 30.Other DATE OF RE-INSPECTION: Inspe is Si ure Print: 31.Dump*star 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 re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 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 Identifying Information-Original 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 * 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* Protection*PP * 3-302.11(A) Food Protec 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 _ 3-501.19 Time as a Public Health Control* 3-302.15 Washing Fruits and Vegetables * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* _ _ Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 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 Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g ( ) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 - Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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 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* Effective 11112001 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 4-602.11 _ Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* * 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-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* F 10 Proper,Adequate Handwashing Ratites-165°F 15 sec* ing,mobile food,temporary and residential Authority 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145 F kitchen operations should be debited under Game and Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g• g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 * 5-205.11 Accessibility,Operation and Maintenance 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures 1 6-301.11 Handwashing Cleanser;Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision `' 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S.59017ormback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. &OM°FtHE r°w TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: L Date: age: Of ti �/ OFFICE HOURS cro PUBLIC HEALTH DIVISION 8:00-9:30 A.M. 1 gpRABLE. 200 MAIN STREET 3:30 4:30 PM. Item Code C_Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Verifie d M � MON.-FRI. �DlE MPe.m� HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECT) h REPORT 0 Name Date a of Type of Inspection n Routine Address I/AfRisk ,rood Sery Re-inspection Level Previous Inspection Telephone Residential Kitchen Date: i Mobile Pre-operation Owner HACCP Y/N Temporary Caterer 70ther al Person in Charge(PIC) Time Bed&Breakfast n: RM L 1A1L=2:= A zaffiffl Inspector DZMO d11 Each violation checked requires an explanation On the narrative p ge(s)and a citation of specific provision(s)violated. IV r 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 411 ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ZU ❑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 Foo ❑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 Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than 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 8 non- tical violations. If 1 critical refrigeration. within 10 days of receipt of this order. viola' ,4 to 8rion-critical of ions C 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Ins ctor's i re P int: - 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 Pf 'S Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N �� Dumpster Screen? Y N :. Violations related to Foodborne lliness' - - - - - -" - Violations Related to Foodborne Illness Interventions Interventions and Risk-Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) '_ Assignment of Responsibility*_ _ $ Cross-contamination 14 Food or Color Additives e Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(l) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 "1 Person-in--Charge Duties " ` Cooked and RTE Foods.* 3-302.14 Protection from-IJrrapproved Additives* 19'' PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(Fp ._ _ 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 3-501.16(A) Roasts Held At or Above 130°F PP 3-302.11(A) Food Protection y 7-201.11 Separation-Storage* Applicants* * P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use*_ _ _ 3-501.19 Time as a Public Health Control* * Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* - - - - - - - - - 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) 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 1 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and 71 FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 - 1 Food and Water From Regulated Sources F9 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* ,Pest Control and Raw Seed Sprouts Not Served* _ _ _ 7-206.13 Tracking Powders 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 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 Drinking-Water from an Approved System-* Eggs 5-101:11• 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or - - - - - Equipment* Not Otherwise Processed to Eliminate 590.006(A) I Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ep ctiw/02001 4-662.-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* 3-401.11(A)(3) Poultry,Wild Game,Stuffed SPECIAL REQUIREMENTS Shellfish*- 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meatat,,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* i Sources* ing,mobile food,temporary and residential . 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and iAu Mushrooms Approved By - - 2-301.11 Clean Condition-Han Arms* Hands and A * 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. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* _ - 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 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 * (Blue Items 23.30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 1.003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability - 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 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. F IHEr TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: 60/ S-Off-m4r/a� Date: 30 Page: / of _ .° OFFICE HOURS IT PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 M-8 -46 No Reference R Red Item PLEASE PRINT CLEARLY �A'FDN1P�' FOOD ESTABLISHMENT INSPECTION REPORT 508-ssz as44 Name c Date a of Type of Inspection G (ne' Routine So rvvA Address Risk oo Re-inspection y " h, J Level RetadilService Previous Inspection 2 7 4"1 U Telephone Residential Kitchen Date: Mobile Pre-operation YI U Owner HACCP Y/N Temporary ec Illness Caterer neral Complai Person in Charge(PIC) Time Bed&Breakfast HACC n,, e a In: Other a Oki- G'Ua If, C Inspector v w ^ Out: da a l 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) ❑ 1 Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ � J Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ v U ". 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) Corrective Action Required: o ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Y y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspectioNto ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) checked indicate violations of 105 CMR 590.000/Federal Food Code. This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations re ardless of the number of critical, results in an F. 25.Equipment and Utensils (FC 4 590.005 B=One critical violation and less than 4npn-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 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 C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up, 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations obsepied,7 to 8 non-critical violations. If 1 critical refrigeration. y 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to An I n-critical vi lations=C. 30.Other DATE OF RE-INSPECTION: Inspec is Si re' Pr t 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N C's ' nature #Seats Observed Frozen Dessert Machines: Outside Dining Y N \ Pr t:PI Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen o 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* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) jDe-.onstration 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* g7-102.11 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 590.004 11 Variance Requirements * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Reared or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B• Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations * 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 Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 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* Not Otherwise Processed to Eliminate Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* * gg Equipment 590.006(A) Bottled Drinking Water*' 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effe cri�tiuzoor 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 Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 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 * (Blue Items 23-30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* 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 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. No................_.....-- FuR............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Disposal Works Tonstrurtion Prrmit Application is hereby made for a Permit to Construct ( ) or Repair (V) an Individual Sewage Disposal System at: --.........- _......... ------------------------------ --------- ..................... ......... .......................................... i Location-Address or Lot No. V` ................................................. ............ ..--•-- Owner Address wA'�` .... C �S ®:� �- ................................ ------•-•---...............-------•.................--•---•-----•••--•-----..............---...... Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures . w Design Flow............... ...........................gallons per person per da dotal daily flow___......2.8.�................_gallons. ,� WSeptic Tank—Liquid capacity ®?gallons Le ngthZ 7.. _<..... Width. .1_`-... Diameter................ De th..s-__. ' x Disposal Trench—No. .....z.......... Width.... Total Length....,.'j!....... Total leaching area...1. (...sq. ft. Seepage Pit No...... _. Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( 2) Dosing.tom— '-' Percolation Test Results Performed by..... .as t-J1Q_1Z%T...___�z'�� Date.....I�� D•-iae a Test Pit No. 1.....! =_minutes per inch Depth of Test Pit.....!3 R_*... Depth to ground water.._!].' ........... Li. Test Pit No. 2.-.5..`L..minutes per inch Depth of Test Pit...... Depth to ground water.....:--........___. a .... O Description of Soil........ • o j 5e ;ter Gz .r-�" ................ x ------------------------------------------------ w U Nature of Repairs or Alterations—Answer when applicable._....._&�I<Ec e.....__Y-k<�_&�.... .._ a?_- l Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed�----------•--••---•................•---------••......--••---•--•--- Date ApplicationApproved By-••••••-••-----•-•--••••--•--...•••••---...-•------------------•-••--•----.............--------- Date Application Disapproved for the following reasons-----------------•-----........--------------------------------....-------------------------•••••••••....-•..._.. .....................•---...---...............---------------.......----------•--------•---•------...-----•••---••--•--------••--•••---•••---•-•------••-••----••----•••--...----••-----••••-••-•---•--- Date PermitNo......................................................... Issued...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH wrtifiratr of Bout liunr�e THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired y --•- -•-- -•----•-•-------••................•-•---••-•---------•----•.....--•---•--•••-•-•--------------. -----•.......-----•-•-•--........... �v . I Instal at.... ---••.... . n- ` � 8$- -&"/,.5t:. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector....-------•------......----------•----------......----------....•...............•. THE COMMONWEALTH OF MASSACHUSETTS BOAR^^7D� OF HEALTH Tel✓1//1/n..........'OF...l. , G......................................� rL.................... No......................•• FEE........................ Disposal Works T-Vono#r ion Uprrutit Permission is hereby granted....... 1.. _c ...__.... .`.V.�.f M y�j d � � . ....... ... to Construct ( ) or Repair (L- an (,ndividull Sewage Disposal Sy tat No.77 s f c j`Q� T O v✓NEI •,-, .. st.` �� j. � #� -----•----_-----...... ..................... Street as shown on the application for Disposal Works Construction Permit No....................• Dated.......................................... 'r --•----••.----•- DATE ....... Board of Health FORM 1255 A. M. SULKIN, INC., BOSTON I� No................_....... Fxs........................... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T6.�✓n/_.........-.oF...13..>7,2n/ •T--F 3 _r:------------------------------ Appliratiun for Disposal Works Tontrur#ion Vprrmit Application is hereby made for a Permit to Construct ( ) or Repair (V) an Individual Sewage Disposal System at: .fl,.✓ n/ tf .. .�.7✓ ............................................... 5 Location-Address or Lot No. Owner Address Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures ---------------------------••••. - W Design Flow............... ......................gallons per person per dayLeTota1 daily flow.......... __.__._2._S_00____._______._.___gallons. Septic Tank—Li uid'ca acity __ alons L_enh___________ Width!_ .._____. Diameter________________ Depth_ � 2W ............. Disposal Trench No.__ t-.. ,_. Width___ ..___ Total Length._. ........ Total leaching area__f_q_9_l_____sq. ft. Seepage Pit No......... ......... Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (2 ) Dosing tank-()F —� Percolation Test Results Performed by :'✓�.._____ Date___......................................+ �// '� _,o0 a 6 t �=:3 r � Test Pit No. 1____ __________minutes per Inch Depth of Test Pit..... Depth to ground water_.___.___R_.___._____. (i, Test Pit No. 2...`__—__._minutes per inch Depth of Test Pit.....!-:__?...... Depth to ground water.....-'^.............. P4 •••••---••-•-•----------•---••-•-••-•••---•••-••--•-•------•-•-.....•-•----•----•---•••-••••••--•--•......................................................... 0 Description of Soil_.._.__ _ c> . P•-----..4..:�_....rra.e c1� __ ) .' '/ ' " Q 1 x ........................................................ V -----------------------•----•------------------•----.-.-----•----------------------...----.....-------._..... --•-------•--•---------------•-- ......................................................... -------------------------------------------------------------- ---•------------------------------- •-••••--•-•--------•---------••--•-------••••••-••-••-•--•--••-••••••••••-•-••-••---------------- U Nature of Repairs or Alterations—Answer when applicable___._ ......- .f�_'._N_._____�___ _r_ _....- _._�..:_�_�":. =... y•-•-•-•••••-•--•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed_� -•---•----•-••--•••-•.............•-•-...._........•------••-•--••--••-••...---- ........................... Date ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons_________________________________________________________________________________________________________________ ..............•--•--...._..--•---•-••--------------••----•--•-------------•-----•----•-----•---------•---••----•------•---•---•---•--•••-•-••-----••••-•--••----•••-------------•-•••--•---••-•--------- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......�.....�..�!/Gl/ OF..�`'.�"-�'�2 . � - �:r� .�i ..•--......... ................. . .... ......._.................... (Irrtifiratr of Tomptianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (�) -------•-----•----•----------------------------------------------------------------------------------------•---•---......_...-----•••........_.....---------_... Installer _ o --•- ---- -- ----- -----•---------..----._.....-•-•--................................. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_________________________________________ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ... .....`�...`N.:�.............OF.!,./.:�•iZ�✓._...i..�� / C No......................... FEE........................ Disposal Works Twonotrttdion rruti# Permission is hereby granted.____ _'•_ r•••••••••-•'_"n/ 7- �} --•-•••--••----•--•.--•-•.............••--••--•----••-•----••••--•--•--••-•------•-••-•••-••-••-•-..._....•--_-•--- to Construct ( ) or Repair /Individual Sewage Disposal System , at No.�v. c i- F�7 1 o "V-'V t .J� 01 ,",,.�' ,l , . 'S' 1 i � S --"'a L A c��r_.:�_.� .. Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... .....--•--...--•-•----•----•-•-•-------------•------------------------------•--•---•............._......_ Board of Health DATE_------•.................••--•-•----•----•-----..._._..........--•-••--------- FORM 1255 A. M. SULKIN, INC., BOSTON No......82- /r1,5 Fps....... ... ��..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH - Town.......OF......Barnstable............................................................. ApplirFation for UhnVasFal Works Tomil.rur#inn Frrutit Application is hereby made for a Permit to Construct ( ) or .Repair ( x) an Individual Sewage Disposal System at: . 5.-I_VA 14Et.Rd...,...Hyannis, MA 02601 ......................•• ---------•-----------------••-•--------------------------• ......-----------------------.------.. Location•Address New Yrok Deli & Bahr�' Vincient D'Olimpio, 03 3Noanough Rd. , Hyannis, 02601 - _._... - ...... ..... ...................... ....................-............................................................................. Qwner W A & B Cesspool Service 128 Bishops Terracae ` ,,finis MA 02601 a .......... p.............•-•---_....'................---•'-•-•-----..._..----•-.....--•- Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Pa Other fixtures -----------------------------•-- . W Design Flow............................................gallons per person per day. Total daily flow----................--......I................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter..........--........ Depth below inlet..................... Total leaching area..................sq. ft. Z Other Distribution box ( ) 'Dosing tank ( ) Percolation Test Results' Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit..................... Depth to ground water........................ fTo Test Pit No. 2................minutes per inch Depth of Test Pit----........--...... Depth to ground water........................ a --•---•---•-------••-•-•----•-------•-•----------•-•----------------•-.----------------------------------- •---------- •------------------------------------- 0 Description of Soil----------------------.Sand_........--•-----------------------------------•---••-------•------•-•-•--------•-------••---•••••••-••---••-•--•-•---•-......_....----- W .........................................................................................................................................................-.............................................. UNature of Repairs or Alterations—Answer when applicable..axpantion-•q ....leach field. ---------------------------------•--•-----•-----•--------------•------•----•-••------------------•--------••-•--•--•----.....---•-••-•-•----.....•-------•-----------•------•............_..._......---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board f health: 4/ 1/82 SignedV. -Z� �..i...... ... . C... .......................... Application Approved By............... -:..4...-- ................ --•--...-•-•-------��e 1/82 Date Application Disapproved for the following reasons:-------•------------------------------------------------------•----------------••---------------•-•-------...... .............••-----•-----•--•-•--•-•----•--•-----------•--........-------•-•------------•••-•----------•........----•-----•---------------------------------------------------------------••-••--------- Date Permit No.-._12-.................... 4-/ 1 82 Issued. C --- ------------------------------------- Date No.....R2— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................o.wn--.-..--OF.....Barnstable...-. Appliratiun for Disposal Works Tonstru.r#ion "permit Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: - S..Iyanou h_Rd:.e..Iirann st MA 02601 -- ---------- -----•----•-•---------------•.....-•----•-•------•-•-•---•-•-------------•-- ---•----•------- 1 Loc tion-Address V incient D'Olim i o New Yrok Deli & Ba kery ..........................•-- p , �.°.I��nou�h Rd., Hyannis, 02601 caner W A & P Cesspool Sere ce 128 Bishops Terracae, finis, MA 02601 Installer Address d Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures -----------••---•-•-----------------•-••---•--------.-._....--------------•-----------------------------........--•---------...-•-•••-•._......_------ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+ ...................................................................................................•-...••••-•---------....---•••---- ..... DDescription of Soil......................SSr:Sand.......................................................................... --•---•---•--•---••-----•---•-•--••-•- x W U Nature of Repairs or Alterations—Answer when applicable-expanti on of leach field. -------•-------------------------------------•---------•.....---- -•--•••-•--------------•-•--.....-••----------•--•---•••-----•-----••••---••.....----•--............._._..•--•-•-----•---••--•-•-••-------•-••--•-••----••---••••---•-•••••••-•••--• •--------••-••---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board f health: t{ 1/$2 Signed_ Win! It = -x --�.(el..... ................................ Application Approved By. ,. /(j �f``1/32 Date Application Disapproved for the following reasons:.............................................................................................................. ---•---••--------------------•----.._.__....-•-----------._....----------..__._-.._..---.._._..------------•-----•--•••---••••-•---•------••------••-•••---•----••---•••••--•-•••••----..-..-•---•._..._ ' - � •"' Date Permit No.. �2 ---••••._...._.....•••--•---.._..-•-•-------- Issued 4�.-1/�2•----•--.....---•-•-•-•.........•---• Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................T cw.n........OF..�arnatable .. ....................................................•... CIerfif iratr of Tomph anrr THIS IS TO CERTIFY Thatthe I t i u 1 Sewag Di osal �✓stem onst> e or Repaired by_ A & B Cesspool Service, �` shops �'errPace 0�lyannIs, ` 60�i at••_•55 Iyanough Rd. - Route 28, Hyannis, 'M* 32601 - New Yark Deli & Bakery •...................•-----------._......--•••-__.._ ..-..-----------•-•---••--•-•--••--••••-----•-••--•---------.....-••--•---•---•-._......----•-••••••-••- has been installed in accordance with the provisions of TITLE 825 of The State Sanitary Cr)47aj/bggcribed in the application for Disposal Works Construction Permit No_________________•--/ _t --------- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 4/^ /82 DATE...-•---- -••-•.....................................................•--.._._. Inspector....................��.— THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..................Town......-......OF...-..Barnstable $ 5.00 No..._.._.2.-� ! FEE........................ Disposal Works C�ono#rudion rrmit A & B Cesspool Service Permission is hereby granted --- --- --- --------------•--.. -•••••.......... ._.... to Const ct ) or Re it (x ) a I vi al Se lye a spo �1 st at No.__93 Ix amough ff. - Roue , Hyann , 11k 06;l 'New York Deli & akery .. ......--••---_.. .................................•--•-•--.--•-•••--- -------••---•••-•-••---:_... Street 82— 4/1/82 as shown on the application for Disposal Works Construction Permit No_ __________________ Dated.......................................... ----------------- oa d of Health DATE................ 1'� ------------------------•-•-•-------------•-• FORM 1255 HOBBS & WARREN, INC., PUBLISHERS + N Fzz$....i.00......... ... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Town..........OF.........B4rwta.ble... ..................................... Appliration for Uiipagal Workii Tows union antic Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 5.. �an9ugkt..�d.., Rplit�e__28., xY T ....02601•------------••-------------•---------------•---- ---------------------- Location-Address or Lot No. Vinciet D'Oi �1P 4.......--•......................• .Jyariough- -, H3rannis,..MA....J12fia1.............. Owner Address aA-&-B Cesspool-.Sipryige•-•-...•__........-•-----•••••......••........ 128..Hishops..Terx�a o s, A ( 64i PQ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ----- ................................................ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity....---.....gallons Length................ Width................ Diameter...-------.----- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) �-, Percolation Test Results Performed by.......................................................................... Date---------------------------------------- aTest Pit No. 1................minutes per inch Depth of Test Pit.---............---. Depth to ground water-..--...-.----.--....._- �T4 Test Pit No. 2................minutes per inch Depth of Test Pit...--............... Depth to ground water...--------.--.-.._.---- P4 •---•---•-•--•--------------------••-•---••---•--•••-•-•-•-•-•••------•---••---•--•-----•----•---•-•......................................................... ODescription of Soil--•••Sand------------------------•----•----------------------------------------------------------------...---------------------------....---•••............ V ...-•---•------•---••-•------•-•--••-•-•----•-••--•••-•--•-----••-•--•-•----•-•---••-•--•-•••......------•---•--•-•--•-••-•------•-••---••••----•-••--•-••-•-•---•---•---••---•••--••--......-••---•--- W --------------------------------------------------------------------------•--......--••-•-•--•-••--•-------.........---------•-----••---------------••-•----•-••----•••--•......------•--•--•-•-•---•••- UNature of Repairs or A ' ns—Answ when applicable.---remover--ajad.. �e-place ce...exjst3ng.,.l.e.aeh..fie1d. -• ----------------------- �-�••--- •... . -• •.... ...... t' --------------- Agreement: � C r .� L The undersigned agrees to instal th oredescribed Individual Sewage Disposal System in accordance with the provisions of'T y g g p y 5 of the State Sal Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has been issued by the boardpf health. Signed. -••-----•- �� Date �-- �/►� Application Approved By......- Xf . --•----•-----•----•--------------------- ..........12/30/aQ........... Dat Application Disapproved for the following reason :-•-•-•---•--•-••----•-•---•-••••----•-•-•------•••--•-•--•••-•-----------------••-----•-•-..Da..e.............. --.......-•--------------------------•---•--•----------------•-•----------•------•---........•---•----....----------------------------------------------•---------------- ............................... Date PermitNo.......80............................................ Issued................ .................... Date No....$p,.. .. FEB.$...5.&D........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................T01M.........OF...........$9 -Mtal:I24.................................................... Appliration for Diopoial Workii Tomitrurth n amit Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: r35 �3 h-Rd.f... a�Ite 28,..-H3r,- �-s,•--aM-----02601••-•-•••••---••----••-•-•---------------••--......._.:.......... ... -------------.-... Location-Address or Lot No. v3.ncs� .•Ili-91 p �--------Owner------------------------------------------ -55-1yanow-h--Rd -;---H� s; a 64� ..... W A.&...E..Gesapaol..S9xvJca--------------------------------------------- 128LBishopa-. tersacs _s,---MA----- 2601-••--- Installer Address dType of Building Size Lot............................Sq. feet U. Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a►-� — Other—Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( ) Ga Other fixtures .................................. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity..--........gallons Length................ Width................ Diameter...-.----------. Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter--------..------.--- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results. Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..--........--.......... (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ...................-........................................................................................................................................ 0 Description of Soil........ aAA...................................................................................................................................................... x V -----------------------------•--------------------•-----•-•--•--•----•------•--------------••-----------------•----------------------------•-----------•----------------------------------- W ---- ------------------ •----------------•----••--------------------•-----------•---------------•-----------------------------------•--------•-------------------•----------------------.._...._..... UNature of Repairs or Alterations—Answer when applicable.... 3► ye---and._rep1ace---eydat -.l@acL..fi.ad. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with 1 the provisions of I- p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.l <, Z=-+-_ .�:/�:!.sr-. = , ).--- -•-12/30�30 Application Approved B �sons11_1 -- -----------�- D---------------- 80PP PP Y �3Application Disapproved for the following re -----------•-•-----•----•--•-----------------------•---•--•-----------•-------...------••-•_._.._...._ --•--•----•--•-------•-••---•-----•-•-•----•--•-------------•--•-•••-•---......--•--------•-----•--------------------••----- '�------------------------------------------------------- Date Permit No......... ..---.....--•-••-•••--------------•-------. Issued.................12/3Q1 �.... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH F...........Barnstable.............................................. 01.1rrtifirttfp of Tontplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X) by_.--•-A_.. . .Cesspool aexvice,�..128_Bishops-_ierrace. _Hyannis,---I%---Q2601...................................... Installer at Iyanou h Rd'e Route 28. H,yannis,�...................................................06© '0imp3.o's•. has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..........80".-.7►_pe......... da.ted..----------12/NN................. THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A UARANTEE THAT THE SYSTEM.,W LL FUNCTION SATISFACTORY. DATE.......... ...`. ...� _... �.................. Inspector....... ------------------------ .......... THE COMMONWEALTH OF MASSACHUSETTS J�F BOARD OF HEALTH 1."F....... 710.tAtI e................................................... No...$o..... �� FEE.....$..5.00.... Mipood Works T11nstration pamit Permission is hereby granted............... & H Cesspool._aq.r to Construct ( ) or Repair ( X) an Individual Sewage Disposal System a S1 I anou hd. Koute 23 Han t No.•. A.•.._02b............................D-l:01imI?io's Street as shown on the application for Disposal Works Construction Permit No.--fi0----.------ Dated..................12/30/Q0.--. -•---------•------•--------------•------ oa ealt DATE......../.�....---.7p . 40-------------------- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS ILLAGE a n n _DATE PPLI(fANT •,., c en ©1. A � v _ FEE_ kDDRESS dJ Y �� /. 2 �:e "z_� tf cs TELEPHONE NO:. (Non-refundable) ENGINEER TELEPHONE . NO._ )ATE SCHEDULED l% 3 (Aeflicantlg signature) o . • • • . • o 0 0 0 0 0 • o • o 0 0 0 0 • • o . . . . . . . . . 0 • • • • • • • o • • • • . • • o . • . . o • • . • • • • e • o • • • • • 0 • • o • • i • . SOIL LOG SUB-DIVISION NAME — DATE_ / [-Z) U1 S 3 TIME 2- 3 O XPANSION AREA: YES NO ✓ _ _Ce— Z. .5 Q/'Z`. _ENGINEER OWN WATER ✓PRIVATE WELL \%0Lf " 1 BOARD OF HEALTH P! � r3 CQ Ss i�po EXCAVATOR KETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests , locate wetlands in proximity to test holes ) DONE 3J I /9 2- NOTES : F- ivoo R ram' 2 8 MX D'' L7. fL ss r. A KER,y oo, � 1 P,F►V�D � s 7'vcka o rows+ 4 .PERCOLATION RATE : 2 M•-+/►r1 I'TEST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: C v a ✓'.t �'o��o� 2 3 /w 3 4 „ G v Qa.rS -S Q-14 4 - G 5 5 , r 6 6 7 w1 e.cl. S ter.d� 7 8 8 Tr ar c g, 9 9 10 a t c e- 10 11 11 (vse ?- L000 �® r0 /SOS,12 w a te✓^ / L) 4-a�� 12 13 14 14 / i 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE : LEACHING FIELD LEACHING PITS LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE . REASONS : a u NOTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P . E AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT InL y wyw ��' eI rl III INSIDE FACE .:1 43 �- •° e OF MANHOLE , POURED OR HAND PACKED h ITU/ SS�SSp�S M.AP 3 17 COMP/LED NON•sRRu:K POUT tIALLEMiTE LG�° 3! r3 A FROM me WATERPLUD,EMOECO OR AGENCIES APPROVED EQUAL ,RP ocArioNs J'MAX 7HE PAN/ES _I F N r EEN E J R. 1. 7"H/S — tPIPE N/ 2 4p rpA. GAf?, PyILIRT.93369 SAFE G FORMED OPENIN Z pq: G66ALO 599693 °°�o�s 3 39 CE CONCRETE ENCASEMENT 1? - F ORM rD —TO 12"EACH SIDE Of PIPE CE USLIC N/F PK�pls AND. 9 a S I M JpNN 231140 �ERj. PIPE CONNECTION DETAIL N 35 J using non Arink grout CN O NO7 TO SCALE lys 35 k Q R a C Ci3ti /G I � 25 FeoFtisEO B"P✓C 25 20 tie �� v v W 20 N n h N n � o ? ? 4 1 /5 /5 - lK, � N 8 /0 V /0 HOOT/lONTAL /"= 20' PROF/L E. vER r/CAL /"= 4' FOR PERMITTING PURPOSES ONLY IL co✓�-- 5 P� �k ..tip. '' y r A,le, � Z sToQy CP „ Cove, ypSTS S�. T�s NIF 0 0L�MP10 > E T P02534 v�NG NCERT. � rou A)D o 17 'i 5 n J Cif 5.4 � 17 r s h t to -roe I � i c ��5 old l j / % 1 Wye 1 j 1 at 2 114 Ft deep r existing grease trap 4-t 1 r o•.' existina y r '�,.,.....,,..... urn 5tat ......... •..,,.. MAP 343 - 05 1 p {� ... 55 lyannough Road / } If xf. ry t f t J ,r ..... t In f' 45 deg bend at 3 ft deep k t f t k [ f i ft ............ r 1 1f _.........................._._ 14 114 fit _.............. rt if t �tr 3 INcip Parcel ' 343 - 08 -11W 343 - 09 74 Cedar Street. Il ;l j / tied in ) Aug 15 . 03 MAP 343 - 07 (` €.....� # / ............_...._............ 75 lyannough Road / f 80 Cedar Street r ...._ Hyannis l _. --- TOWN OF BARNSTABLE LOCATION TM r,ci._ Tyanoucrh Rnad SEWAGE # ��77 VILLAGE. Hyannis ,Mass . ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. ,T p;macomrer & Son Inc. Connection common seiner �eli & Bakery PRIVATE WELL OR PUBLIC WATER PW _ s BUILDER OR OWNER D olimpios Realty Trust DATE PERMIT ISSUED: DATE ` COm.PLIANCE ISSUED: 12/23/88 VARIANCE GRANTED: Yes �No XXXXXXXrXXXXXXXXXXXXXX `-n zh� i vs p R7 pco I OVER-ALL CONDITIONS: l:lk� 1T-4" 160 PANEL CONSTRUCTION: ;Al f.IC6 FIto I'}f 'A"rc rrk r;t:A cvit�a xt]tviom SRC DOORS CAIlOUTS: I•: .M hl {drM1.UL :•.1. 2...1 3�'X Sys' NET OP ENWG5: G LA5 5: SAS r-1 ]. 1 k ..r..'C,-'_�' °' 60 `' X 3(ori r 0" W Ot-K. T 15M { .'filrq.r IfU.REFRIGE RAJ.6�i u'Fi o,dL:iff�v..f/°:1.:•..+�a TION: _ Commonwealth of Massachusetts Official Use Only l� k Department of Fire Services Permit No. ----- -- — — ----Occupancy andFee Checked - ,T BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] eave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK - All work to be performed in accordance with the Massachusetts Electrical Code(iyIEC),5 7 CMR. .00 (PLF,ASE PRINT JNINK OR TYPEALL INFORMATION; Date: 3 City or Town of: —Ale IS��,3 L � To the Ins ectol^ f Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) G p L ce� � �y,�;y�U�/j � /�K A 4hv_. a Owner or Tenant ,-'L 3 u iU so AEG t>L ye Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No,of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Nuinbei of Feeders and Ampacity Location and Nature of Proposed Electrical Work: r� ... - y Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No,of Lighting Outlets No.of Hot Tubs Generators KVA No,of Lighting Fixtures Swimming Pool Above In- o.of Emergency Lighting grnd. ❑ d. ❑ Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No, of Alerting Devices Tons g No. of Waste Disposers Heat Pump Number Tons KW. No.of Self-Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KWSecurity Systems: No.of Devices or Equivalent No. of Water KW No.of No.of Data Wiring: Heaters Ballasts Signs No.of Devices or Equivalent a, No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent Q • Attach additional detail if desired or as required by the Inspector of Wires. 0, INSURANCE COVERAGE: Unless waived by the owner,no perririt for the performance of electrical work may issue unless the Iicensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The �t undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE JK BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work:, (Expiration Date) W (Whenrequuedbymunictpalpolicy.) Work to Start: Inspections to be requested in,accordance with MEC Rule 10,and upon completion. X certify,under thepains andp alties 1)*u that the information on this application is true and complete.. FIRM NAME: ALIC.NO.: 3,J Licensee: �, G� Signature � LIC.NO.:;g -2 (If applicable, enter "exe "in the license ber 1'ne.) :Bus.Tel.No. ?--A Address: ar Alt.Tel.No.: OWNER'S CE : I am aware t the Licer6ee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. Ao 1 41 Ir I Z�1 3p 7- ors vJ %2 - �1 p4A 16 sir I y� Iz gf,LL gOXS tom/ 'Z '',�vas � — 31V 7-0 go ,i HF04 ryl i i O`1ER.,kLL CONEIITIONS: i 1 .r;r7r• r _ fT-4" [1601 6oX Nui6kT ��y► ! ; PANEL CuNSTROCTION: SRC DOOR5 CALLOLITS. NET CPEN[NGS: q ,-+ G Las S: ' 60 '' X 3 C" I R EMI GE RATION: f � .01 j f - 00 3 C3,;i c-( 'S ,,n c�V D7 S. r4 � 1� RY x 7 N � 5,�, � 11 r r t!> btj &j, n O Oci Ke� 36 -07 hn 5s� Sod 5a,C ) aa `' x 30 " �� S•�,300�� E�' • ,� a�� . t6 � d�t¢usrael6 � Oz. r✓G // 2Al 6p, � — G 28 a 5 r{ 1 I ;.r� V pIJ J x , \ � 1 oJrr o �.p JNJ 1L IC E I/XL1 1 v 1 e y� -14 r f LOCAT/ON MAP F AR�lN GrON N/F OIO� N/ IMPIO SCALE.' /" = 2065' s,ka 3 M NCENr ;/268 £, �ERE5�401144 T• ��E y VI 330 JS� �ti=E¢" poSEo DR!✓ ��G JIoE .�G P PF pLuo 4nh 1�2�G µ/io6 3,leWe �w SAe.S M�rr3zF ON SONv I� V LIAM/F j068 S gjo yT°P� o G_ „z® FEti'cE E R 3 W I L 24 p 0/ 2 2 9J �u c :0 0,pop 06,e- "5 "rRAP COWAA,�' M.N.co✓�¢ 09 6L'l7 BG �� p( 19rt4 z9 Z e 9 7�K�hy� 1 ��a y/� zyx1 x` zT`I t of E¢ o`L 509P 2oo0D "{E II ,(°DG� I .G a s ss t fo�G ��5 ¢o ;� •�6�I �� ,I�o �I` '' wgu/coi�� rb I31k 3:x= �U pcb�� Gy/ l4A, c EL. fE� P� �L ��lr �''tt'h �.a�'(�a • • ¢•!J.X G'3or. � �„r+"' g�,6�� 30�• 30 ! Zd i� � ` TyP) S�Q. N/F 0 OCIMPIO SrGti( �o�vr�AVINGENf P CERT 102534 .. V 2 p�UO R P' L = 3 9� �� rl�.� 0 AL F `o � �JF I P� �ET 3o 17 km 3,XZ 51 6 a :KED ,.. \r�S S O�S A.A oLLEMITE � r3' ps,�— OR' I �Ra 1 R rJ1F ,eNEr� � _ y 3Y3-a�,S TOWN OF BARNSTABLE SEWER RENTAL RECORD I METER RATE CARD NAME AND ADDRESS OF SEWER. CONNECTION BILL TO - NAME AND ADDRESS TYPE OF BUILDING REMARKS D ' OLIMPIOS REALTY' E- T YEAR PREVIOUS READING PRESENT READING CUBIC FEET USED TOTAL CHARGE � 1 Sr r I II 1 I JAN-20-2001 TUE 04:23 PM BAGELPORT 508 790 1048 P. 01 (508) 362-3221 Invoice No.: CAS'RIS SEPTIC SERVIiCB p.®Box 7, Yarmouthport, Mass. 02675 Fax # (508) 362-7878 T1'11,.t+: V INS'I'A 11,E.D DATE: NAME: LAY STREET: _II CITY: -- MAILING ADDRESS: Cesspool (s) Pumped: Extra Hookup: $5.00 a link after 2 links $ Line Snaked: Labor: Dump Fee: Cash Rec'd $_-___�_,---____—,.____^I.��'I'AI� $ - THIS IS YOUR BILi.. - r Town of Barnstable Building Department 200 Main Street,Hyannis,MA 02601 508-862-4679 fax 508-862-4725 Initial Site Plan Review Issues & Concerns Applicant: FOGO Restaurant&GOL Market Cafe SPR#: 054-18 Property Address: 25,55&67 Iyannough Rd.(Rte 28)&80 Cedar St,Hyannis Informal Review with Representatives Map/Parcel: Map 343,Parcels 002,005,006&008 Plan dated February 16,2018 Zoning: GM—Gateway Medical District&MS—Medical Services,WP Overlay District Proposal: Inerior renovation of existing restaurant building to include new seating in cafe and pizza restaurant. Site work includes relocation of existing business sign;restriping of existing parking area;and,installation of accessible parking signs. 10 employee/overflow parking spaces are proposed at 25 Iyannough Road(Rte 28). The above proposal was reviewed in an informal site plan review meeting held with the owner and representatives on July 31, 2018 Present Brian Florence, Building Commissioner/SPR Chairman Brian.Florence@town.barnstable.ma.us Deputy Chief Dean Melanson, Hyannis FD dmelanson@hhyannisfire.org Richard Scali, Licensing Director Richard.scali@town.barnstable.ma.us David Stanton, Chief Local Health Inspector david.stantonna,town.bamstable.ma.us Darcy Karle, Conservation Administrator darcy.karle@town.bamstable.ma.us Anna Brigham,Principal Planner Anna.Brigham@town.bamstable.ma.us Paul Wackrow, Principal Planner Paul.Wackrow@town.bamstable.ma.us Griffin Boudoin, Senior Project Mgr—Water& Sewer, DPW Griffin.Boudoin@town.bamstable.ma.us Maggie Flynn, Administrative Assistant Licensing Mar aret.Flynnatown.barnstable.ma.us Mr. Vincent D'Olimpio, Owner Attorney David Lawler Dlawler.atty@verizon.net Matt Eddy, Baxter Nye Engineering Meddy a,baxter-nye.com Ellen Swiniarski—Coordinator Ellen.Swiniarski@town.bamstable.ma.us Attorney Lawler explained the scope of the proposal indicating that 80 Cedar Street also has a residential use at the front of the property. Proposal is to increase total number of seats, renovate interior in the caf6 and pizza restaurant, restripe the parking area, including accessible parking spaces/signage. An easement across the abutting property, 35 Iyannough Road(Rte 28), is proposed to allow safe use of 25 Iyannough Road(Rte 28), also owned by the applicant, for 10 employee parking spaces offsite. The following comments were offered by staff at the meeting: Brian Florence, Building Commissioner/SPR Chairman Tel: 508-862-4038 • The zoning district for the property has recently changed to Gateway Medical (GM) with 80 Cedar Street remaining in the Medical Services District(MS). Project will need to be reviewed under the requirements for the GM/MS Districts regarding zoning prior to site plan review approval. • The need for formal site plan review will be determined based upon whether zoning relief is required. • Will work offline with applicant/representative regarding follow up for zoning district requirements. Deputy Chief Dean Melanson, Hyannis FD 508-775-1300 • Confirmed that the proposed layout provides better Fire Department access. • Hyannis Fire Department ladder truck turn radius will need to be added to the plan. • Fire alarm system will need to be extended into the pizza restaurant. 1 i David Stanton—Chief Local Health Inspector 508-862-4647 • Internal interconnection between FOGO kitchen and pizza dining area will need to be created to meet Board of Health requirements. • A BOH variance for reduction of the required number of bathrooms exists for FOGO and was conditioned to limit to 83 seats. An additional bathroom will be needed for increase in seating. Consultation with the Health Department is recommended. • Sizing and location of existing grease traps will need to be confirmed. The addition of seating may require an increase in the grease trap capacity, or possibly an application through the DPW and Health Department for a grease trap variance; contact DPW for a determination. • Consultation with the plumbing inspector to ensure compliance with plumbing code is recommended. Griffin Boudoin, Senior Project Manager- Water& Sewer Town of Barnstable DPW 508-790-6400 • Existing grease trap appears to be undersized = 1000 gal. 2 grease traps are located onsite. Consultation with DPW will be required for conf=ation/determination of required sizing of grease trap. • Confirmed ADA parking and improved onsite circulation. Richard Scali—Director of Licensing 508-862-4778 • HC parking space signage must be installed in accordance with Town of Barnstable ordinance. Maggie Flynn—Administrative Assistant, Licensing 508-862-4774 • Proposed seating changes will require amendment of the existing Common Victuallar License. Anna Brigham, Principal Planner—Planning&Development 508-862-4682 • The provision of landscaping in the parking area is encouraged. Continued. 2 Town of Barnstable OF1HE l Building Department Services Brian Florence, CBO Building Commissioner BARNSTABLE * BARN STABLE, 9 MASS. stosan+Eiis oirzn�iiene"av+sir+,e� �0 200 Main Street, Hyannis, MA 02601 1639. 639-2010 '°rFn N►n�& www.town.barnstable.ma.us 55 Office: 508-862-4038 Fax: 508-790-6230 May 3, 2019 D Olimpio Realty Trust c/o Attorney David Lawler 540 Main Street, Suite 8 Hyannis, MA 02601 RE: Site Plan Review 4025-19 FOGO Restaurant& GOL Market Cafe 25, 55 & 67 Iyannough Road (Rte 28) and 80 Cedar Street, Hyannis Map 343, Parcels 002, 005, 006 & 008 Proposal: Interior renovation of existing restaurant building to include new seating in cafe and pizza restaurant. Site work includes relocation of existing business sign; restriping of existing parking area; and, installation of accessible parking signs. 10 employee/overflow parking spaces are proposed at 25 Iyannough Road (Rte 28). An easement across the abutting property, 35 Iyannough Road(Rte 28), is proposed to allow safe use of 25 Iyannough Road (Rte 28), also owned by the applicant. A total of 160 seats are proposed with 20 to be located outside. Dear Attorney Lawler: At the formal site plan review meeting held April 18, 2019, the above proposal was found to be approvable subject to the following: • Approval is based upon, and must be substantially constructed in accordance with, site plans entitled"55 Iyannough Road, 67 Iyannough Road, 80 Cedar Street, Hyannis, MA" 4 Sheets, dated February 16, 2018 last revised August 14,2018 including grease trap detail and FD truck turning template,prepared for Vincent D'Olimpio by Baxter Nye Engineering & Surveying, Hyannis and floor plans depicting GOL Market Cafe Layout dated July 15, 2018 prepared by RYFT Designs LLC; and, floor plans "Addendum for: FOGO Restaurant" dated December 4, 2011 prepared by WKdesign. • Special Permit relief from the Planning Board pursuant to Chapter 240-24.1.11A4BN(1) for offsite parking for employees, located at 25 Iyannough Road, will need to be granted. • Recorded easement for passage across the abutting property at 35 Iyannough Road, Hyannis, for proposed use of 25 Iyannough Road for employee parking will need to be provided prior to the building permit stage. • At the building permit stage,the fire alarm system will need to be extended into the pizza restaurant per Deputy Chief Dean Melanson, Hyannis FD 508-775-1300. • Internal interconnection between FOGO kitchen and pizza dining area will need to be depicted on a floor plan for Board of Health approval. Tom McKean, Director, Health Dept. 508-862-4640. • Consultation with the plumbing inspector to confirm compliance with plumbing code for bathrooms and grease trap sizing/# of seats is recommended prior to the building permit stage. Contact: Robert Duffy, Plumbing Inspector 508-862-4038. • HP parking space signage must be installed in accordance with Town of Barnstable ordinance. • Proposed seating changes will require amendment of the existing Common Victuallar License. Contact: Maggie Flynn- Licensing Assistant 508-862-4774. • The provision of landscaping in green space in the parking area is encouraged by the Planning and Development Department. • Applicant must obtain all other applicable permits, licenses and approvals required. Upon completion of all work, a registered engineer or land surveyor shall submit a certified"as built" site plan and a letter of certification,made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan(Zoning Section 240-105 (G). This document shall be submitted prior to the issuance of the final certificate of occupancy Sincerely, Y Ellen M. Swiniarski Site Plan Review Coordinator CC: Brian Florence, Building Commissioner, SPR Chairman Deputy Chief Dean Melanson, Hyannis FD Griffin Beaudoin, Interim Town Engineer, DPW Tom McKean, Health Department Director Licensing Planning Board Matt Eddy, Baxter Nye Engineering Town of Barnstable L_I G Department of Public Works Permit Num er Sewer and Trench Permit Connection Disconnect Mod or Repair Map Et Parcel# : 3 7 3 OQY Water Supplier Street z yQ'oo U ®, Sewer Account# Village �TQ��i�� Permit Fee Ft Check# ,5d• LTD (6 1. Residential Bldg Fee-$420.00 ; Commercial B/gFee--$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 Owner Name J Contact Name MailingAddress y� �y �� j Business Address :3Z /�/� jd /'�/>- V) U / 'd Contact Phone Telephone :-503e- 7 Contact Fax Property Use Information, 75 Residential 71 Commercial : 2/Commercial Use Industrial Standard Industrial Code Number of Bldgs : 0/2C OF 7WO Size of Parcel (acres) f Pipe Dia Et Material Pipe Length ; O 7 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(t 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 dra-ovings must be submitted, with this application form, to the DPW for all commercial or industrial installations. The drawings must be app ved before a permit will be issued. Contractor Signature 8 Date y - 4 DPW Approval Signature Ft Date a �Q Sewer Permit Expires �-3 Z ®a� CJ [-.......r..........a:....r-.... i e..... �n�n n�.... 4 ..a A 1 Cry � �� G2�s� I � Q 1j,�� 2� i ' r } �r I � ��• Caa I i '{�{ 1 z. 4 } 1 p I i. �� i+•i .re Ij l � M r li. �li ti! i •I r�_iii � !• i; bSIl1, lOW � r 1� �+ 1 lllj t �i��1� 1 S r�' t��•` :d��}�� I%I�{ € �8 it i}S i�T r!'a, b � � 1'.f G' i��"�lk� �; •l� ftl: 1 r!r {�I (�{� ! 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Cuffing Boardi'10idthi j 70 6,$8 I'nchies r, r bitefict%0A.dth, : £ 48 NE Inctues, NG;mf1dnali Md11ft 72 Oncihes ' i + C ttinn Board Depitf'u�_ 19 7,16 Inches i lstttei w IN-Vih, ! 22 7;`8 IIm—hies. imeoclir'Height 1 26 1., Inc:hes. ti►,0&k Surface Height i 35 V4.Ilnndhes. - -,.V - Atnps 9.8 A,trtps Heirtz 60 Hertz Phase, I - :1lPhase� _ Voltage � 1116 Voll15 r 1,104 Size pin Capaafty 9(Pains + grass,Type Daa Cppa.city 16 cu.fL I CompriessDr Ldcaflon C Sidle:01aunledi CD ires&or Stryfe. Sudle.$'Dear Breathnun,gi ype . r4l , irn��&of DaQrl's 2 f ' Nu mbeir of Shellves 2, Rekigerannt Tpe R-29 t, K j RoOrigeri3don Tf pe Air Coolledl TeUpp.rature Range -3-3 40 Degirees F i r� , ; "' k : _. � �- ,.. _�. � G � ,. +b � � �� ® ... �.. �'*'+ � F � ' �i ;. .r ;� Product Information Technical Details .Length 35 Inches Width 20 1/2 Inches Height 43 3/4 Inches Bowl Depth 12 Inches Work Surface Height 361/2 Inches Basket Drain Size 3 1/2 1 nches Bowl Front to Back 15 Inches Bowl Left to;Right 15 Inches Drain Outlet Size 11/2 Inches Faucet Centers 8 Inches, Gauge 18 Gauge leg ConstructionGalvanized Steel Material Stainless,Steel NSF Listed Yes Number of Compartments 3 Number of Drainboards None Stainless Steel Type Type 304 Style 1 0 Drainboards • 1 4� _ Ij( . 4 4. wti . , i ' M M' i BL ` ET,T IOGODBMT SPECS Width dth7B 1,116 Inch e.s Depthi 45 5,116l nclh es, [Hen lTt 65, 518 Inches 'Deck Width 60 Inches Deck Cie, t; 36 Inches Deck Height 1,01 Inches 'Door Type Solid Exteribir M a,terlal StalinlIess. S- ite-el Inner or Maitterial . Iumv iniize,d t, l . ad!e iin Amer cap Yes, NSF Listed s Number of 10" Pizzas 36 Pizza Number ber of 14" Il i ZZ8 S, 1 RIZZa s Number of Decks Power, 'Type Natural Gas Style Deck- t li Te m pera,tu re Ran nge 30-0 .-.:65.'0 Dlo eos, IF Total BTU 11170.000. L � got Y Fr µ a >ai 14. _ .`a .ram ..r•^ . . r f _ l Product. i nformatio n ec nu l Details Width 60 Inches Depth 30 Inches, Height 15 Winches Each B u mer U! 30,000 N u;mber of Burners 5, � Number of Corvtrols 51 Total BTU 15OPOOO1 Type Griddles Control Type Mainuall Gas Inlet Size /41nch s Instal Iation T pe C_ounte op I r Type Natural Gas s.i i L;A!"- �. _ Af I am 01 �r- t1: W.,WkF% ti� s• P I { SPECS Length 12 'In chips 'Width '16 Inches Height. '10 Inches Bowl Depth 4 Inches Bowl Fro rat to. Rack. 9 Inches- Bowl Left, tcc Right. 9 Inches Fan cet Cente ,Inches Fan�cet I ncl ud,e 'es: Row Date, 2 G,PM Ini tallation; Typo. 'W. ,a1 l Mounted Material Stainliess Steel 1 IF iL-i�Sted Yes, tai nlesls, S-Reell Type Type '304 Type Hand Sinks wm. 4 — El �,�-,+r� Arr 10N A CUIDADO i CAUTION A� s s 1 9 f 4 111001111 e s :. PffCO 35C4S LP SPECS Widths 1 118. 1 nchies Depth 30 9132 llnche .. Height, 46 Iln ches Fry Pot,Widths 14 l nch es, Fry Pot, Depth l4 linches Burner Style Tube Cabinet -Stainless Steel Capacity. 5 - 410 Ilbb., Gas In l!et Size 314 Inches Made, iin America Yes NI F !L- 'stied • Number of Fry, Baskets, Number of Fry Pots, 1 Power Typo, Liquid Propane split Pot No Tern pe ratuy re Ba d e 200 - •4010 Degrees F Total BTIJ 9010010 Type Gas Floor Fryer: 1 P19-51 FOGO BBQ Town of Barnstable E ° Building Department Services +�# r Brian Florence,CBO i u�SBLB, v, 0� Building Commissioner 69 hut A� 200 Main Street, Hyannis,MA 02601, www.town.barnstab1&ma.us Office: 508-862-4038 Fax:508-790-6230 Construction Control Package Site Address: FOGO BBQ & GOL Market, 43-55 Iyannough Road, Hyannis, MA T. Varnum Philbrook, P.E. -Af~Engineer: Name: Philbrook Engineering 107 Beach Street, Dennis, MA 02638 Address: 508-385-8682/508-364-1301 Telephone Email: Tvarnphil@Verizon.net Contractor: RYLEY Construction, Inc Name: John Ryley 8 West Bay Road, Osterville, MA 02655 `• Address: `= 401-484-2315/774-361-6466 Telephone: < ryleyconstruction@gmail.com Email: Owner, Vincent D'Olimpio Name: Address: 49 Iyannough Road, Hyannis, MA 02601 Telephone: 508-420-1414 Email: vdolimpio@robert.com P19-51 FOGO BBQ Town of Barnstable rc o� Building Department Services o, Brian Florence,CBO aARNSTAS Building Commissioner t+a bmss. t env a,,�' 200 Main Street, Hyannis,MA 02601 www.town.barnstable.me.us Office: 508-862-4038 Fax:508-790-6230 Massachusetts Existing Building Code Anatvsis Reson 20151ESC wt MA amendments Site Address: FOGO BBQ & GOL Market, 43-55 Iyannough Road, Hyannis, MA - Map: 343 Parcel: 3 4 3 0 0 5 Village: Hyannis Applicant name: John Ryley Phone: 401-484-2315/774-361-6466 ryleyconstruction@gmail.com E-mail' A-2r (Restaurant/Bar) & F-1 (Bakery/Cafe) Risk Category: II Use Group: Occupancy Limit: A-2 by Net Area; 221 A-2 by Seating; 120 + 20 I.A.W.780 CMR 2015 IEBC 301.1 -The permit application shall comply with one of the following methods: Choose One:® Prescriptive method ❑ Work area method ❑ Performance method Construction Control ®Yes ONO If Yes Documents shall be In accordance with 780CMR 34.00 MA Amendment to 2015 IEBC.The building Owner shall cause the existing building(or portion thereof)to be investigated and evaluated.The Investigation and evaluation shall include at least:structural,means of egress,fire protection,energy conservation,lighting,hazardous materials,accessibility,and ventilation for the space under consideration and,where necessary, the entire building or structure and foundation.The results of the Investigation and evaluation shall SN of M� be submitted in written report form. o�� SgcyG T VARNUM u� og PHILBROQK USE FILL IN FORM OR ATTACH DOCUMENTS AS NEEDED FOR EACH EVALUATION MECHANICAL CATEGORY BELOW: .0 p o. 6 � See attached stamped Renovation & L/S plan Structural,,,,,,,,,,,,,,,,,, S1ONAL EN See attached stamped Renovation & L/S plan Means of egress,,,_,,,,,, Z3 5p-4-ZpZ0 See attached stamped Renovation & L/S plan Fire protection,,,,,,,,,,,,,; Energy conservation Yes, Openings & New Construction Areas Required : Lighting Yes, Electrical Permit & Design As-built Required 9 g........................ Hazardous Material,,,,,; none Accessibility See attached stamped Renovation & L/S plan Ventilation,,,,,,,,,,,,,,,,,,; Yes, Mechanical Permit & Design As-built Required Description of Proposed work See attached Descriptive Narrative; Essentially Document/Bring Current Existing Restaurant, Bar, 3 Kitchens w/ Integral Restrooms AND Renovate/Bring Current Existing Pizza Area w/ Integral Permitted Restroom AND Renovate/Alter/Bring Current New Cafe & Bakery w/ Integral Permitted Restrooms PHILBROOK ENGINEERING 107 BEACH STREET Project: FOGO BBQ/GOL MARKET DENNIS, MA 02638 FOR PERMITTING Project No: P19-51 1-508-385-8682 Date: 23 January 2020 DESIGN LAYOUT NOTES-Document&Renovate Existing Building Areas ---------------------------------------------------------- ---------------------------------------------------------- Sheet Note Description No. Uj 1-9th_ed� -------- -------- ------- ------- ------- ------- ------- -------- -------- 1 of 1 Narrative: The Floor Plan for this building is being renovated to accomplish a number Renovate of related code and construction requirements. There will be no increase & in area or space. There will be an increase in seating occupancy when the Life/Safety existing'office/storage'area is changed to a cafe w/bakery functions. The plan for these code upgrades and alterations is attached for reference. Currently the building has a reportable fire alarm system which is deemed adequate for its'current occupancy. However,a device audit was conducted to specifically address the renovations,AAB compliant restrooms and new altered spaces. Further,deficient items were identified for replacement or re-configuration. These are shown on the attached plan. Fire alarm work will require a separate permit from the Bldg. Dept. IEBC 2015: Compliance Method-Prescriptive Compliance Method for Alterations(Sec. Summary 403)and Change of Use(Sec.407). Sec.403 Alterations are Level II IAW Chp.8. Para.301.1.1 and Chp.4 Sec.403 Alterations&410 Accessibility. There are no MA Amends for these sections. Para.401.2-Building Elements and Materials to meet the IBC 2015 require- ments. Existing materials already in use may remain unless deemed unsafe. Para.403.1 -Alterations being made will not make the building less conforming than the building was prior to the alteration. Para.403.3&4-There will be some changes to the gravity(snow) load resisting construction. Accordingly upgrades(strengthening)to roof systems are in- cluded-see attached plan. Para.410.3-The extent of the alterations do not pose a requirement for any greater accessiblity. The alterations do include upgrades and the fit-out of additional AAB compliant restrooms along with seating and travel paths. Para.407.1 &2-Change of use takes existing B/S-1 spaces and converts them to a partial A use(more hazardous)space plus the new F-1 Bakery change. For construction and separation (use and also Phase work)this change needs separation IAW Tbl.608.4 IBC 2015 Base Code for non-sprinklered buildings. Para.407.1.1 -Change of character of use-adding Amusement Space. Proposed occupant load will be 40. This is less than the 50 occupant threshold so does not trigger any further work IAW Para.430.1 IBC 2016 Base Code(MA Amend) Para.804.2.2.1 -Fire Protection; none of these current uses or the proposed change of use require automatic sprinkler protection based upon combined total existing area and uses. All work is less than 33%of the assesed value. Para.804.4.1 -Fire Alarm; Existing alarm notification devices shall automatically activate throughout the building. Where there is no equipment alarm and notification equipment shall be provided. IN OF M,gss9 yG c T VARNUM s PHILBROC K MECHANICAL 9No.3 6900 o � (ONAL ENG PHILBROOK ENGINEERING 107 BEACH STREET Project: FOGO BBQ/GOL MARKET DENNIS,MA 02638 FOR PERMITTING Project No: P19-51 1-508-385-8682 Date: 23 January 2020 DESIGN LAYOUT NOTES-Document&Renovate Existing Building Areas Sheet Note Description No. uj1-9th ed -------- -------- ------- ------- ------- ------- ------- -------- -------- 1 of 1 IEBC 2015 Bldg.Code-Structure, Fire, Life/Safety-NO Change, Existing Uses remain Renovate &IBC 2015 Wood Frame-1 Story Type of Construction-V-B Unprotected 8, w/ Uses;A-2r(Restaurant)&Cafe(w/F-1 Incidential/Bakery) Life/Safety MA Amend �SN OF MgSsq y 0 No Change in levels of Protection or Use. T VAR NUM GN o PHILSROOK Egress/Life Safety MECHANICAL [Txx'^l Use&Occupancy-Assembly; Restaurant-Seating=140 No 069 Travel Distance& Egressway Widths s r xxX�Multiple egress paths, all < 200 ft w/o automatic sprinklers �ONALEN and all door widths are nominal 36" - OK Doors-Existing&New;ADA Hardware required as noted —Lx= Exterior - Out-swing although occupancies vary < & > than 50. Interior - for Common Area/Restroom/Exam Room. Nominal 310" Interior - for Lessor Rooms. Nominal 2'8" Fire Signaling&Fire Detection 5x Fire Signaling & Fire Detection - Systems in-place. Upgrades to Horn/Strobe and local fire alarm system w/ manual controls and compliant notification equipment Fire Framing-Tenant separation locations �6x=No Change in Total Areas or Space. A new separation is required IAW Tbl. 508.4 (Base Code) - 2 hr Assembly for non-Sprinklered between A use & B/F-1/S-1 uses. This is also the Phase line. CMR 521 ADA Access-Yes, Public Areas;Access&Service must fully comply �7x The proposed reconfigurations maintains direct access to the entrances, dining areas and restooms which are part of the work. CMR 548 Plumbing-Fixture Count based upon occupancy use/load 8x Female - 3 WC provided - support 90 women & Male - 2 WC provided - suppport 120 men NOTE - For actual use, total 140 occupants so 2 & 1+1 are OK Female & Male Lavatories - 2 Dedicated - support 200 occupants ea NOTE - For actual use 2 more UNISEX add another 25 Women & 50 Men Misc. - Water Foundation & Service Sink are NOT required IECC 2015 Energy-COM-Chk compliance �9x No Changes to Existing Perimeter. In-fill walls along w/ HVAC and Lighting to comply with current codes Electric Natural vs.Artificial Lighting: <8%Glass areas [—lOx Insufficient windows (<8%) so artificial lighting is required for the interior spaces. Fixture count and wattage from COM-check HVAC Natural vs. Mechanical Ventilation: < 4% Opening areas IMC 2015 A-2r; Repairs & upgrades as needed for ducting & serivice. llx Restroom requires 70 CFM/fixture (WC) on light activating circuit. A-2r; System design check requires 7.5 CFM/person People = 450 CFM and .18 CFM/sq ft Area = 205 CFM. Total equals 655+ CFM for IAQ A-2r (Bar & Pizza) ; Correspondingly require less totals for IAQ f P19-51 FOGO BBQ Initial Construction Control Document To be submitted with the building permit application by a Registered Design Professional for work per the ninth edition of the Ulf Massachusetts State Building Code, 780 CMR,Section 107 FOGO BBQ & GOL Market Project Title: Date: 23 January 2020 Property Address: 4 3-5 5 Iyannough Road, Hyannis, MA Project: Check(x)one or both as applicable: New construction +xx Existing Construction Project description: T. Varnum Philbrook 30690MA 30 June 2020 1 MA Registration Number: Expiration date: ,am a registered design professional,and I have prepared or directly supervised the preparation of all design plans,computations and specifications concerning': o Design and Construction by Engineer-of-Record Architectural _xx Structural +xx Mechanical _xx Fire Protection +Xx Electrical _XX Other. Engineer-of-Record + indicated work by MA licensed tradesman - separate permits required for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I (or my designee)shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. 2. Perform the duties for registered design professionals in 780 CMR Chapter 17,as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official,I shall submit field/progress reports(see item 3.)together with pertinent comments,in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a'Final Construction Control Document' H of Mgssgcy Enter in the space to the right a"wet"or electronic signature and seal: �° T VARNUPHILBROOK M MECHANICAL (n Phonenumber: 508-385-8682 Email: Tvarnphil@Verizon.net No.306900 Buriding offldaIIlse 011Iy �sSIONAL �G\ Building,Official Name: Permit No.: Date: Note 1.Indicate with art Y project design plans,computations and specifications that you prepared or directly supervised.If'othei'is chosen,provide a description. Version 01 01 2018 P19-51 FOGO BB Construction Control Progress Checklist To be submitted at completion of required site reviews for construction progress per the ninth edition of the Massachusetts State Building Code,780 CAM Section 107 FOGO BBQ & GOL Market 23 January 2020 Project Title: Date: Permit No. Property Address: T. Varnum Philbrook 30690MA 30 June 2020 I, MA Registration Number: Expiration date: am a registered design professional and I or my designee have observed the following work, and to the best of my knowledge, information, and belief the construction work indicated below has been performed in a manner consistent with the approved plans and specifications: Schedule Inspections a day or so in advance to avoid work holdups . "'�"""�"�=R� iiiir� =Site.`nevie4+f•`ardpociurientatiaii;for�,'o�tioas'§i-. tia's;; pfz �s1i'#icSijn�:`'�'`:�:;��"n!; ..`�.'-� ;•,�,,�y.;ii:nr;?".✓4"fjh;�:�:ra:�• _]�;'.ra ,-.� .L � .;,�;. r:;� Qua.0:'a�;"c��~��R!CO11tTa"bC�6r.'��i,��j;��xi7E -�:::l._:;::::�tcbe eil:'::ihea "to"f[ate3e•"tet�edrilesl=' .:`"r4fessiona�o"iEl4�i e�i ee r.M: Site Review and Documentation rX:4 Site Review and Documentation Soil condition and analysis :W Energy Efficiency Requirements xx Footing and Foundation,including Reinforcement and XX FireInstallation Foundation attachment Alam Fire Suppression Installation] x Concrete Floor and Under Floor •��•4 Fiel Lowest Floor Flood Elevation •r��- d Re orts$ Structural Frame-wall floor roof Carbon Monoxide Detection SYstem4 Xx ' Lath and Plaster/Gypsum - Seismic reinforcement Smoke Control Systems(Special Inspection persectionc 909.3 Fire Resistant Wall/Partitions framing XX and 90419. r: `.• Fire Resistant Wall Partiflons finish attachments Smoke and Heat Vents r Above Ceiling inspection Accessibill 54 CM XX Fire Blocking/Stopping System XX Other: sx::r•: Emergency Li tin Exit Si na a Means of E ess Com oneness XX Special Inspections(Section 1704): ;. Roofing,co in S stem Venting Systems,(kitchen and cleanouts chemical,fume ".q:, Mechanical Systems xx 1.Indicate with an'x'the work you reviewed for compliance with the approved plans and specifications and describe in detail below. 2,Include NFPA 72 test and acceptance documentation 3.Include applicable NFPA 13,13R,131),14,16,17,20,241,etc.-test and acceptance documentation 4.Include NFPA 720 Record of Completion and Inspection and Test Form S.Include field reports and related documentation 6.Nothing contained within construction control shall have the effect of waiving or limiting the building official's authority to enforce this code with respect to examination of the contract documents,including plans,computations and specifications,and field Inspections. Description of Construction Work Observed": a. Describe in sufficient detail the work(i.e.foundation steel reinforcing,kitchen vent system,etc.)and the beat! on the project site,and list if applicable,the submittal documents that pertain to the work which was inspec ��z�of Mass �� 9cti Enter in the space to the right a"wet"or ��° T VARNt1M Goa Email: Tvarnphil@Verizon.net electronic signature and seal; MECHA o 00K N 508-385-8682 t MECHANICAL No.30690 Phone number. v o ' BuildhigOfJleal Use Only A Building official Name: Date: Version 0f0! 2018 CutLess File Folders 48420 Tops-Products.com/Pendaflex MADEIPIDSA 30% PCF P4 f ! « dj � 7! f l i 1 _ r - Town of Barnstable , Mass Department of Public Works existing pump stat Modified existing new 2,500 gal Jan 7 , 19 manhole grease trap _ — --- _ wye at existing 4 ft deep pump stat O 4" Cl I tied - In inlet pipe�ivent pipe Aug 15 , 03 existing grease trap 80 Cedar Street 45 lyannough Road Hyannis 55 lyannough Road Hyannis 3 Iyannoug Road Hyannis Map i* Parcel Map £t Parcel ®] 343 - 05 343 - 05 Plan View Scale : 1" =30' I < -- lyannough Road --- Modification to 2,500 al Grease Trap L g P at 43 - 55 lyannough Road Hyannis 11 x 17 Sheet 30 Scale : H GOL MARKET ADDITIONS cN cn ,w 55 ROUTE 28 �' Z �•:"' 1 a O HYAN N IS, MA > o IN GENERAL STRUCTURAL NOTES GENERAL STRUCTURAL NOTES SHEARWALL SCHEDULE SHEARWALL HOLDOWN SCHEDULE"' O W 1.ALL SSACHUCONSTRUCTION ETTSSTATEBUIL IN ACCORDANCE CODE, WALL FRAMING CONNECTIONS WALL TYPE SCHEDULE FOUNDATION HOLDOWNS Y MASSACHUSETTS STATE BUILDING CODE,EIGHTH EDITION(780 CMR),AND ALL AMENDMENTS, WHICH IS BASED ON THE 2009 INTERNATIONAL a �r BUILDING CODE. 1. ATTACH EXTERIOR WALL STUDS TO THE DOUBLE TOP PLATE AT THE ROOF i5/z'PLYWOOD-(EDGES BLOCKED) WITH(1)TSP CONNECTOR AT 32"O.C. PROVIDE(9)-10d x 1 y NAILS TO THE 8d COMMON OR GALVANIZED BOX NAILS @ 6"O.C.EDGES TO FOUNDATION ON W/ P ANCHOR BOLT PLACED BEFORE POUR.ATTACH 2.THE WIND DESIGN CRITERIA FOR THIS BUILDING IS IN ACCORDANCE STUD AND(6)-10d NAILS TO THE DOUBLE TOP PLATE. CONNECTOR TO BE AND 12"O.C.FIELD. TO FOUNDATION W/APPLICABLE ANCNORMATE.IF REQUIRED USE WITH RUCTION FOREST AND PAPER ASSOCIATION(Y DWELLINGS ,"WOOD FRAME O CNW5/COUPLER NUT BETWEEN ANCHOR BOLT AND 5/"THREADED ROD CONSTRUCTION MANUAL FOR ONE-AND TWO-FAMILY DWELLINGS(WFLM),° APPLIED DIRECTLY TO 2X FRAMING. 15 e e J _ AND THE"MINIMUM DESIGN LOAD5 FOR BUILDINGS AND OTHER NOTE:NOT REQUIRED WHEN USING H2A CONNECTOR PER NOTE ON ne /z'PLYWOOD-(EDGES BLOCKED) TO CONNECT TO HOEDOWN. O Bd COMMON OR GALVANIZED BOX NAILS @ 3"O.C.EDGES .. STRUCTURES -0 THE BASIC WIND SPEED FOR THE DESIGN OF THIS STRUCTUREURE IS I5 120 MILES PER HOUR WITH EXPOSURE CATEGORY B'. I 2. EXTERIOR WALL STUDS OF UPPER FLOORS TO BE ATTACHED TO STU ON AND 12"O.C.FIELD. ' I DS THE FLOOR BELOW ACROSS THE RIM BOARD W/(1)CS 16 COIL STRAP W/ (14) 3 15/2'PLYWOOD-(EDGES BLOCKED) BUILDING OFFICIAL FOR THE STRUCTURAL FRAMING INSPECTION(5). IF () I0d NAILS(7 NAILS AT EACH END OF STRAP)WITH A STRAP CUT LENGTH OF8d COMMON 3.THE CONTRACTOR IS RESPONSIBLE FOR CONTACTING THE LOCAL i 18" THE CLEAR SPAN ACROSS RIM BOARD. STRAPS TO BE SPACED AT 32"O.C. AND 12"O.C.FIELD.ELD FRAMING AOT ADJOINING PANEL EDGES W THE BUILDING OFFICIAL REQUIRES THAT THE INSPECTION(5) BE (EVERY OTHER STUD).STRAP I5 NOT REQUIRED AT SHEARWALL HOLDDOWN SHALL BE 3"NOMINAL OR WIDER AND NAILS SHALL BE w SHEATHING. WOO TO BE APPLIED OVER PLYWOOD CS 16 COIL STRAPS S YD S . COMPLETED BY THE ENGINEER OF RECORD,THE CONTRACTOR SHALL LOCATIONS STAGGERED. � a CONTACT THE ENGINEER OF RECORD M HOURS PRIOR TO THE TIME WHEN 3. EXTERIOR WALL STUDS THAT ARE ABOVE BEAMS IN THE FLOOR FRAMING NOTE:FOR PLYWOOD SHEAR WALL TYPES 1,2,AND 3 LISTED THE I ALL STRUCTURAL IS TO BE PERFORMED. THE CONTRACTOR SHALL INSURE SHALL BE ATTACHED TO THE BEAM WITH(1)LTS12 TWIST STRAP AT 16"O.C. 1 a THAT ALL STRUCTURAL MEMBERS AND CONNECTIONS ARE VISIBLE FOR (CUT SMALL SLOT IN FLOOR SHEATHING FOR STRAP). STRAP IS APPLIED ABOVE,Bd COMMON OR GALVANIZED BOX NAILS =LENGTH x 2/Y INSPECTION. IF DURING THE INSPECTION, ANY PORTION OF THE DIRECTLY TO 2X FRAMING. GUN NAILS MATCHING THE NAIL DIAMETER AND LENGTH MAY BE STRUCTURE I5 DEEMED NOT VISIBLE OR I5 INACCESSIBLE FOR USED AS A SUBSTITUTE. INSPECTION, FINAL APPROVAL OF THE ENTIRE STRUCTURE WILL NOT BE NO. REVISION/ISSUE DATE GIVEN UNTIL THIS CONDITION IS CORRECTED AT THE CONTRACTOR'S 4. ATTACAT 16"O.CHAND PROVIDE(4)10dNALOWER LEVEL STUDS ILS TO STUD AND(2)10d NAILS TO SILL FOUNDATION SILL PLATE WITH SSP IP SOLE PLATE CONNECTION SCHEDULE EXPENSE. AND SOLE PLATE ((1)10d EACH PLATE). 4.ALL WOOD CONSTRUCTION CONNECTORS AS SPECIFIED ON THESE CONNECTIONS FOR WALL OPENING ELEMENTS (REFER TO DETAIL CONNECTION TO FLOOR RIM BOARD 5. CONSTRUCTION DOCUMENTS TO BE SIMPSON STRONG-TIE IN ACCORDANCE e) WITH CATALOG C-2014. IT I5 THE RESPONSIBILITY OF THE CONTRACTOR TO WALL TYPE SOLE PLATE CONNECTION TO RIM BOARD PROJECT ADDRESS: INSTALL ALL CONNECTORS IN ACCORDANCE WITH MANUFACTURER'S HEADER SIZE HEADER TO JACK STUD TACK STUD TO SOLE PLATE SPECIFICATIONS. L=V-0"TO 4'-0" (1)LSTA 9 (1)SP4 (3)-16d COMMON WIRE NAILS PER 16" 5.ALL ENGINEERED LUMBER PRODUCTS TO BE I-LEVEL TRU5 JOIST(OR L=4'-1"TO 6'-0" (2)LSTA 9 (2)SP4* EQUAL)INSTALLED IN ACCORDANCE WITH MANUFACTURER'S L=6'-1"TO 8'-0" (2)LSTA 12 (2)SP4* Al (4)-16d COMMON WIRE NAILS PER 16" 55 ROUTE 28 SPECIFICATIONS. L=8'-1"TO 10'-0" (2)L5TA 15 (2)SPH6* -,3,r, HYANNIS,MA (3)-SIMPSON SD525312(1/a'x V2") ZC z 6�-,c0"",l'8("0 7 ROOF FRAMING CONNECTIONS `ALTERNATE:THE CONNECTOR SHOWN FOR THE JACK STUD TO SOLE PLATE WOOD SCREWS PER 16" { CAN BE SUBSTITUTED WITH THE SAME CONNECTOR SHOWN FOR THE JACK 1.ATTACH OPPOSING RAFTERS AT THE RIDGE OVER THE TOP OF THE RIDGE STUD TO HEADER. ATTACH CONNECTOR WITH HALF OF THE REQUIRED CONNECTION TO CONCRETE FOUNDATION WITH(1)LSTA 18 TENSION STRAP AT 16"O.C.STRAP TO BE INSTALLED OVER NAILS TO THE JACK STUD AND HALF OF THE REQUIRED NAILS TO THE ROOF SHEATHING INTO RAFTERS W/10d COMMON NAILS TO RAFTERS. FOUNDATION RIMBOARD.CONNECTOR TO BE ATTACHED DIRECTLY TO 2X FOUNDATION SILL PLATE CONNECTION TO CONCRETE FRAMING AND RIMBOARD.ALTERNATE CAN NOT BE USED WHEN SOLE PLATE /•1;," 2.ATTACH THE END OF EACH RAFTER/TRUSS TO THE DOUBLE TOP PLATE OF I5 ATTACHED DIRECTLY TO FOUNDATION STEM WALL OR CONCRETE SLAB. 5/8'dio.ANCHOR BOLTS AT 32"o.c. THE EXTERIOR WALL WITH(1)H2.5A CONNECTOR. CONNECTOR TO BE :'p APPLIED DIRECTLY TO 2X TOP PLATES ON OUTSIDE FACE OF WALL. NOTE: NOTE:ANCHOR BOLTS REFERENCED ABOVE TO BE%"DIAMETER A307 - ALTERNATE:-USE(1)H2A FROM EVERY RAFTER TO WALL STUD BELOW. T5P STEEL ANCHOR BOLTS WITH Wx 3"x 1/4"PLATEWASHER WITH 7" CONNECTOR PER NOTE'1',"WALL FRAMING UPLIFT CONNECTIONS",15 NOT 1. HEADERS 4'-1"AND LARGER REQUIRE(2)JACK STUDS AT EACH END OF THE MINIMUM EMBEDMENT INTO CONCRETE. REQUIRED WHEN USING(1)H2A AT EVERY RAFTER. HEADER(EXCEPT-HERE NOTED). ALTERNATE:TITEN HD BOLTS WITH Wx 3"x%4"PLATEWASHER M C I<E N Z I E 3.BLOCKING TO BE PROVIDED ABOVE THE DOUBLE TOP PLATE OF THE 2.PROVIDE(1)SSP FROM EACH KING STUD TO DOUBLE TOP PLATE OF THE ENGINEERING EXTERIOR WALL AT THE ROOF WITH ROOF SHEATHING NAILED TO THE WALL,WITH(3)10d NAILS TO DOUBLE TOP PLATE AND(4)-10d NAILS TO KING SHEARWALL CONSTRUCTION BLOCKING AT 6"O.C. PROVIDE'V'NOTCH IN BLOCKING TO PROVIDE STUD. FOR SECOND FLOOR HEADERS,PROVIDE(1)CS 16 FROM EACH KING CONSULTANTS ADEQUATE VENTILATION AS REQUIRED. BLOCKING TO BE ATTACHED STUD ACROSS THE RIM BOARD TO A STUD IN THE FIRST FLOOR WALL �.d,;i.— "„i DIRECTLY TO DOUBLE TOP PLATE OF THE EXTERIOR WALL W/(1)RBC BELOW. FOR CS 16 STRAP SIZE REFER TO NOTE"2"ABOVE.FOR FIRST FLOOR 1.ALL SHEARWALLS TO HAVE DOUBLE TOP PLATES AND DOUBLE 2X STUDS AT CONNECTOR. HEADERS PROVIDE(1)CS 16 FROM EACH KING STUD TO THE FIRST FLOOR RIM EACH END OF THE WALL. BOARD. FOR CS 16 STRAP SIZE REFER TO NOTE"4"ABOVE. 2.FACE NAIL DOUBLE TOP PLATES W/16d NAILS AT 16"O.C. USE(12)-16d 1279 MILLSTONE ROAD FLOOR FRAMING CONNECTIONS 3.KING STUD TO RIMBOARD CONNECTION SPECIFIED IN NOTED'AND NAILS T EACH SIDE OFF LAP SPLICES IN TOP PLATES. SPLICE LENGTH TO BE BREWSTER, MA 02631 q ABOVE I5 NOT REQUIRED WHERE A SHEARWALL HOLDOWN IS ADJACENT TO A MINIMUM OF 4'-0"LONG. (7 7 4) 35 3-2144 1. PROVIDE(2)1%4'WIDE LVLS UNDER INTERIOR SHEARWALLS WHEN - THE OPENING. PARALLEL TO THE FLOOR FRAMING DIRECTION. IF CS 16 COIL STRAPS ARE 3.NAILING FOR PERFORATED SHEARWALLS TO BE CONTINUED ABOVE AND SPECIFIED AS HOLDDOWNS AT THE END OF THE SHEARWALL,WRAP THE BELOW ALL OPENINGS IN SHEARWALL. 'd' STRAP(STRAPSSAROUNDD THE(2)13/4"WIDE LVLS AS SPECIFIED,WRAPPING THE THE LVLS.IF HOLDOWN AT END OF SHE RWALL IS A HDU 4.ATTACH DOUBLE 2X STUDS AND BUILT-UP CORNER STUDS AT SHEARWALL LEGEND ENDS WITH(2)16d NAILS AT 6"O.C.FOR ATTIC/SECOND FLOOR TYPE,SUBSTITUTE(2)13/4'WIDE LVLS WITH 3'Z WIDE PARALLAM(MIN).SEE SHEARWALLS AND(2)16d NAILS AT 4"O.C.STAGGERED FOR FIRST FLOOR DETAILe SHEARWALLS. XD 2. PROVIDE 3 112"WIDE PARALLAM PSL BLOCKING OR(2)13/4"WIDE LVL SHEARWALL TYPE = =" '. BLOCKING UNDER INTERIOR SHEARWALLS WHEN JOISTS BELOW ARE 5.REFER TO HOLDDOWN SCHEDULE FOR TIE DOWNS AT SHEARWALL ENDS. I _s."`A_,XEr A` R41S..PCf_-c PERPENDICULAR TO SHEARWALL.PAD WEB OF TJI JOISTS AS NECESSARY. - O SHEARWALL GRIDLINE � CNIL \\11 Na 39MBo/m 3. ATTACH THE DOUBLE TOP PLATE OF THE EACH EXTERIOR WALL TO THE O SHEARWALL HOLDDOWN TYPEFG oIry�EE"`a°yrc RIM BOARD OF THE FLOOR ABOVE WITH(1)LTP5 CONNECTOR AT 24"O.C.OR I,J31/1 W/(2)10d TOE NAILS PER 12". 1 i • SHEARWALL HOLDDOWN t --SHEARWALL f I P PERFORATE SHEARWALL. CONTINUE PLYWOOD ABOVE AND BELOW I JOB#: 17-299 SHEET OPENING WITH NAILING ACCORDING TO SPECIFIED SHEARWALL TYPE. XK Xi #OF KING AND JACK STUDS AT OPENINGS i DATE:12-31-2017 Gi . SCALE: NONE O JiiGK5TUD) K1NG5TUD5 MODEL# DIA. MIN.EMBED. MIN.REBAR LENGTH DUILTUPGOPNEPSTU 5 MODEL# DIA. MIN.EMBED. MIN.REBAR LENGTH (#PER PLAN) CM1N OF#PER PLAN/55N OP e) SSTB 16 5!8 12-e— 50" CM/N OF+F PEP PLAN/G5N OP�) SST816 5/8 12/e" 50" OPENING SSTB20 518 16/8" 58" WF SSTB20 5/8 16%" S8" — — — — — SSTB24 5/8 20/8" 66" SSTB24 5/8 20/e" 66" — _I — — 55P AT/6"O.G. SSTB28 7/8 24/e" 74" SSTB28 7/8 24/e" 74" r^ SSTB34 7/8 28/e" 82" 11DU110LDOWN SSTB34 7/8 28/e" 82" S61x30 1 24" o' (PEP PLAN) SBlx30 1 24" 96" (PEP PI NOTE:#4 REBAR TO BE CENTERED ON HOLDOWN AND LOCATED NOTE:#4 REBAR TO BE CENTERED ON HOEDOWN AND LOCATED (PEP PLAN) 3"TO 5"DOWN FROM TOP OF FOUNDATION WALL PER SIMPSON 3"TO 5"DOWN FROM TOP OF FOUNDATION WALL PER SIMPSON MANUFACTURER'S SPECIFICATIONS. MANUFACTURER'S SPECIFICATIONS. O ° 55P AT 16"O.G. ° 450 ° #4RREBAR� 55TD NOLDOWN ANGt1OPa ° a PLATE 55TD APPOW ON TOPa #4 PEDAP : OF ANG"OP DIAGONAL IN ° MIN#4 PEDAP " 3"TO5" a° /10LDOWN ANG110PGOPNEP APPLIGATIONto y„4. .aPEDAPa P051TlON 1N WALL PEP ED6E DlSTANGE 4 . ° n wANGPIOP DOLT 5/MP5ON MANUFAGTUI'EP'S 1.95"FOP 2X4 WALL SILL PLATE O-Ee 65N) Q 5PEG/FlGA7_1ON5 21� "FOP 2X6 WALL AP1GtiOP DOLT 4 EDGE D/STANGE Y55TD 11440OWN A NctlOP 55TD/iOLDOWN,ANGHOP /1� "FOP 2X4 WALL (PEP G5N) aMIN.REBAR LENGTH —{ . 5"M/N.215"FOP 2X6 WALL n/ Q I W SECTION VIEW PLAN VIEW SECTION VIEW PLAN VIEW < HD HOLD DOWN AT WINDOW OR DOOR OPENING HD HOLD DOWN AT EXTERIOR BUILDING CORNER V H DUILTUPGOPNEP5TUD5 MODEL# DIA. MIN.EMBED, IN.REBAR LENGTH W ll7/N OF#PER PLAN/G5N OP e) SSTB 16 5/8 _ 12/8" 50" OU1LT UP 5TUp5 CHIN OF#PEP PLAN/G5N OP ) p a SSTB20 5/8 16 5/e" 58" WF LSTA STPAP AT i6"oc. SSTB24 5/8 2_05/8" 66" (PEP G5N) 11DU110LDOWN SSTB28 7/8 24%8' 74" 01 SSTB34 7/8 28 82" ROOF 5/iEAT111NG (PEP PLAN) SBiX30 1 24" 96" NO. REVISION/ISSUE DATE NOTE:#4 REBAR TO BE CENTERED ON HOEDOWN AND LOCATED HDU 110LDOWN ° 3"TO 5"DOWN FROM TOP OF FOUNDATION WALL PER SIMPSON (PCP PLAN) C7)IOd NAILS ° MANUFACTURER'S SPECIFICATIONS. I CEAc11 END) 55P AT 16"O.G. MIN.REBAR #4PEDAP ++++ ++ +++++++ PROJECT ADDRESS: pAP.ALLAM TYIPEADED POD --------- ------- ----_---- EDGE D15TANGE 3"TO 5" — °° m (PEP PLAN) 5EE ALTEPNATE FOR 2X4 WALL Z POOF PAFTEPS PEP PLAN 55 ROUTE 28 a �4PEDAP* 4 2,95"FOP ZX6WALL = gPLATEWAStIEP HYANNIS,MA 55TD 11OLDOWN ANG11OP ALTERNATE 5/l_LPLATE ° a PLAGE55TDAPPOWONTOP ATTACH OPPOSING RAFTERS BELOW ANG110P DOLT STD t10LDOJ ANGl10P o OF ANGIiOP DIAGONAL IN NOTE RIDGE BEAM/BOARD WITH 2 x 4 (PEPGSN) GOPNERMPL/CATION DRILL HOLE FOR THREADED ROD COLLAR TIE AS SHOWN. RIDGE THROUGH PARALLAM AND ATTACH W/ STRAPS NOT REQUIRED WHEN SECTION VIEW PLAN VIEW NUT AND Wx3"x4'PLATE WASHER USING A COLLAR TIE. q 1 . 3 HOLD DOWN AT INTERIOR BUILDING CORNER 1 . 4 INTERIOR HOLD DOWN INTO 1 .5 RIDGE RAFTER CONNECTIONS HD HD BEAM IN FLOOR FRAMING RF M c i<'E N Z I E ZXDLOGKINGDETWEENPAFTEPS 111 ENGINEERING POOF 511EAT111NG (NOTGH FOPVENTILATION 1F PEOUIPED) POOF 5t1EATt71NG CPEFEPTOAPclltTEGTUPAl �(NOT 5t10WN FOP GLAPW_0 2X4 WALL 2X6 WALL CONSULTANTS EUC�C NAILING PLAIDS FOP t1OPE DEr III-) ;.POOF PAFTEP PEP PLAN 6"O.C. 4"O.C. 6"O.C. 4"O.C. 1279 MILLSTONE ROAD EDGE NAIL-INC) BRE7 7 4) 3 MA 14 4 ++ + + + + + (774) 353-2144 02631 6a6 DP.P05T + ++ + ++ 110LD DOWN + + + + -DOUDLE 2X TOP PLATE �(EPDPLAN) ++ ++ (PEP PLAN)ROOF P.AFTEP PEP PLAN(PEFc`P TO � APG/1lTEGTUPALPLANS FOP RAFTEP PLAN VIEW ELEVATION VIEW PLAN VIEW ELEVATION VIEW -�4F='ems DIMEN5/ON5 AND EAVE DETAlL1N5) I ; b1A.4KA MdCENZ:E . DOUDLE 2X TOP PLATE T5P(INSTALL PP10PT0 NOTES NOTES N. a9oea PLYWOOD 5t1EAT11IN5) 1,ATTACH STUDS AT BUILT-UP CORNER TOGETHER WITH(2)ROWS 1.ATTACH STUDS AT BUILT-UP CORNER TOGETHER WITH(2)ROWS DElJ70P11EADEP I 2X 5TUD5 NOTE:NOT REQUIRED IF H2A OF 16d(0.162"x 3.5")NAILS AT 6"O.C.FOR 2ND STORY SHEARWALLS. OF 16d(0.162"x 3.5")NAILS AT 6"O.C.FOR 2ND STORY SHEARWALLS. CIF 5HO IN ON PLANS) IS USED AT EVERY RAFTER 10�31/(y I-12.5A 2.ATTACH STUDS AT BUILT-UP CORNER TOGETHER WITH(2)ROWS 2.ATTACH STUDS AT BUILT-UP CORNER TOGETHER WITH(2)ROWS SECTION VIEW (INSTALLPPlOPTODLOGKIN6 ELEVATION VIEW OF 16d(0.162"x 3.5")NAILS AT 4"O.C.STAGGERED FOR 1ST STORY OF 16d(0.162"x 3.5")NAILS AT 4"O.C.STAGGERED FOR 1ST STORY AND PLYh/000 5t1EAT_H1NG) SHEARWALLS. SHEARWALLS. ALTERNATE:H2A JOB#: 17-299 SHEET 1RF RAFTER TO TOP PLATE 4 ° 7 BUILT-UP CORNER AT END OF SHEARWALL DATE:12-31-2017 RF WF -- -- ---- SCALE: NONE G 1 • 1 NSTRUCTION NOTES: N 1)WEL ASE PLATES TO VERTICAL RIMBOARD I TUBE STE POSTS. POSTS TO BE nou�LE roP PLATE �1M°OA�n ATTACHED TO ONCRETE • , (2)2x12WA7EROR PECIFIEPV FOUNDATION WI THREADED ROD F--1 (tYl'ICA REFERfOPLANFORSPECI EAnERREOLIIR MEN s) ` . ANCHOR BOLTS (AS R PLANS). MOMENT FRAME HEADER AS SPECIFIED(SEE NS) H z LsrA2 (IN51LM FAKE OF WA(L LsrA2a 5rRAp 2 COLUMNS TO BE SPLIT A EAM O HEADER fO 2z6 (IN51PE FACE of WALL) ) PROVIDE PLATE AN C� IfA126RfO(D-2,6 LOCATIONS AND 3/4"PLATES T E l'OMENrGONNEcr N C� FA5SNrOPFLATTo WWITH USED TO CONNECT COLUMNS TO FAPPIG Rro W Q BEAM TO PROVIDE MOMENT PROV EDErAIL Q (2)ROW5 OF 16d 51NKER 5 Ar 5"O.C. A Q FA5rEN5HEAIHINGfOhEA17ERWl dcoMMON CONNECTION. (IF FLITCH PLATE MOMENTF HEADER AS SPECIFIED(SEE PLANS) OP6ALVANEEnDOXNAIL5IN-5"60 rrEPNAS 1 HEADER. ARE USED, KNIFE CUT ~ sHOwN ANn 3"o.c,w ALL FRAMING(sru oLoalN�IN slLLs) COLUMNS 50/50 BETWEEN Yf55 P05r 14 ui A5 SPECIFIED \, I. COLUMNS AND FULL DEPTH AT (2) 2x6 2x6 FRAMING A5 SPEGIFIGED Q FOP A PANEL SPLi <! t," En), PANELEI7GG. ! woc I CONNECTIONS) 5MCTLF&PANEL ANn 0 '?W(M N 2 "OF Min J 5H6A1H1NIG HEI�1f wAL, r�ocK! A��W1 3) CONTRACTOR TO VERIFYALL (3? I6d SINKERS DIMENSIONS PRIOR TO V (� MIN.2"C'x%6"PLATE smnw H(tnown CONSTRUCTION. � U WA9tIZ W u o 51HTJI4' nOWN �ri . 0 a W 171A.ANCHOR POLr (7"MIN.EMPEPMENf) NO. REVISION/ISSUE DATE SIDE ELEVATION Z_ 2 • APA PORTAL WALL 2 • STEEL MOMENT FRAME EXTERIOR WALL PROJECT ADDRESS: (NOT TO SCALE, FOR EXAMPLE ONLY!) (S BSERVIENT TO MOST RECENT TT-100 BY THE APA) (NOT TO SCALE, FOR EXAMPLE ONLY!) 55 ROUTE 28 OPTION #1 HYANNIS,MA HEADER SIZE ® ® © CD; C C L=1'-0"TO 4-0" (1)LSTA 9 (1)SP4 (1)SSP A5E PLATE AND ANGl109 1INGI70R DOLT A5 PE,P PLAN PER KING STRUCTURAL / / Lr5 A5 PER PLANS U5E L5'EDGE 015TANGE FR N(1)SSP PLYWOOD 5/DE-5 OF PLATES(M/N AND L=4'-V TO V-0" (2)LSTA9 (2)SP4 PER KING SHEATHING TO 22V"FROM ED6EOFGONGP (tim (1)CS 16-(6)Sd NAILS MATCH ELSWHERE. EMDED 70/5"(M/N)EM EDMENT L=6'-1"TO 8'-0" (2)LSTA 12 (2)SP4 1)SSP EACH END OF STRAP PER KING PER EACH KING STUD NAIL OF d0UBLE ROW MILS TOP EADER(PER PLAN) USE 5E7 GONSrRU lON EPDXY (SEE NOTE W) AND BOTTOM OF L=8'-V TO 10'-0" (2)LSTA 15 (2)SPH6 (1)SSP PANEL INTO DOUBLE PER KING TOP PLATE AND (2)ST2122 (2)SPH6 PE1R KING HEADER AT Wo.c. �- M c I(E N Z I E 000 ENGINEERING OPTION #2 CONSULTANTS HEADER SIZE ® ® © EO i _. WINDOW/DOOR OPENING (1)-cs16 (1)SSPFF, 1279 MILLSTONE ROAD L=1'-0"T04'-O" EASCH END PERKING STRUCTURAL BREWSTER, MA 02631 (2)-css (1)SSP PLYWOOD Q ®� (774) 353-2144 L=4'-V TO 6'-0" wi(s)d PER KING SHEATHING TO (2CC818 H END (1)CS 16-(6)8d NAILS MATCH ELSWHERE. L=F-V TO 8'4' w/(s>d SEE NOTE (1)SSP EACH END OF STRAP NAIL DOUBLE ROW EACH END '3' PER KING PER EACH KING'STUD OF 8d NAILS TOP (2)-cs 16 (1)SSP (SEE NOTE'4') AND BOTTOM OF Q L=8'-1"TO 10'-0" w/(8)ad pER KING PANEL INTO DOUBLE EACH END TOP PLATE AND L=IVA"TO 16'-0" (2)s72122 (1)SSP HEADER AT 3"o.c. PER KING 1rM� aL$ CIViI ^' -NOTES: No.seaNN ONRL 1. HEADERS ORS DIRECTLY LARGER REQUIRE(2)JACK STUDS EACH END OF THE HEADER. T T S T ION VIEW PLAN _VIE Ora(/1 J 2. CONNECTORS SPECIFIED ABOVE SHALL BE ATTACHED DIRECTLY TO 2X FRAMING MEMBERS. 1J L! 3. NAIL FULL HEIGHT JACK STUDS TO KING STUDS WITH(2)-16D NAILS PER 6"O.C.(JACK STUD TO SOLE PLATE STRAP NOT REQUIRED) Ju 4.STRAP NOT REQUIRED WHERE SHEARWALL HOLDDOWN IS ADJACENT TO OPENING. 5. DETAIL FOR WINDOW AND DOOR FRAMING ONLY. OTHER STRAPS AND TIES NOT SHOWN FOR CLARITY. _ 2 MOMENT F E EASE PLAT JOB#: 17-290 SHEET 2 3 T DATE:12-31-2017 WF F RAM I N G A T WINDOW AND D®O R P E N I N�� Ei' (NOT TO SCALE, FOR EXAMPLE ONLY!) I SCALE: NONE G L ' 2 _9f NEW ROOF ABOVE ENTRY r E 15T IN OIROOF ' �l ANDERSEN CXIIJI3-3,FIXED W/BLACK GRILL,SASH,FRAME. : I' ff I �n 4 :IEIM I ! • I I ! ' BARNBOARD STYLE I I 9 6i Eng,stamp % IX3 SECOND MEMBE I HARDI PLANK IX8 SOFFIT,FACIA FM Ir ': I, 4 II FM LM _ — _ ' III_I I .___. _ _ ':.__.:.._ _ _ _ - _ i1L__ a� 111 - _ - _- -- - :_ - _..- '� I I I1, - .._ y i - ... .. - --- -- - Ii�,Ilr c WHITE CEDAR SHINGLE 5"TO WEATHER a - - - - - - q I 1 a - { Jt 1 IrN �.:y. I LY !°p, I a I:y. I illy{ ..11�it rL� :i [I I 'tl r I r.l IX4 WINDOW AND DOOR CASING :, yi, SCALE: VV t 4 I._i... II.I: :II I: ha.14 1a I 1' 41 41 f� �.'f #. ,. .._l.F '�ro.Grp:., ":..+1STG.Ib.:�..r- �' I HARDIE PLANK I ... ..' : 1 -.,p _t,... AS NOTED I DRAWN BY: itt I ward(ss f gn PROPOSED NORTH ELEVATION ... ._. ....._.__. .._ BARNBOARD STYLE (O HARDI PLANK ON \" 4'-0"PARAPET WALL ^1f NEW ROOF ABOVE ENTRY O - EXISTING ROOF 1� I I it i I i I ^ I I I I I , - _ _._ _i. I..., v _.' 1 I I l - _ YYi . I�i - �•N 1.I J I _L.I. 11 •_�I I I I I: I I i I 'I 1 _ 9 . .TW-i .EC LGHNGI !rr I - I -.I. I / / r I.: ' 7 _ _.. _. y ,'' _ - _ _—KUMA WRAPPED&X&POSTS V .I JJ 111 .fl I I II .I:1 I 1 ,I,`11 1..yL._7 11 s I 9 I I-FI�RDIE PLANKy ( — —�, 1 I 1;••'' — — - — - e --- -'----_ - - -'-. -• - ------ ----- I l r 1, I I}T.°Al 0'-]' b'-]' 0-3' ........... ...�[.'�_,l '1...�i7.�:{'P r1�' i l.:ir-:5�•t� YI�tii�t."1�r a l r: —. aLL-b'-e'X W.0, 1 ' . .. APPROVED: COI'•NE,WI FRAME G E W/41R11MIM REVISED: PROPOSED EAST ELEVATION ,4 1 b � � / EXISTING PREP/' KITCHEN V . EXISTING MARKET Eng,etemp I' / /// •; % j/ / / ;/ CREATE 8'x I'OPENING TO HALLWAY TO CAFE ��• / j // / BEAM ABO/VE BY OTHER ' / / - COMMEROIAI GRADE EXIT OR uTE DOOR ' /EXISTING/EXIT NEW OVERHANG . "/� /% P 'I'-9 FRAME FLOOR AREA TO MATCH EXISTING HEIGHT OF NEW CAFE FLOOR. INSULATE W/R38 FG. IN5UL / / / / ! ' / ,/ 1 i I CAMMERCIAL GRADE WINDOu'S / /, " /' /% I EE AND 3/4"ADVANTEK SUBFLOOR.12XI2 CERAMIC TILE. 5 MANUF.INSTALLATION SPED'S _ WALLS TO BE INSLUATED W/R20 FG. INS / s- OR SPRAY FOAM TO ACHEIYE R20 /EXISTING STOREROOM/ 1/2"GWB,PAINTED FINISH TBD. / I ;' " SCALE: ( TRADITIONALLY FRAMED WALLS MARKET STRUCTURE CEILING TO BE FINISHED W 1/2"GWB A. j;/ // '�� / / ' / // AND ROOF STRIIDNRE AS NOTED TAPED AND FINISHED.PAINTED FINISH TBD. : / ! -INSULATE W/R38 FG DRAVM BY: .INSUL. / / % /' / / � / I I • EXHAUST FANS REQUIRED, j_' wkdestgn o 1' ' .i noa-` 1 _ j/ j% / Gq _ ROOF TO CON515T OF: , / ��IIALL TO TRANSFER NEW ROOF LOADS KTO STING EXTERIOR BEARING WALL MATCH EXISTING ASPHALT SHINGLES EXI 1 ....�..'_j. _.. ________ _ __ ________ ___ ____ __•__ __ __ ___________ 5/8 CDX SHEATHING CASED OPENING ICE AND WATER AT ALL HIPS 12 N C RAKES AND EAVES _ 2XIO RAFTERS m 16"O ' B 1 °m OC.i, JL, / / 2X8 CEILING JOISTS .L;4_ a I x R38 FG INSUL. —u_ "1/2 GYPSUM WB.TAPED AND FINISHED. �\ NEW CAFE I q• 2X6 WALL TO CONSIST.OF: O ALARMED EMERGENG 1-1 ` . ".! _ _ � WHITE CEDAR SHINGLES Z. EXIT DOOR I /i _1 /'// 5"TO WEATHER,TYPAR HOUSEWRAP j I I/2"PLYWOOD SHEATHING I. I BA N j I. /'% 2X6 a 16"OC. R20 FG UL Lu 0 i s 1/2 EXPOSURE"B"REQUIREMENTS 1 ; � I I ��"' 1 ,'/ DRY WALL LL TAPED AND FINISHED `1 / — — — — 1 MATCH NEW FLOORS W/EXISTING FLOOR HGTS. ` �\\ e i I\1 2XIO FLOORJOISTS J WASTE LINE TO BE ELEVATED IN ORDER TO IE O O 16"OC.W/5/8"SUBFLOOR(VERIFY) INTO EXISTING LINE ADJACENT; �� 2X6 P.T. PLATE. \1 8"X 4'POURED GONG. FOUNDATION UPON POURED \\\ "\� I i+.• y_ .j CONCRETE FOOTING(VERIFY) r(� NEW 2"DUSTCOVER THROUGHOUT VJ EXISTING STORAGE"\\ 1'\ ' AREA \ BANQUETTE O \\ \ AbJ�ceN / SECTION THROUGH \ / SCALE: I/a•.I'q' \w BATHROOM/CAFE PLAN APPROVED: IEdKENM cmL REVISED: �� SaWrdey,Oe bbs}I,30n A 2 - - 1 3 I Erg,stamp IX15TIN,3TWCNRE EXISTING STRUCNRE EXISTING ST-C.F E __/� �� /.•/ I SCALE: KNEE WALL BELOW TO SUPPORT ROOF RAFTERS. AS NOTED / DRAWN BY: , wkdaBIJn ..w/ 8"X 4'-0"POURED CONCRETE FOUNDATION 5emday OCloba]I.1011 _•r .f TO ACHIEVE 3000 PSI IN 28 DAYS Txa Rnr,ERs F SET UPON A 10"X 20"KEYED FOOTING W/(2)5/8"REBAR THROUGHCUT. DuwER VENTS SUPPLIED BY FOUNDATION CONTRACTOR N' 5/8"J BOLTS W/3X3XI/4"PLATE WASHERS /Z, 2XIO FLOOR FRAMING o 16"O.G. 1 1 I uae FENOEBOARD / Z EVERY 32"O-C- / .N UTILIZING U210 JOIST HANGERS AT LEDGER, ' LEDGER TO BE ATTACHED USING 5"LEDGER LOCKS WATERPROOFING BY CONTRACTOR Z (2)VERTICALLY VERY 16"O.G. I j; VERIFY IF EXISTING RAFTERS ARE .1 COMPATABLE TO CURRENT MA.BUILDING CODES / 2"POURED CONCRETE DUST COVER IF NOT: ' THROUGHOUT _ 2XI0 RA FTERS o 16"O.C.R38 FG IN5UL -- IX8 FENCEBOARD FOR"LAY ON"ASSEMBLY H2.5A HURRICANE TIES AND LTP4 , SIMPSON HDU4 O 1�\\ W/SSTB20 ANCHOR BOLT ---- VERIFY LOCATION OF WASTE LIN \\ +' \\ VERIFY PROCEDURE TO INCORPORATE HABITABLE SPACE +. �' ;� + r l �I (�- `\\\ \ (I.E.HANDICAP BATHROGMSJ WITH ADJOINING STORAGE ,I II I `\\• EXISTING STOR GE�. + AREAS �{I\,\(yil'\+\ .- �.� nREA \ \ / / IXISTINQ 1 IXISTING STORAGE AREA y�• lllJ1�� ^{{{{ �W A- FOUNDATION PLAN SCALE' I,4 .I-0' � FLOOR FRAMING PLAN � SCALE I14"'I'-0- ROOF FRAMING PLAN {� SCALE. 114 .I'-0" n�^ —I DESIGN LOADING DEAD LOAD=10PSF LL=ASSEMBLY/MERCANTILE IOOPSF SNOW LOAD=35 PSF GROUND SNOW LOAD WIND LOAD=120 MPH EXP."B" ` an' 0"XA. JmEmm APPROVED: CIVIL a , REVISED: !o(31/17 sew.eey,oceba,s,xon AD4 BATH FOUNDATION, i;R00F, FLOOR P43 AN'S EXISTING PREP/ CREATE I-OPENING To KITCHEN • u.A-TO CAFE BEAR LINTEL remo`N_s DETAIL) EXISTING MARKET /////////Zzzzz= gzzzz= EAMS' T*,-1 1 J1,11 I LL$ A�COLOR .NO NT E.C LOR LLS AND j (2) �111_I EILI.T TA!, /,2 LvL bE�rLl5i I IGT co No 4 41 — — — — — — — — — — — — — — — —- - — — — — — — — — — - NEW OVERHANG En g,stamp OW. 4 1111ER�Al -1 1 STOREFRONT HALLWAY PLAN WINDOWS AND DOOR.ROOALL6 ...LE,.14'.Tl" TRADITIONALLY FRAMED. EIll..N N..�-.5TWO ANCHOR BOLT .tol EX(5TING 10"X12'POURM CONCRETE WALL EXISTING 8"STEEL'I"BEAR,LINTEL KNEWALL FOR BEARING TY, 12 SCALE: AS NOTED (2)S 112"LVL ABOVE I DRAWN BY: wk6ce5len NEW CAFE 'ROOF'TO CONSIST Or: E,, 22,To" MATCH EXISTING ASPHALT SHINGLES 4 R QQ0 " DETAIL OF EXISTING (ujcur aoQ) ,3/CDX SHEATHING n ICE AND WATER AT ALL HIPS - ASSUMED RAKES AND EAVES LVL EA.— 2XIO RAFTERS-Ir."OC, W/H2.5A 2XS CEILING JOISTS LTP4 AT IR38 rG INSUL. F—EBOARC,L 1/211 Gyp5um WB. TAPED AND FINISHED. 2XS WALL TO CONSIST OF: TRAN51TI0N OF ADJOINING BUILDING WHITE CEDAR SHINGLES iD 10 5"TO WEATHER,TYPAR HOUSEWRAP 2XID RAFTERS 1/2"PLYWOOD SHEATHING Oc. R20 FG INSUL IX6 FENCEBOAR FORO.C. "LAY ON"ASSEMBLY 1/2"DRYWALL TAPED AND FINISHED H2.5A HURRICANE TIES AND LTP4 AT FENCE50ARD S� SLAB --MATCH NEW FLOORS W/EXSTING FLOOR HGT.S. SEE 5TRRAL ti DRAWINGS AND WITH MARKET D NOTES REIlFOING STEEL H2.54 LAY ONGRAVEL 'o. TRIPLE 5 Ir LVL BEAM AT TRAN51TION TRADITIONALLY FRAMED WALLS POURED CONCRETE SLUMP FLOOR AND ROOF STRUCTURE is 1 1; 4'-O"X 5" PORED CONCRETE rOUNDATUON UPON ROOF FRAMING FLAN &'X20"KEYED FOOTING TYP. SCALES A"-I'C" SECTION THROUGH Qi CREATE NEW FLUSH TRANSITION FROM -AL.; 114 EXISTING STRUCTURES/FOUNDATION EXISTING MARKET FLOOR TO NEW 4"POURED AND EXISTING POURED WALL POURED AND POLISHED HALLWAY FLOOR G 14 1 2'X2,'MONOPOUR/SLUMP AND 4"POURED FLOOR W XS,. _L W/4'Xa"POURED CONCRETE WALL ------------------------------------------------------------------------------- ---------- 5/5"J BOLTS W/3X3XI/4"PLATE WASHERS 7 7/�/ ,// - �- - EVERY 32 O,C. - - ------------------------------------------------ - 4"POURED CONCRETE FLOOR APPROVED: REVISED: —.1.Ocbber n,To,, FOUNDATION PLAN /0/51/q STRUCTURE A NEW HALLWAY 44 Eng,stamp j STRUCTURE ABOVE ENTRY ' S T R U C T U R E 2X8 RIDGE AND RAFTERS.. /' i ' /30'-3' ERIFTiOENIER OF'eNTRTDOOR6 / _ L/° DOUBLE>XIO RAFTERS BELOW / ' /'' I (• i",r;o:,\J I _' -- - _ qti' I •1 C (2)2XI0 : i i I. 1 Ace O$T caps B`>� i•Y tt ABUbe POST BASEb I. i , I l0-3 I - I lo'a' l lo'-s• 9'-e' I °ALA cownNs SCALE: 1 CONTINUATION OF ROOF FRAME - AS NOTED L SEE A4 H2.5A DRAWN BY: EAST/LOT SIDE wkde5len FRAMING PLAN I =I'-O" s.my.o«cee.n,Ton I` ❑T� LTP4 NO WORK ON V S T R U C T U % EXISTING WEST WALL ABU47 / NEW / PARAPET WALLS / { / 2XI0 RAFTERS m 16"O.C.' �= 2X 6 LEDGER l3)2XIO / % y I ... BEAM BELOW /( 2X6 COLLAR TIES 16"O.C.,' sInILAR To AEL'eo / —LU526 I I D 6X6 PT POSTS W/12" H2.5A SONOTUBE BASES NORTH/STREET SIDE FRAMING PLAN APPROVED: LikKErME cmi f'b Sam . REVISED: sw.ynj,ocmca,n.Ton 10/31'17 OVERHANG FRAMING PLAN 45 HARDIPLANK f TYPAR CDX 6/12 NAIL PATTERN,PL CONST.ADHV. - 2X4, W/1/2"GAL LAGS,LEAD MASONRY ANCHORS PL CONST. ADHV. 16"OC. 'I Frig,clamp 2X4 PT PLATE, W/1/2"GAL LAGS,LEAD MASONRY ANCHORS PL CONST.ADHV. 16"OG. MASONRY ANCHORS S T R U C T U R E EXISTING CONCRETE WALL - , I 6X6 wl.4Xwl.4 U.WCt j 5'-a / THROUGHOUT,, EMBED �� - yENEEfi2 r466EM8L`r' POURED CONCRETE I / ' NTJ- WALKWAY W/Il4•PITCH TO I_' 4'CURB CUT FOR / PARKING AREi.__— -- --- _-- I ADA COMPLIANCE m ALIGN W/ENTRY DOOR � I I - — - - - - - - - - - - - - - - - - - - - -- - - -. - - - - --- - - - - - - 0' 14,5/B".-AR •0 AT ENTRY .=O 0 `0 6'CURB CUT FOR ADA COMPLIANCE SCALE: 1O-r IOQ• I 10.1" e'-B"� AS NOTED CONCRETE WALKWAY DRAWN BY: SEE A4 a wkdes(gn EAST/LOT SIDE FRAMING PLAN 1/4" 1'-O" O O 5 STRUCTURE Lu I I ,j 6X6 w1.4Xm1,4 uwM l4)5/8"REBAR---tO 1 TNRWGHOUT,3"EMBED •I Ti. r I <"POURED 4'CUR CONCRETE _ B FOR -�_ t 1:�!I I —WAY Ulf-"PITCH TO �� Q AD4 COMPLIANCE /- __----- l—_'� PARKING AREA. O L — CONCRETE FILLED BOLLARD r'`-• O.CURB CUT FOR O — — —�— — — — —O O. O ADA COMPLIANCE / (4)B/B"REBAR A�CURB CUT FOR �!J!// ADA COMPLIANCE 12"SONOTUEE 3'BELOW-4'ABOVE GRADE,LOCATED y I'-0'DIRECTLY IN LINE W/PT POBTS, �T PAINT"HAZARD YELLOW" V 14%8' I 14'.B• I NORTH/STREET SIDE CONCRETE LAYOUT 1/4" I'-0II 3 APPROVED: - CML MB]90f+A REVISED: Snrbry,Octcbp�)},TD1T ' CONCRETE FLAN/SECTION/VENEER �fQ - I EXISTING FLAT ROOF Eng,Stamp �j EXISTING WEST WALL NO WORK TIE BACKS f NEW FRAMED PARAPET WALLS 1 ABOVE EXISTING i EXISTING TRUSS ROOF SALE: AS NOTED j DRAWN BY: _- . wkdes(gn 3 PITCH - 3 PITCH SEE DESIGN BY "CRESSWELL CONSTRUCTION" 2x6 a 16"oc FOR PARAPET WALL. IIX&,r ENCEBOARD fITF4 2X8 PARAPET WALL: 2X8 PT PLATE SCUPPER6ELL_ 2X&B 16"OC. (2)2X8,TOP PLATE.CAP MATERIAL TED. 6"SLEEVE ANCHOR TO EXIST O CONCRETE WALL.VENEER PER PLAN. Q NEW FRAMED PARAPET WALLS v (EXISTING TRUSS ROOF) ABOVE EXISTING or YEAR ARCH SHINGLE _ Cam. 2XI0 2x8 RAFTER o I6"OC. O "Ew evoc6aaarAn oveawA"� 2X6 COLLAR TIE m 16°OG. 3X4" KOMA BEADBOARD CEILING 6"XI/2"CONCRETE SLEEVE ANCHORS ^ (3)2XI0 BEAM (1)EVERY 18"OC.STAGGERED FOR - `v ox PT POST BOTH LEDGERS CRICKET FRAME PLAN KOMA WRAP - AC6 P05T CAP EXISTING POURED CONCRETE WALL AND 8"STEEL"I"BEAM(VERIFY) O HEADERS/LINTEL'S TO REMAIN. INFILL/REFRAME EXISTING WINDOW OPENINGS p — W/2X6 FRAME STOCK TYP, O 1 n DOCUMENT EX15TING CONDITIONS AT DEMO SIMPSOPJ ABUE4. GALVANIZED STEEL COLUMN FORWARD TO ENGINEERING FOR REVIEW, BASE--SEE STRUCTURAL 7 PLANS AND MANUFACTURER'S f DETAILS 5"BOLLARD 5'-O" 4"MIN. REINFORCED DECK, Q T /CURB/SONOTUBE AND MONOPOUR W CONCRE E SLAB RAVEL WW8 REINFORCING STEEL ;. SECTION D APPROVED: n"sonoruBE Lku A. TYPICAL OF ALL COLUMN LOCATIONS CML REVISED: 3/81I = I'-O" Io�31l17 CRICKET/SECTION D o4l EXISTING RAMP SYSTEM TO GRADE E- HRN/STRB EXIT E-LITE sTROBE EXISTING OWNER / CLIENT OF PROJECT: RAMP UNISEX RE5TROOM EXISTING ADD ADA COMPLIANT t Y 2 TCENT D"OlUMPIO WALK-IN / GRAB RAILS, PAPER LEGEND COOK LINE W/ a HOLDERS & MIRROR PHONE: 508-420-1414 OPEN FLAMES & COOLER NOTE EXIT HRN/STRB ANSUL FIRE SUPPRESSION EMAIL: VdolimpioC�roberEpauI.COM ( II I SYSTEM WEB: www.robrtpQul.Cam ! l l EXIT EXIT UG W - ( I I EXISTING 0 0 HT / BATTERY Baa UP �/ ( ( ( ( CO KITCHEN AREA IXiT EXIT/EMERGENCY LIGHT COWINATION PACK CONTRACTOR: I (I W/ BATTERY BACK-UP EXISTING DIRlEGTlONAL. IXIl LIGHT PAC( \A/ JOHN RYLEY EXISTING Ro WOMEN 5 RESTROOM EXIT w/ BATTERY BACK-UP co L_jRYLEY CONSTRUCTION E I MEN'S RESTROOM sa ( II E( COOK LINE W/ SD " DUXBURY, MA 17 OPEN FLAMES & GV Co E EMERGENCY PA CK BATTERY BACK-UP o (� ANSUL FIRE SUPPRESSION PHONE: 401-484-2315 Z SYSTEM HEAT CARBON MONOXIDE DETECTO? FOR COOKTOP - - EXISTING EXITO�60 0 co GAS VALVE SHUT-OFF TVD-1 = 52 FT_ DINING AREA FACP HEAT '� ' FIRE ALARM CONTROL PANEL FACPF { -60 SEATS . HEAT � `�' mxw AREA = 1,144± SF. OUTSWING � RESTROOM LIGHTACTIVATED CIRcU�/FIXTURE (WF) EXIT DOOR FAN HRN/STRB 1- —.-._ —.-—- I ( FE I FIRE EXTINGUISHER - 10 L8. BC 00 PS GAS VALVE CONTROLLED BY CO & ANSUL.SYSTEM HRN/STRB I I ( ❑ W EXISTING DECK AREA I EXISTING f RATE OF RISE HEAT DETECTOR - 20 SEATS i BAR AREA HEAT - 28 SEATS 1 0 HP.N/STRB HORN / STROBE ANNUNCIATOR I� I AREA = 1.343 ± SF. I ! ( (INCLUDES KITCHEN AREA} i I PS FIRE PULL. STATION o O lw - 04 n e�1 Sp SMOKE DETECTOR - PHOTOELECTRIC - h°{ F� PIZZA. OVEN STROBE STROBE ANNUNCIATOR �•( �? TYPE II KITCHEN CO HOOD SYSTEM (WASTE HEAT & VAPORS) HANDC) WASH 3 BAY SINK H SINK Q o 0 �-t EXrF EGRESS TRAVEL DISTANCE (FIRST FLOOR) - 48 & 52 FT. 0 TVD-2 EXITf EGRESS TRAVEL DISTANCE (FIRST FLOOR) - 30 & 70 FT. ( PROPOSED Tvo_3 EXTIT EGRESS TRAVEL DISTANCE (FIRST FLOOR) - 48 & 58 Fr. PIZZA AREA FIRST FLOOR PLAN - --12 SEATS FIREWALl ASSEMBLY: WP 4135 SCALE 3f 16° 1 � AREA= 872 + SF. 2 HR. WOOD STUD W/ 2 LAYERS OF �" GYPSUM WALLBOARD = = ' - _ - . _ _ ON EACH SIDE AND SOUNDBOARD ON ONE SIDE W/ 3" FRICTION FIT FIBERGLASS INSULATION I TIGHT TO UNDERSIDE OF ROOF STRUCTUREEl: 13 t I TREYED CEILING FRAMING; (HEAT � 2" x 8" RAFTERS W/ 2" x 10" �- TOTAL SEATING = 140 CEILING JOISTS @ 16" O.C. _ _ _ m C-JOISTS `ELEVATED 2'-0" TOTAL EMPLOYEES = 21{ TVD-2 - 30 *FT. - — FASTEN Od MAILS/ -TOTAL GRO55 AREA 4,431 _ SF10 DEDICATED AMUSEMENT SPACE; _ AMUSEMENT OCCUPANCY ( y = 40 FOR AREA < 50 m PROVIDE 2'-6" SQ. x 12" DEEP POSTS; 4" x 6" CONCRETE BEARING D-FIR; W/IN FOOTER PAD PHASE I GYPSUIM WALL - 3 LOCATIONS MEMBRANE SHOWN _ REVISIONS PHASE II E-UTE OBE 1-23-2020 -PHASES, EXISTING FIREWALL ASSEMBLY 4-2020 UNISEX RESTROOM 2—ADDITIONAL NOTES SD a ADD ADA COMPLIANT FAN GRAB RAILS, PAPER HOLDERS & MIRROR NOTE PHASE I LLAJ ELAJj QUO 0 PHASE II ENGINEER: S FLOOR =3 BAY SINK GA- - �ri .- CO FRYERS T. VARNUM PHILBROOK WALL TOO BE HEADER; 2 EA �- 1.75" x 9.5" LVLs REMOtVED POSTS: 4" x 4" GRIDDLE P�ITL.SR©OK ENGINEERINGW f 2 ROWS OF -- D-FIR W/IN ——$ — — — SCREWS ® 12" C. 107 BEACH STREET DENNIS, MA 02638 GYPSUM WALL TYPE I KITCHEN GOOK LINE W/ RIDGE BEAM; 2 EA ( MEMBRANE HOOD SYSTEM OPEN FLAMES & tVOrnPhil@gmail.com PHONE: 508-385-8682 1,75" x 14" LVLs (GREASE, HEAT & ANSUL FIRE SUPPRESSION W/ 3 ROWS OF ( VAPORS) SYSTEM SCREWS ® 12" O_C. 6 x 6" �1J HAND POST; o ( � WASH � ti D-FIR W/ V- SINK T VARNUM G GYPSUM WRAP EXISTING o PHILBROOKco I ; ( �! 0FAN` UNISEX RE5TROOM MECHANICAL 1 �No.306900 � a HEAT ,� ADD ADA COMPLIANT o� Fo�s7 �ti �` rl PROPOSED SD f� HOLDERS GRAB RAILS, PAPER MIRROR / NOTE CAFE E-UT - 20.5EAT5 srROBE EXISTING P19-51 OUTSWING AREA - 10 39±SF. PS IT DOOR PROJECT PROFESSIONAL OF RECORD EXISTING _--�- OUTSWING EXIT DOOR DRAWN BY : PHILBROOK ENGINEERING DATE : 1-17-2020 STROBE x La —I E-LIT - EXISTING SCALE 3/16" 1'-a" POSTS; 4" x 6" 20 MIN. 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