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HomeMy WebLinkAboutB2 BURRITO BISTRO - FOOD B2 BURRITO BISTRO HYANNIS f IKE Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. aAWNWABLE, F.P.(Thomas)Lee,. I maSx s6)9• ti� 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: 620 Issue Date: 01/01/2022 DBA: B2 - BURRITO BISTRO OWNER: B2 - BURRITO BISTRO INC. Location of Establishment: 790 IYANNOUGH ROAD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 64 OutdoorSeating: 0 Total Seating: 64 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: F For Office Use Only: Initials: Town of Barnstable Date Paid aG/ Amt Pd$ ��•V BAMSTABIX Inspectional Servicesa � -P 1639. Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 11/16/2 021 NEW OWNERSHIP RENEWAL X NAME OF FOOD ESTABLISHMENT: B2 Burrito Bistro ADDRESS OF FOOD ESTABLISHMENT: 790 Iyannough Rd, Ste #5, Hyannis MA MAILING ADDRESS(IF DIFFERENT FROM ABOVE): /� E-MAIL ADDRESS: taco@burritobistro.com 0x TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (5 0 8) 7 71 - 6 0 71 �- TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES NO X ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: 64 OUTSIDE: 0 TOTAL: 64 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) X 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*** REOUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP REV3-2019.doc OWNER INFORMATION: FULL NAME OF APPLICANT Christopher Tucker SOLE OWNER: NO OWNER PHONE # (5 0 8) 6 8 0-6 6 3 2 ADDRESS PO BOX 734, Hyannis Port, MA 02647 Christopher Tuck CORPORATE ADDRESS: 790 Iyannough Road, Ste #5, Hyannis MA 02601 PERSON IN CHARGE OF DAILY OPERATIONS: Joao Motta 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. Joao Motta 01 / 11 / 2026 1. Joao Motta 12 / 21 / 2023 2. Tatyana Revkova 02 / 07 / 2024 J ��- kq�� — I I / IhiZc�Z, SIGNATURE O PLICAA � NT DA�T^E ***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/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 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.doc I 1 � Town of Barnstable BOARD OF'HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. SAWNSTAU.L :`. Paul J.Canniff,D.M.D. MASS F.P. Thomas Lee Alternate z � 200 Main. Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 620 Issue Date: 01/01/2021 DBA: B2 - BURRITO BISTRO, INC. OWNER: CHRIS TUCKER Location of Establishment: 790 IYANNOUGH ROAD HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 64 OutdoorSeating: 0 Total Seating: 64 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: I . For Office Initials: Town of Barnstable � Date Paid l-,A'D -nAmt_P-d 0$�lJ • TiAtiN81A1t E. • Inspectional Services 039. I' � Public Health Division Check# s 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 (v1 I a b NEW OWNERSHIP RENEWAL X NAME OF FOOD ESTABLISHMENT: B2 Burrito Bistro ADDRESS OF FOOD ESTABLISHMENT: 790 Iyannough Rd, Hyannis MA MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAILADDRESS: taco@burritobistro.com TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5( 0 8 � 771 6071 TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES NO X ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: X SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: 6 4 OUTSIDE: 0 TOTAL: 6 4 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) X 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:1Application FormsWOODAPPREV2018.doc PLEASE CALL 508-8624644 OWNER INFORMATION: FULL NAME OF APPLICANT Christopher Tucker SOLE OWNER: YES/NO OWNER PHONE# (5 0 8) 6 8 0--6 6 3 2 ADDRESS PO BOX 734, HyannisPort, MA 02647 K CORPORATE OWNER: 014z fToJhXEDERAL ID : CORPORATE ADDRESS: 790 Iyannough Road, Hyannis MA 02601 i PERSON IN CHARGE OF DAILY OPERATIONS: Joao Motta 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, Joa 1. Motta 2. Tatyana Revkova 02 / 07 /2024 �) v i2u SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-8624644 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 httg://www.townofbarnstable.us/hesithdivision/applications.ast) OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. QMpplication FomsTOODAPPREV2018.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARN gCABM � Paul J.Canniff,D.M.D. e . 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 620 Issue Date: 12/10/2019 DBA: B2 - BURRITO BISTRO, INC. OWNER: CHRIS TUCKER Location of Establishment: 790 IYANNOUGH ROAD HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 64 OutdoorSeating: 0 Total Seating: 64 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: J MOBILE-ICE CREAM: �a'0� ' FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: , ��rteFor Office Use Initials: Town of Barnstable Date Paid 11 WITAmLPs1$ • �� • Inspectional Services Public Health Division .: Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL X NAME OF FOOD ESTABLISHMENT: B2 Burrito Bistro ADDRESS OF FOOD ESTABLISHMENT: 790 Iyannough Rd, Hyannis MA MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: taco@burritobistro.com TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (118j, 7 71_ 6071 TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES NO X ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: X SEASONAL: DATES OF OPERATION: ! / TO NUMBER OF SEATS: INSIDE: 6 4 OUTSIDE: 0 TOTAL: 6 4 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) X 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 QMpplication FormsTOODAPPREV2018.doc PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT Christopher Tucker SOLE OWNER: YES/NO OWNER PHONE# (5 0 8) 6 8 0-6 6 3 2 ADDRESS PO BOX 734, Hyannis Port, MA 02647 CORPORATE OWNERrkn_Jtp�Q FEDERAL ID NO. : .� CORPORATE ADDRESS: 790 Iyannough Road, Hyannis MA 02601 PERSON IN CHARGE OF DAILY OPERATIONS: Joao Motta 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. Joao Motta 02 / 11 /2020 1. Joao Motta 07 07 / 2020 2. Gabriella Da Dilva 09 / 09 /2024 Lt�/ Z1 / Zo \,:�A SIGNATURE O APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-8624644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asi) OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1st to Dec.31'each calendar year. IT 1S YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:1Application FormsTOODAPPREV2018.doc w �p.NE rok, TOWN OF BARNSTABLE. - - HEALTH INSPECTORS Establishment Name: {' �d �( ate: � Page: of �P� a OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �A a3. HYANNIS, MA 02601 sob-8sz-as44 No Reference R,Red Item PLEASE PRINT CLEARLY, - lEDN1P, FOOD ESTABLISHMENT INSPECTION REPORT Name ^�y; �^ _ Dat Tvoe of Tyne of Inspection O er ti n s ou n 0G r Address O t'1 Risk e-mspection Level Retail Previous Inspection �� ! Telephone ' Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness yl Caterer General Complaint Person in Charge(PIC) Time tied 8 Breakfast HACCP In: Other Inspector I, �� Out: �J kj)-i 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 v V ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) _ G v�j ❑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 /1, �u within 90 days as determined by the Board of Health. Overall Rating ❑ VoluntaryCompliance p ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today, a items checked indicate violations of 105 CMR 590.000/Federal od Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC 4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations g 26.Water, entanand Waste if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot Plumbing (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 ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If i critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation 4 t n-critical viol =C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: r�lnspejSi u PI 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature ! 0 Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violation related to Foodborne-Illness Violation 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 1q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved kdditives* 9 - - PHF Hot and Cold Holding_ Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 1 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-201.11 Separation-Storage* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.1 1(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* 7.262.12 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 Reservice 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* 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 Wazewashing-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. Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 163-401.11A(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* - * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective tarzoot 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tem or and residential Sources g• P aTY 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 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 590.004(C) Wild Mushrooms ( )( )( ) 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 C Commercial] Processed RTE Food-140°F* Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification g Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* Temperature Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 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 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. OFIKE• TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: ( '-' Date: Page: of ti 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 � M63q `e� HYANNIS, MA 02601 MON.-FRI. NO Reference R-Red Item PLEASE PRINT CLEARLY 1°rFD MPS° FOOD ESTABLISHMENT INSPECTION REPORT 508$62-4644 Name Date (� Type of I ec ion LM si Routine -- Address �� Risk ood Serv' a e-inspection � Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 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 ( 1 Anti-Choking 590.009(E) ❑ �\ � Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities v EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives S it ❑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 1 fir, ��J�J ❑ 11.Good Hygienic Practices ❑ 22.Posting of ConsumerAdvisories L \j Violations Related to Good Retail Practices(Blue Items), Total Number of Critical Violations - iC 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 ems ❑ 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 6=One critical violation and less than 4non-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. y 29.Special Requirements (590.009) s o within 10 days f receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: nspec s ' at 31.Dumpster screened from public view I 1 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y IN - U #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Sign lure Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N lam/ 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 Assi ent of Responsibility* 6 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) I'� 14 Food or Color Additives * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 18 PHF Hot and Cold Holding 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41*F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Conta 7-102.11 Common Name-Working Containersiners* 590.004(F) P g * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 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 Reated 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* 4-501.111 Manual Warewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served Y 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. Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 163-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg°nee uvzooi 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 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-I55°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods s of Sanitization-Ho[Water and- 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009 A( )-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16 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 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products P 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 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. I °p IKE row TOWN OF BARNSTABLE _ HEALTH INSPECTOR'S Establishment Name: � Date:rJ - �'l Page:.. of ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 9cbp M67q:a 0� HYANNIS, MA 02601 M- - 64 No Reference R-Red Item PLEASE PRIN EARLY. soa8 sz4 �saa 'FDN1P' FOOD ESTABLISHMENT INSPECTION REPORT Name Date l. Type of sec ion o ne Address Q Risk ood a pection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in C arge(PIC) Time Bed&Breakfast HACCP In: Other � % Inspector ` _ Out: � � ,r G Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. fiN9 n Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Yy - Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HS . ❑ 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) I Corrective Action Required: ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating ry p ❑ ❑ p ❑ y y ❑ 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 (FG3)(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 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 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address 29.Special Requirements (590.009) within 10 days of receipt of this order. violation;4 to 8Aon-critical violations=C. 30.Other DATE OF RE-INSPECTION: Insp ct ' g tur 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 PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y. N Dumpster Screen? Y N ✓ 1 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* S 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 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties Cooked and RTE Foods. 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs.Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*Other* 590.004(F) * 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-WorkingContainers* 3-501.16(A) Hot PHFs Maintained At or Above 140'F Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-202.11 Restriction-Presence and Use* 20 Time as a Public Health Control Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 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. 1 6 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* Equipment* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* ey criw riuzooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Cheuucal* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Mid 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 77 Reheating for Hot Holding practiRequices should 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 23-30) 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items non-critical Critical and 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 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°17 Item Good Retail practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F * Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 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 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8403.12 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. a a 4. a METOWN OF BARNSTABLE HEALTH I E HOUROR's Establishment Name: Wmf Date: 10/o/13'Pager o{ v� o OFFICE HOURS 1 PUBLIC HEALTH DIVISION 8:00-9:30 A.M. • 8ARNSTABLE. • - I 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 508 N.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY rFD MP�e FOOD EWABLISHMENT INSPEK5CTN REPORT. /J Name Date vo600 e of T e sec io O Ine Address RRisk od Servic pecti n _X M Level Previo Telephone Residential Kitchen Date: Mobile Pre-o t' Owner HACCP. Y/N Temporary Suspect III ess / fi Caterer General Complaint Person in Ch rge(PIC) Time Bed&Breakfast HACCP p Other Inspector - Each violation checked requires an explanation on the narr ive page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT. ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals , FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) 171 ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures l ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling TJ ❑ 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 \J� 0 ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories `��� 111 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. Mo ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an ins ection today,the i m ❑ 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 nsils (FC-4 regardless of the number of critical,results in an F. 25.Equipment and Ute 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 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 v ions observed,7 to 8 non-cri cal violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. iolatio ,4 to 8 non-critical viol ons- 91 30.Other DATE OF RE-INSPECTION: In is Si nature Q� r - 31.Dumpster screened from public view &- J,�-) Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N . #Seats Observed Frozen-Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size. Variance Letter Posted Y N Dumpster Screen? Y N ` Violations related to-Foodborne Illness Violations Related to Foodborne Illness Interventions F `a 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.* { Additives* 19 PHF Hot and Cold Holding 2-103.11 = Person-in-Charge Duties 3-302.14 Protection from-Unapproved Contamination from Raw Ingredients 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F ,15 - Poisonous or Toxic Substances 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* 7-201.11 Separation-Storage*Applicants* - * P g 20 Time as a Public Health Control 3-302.11(A) Food Protection 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An _3-302.15 Washing Fruits.and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 - Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR . 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( � Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 - - Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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* 3-401.11A(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 E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved Sys[em* Eggs_ * Not Otherwise Processed to Eliminate Equipment 590.006(A) Bottled Drinking Water* - 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effect[-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 see* 590.006(B) Water Meets Standards in 310 CMR 22A* 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 PHFs SPECIAL REQUIREMENTS Shellfish* 4-70111 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009 A Ratites-165°F 15 sec* ( )-(D) Violations of Section 590.009(A)-(D)in cater- Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave 2-301.11 Clean Condition-Hands and Arms* the appropriate ro riate 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* * 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11 B Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.11 PHF's Received at Proper Temperatures O g 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-101.11 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* F 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-501.14A g 3-202.18 Shellstock Identification* 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-204.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006, 590.004 Labeling of Ingredients* Supplied with Soap and hand Drying Devices (n 9 9 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* Sr 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. THE r ;� TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: aik, Lo y/`I °ate: age: oOFFICE HOURS PUBLIC HEALTH DIVISION 8:00=9:30A.M. BARNSfABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. `0 HYANNIS, MA 02601 soa-s2 asaa No Reference R-.Red Item PLEAS RINT CL RLY FOOD ESTABLISHMENT INSP C REPORT Name Date Ta of Type of Inspection Routine Address Risk ood Servi Re-inspection Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ 1A 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 V ❑ 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 v ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding VA 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 6=One critical violation and less than 4non-critical violations 9 (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 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8non-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 no -cri I tipal violations=C. 30.Other DATE OF RE-INSPECTION: Inspe Sig ur 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 Signat re Print: 1 . Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N J 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[0 41'F/45°F Within 4 Hours* * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* Cooked and RTE Foods.* *_- 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives - Contaminatlon 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* g * 3-501.16(A) Hot PHFs Maintained At or Above 140'F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130'F* 7-201.11 Separation-Storage* Applicants* P g 20 Time as a Public Health Control 3-302.11(A) Food Protection* 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 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* 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 Warewash ing-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. Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 163-401.11A(1)(2) Eggs-155'F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food ContactEggs Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef crave 1nn001 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 4-70111 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165'F 15 sec* 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 * 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140'F Critical and non-critical violations,.which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70'F * 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 5-20411 Location and Placement* 3-501.14(B) Cooling P14FS 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. `Op THE row TOWN OF BARNSTABLE _ HEALTH INSPECTOR,s Establishment Name: Date: I Page: of - o OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. L 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. .639.p�m HYANNIS, MA 02601 508-862 as4a No Reference R-Red Item PLEASE PRINT CLEARLY 'EDN1P' FOO TA IJSHMENT INSP49C ION REPORT 41 Name Date P(% Type Ins ec 'o 1 1 I t I O r Roe Address Risk I Fofod Service -Re-inspection r I Level -Retaiill� Previo}�O 's e�ctr- J- 9 Telephone Residential Kitchen Date: I' � I/7 ' J ' Mobile Pre-oftio U�' 1 c ` DAT Owner HACCP Y/N Temporary Suspect Illness ' Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP e� r A r ' n: Other i Inspector , � 11) V,uffinj�j( t: r o r Each violation checked requires an explanation on the narr tive page(s)and a citation of specific provision(s)violated. r Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ r / ' / 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) ❑ / v l / a FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands / J ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS f ` r ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious.Restricted/Excluded ❑ 15. Toxic Chemicals - Q.J FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) `° 4.Food and Water from Approved Source r r v ❑ pp ❑ 16.Cooking Temperatures - � "' yr ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy ofdngredient 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 r r r ❑ g g ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories #/I ' - J / Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Y / r r Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,thre ite,•s checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 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 4 non-critical violations 9 26.water,Plumbing and waste (FC-5)(590.005) establishment permit and cessation of food establishment operations. d if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9non-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 nop-criticab.violations. If 1 critical refrigeration. vi lation,4 to 8 non-critical I lation -C. 29.Special Requirements (590.009) within 10 days of receipt of this order. I 30.Other DATE OF RE-INSPECTION: Ins ctorsSignatur (� print: 31.Dumpster.screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N - #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N s 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 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* 7-1011 Common Name-Working Containers* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2'. Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F Applicants* 3-302 7-201.11 Separation-Storage*11(A) Food Protection* p g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004(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 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources y Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not.Served* Pe 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112' Mechanical Warewashing-Hot Water Monitoring* 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. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* 5-101.11 Drinking Water from an Approved System _ gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff aiv 11112001 4-602.11 _ Cleaning Frequency of i]tensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS -703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 8 g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g• p ra*Y 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail In. tices 3-201.17 Game Animals* 11 - Good Hygienic Practices 17 Reheating for Hot Holding Requirements. Id 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* 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) 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 - 3403.11(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* 78 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°17 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 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products P 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ASSESSORS MAP NO* 3 1 No. ���� "�" PAAtI►N0. Fee THE COMMONWEALTH OF SSACHUSETTS ntered in computer: 4e� .J PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLEi MASSACHUSE �PdFEe �T 0[p�prication for OiOpogar *pgteem Construction Permit q-001 CV-4 Application for a Pe ' nstruct( )Repair( )Upgrade( )Abandon( ) ❑Complete y em ❑Individual Components Location Address or Lot No. 0147 �yCrP/� � Zner's Name,Address and Tel.N 145`AA ,l Assessor's Map/Parcel G j r, V Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ►1 J�N Type of wild' g: f��$'Z.bl Gar - I Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank I tyK z7! nyL Type of S.A.S. Description of Soil Nature off`Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signed Date '" Application Approved b Date U Application Disapproved for the following reasons Permit No. :—'0,0 Date Issued TOWN ORARNSTABLE LOCATION �lo %_ / I�flprl SEWAGE . ./,����r�l� -�(.iA�1 SEWAGE # 2-000 VILLAGE r r ; --0 ASSESSOR'S MAP & LOT INSTALLER'` AME 8t PHONE NO. SEPTIC TANK CAPACITY _�-r.2�r�,� Q/AP �•Orel jGI/'rn,>� LEACHING FACILITY: (type) �/A (size) i N0,,0F EEDROOMS BUILDER OR OWNER- PERMIT DATE: ��3 lCm COMPLIANCE DATE: 0 Separation Distance Between the: Maximum.Adjusted Groundwater Table to.the Bottom of Leaching Facility Feet I Private Wate'r Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching„Facility(If any wetlands exist within 300.feet of leaching facility) Feet Furnished by O p I vZ �q E ` ®� i_ No. !+ l' �GI 4J 0 t '7 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS ZippYication for Migogar *p5teem Construction Permit &- Ir:50 _JT- � Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete Systert� ❑Individual Components Location Address or Lot No. .�- ,rn I� ��" ..LA�'l�C7YJ,��s ner's Name,Address and Tel.No. , • Assessor's Map/Parce7 �j Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: f Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures w" Design Flow gallons per day. Calculated daily flow gallons. `Plan Date Number of sheets Revision Date _Title Size of Septic Tank J C>d L1 d5r.05: L j Type of S.A.S. Description of Soil ,l Nature of Repairs or Alterations(Answer when applicable) ZZ J.'g ,+cam I_Z_ r E-. Date last inspected: f` Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation untilla Certifi- cate of Compliance has been issued by this Board of Health. Signed Date `��� r Application Approved b Date ; Application Disapproved for the following reasons r Permit No. � " Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,tha the On�„site Sewage Disposal System Constructed(Repaired ( ) Upgraded ( ) Abandoned( )�by�j �„✓at en constructed in accordance with the provisions of Title 5 and the for D, posal System Construction Permit Nc" e �ted gel Installer Designer .- h/ I �e 1 %I The issuance of this ppernut sr all not /be c,jnstrued as a guarantee that th 's;yast/emnill functiioyn as designed `Date 1 i IlI 1f InspectorA° /I V ------------ No. �� 1� Fee k7 L/� � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS x0igpoga1 *pztem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrra ez( )Aban.o System located at 4s' +r+ PF and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5.and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this ,eilnit. Date: ! Approved b a 1x` 41 i I pU T DATE: 7 ,I:j r FEE: �i eq'{/l' BAmsrABLE, 11tA,S9. 9� s639. & REC. BY ArFD MA'S Town of Barnstable SCHED. DATE: Board of Health 367 Main Street,, Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION "� S ,-A Iq O Z�Property Address: � /-)/BUJ � 2� (—JZTIT� � p rn�i Assessor's Map and Parcel Number: Size of Lot: i Wetlands Within 300 Ft. Yes Business Name: ��Z ����'� �S?Le7 LAC No Subdivision Name: APPLICANT'S NAME: L 1r-1sT0C-'V-(tQ Phone so 1 tLl-7 7 y Did the owner of the property authorize you to represent him or her? Yes _ No PROPERTY OWNER'S NAME CONTACT"PERSSON f Name: 1 i�1r1 eso�v� LL.C. Name: I-- ,C\ J)Zet-xcq, - Ur� 1Ze t4*% /3c� so. Fc-o-,VA C,,J, �p\er r?t.�ce, Ste, a -ic0 M RT Address: 1 O 3 Address:�3oa ,....a , 6 Z 0 b Phone: Phone: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if ri-lore space needed) QeQ Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4) copies of floor plan submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same ownerneasee only],outside dining variance renewals[same ownedleasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed)) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G. Rask, R.S., Chairman NOT APPROVED V1 Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A. Murphy,M.D. AID Q:/WP/VARIREQ r URBAN RETAIL PROPERTIES CO. Capetown Plaza _Tenant Space Sq. Ft. Use Seating Tweeter, Etc. #1 15,202 Electronics Papa Gino's #'s 4/5 3,500 Food Seats 92 Filene's Basement #6 36,000 Dept. Store Pearle Vision #7 2,040 Eye Care Cards/Gifts #8 3,000 Cards/Gifts (coming soon) Dansk Designs #9 . 3,750 Home Goods Lady Grace #10 1,500 Lingerie Radio Shack #11 2,000 Electronics Vacant #12 2,250 Barnes & Noble #13 11,95G Books Cape Cod Crafters #14 4,400 Arts &Crafts Coconuts #15 4,500 Music/Videos Kmart #16 94,500 Dept. Store Vacant #17 20,640 D'Angelo Subs #18 1,160 Food Seats 16 Tiki Port Restaurant #19 4,276 Food Seats 235 Fleet/ATM #20 414 Banking Vacant #22 5000 Health Stop #22 2,500 Clinic Vacant #23 6,000 Boater's World #24 5,000 Marine Supplies IHOP #25 2,600 Restaurant Seats 102 FOUR COPLEY PLACE SUITE 400 BOSTON,MASSACHUSETTS 02116-6501 617-262-6624 FAX 617-375-4482 TOWN OF BARNSTABLE �F THE t0 OFFICE OF 6 'n B9ANSTSBL ; BOARD OF HEALTH y MABB p� �p 059. `e0 367 MAIN STREET p'For�av^ HYANNIS,MASS.02601 July 12, 2000 David Reiner Urban Retail Four Copley Plaza Suite 400 Boston, MA 02116 RE: Burrito Bistro, Inc., Capetown Plaza, Hyannis Dear Mr. Reiner: Your request for a variance to provide only two restroom facilities at Burrito Bistro Restaurant, Route 132, Hyannis, is not granted. The Board of Health regulation specifically requires separate toilet facilities for male and female employees, and separate toilet facilities for male and female patrons at each food service establishment with a seating or standing capacity of over fifty (50) patrons. Sixty- five (65) seats are proposed at this food service establishment. The Board of Health may vary the application of any provision of these regulations, with respect to any particular case when, in its opinion, the enforcement thereof would do. manifest injustice; provided that the decision of the Board of Health shall not conflict with the spirit of any minimum standards established by these regulations. The applicant failed to establish manifest injustice and this application for a variance conflicts with the spirit of the minimum standards established by the regulations. Therefore, your request for a variance from Part II, Section 1.00 is not granted. Sincerely yours, Susan G. Rak, R.S. Chairperson Board of Health SG R/bcs reiner • ✓ B 2 Burrito Bistro Variance Request Prepared by Christopher Tucker B2 Burrito Bistro, Inc. 12 Circuit Ave. Hyannis, MA 02601 Tel: 508.775.4778 Fax: 707.371.1396 Email: christucker@rcn.com Property Realtor David Reiner Urban Retail Properties Four Copley Place, Suite 400 Boston, MA 02116 Tel: 617.262.6624 Fax: 617.375.4482 • Town of Barnstable Board of Health 367 Main Street Hyannis, Massachusetts 02601 Re: Variance Request, Regulation 11 — Toilet Facilities B2 Burrito Bistro, Inc. is requesting that the Town of Barnstable grant a variance on Regulation 11 - Toilet Facilities for its proposed 64 seat restaurant that will be located in the Capetown Plaza, lyanough Road (RT 132), Hyannis, Massachusetts. B2 is establishing a quickservice restaurant with a menu that encompasses a variety of Mexican-style dishes and non-alcoholic beverages. Menu prices and food portions are value-oriented. The estimated check average is $6.25 per person. All menu items will be ordered and served over counter for eat-in or take- out dining. For more details see the attached "Menu". 132 will serve lunch and dinner seven days a week between the hours of 11:00 a.m. to 9:00 p.m. B2 estimates it will serve an average of 225 covers per day. Depending on the time of year, up to 30% of that will be for take-out dining. All menu items will be served in or on disposable paper and/or plastic containers. All eating utensils will be disposable plastic utensils as well. The restaurant building size is 2,500 sq. ft. The restaurant design has a dining area of approximately 960 sq. ft. with 64 seats. The majority of the tables are four tops. The table and seating breakdown is as follows: Eleven - four tops. Six - two tops. Eight - counter stools. For more design details please refer to the enclosed "Equipment Floor Plan". B2 will present a very clean fashionable decor. The dining atmosphere will be very casual and relaxed. B2 estimates that on average its customers will be composed of individuals and parties of two to.four. The space presently has two handicapped bathrooms that are in operational condition. B2 will install a separate sanitation line, drain line and a 1000 gallon grease trap. Depending on the time of year, and time of day, B2 requires three to five employees per shift, two shifts per day. Each employee will be trained in several aspects of service and production, instead of limiting each employee to one task such as cashier. However, each employee will be given priority tasks and instructed to help out in other areas whenever possible. 132's daily operations require the following employees: Manager: The managerial duties include management of the day-to-day administrative and general functions of the operation. The manager will also provide back-up support for all other employee jobs. Mr. Tucker will hold this position. Cook/Food Server: The cook's main priority is the preparation and processing of all hot and cold food items and orders. He/she will also participate in the physical inventory, ordering, receiving, and storing of food and non-food inventory items. Beverage and Dessert Server: The beverage server is responsible for processing hot and cold beverage orders, dessert orders and assists in processing hot and cold food orders. Cashier: The cashier is responsible for receiving customer orders, collecting payments through the cash register, and assisting in processing hot and cold beverage orders. Sanitation/Prep Cook: This individual's duties include pot washing and general sanitation of the dining room and kitchen during service. This employee is also responsible for the cleaning of equipment, counters and floors at closing time. He/she also assists in the preparation, receiving and storing of food and non- food inventory items. Employee uniforms will consist of a B2 T-shirt, large heavy-duty apron with 132's logo prominently displayed and khaki pants. B2 will supply T-shirts and aprons; Khaki pants are the. responsibility of the employee. Employees will be instructed to wear the appropriate work shoe. Mr. Chris Tucker has conceptualized and researched B2 Burrito Bistro. Mr. Tucker is a highly motivated self-starter and has an extensive and versatile background in food preparation and production, as well as sales, marketing and business management. Mr. Tucker attended Johnson & Wales College, in Providence, R.I., specializing in culinary arts, restaurant production and food and beverage management. Mr. Tucker has an extensive background in food production, with eight years of cook and/or chef experience at the following establishments: Eastward Ho Country Club, Chatham, Massachusetts; Sam Diego's Mexican Bar& Grill,.Hyannis, Massachusetts; The Red Pheasant Inn, Dennis, Massachusetts; Tivoli Gardens, Christiansted, St. Croix, U.S.V.I.; Off the Bay Cafe, Orlean. s, Massachusetts; Wunderbar Restaurant, Paia, Hawaii; and Cafe Kiowai and Prince Court, Maui Prince Hotel, Makena, Hawaii. In addition to his culinary and restaurant operations experience, Mr. Tucker has a successful business management background. While residing in Hawaii, Mr. Tucker served as U.S. Sales Manager for Hot Sails Maui, a corporation specializing in windsurf sail design, manufacturing and distribution. While residing in Hood River, Oregon, Mr. Tucker successfully co-founded a 1.2 million dollar wholesale sporting goods distribution company,Outside Sports Inc., and served as General Manager for four years. Mr. Tucker was responsible for all aspects of the company's start-up and managed the daily operations including; r accounting, purchasing, hiring and training employees, sales and marketing. For more information on Mr. Tucker please see the attached "Resume". For the following reasons B2 is confident that the existing two handicap bathrooms will more than adequately serve its employee and customer needs: B2 estimates 30% of its business will be take-out. B2 requires three to five employees per shift. For convenience purposes 70% of 132's tables are four tops. B2 anticipates that its customers will commonly be comprised of individuals and parties of two to four. Therefore at any given time the dining room will operate well below maximum seating capacity. In closing, B2 hopes the Board of Health will graciously allow B2 to operate with a seating capacity of 64 seats, without having to install a second set of employee bathrooms. In advance, thank you for your consideration. Sincerely, Chris Tucker B2 Burrito Bistro, Inc. I SMOOTHIES JAVA BAR Regular 2.39 Large 3.49 Coffees House * International * Flavored Fruit Smoothies House Berry Blast strawberries, blueberries, Decaffeinated Coffee House International raspberries, bananas, apple juice. * Pineapple Hula pineapple, Iced Coffees Mexican Grill and cafe blueberries, bananas, apple juice. Tazo Teas Raspberry Ripple raspberries, Hot Chocolate bananas, apple juice. Blueberry Blues blueberries, bananas, orange and apple juice. DESSERTS Peachtree peaches, orange and apple juice. B2's desserts are baked fresh daily and Yogurt Smoothies are absolutely delicious! Strawberry D'lite strawberries, Tortes Brownies Burritos orange juice, vanilla yogurt. Cookies Biscotti Blue Moon blueberries, bananas, apple juice, vanilla yogurt. Flan Cheese Cake S m o o t h.,i e s Raspberry Dazzle raspberries, bananas, apples juice, vanilla yogurt. C o.f f e is Peachsicle peaches, bananas, orange juice, vanilla yogurt. Bottled Drinks 3 O'clock Express bananas, coffee, Coke Diet Coke Sprite Me s s e r t s vanilla yogurt. Arizona Ice Tea Nantucket Nectars Boosters.............................. .50 ea. Fresh Samantha Juices Energy ginseng & protein powder. Spring Water Health multivitamin & minerals. Fountain Drinks Mind Bender ginko biloba & ginseng. Regular .99 Large 1.29 Tasty Food Cold Killer vitamin C & echinacea. Cooked Fresh - Served Fast Protein Blast isolated soy protein. Burrito Bistro Route 132 - Capetown Plaza Serving Lunch & Dinner (Next to Barnes & Noble) Seven Days a Week Hyannis, MA 02601 Served with fountain beverage and tortilla chips. 508.775.4778 Dine-In or Dine-Out Quesadilla melted cheese in a grilled flour www.burritobistro.com tortilla ...............................:......... 2.99 tasty@burritobistro.com Burrito Bowl chicken or beef covered with cheese served in a bowl with rice.... 2.99 We accept most major credit cards and good old cash. Route 132 - Hyannis Taco beef or chicken served in a flour tortilla ] g with cheese and lettuce ................. 2.99 p 2000 B2 Burrlto Bistro,Inc.All rights reserved. B2's Salsa Bar Features a Variety of Fresh Salasl MODERN • • UESADILLA BURRITOS Thai Burrito chicken, satay peanut sauce, Melted jack cheese in a grilled flour tortilla with B2 and cilantro. ................................. 5.49 cilantro, Burritos are wrapped in an ; cilantro, sour cream, and salsa fresco...... 3.99 oversized warmed flour tortilla Santa Fe Burrito chicken, ancho chili peps With: and served with tortilla chips. mayonnaise, rice, lettuce, tomato, onion, an Steak .............................. 4.99 Burrito Max black or pinto beans, rice, cheese, cheese. ....................................... 5.49 Chicken ............................4.49 salsa, lettuce, sour cream, guacamole and Pork ................................ 4.49 choice of: Hawaiian Burrito steak, teriyaki sauce, ri Fish ................................. 4.99 and pineapple.. .............. 5.99 Veggies............................ .4.29 Steak .............................. 5.49 � .. Chicken ........................... 4.99 Texas BBQ Burrito steak, barbecue sauc( Pork ................................ 4.99 rice, black beans and cheese. ......... 5.99 Fish ................................ 5.49 SALADS Veggies ........................... 4.79 Tostada flour tortilla hard shell filled with 62 Burrito black or pinto beans, CharGrilled TACOS romaine lettuce served with black or pinto Veggies, sour cream, and choice of: beans, sour cream, cheese, salsa fresco, bell Steak .............................. 5.49 Meat Tacos flour or corn tortillas stuffed H pepper and carrots.........................3.95 Chicken ........................... 4.99 salsa fresco, lettuce, cheese or sour cream With: choice of: Pork ................................ 4.99 Steak .............................. 5.49 Fish ................................ 5.49 Steak .............................. 2.99 Chicken ........... 4.99 Fajita Burrito rice, grilled peppers and onions, Chicken ........................... 2.59 . ................ Veggies ........................... 4.99 sour cream and choice of: Pork..................................2.59 Fajita Salad romaine lettuce served with Steak .............................. 5.75 Seafood corn tortillas stuffed with cabbage grilled peppers and onions, sour cream, cheese Chicken ........................... 5.25 B2's Baja Sauce, salsa fresco and choice of: and choice of: Pork ...I............................ 5.25 Steak .............................. 5.49 Classic Burrito black or pinto beans, cheese, Fish ................................ 2.99 Chicken ........................... 4.99 salsa fresco and choice of: Veggie Tacos flour or corn tortillas stuffed Pork .................................4.99 Steak ................... with salsa fresco, lettuce, cheese or sour cri 62 House Salad romaine lettuce served with Chicken ................•.••,••,,,. 4.99 and choice of: salsa fresco, bell pepper and carrot. 2.99 Pork ............................... 4.99 Veggies ........................... 2.79 Fish ................................ 5.49 Rice and Beans ................ 2.29 Ranch * Caesar * Vinaigrette Veggies ........................... 4.29 Peppercorn * Blue Cheese Bean & Cheese Burrito black or pinto beans, rice, cheese, lettuce, salsa fresco, sour cream Beans: Black or Pinto ........... 1.29 SANDWICHES b, Rice ................................... 1.29 Bulkie roll with lettuce, salsa fresco, For Maximum Flavor and Freshness Veggies .................. 1.59 cheese and tortila chips. we CharGrill our Peppers and Onions 1.59 Steak ............................. 5.29 Meats and Veggies) Guacamole .......................... 1.59 Chicken .......................... 4.79 Sour Cream .......................... .50 *Fish .............................. 5.29 We Cook our Beans and Rice without Lard or Animal Fatl Cheese ................................. .50 *Fish sandwich is served with * * * * * Tortilla sm:.20. ....... I 50 cabbage and B2's Baja Sauce g Our Tortilla Chips are Cooked on Site Chips and Salsa Bar ............. 1.79 with 1000A Cholesterol-Free Oill Christopher Tucker PO Box 734 508.775.4778 Hyannisport, MA 02647 christucker@rcn.com BUSINESS MANAGEMENT SALES MARKETING Highly motivated multitalented businessperson with wholesale/retail business management experience, and sales and marketing expertise. Successful track record in start-up and turnaround situations. Recognized for the ability to learn and adapt quickly as well as think clearly in high stress situations. Excellent organizational, communication and interpersonal skills. SKILLS / KNOWLEDGE • Sales and Marketing Professional . Project Management • Business Analysis/Strategic Planning • Employee Development/Supervision • Negotiation /Arbitration • Inventory Purchasing/Management • Accounting and Budgeting Experience • Extensive Software Application Expertise PROFESSIONAL EXPERIENCE OAKLEY USA, INC. (NYSE Ticker: 00) - Foothill Ranch, California Designer, manufacturer and distributor of consumer products including high-performance eyewear, footwear, apparel and watches. URL: www.oakley.com Sales Representative- 1011998 to 1111999 Traveled throughout the Northeast region of the U.S. selling and promoting Oakley's footwear and apparel product lines. Managed the ordering, merchandising and inventory of Oakley's products for established accounts. KeyAchievements: • Led U.S. footwear sales force in establishing new footwear accounts. • Increased the number of footwear accounts in my territory by 860%. • Targeted key accounts and developed relationships with a view towards future growth. OUTSIDE SPORTS, INC. - Hood River, Oregon North American wholesaler specializing in importing, warehousing, marketing, distributing and servicing sporting goods. Key product lines: Fanatic Boards, Gaastra Sails, Hot Sails Maui. URL's: www.fanatic.com, www.gaastra.com, www.hotsailsmaui.com. Cofounder/General Manager- 10/1994 to 711998 Responsible for establishing company policies and managing day to day operations including accounting, budgeting, purchasing, marketing, sales and service. Conducted market analysis and strategic planning. Negotiated various contracts that were vital to the company's operations. Hired, trained and managed all employees. Christopher Tucker Resume •Page 2 Key Achievements: • Successfully coordinated and executed the company start-up. • Implemented proactive business strategies that enabled the company to operate cost efficiently and profitably. • Established relationships with International vendors and negotiated import/distribution contracts that saved the company over$175 thousand in product cost. • Created and implemented proactive marketing'and sales programs that resulted in increased sales volume and the eventual successful turnaround of Fanatic and Gaastra. • Increased product awareness and sales volume by traveling throughout the U.S. conducting informative and motivational product sales presentations and clinics. • Purchased $2 million of inventory over a three-year period with a less than 3%end of season carry-over. • Executed the design and layout of websites, office forms, promotional flyers, advertisements and brochures. HOT SAILS MAUI USA, INC. - Kahului, Maui, Hawaii Designer, manufacturer, marketer and distributor of high-performance windsurfing products. Company operates two retail stores: Maui, Hawaii and Hood River, Oregon, and distributes its products in over 20 countries. URL: www.hotsailsmaui.com. General Manager/Sales Manager-8/1990 to 1011994 Multifaceted position that involved managing all areas of the development loft and retail store operations. Responsible for developing and implementing U.S. wholesale/retail sales programs. Participated in conceptualizing, developing, testing, manufacturing, and marketing new products. Key Achievements: • Played an integral roll in the successful turnaround of the company's operations. • Built relationships with retail accounts throughout North America resulting in a 1400% increase in new accounts. • Established customer service procedures and standards that resulted in high customer satisfaction and increased repeat business. • Dealt extensively with retail store buyers and consumers at regional and national trade shows. COMPUTER SKILLS Proficient in operating Windows and Macintosh as well as the following software applications: Microsoft Office, Corel Suite, Internet and Email Applications, FrontPage 98, Act!, WinFax Pro, Peachtree Accounting, Quicken, QuarkXPress, Adobe PageMaker and PhotoShop, Microsoft Publisher. EDUCATION Johnson and Wales College- Providence, Rhode Island Culinary Arts 1985 to 1987 THE COMMONWEALTH OF MASSACHUSETTS BOARD OR H 1 . ..... OF... .. .... ..'. .........:. . Apphrativtt for 15igposal Igor ""'trurti.ott rruti# Applic ' n is her y de for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Systa .... ......... . ... ----- ......... J c .. .............. G4..... .. y�+� .. -• •. Locati�on.Ad e�s1 /� 0t o. ...:... .� ..L.10: !. . ................. �€ . GZ � .............. O r. -� n yy NN �� s " Installers u L�.YX ... ....�... .. Address ................................. Q Type of uil� Size Lot............................Sq. feet U Dwelli No. of BedroomExpansion Attic ( ) Garbage Grinder ( ) ••. ----•-•• .. ...._ _ PH Other Type of Building _.. .Y-0—kay.._._ o. of persons............................ Showers ( ) Cafeteria ( ) QOther fixtures ----------------------------------------•--•----------••---------.............................. W Design Flow........................................�. lons per person per day. Total daily flow---1.. . _. ......_................................gallons. WSeptic Tank,;.L-Liquid capacity o n s Length................ Width-.----------- Diameter................ Depth................ x Disposal Trench— ............ Widt _- ,............... Total Length.................... Total leaching area....,...............sq. ft. Seepage Pit No________ ___________ Diameter-_. -_ors........ Depth below inlet.....I..&...... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ 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____-___-_-_-__------__. •-•-•-•---- ----• ----••.--•- .................. ........................... . O Description of Soil --- ------ - x , c.� ------------- ------- = --------------------•- ------ ��' ; U Nature of Repairs or Alterations—Answer when p�le.------------------------- ------------------------------------------------•---•-------•------- ...-•-•-••-•-•-----•••-----•••...................................••••-••--••-•-•-........................---•-•.••-••--••------------------••-------••-•••-•-------------------•--------••-•••-•-•-•--- Agreement: The undersigned agrees to install the afor ibed Indivi ual Sewage Disposal System in accordance with the provisions of Article aI of the State Sanita C e—The ers' i d further agrees not to place the system in operation until a Certificate of Compliance has a ssued by t e o of health. S' ned.. ----- " Dae Application Approved By-- < . .. _..- ...... ......... - , C Date Application Disapproved for the following reasons:..................................... ......... . ....................... Date PermitNo......................................................... Issued..................... ................................. Date ....................................................................................................................... ... THE COMMONWEALTH OF MASSACHUSETTS J4' BOARD O HEALTH i2 4,..............O,......... �IFL�J `... ............. 5 Tertif iratr oLDi litt"r T �IS)IS TO CERT Y, Tha ividual ewl System constructed ( or Repaired b .,..... ....... ........... ........................................ Iris ------------- -------------. .. --••-•------•.-----•-•--••-----•. has been installed in accordance with the provisions of Article 'I f The State Sanitary ode a descri ed in the application for Disposal Works Construction Permit No.............. ... _-�-----___- dated---._ ---------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS-A GUA ANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............•--•------------------............................................. Inspector.................................................................................... - ------------------ J �1 THE CONOINAONWEALTH OF MASSACHUSETTS BOARD OF H-H 1 TLJ Ap lirativu far Bi.npasal 18orkii Tomitrurtion Vrrmft Applicat• n is herby made. for a Permit. to Construct ( o'r Repair ( ) an Individual Sewage Disposal Syst a r Location-Add or of io ^•• 0 'r" A s .... .Zilding .......... ......nstaller ;Address e of Size Lot..........:................Sq. feet Dwelling No. of Bedroom ...........................t__ ..........Expansion Attic ( ) Garbage Grinder ( ) aOther r ype of Building r,. of persons____________________________ Showers ( ) — Cafeteria ( ) Otherfixtures ------------------------------------------------------------------------------- ; W Design Flow_______________________________ ._:gallons per person per day. Total daily flow__ _ - ____-_:____ gallons. WSeptic Tank •Liquid capacity/ ,y !Dons Length................ Width...._............ Dian*ter................ Depth............. xDisposal Trench— ____-_______ 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. 1..............:.minutes per inch Depth of Test Pit.................... Depth to ground water_-_-_--.- _-_-_. f1 Test Pit No. 2................minutes per inch Depth of Test Pit------------__..._._. Depth to ground water......................... ..................... O Description of Soil._..._._.______• - �;: ___�_ _:$_ _ ___.___ •✓__ _ r ,,,�e9r�-g� �. VNature of Repairs or Alterations—Answer when plicable................................................................................................ w -------------------------------------------------------------------------- --------------=------••--••••-•-•-•---•-- ...--•••••---••••.._.--------------------------------------=------•-•--•- Agreement: The undersigned agrees to install the afor gibed Indiv> al ewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Co e-The u;i er. d further agrees not to place the system in operation until a Certificate of Compliance has , e sued by t oa f health. .r 42 Application A roved B •- � Date Application Disapproved for the following reaso-ns:-----------------------••--••-••-•-•-•••---••-••-•••--••...•-••••••••-•••-•--...•••-••••••••••••---•T........... -----------------------••••-•-••••••_•••••-•••-•-•--••-•••••-..__........_••-••••-----•••••••--••---••-••...•••-•••-••••••••--------•----------•-•-•----------•••••-••--•--•-•-•-••---•---•••••---......_ Date PermitNo......................................................... Issued-------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH .. . ... ^. ........... OF..... ..: -. :......:............... Trr$ifiratr of outptiana TH S S TO CERTI Y, Tha l div:dual Sewa Disposal System constructed ( or Repaired ( ) by ..... 1 §, �, wee i„s�uue �- --� •- - has been installed in accordance with the provisions of Article f The State Sanitary C de 1s descri d ii�the application for Disposal Works Construction Permit No............... ._ _.. ---------- dated ... _ zx. _-------- THE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS ' BOARD F, HEALTH # Al O F .: L . ':. �'�. 7 �� ... '._ No... FEE ............ al pumit Permission i! ereby granted--=--- - Via . .__.. ,` «-••-= s1 - ................................................. to Construct ( for. Rep ( ) an idni Sewage Dispos yst at No.... � "� -- Aj-- ` ... :.... � '...!' ... ........................ ...... •. - Street ,� .... as shown on the application for Disposal�Vorla Construction I?e No.: Dated-- -�. -_._ .•.... DATE-- r 0 o d f Iffealth Y 6 i�"qw' a"nrE+"Y Gt •P Il.•$'�. -^ `I` t FORM 1255 HO©SS & WARREN. INC.. PUBLISHERS 1 • • • JAVA BAR Small 2.29 Regular 3.49 Coffees B2 Offers a Selection of Premium Coffees Fruit Smoothies Berry Blast strawberries, blueberries Iced Coffees raspberries, bananas, apple juice. "� P Tazo Teas Pineapple Hula pineapple, Hot Chocolate blueberries, bananas, apple juice. **Coming Soon** Raspberry Rip raspberries, bananas, B2 Espressos 7 apple juice. Blueberry Blues blueberries, bananas, orange and apple juice. DESSERTS Burrito Bistro Yogurt Smoothies Strawberry D'Itte strawberries, B2's desserts are baked fresh daily and orange juice, vanilla yogurt. are absolutely delicious! Blue Moon blueberries, bananas, Cookies Lemon Squares apple juice, vanilla yogurt. Brownies Biscotti Berry Swirl raspberries, blueberries bananas, apple juice, vanilla yogurt. Tasty Food Peachsicle peaches, bananas, orange - juice, vanilla yogurt. Cooked Fresh Deluxe Smoothies Bottled Drinks Chocolate Truffle chocolate, Coke Diet Coke Sprite Root Beer Served Fast raspberries, bananas, vanilla yogurt. PowerAde Coconut Coolada coconut, pirlecipple Nantucket Nectars bananas, vanilla yogurt. Spring Water 3 O'clock Express coffee, bananas, vanilla yogurt. Fountain Drinks Peanut Buster chocolate, peanut Small .99 Medium 1.29 Large 1.59 butter, bananas, vanilla yogurt. Boosters.............................. .50 ea. Energy ginseng & protein powder. § Health multivitamin & minerals. _ � B2 Bll�'�'i9 B Stl'O Nam , Lunch & Dinner Mind Bender ginko biloba & ginseng. 9Q Iyannough Rd {Rt 132) z x'go �, i Seven Days a Week r CapptOwn Plaza ° Cold Killer vitamin C &echinacea. A Dine-In or Dine-Out w Hyannis, MA OZtaO Protein Blast isolated soy protein. 5Q8 7y71 607 & a � v. '�� °��� , RWww burri�obistro�Gom�; Boosters Help your body burn fat, bond tasty@bu�rltobistro`com muscle, 111Crease energy,�n�edCl eXtra a vitamins'and Route 132 - Hyannis ©2000 B2 Burrito Bistro,Inc.All rights reserved. L SALADS 62's Salsa Bar Features a Variety of Fre0las! • -11J R R IllCOME Tostada tortilla hard shell filled with Thai Burrito chicken, satay peanut sauce, lettuce served with black or pinto beans, sour BURRITOS sprouts, rice and cilantro in a ginger cream, cheese, salsa fresco, bell pepper and tortilla ........................................ 4.99 carrots 4.49 B2's Burritos are wrapped in a ........................................ HUGE warmed flour tortilla Santa Fe Burrito chicken, ancho chili With: pepper sauce, rice, lettuce tomato, onion Steak 5.49Cla§sle 8urrlta biaai<ar pino beansi chee5ei and cheese in a spinach tortilla ...... 4.99 Chicken 4.99 salsa'fresco and,,cl alce of� s s Hawaiian Burrito steak, teriyaki sauce, Veggies ........................... 4.99 � � Steak rice, sesame seeds and pineapple in a Fajita Salad tortilla hard shell filled withChicke k S' 4 49 r o i a ............................... 5.49 Park Binge t rt'll grilled peppers and onions, sour cream, cheese �. � Uegges 4 49 Texas BBQ Burrito steak, barbecue sauce, and choice of: � rice, c beans an c s° U 4 99 a e, black b d cheese in a tomato 5.49 5.49 Steak .............................. tortilla ........................................ Chicken ........................... 4.99 BurritoIaxl,"bla4Ck i pinta beans, rice, Cheese, a Saudi IpttuCe� sour,cre �r► guacamole and � " Indian Burrito chicken, curry sauce, rice, Pork .................................4.99 "Ffjcho[Ce of z grilled onions and peppers in a spinach B2 House Salad lettuce served with bell �a � 549r,� tortilla ........................................ 4.99 Steak . pepper, carrot and sprouts...............2.79 � �� `', ' ,�� �hlbken� � 4 99 Southern Burrito pork, barbecue sauce, �Pdrk rice, pinto beans and cheese in a tomato Ranch * Caesar * Vinaigrette * Blue Cheese Ve ies 4 99 tortilla ........................................ 4.99 ..' Fish, B B;u0Nt6:6l6ck br pinto beam, rice, grilled,, i M.91,, 301iC Eri'AITIi and.ChQi� C1fi �" p i ii Meat Tacos two flour or corn tortillas stuffed �: at8k 4 99 Black or Pinto Beans ............ 1.29 with salsa fresco, lettuce, cheese or sour cream �Chicken, s 4 and choice of: Pork . 4 49 Rice 1.29 Fish ` w .,. 4 99 Grilled Peppers and Onions ... 1.59 Steak .............................. 4.99 l Chicken 4.79 _ Grilled Veggies ....... Fal�ta Burrito rice, grilled peppers and onions, 1 59 Pork................................. 4.79 souri cream,and choice of � g Guacamole .... sm:.50 ..... Ig:1.59 Veggie Tacos two flour or corn tortillas stuffed t Sour Cream .......................... .50 • Stec 5 49 with fresco, lettuce, cheese or sour cream ' ;� Ch cken f .g9 heese ................................. . C 50 and choice of: _ Pork .' 99 50 Sauces...................... Veggies ........................... 4.29 ;' Bean &Cheese B�rr�to black'or pinto bean Tortilla . sm:.25 ...... Ig .50 Rice and Beans ................ 3.79 rice k e \fie ,�IettiiCe�salsa fresco, sour Cream ............. 1.59 and:guacamod r 4'S9 Chips andd Salsa Bar Fish Tacos two corn tortillas stuffed with a cabbage, B2's Baja Sauce and salsa 4.99 For Maximum Flavor and Freshness, SANDWICHES We CharGrill our Steak and Chicken! Served with fountain beverage and tortilla chips. Taco beef or chicken served in Bulkie roll served with lettuce, salsa fresco, We Freshly Cook our Beans and Rice with cheese and lettuce ............ flour tortilla ..... 2.99 cheese, guacamole. without Lard or Animal Fat! * * * * * Burrito Bowl chicken or beef covered with Steak ............................. 5.29 Chicken .......................... 4.79 Our Tortilla Chips are Cooked on Site cheese served in a bowl with rice.... 2.99 Pork .................................4.79 with 100% Cholesterol-Free Oil! Modern Burrito Bowl any modern burrito Fish ................................ 5.29 served in a bowl kid style............... 2.99 �..-.---�q0 � TOWN OAF BARNS TABLE LOCATION �JS®"�! .�r �J cl�� G SEWAGE it 2-coo— Wb VILLAGE I'Y : ASSESSOR'S MAP & LOT INSTALLER' AME&PHONE NO. !J eal 4 O SEPTIC TANK CAPACITY e_ n c, l7q LEACHING FACII.ITY: (type) '=,/A size) NO. OF BEDROOMS IV /I BUILDER OR OWNER )) . CJ40 6S PERMITDATE: �-/23)moo COMPLIANCE DATE: - ® 0O Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist .within 300 feet of leaching facility) Feet Furnished by Plc.c�filrC; /'�.nS�rh e ® Z yr— a� f� 30, No. "( U �� ��! ,_. __ �! /�� Fee /a7�� / THE COMMONWEALTH OF MASSACHUSETTS ( Wintered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Migogaf *p5tem Con.5truction Vermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System El Individual Components AA AV 0t 3Z Location Address or Lot No. 1,q Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 6-0 OA4?0 &M1M RCS60'p-ct llnl.: Type of Building: j?e%itk41Zt Dwelling No.of Bedrooms Lot Size 3'1 L® s ft. Garbage Grinder( ) Other Type of Building No. of Persons '? � �` Showers( ) Cafeteria( ) Other Fixtures Design Flow 2 gallons per day. Calculated daily flow to gallons. Plan Date F 2 cl _Number of sheets Revision Date 1 �7 Title Size of Septic Tank 1 T6 fl Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 4 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss le b oard of H Signed Date Application Approved by Date — 5 Application Disapproved for the following reasons Permit No. 9 e Date Issued lZ ors -10 '7 _1 1371? Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in compute VBLIC HEALTH DIVISION -,TOWN OF BARNSTABLE MASSACHUSETTS 'n YeS ` S S ZIpplication for Migo$al *proem Con,5truction 3dermit Application for a Permit to Construct( )Repair( ' )Uppgrade( )Abandon( ) ❑Complete System ❑Individual Components Z AL,V"UUH 1.3Z. Location Address or Lot No. 17 D Owner's Name,Address and Tel.No. 7 g f j s-a- o Q Assessor's Map/Parcel ' Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �.. a � 0v(F 0 .R �tJt��n � 1 I1c�r RtSot��Ce'�,�Y►C . Type of Building: J?ebFk� - Dwelling- No.of Bedrooms Lot Size 3 s .ft. Garbage Grinder( )` 1 Other Type of Building No. of Persons 5f�4t5 Showers( ) Cafeterta�( ) Other-Fixtures �r +, Design Flow 2G 0gallons per day. Calculated daily flow Z gallons. Plan Date (a q Number of sheets ( Revision Date 2 Title Size of Septic Tank Type of S.A.S. r ,Description of Soil �... .P Nature of Repairs or Alterations(Answer when applicable) ?Rp G'2tcv1.L f �Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system t. in accordance with the provisions of Title 5 of the Environmental Code and not to place the system-in operation until a Certifi- Cate of Compliance has been isst{e�bye ' oard of .ti Signed Date Application Approved by Date / S Application Disapproved for the following reasons ; Permit No. Date Issued ----------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the�On-site Sewage Disposal System Constructed( Repaired ( )Upgraded( ) Abandoned( )by at 7 94. �t o,,c,.�� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No._ �" 7 OF ? dated Installer Designer i The issuance of this e :it$s1w16qt- a construed as a uarantee that the s Pg y�te '11 function s des�ned>/�� Date Inspector — / l d - No. ` -- --------Fee �UU•_� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS -Migozaf I teat Construction ermit Permission is hereby granted to Construct(V )Repair )Up rade( )Abandon System located at1U --,� y (;s. s� '" "— Q 6 u, =Yf'Wn104/6H IP0 /3 Z.._, and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this pe t. Date: Approved by _ 4 AL y I 02/18/1999 13:42 7818267172 A H CAMPBELL PAGE 01 To: Donna Z Miorandi Fox #: 508-790-6304 From: A.Hugh Campbell Jr., A.H. Campbell & Son Inc. Date: February 18, 1999 'egos: 3, including this cover sheet . Dear Donna, Attached please find the receipt for the H2O Grease trap along with the "as built" drawings. The engineering dept. currently has copies of these "as builts". fax My schedule is preventing me from malting it in to see you today, however, I do plan to be there tomorrow morning. If you would like to speak to me before then, you can page me at 617- 867-3943. Thank you again for your help. Sincerely, Hugh Campbell . From the desk of... A.Nyb(4oph N If. General Contractor A.N.Campbel b Son Inc. 56 King PhIINp In Hanover, Mass.42339 tef: (781) 826.8115 fax: (781) 826.7172 02/18/1999 13:42 7818267172 _ A H CAMPBELL PAGE 03 All a3� � l V 02/18/1999 13:42 7818267172 A H CAMPBELL PAGE 02 s• s SHOREY MANUFACTURING=INC 'Z�.Gs. .,Z- _.......... ....:..a . SOUTH YARMO JOE- -f SUBJECT A 9 l SIGNED SIGNED DATE OF REPLY AN 11M ArID FILE FOR ;'11!nW_UP Y� ell No..4--./ 7 Fps...... .........� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............... . .....y.......0F.......Z3 ......./UcS/ --�------.........------ Appliration for Uhip nt Works Tonstrnrtinn Famit Application is hereby made for a Permit to Construct ()<) or Repair ( ) an Individual Sewage Disposal System at: .......fY..f/.Y�f1/............................... ----------------------------------------------------------------------------------•--•--.....---- Location-Address or Lot No. Pi ..142 4V_2T_.__.c �v. -M -------------------------------- -------------------------------------....--...........-.......................................... Owner .................................Address Type of Building Size Lot. Installer � Address � U YP g �-�00Q d...Sq. feet t-, Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) a Other—Type of Building P M4..Mh__.... No. of persons.......QUO........ Showers I; ) — Cafeteria ( ) Other fixtures . W Design Flow......... ...................gallons per person per day. Total daily flow.... '^ __ .....____.............•....gallons. WSeptic Tank—Liquid capacity_SOPOgallons Length-_i.7.__.... Width...7.____._... Diameter________________ Depth_9_-.2,._.. x Disposal Trench—No. .................... Width.................... Total Length..........__y...... Total leaching area....................sq. ft. Seepage Pit No.____-_3.__-_-__-- Diameter------1.¢....... Depth below inlet.....;........... Total leaching area.4Vs ..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_._ _S_..._.... Depth to ground water....Z-3............ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil...... SC M1O/L1.�I...�._ 1�9------------------------------•----------------•--------------•--------------•-•-- U ••••--•--•---•-••-•----•--•-----•••---•---•----•--•-••-•••-•--••-•---------•-----••••----.....•--------------------••-----------•-•-•-•---------••--................................................... W -------------------------------------------------------------------------------------•-----------------------------------------------------------------------------------------••••............-----•-- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... .....•....-•----....••----------------•.•-•--------••------------------•------------••--......._.........•••• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITii: 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. — gned---••••---•--•-••-•••............::..•-•-•••-•------------•-••----•--••-•-•----...--- Application Approved By. . _.... ..-_ .. l� --K_� Date Application Disapproved f t following reasons-------------- .. ------.......-•----••-• ...................................... Date PermitNo......................................................... Issued-....................................................... Date 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............�T CJGZi/1J....OF......./63,9 �1vSl/}.� ..................... Trrtifiratr of Tuntplianrr THIS IS TO CERTIFY, That the Individual rage Disposal System constructed ( or Repaired ( ) by.... ... ............. ----f- ..... ..................................................................................................... `-� Installer at •••.-----1/=----�G � ... -- ----- ------------------- has ben nstalled in accordance with the provisions of TI�"j'L 5 of The State Sanitary Code d c ' ed in the applica, 'on for Disposal ���orks Construction Permit �To.._P �z.-_.---•---- dated------ _.- ----------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................•--.............---...........--•-•-----------.......... Inspector................................................................................... No. / r y FEll.............. ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...----- .7T0.6 U.........OF.......��.//'P/V S /.-r-�--�3--L ................ Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: ..................... ..... ...... . ................................................... --••---•••-----•••-•--••••••......-•••-------..__.........._.......------------................... Location;Address or Lot No. Owner Address W Installer Address f'�, UType of Building Size Lot._ _..�__________________Sq. feet Dwelling—No. of Bedrooms................•...................__.._...Expansio Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building C�f'�-----� p � C3 C'..._..... Showers ( ) — Cafeteria ( )No. of persons.......:.......... QI Other fixtures __________________________________ ----------------------------------------------------------- W Design Flow__-.._.. .. ..�:....................gallons per person Per day. Total doily flow............................................gallons. t�: Septic Tank—Liquid capacity=_01 0.gallons Length./...... Width..l.--_-_----- Diameter................ Depth% Disposal Trench—No. . .................. Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No---------------------- Diameter.....t--_---_----__ Depth below inlet..._:••............. Total leaching areal. _. ....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results w 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.______--__-____---.___. 9 ••-------A-- _------•--------------•---•----------------•---•-----------•----------•-----•-----•-----------------•-------------•---.----- Description of Soil......�.:.................... .... x W UNature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------------------------------ .......................................................... .. ....---•--------... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of T 1.:.`± 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. igned...................................................................................•---•......................•.......------••. X —�`��4 J/�/ ,1 e Application Approved B ...... •----------- -----••--••-. ----------- '� . . -•...........................•..... Date----........_. Application Disapproved r t following reasons:...........:...�_� ..rr�� y,r'0' i --------- --8--•-------••------------•---•--••----•••-----•----•-••................ Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ` .................... Trrtifiratr of Tlantplianrr THIS IS TO CER14,17Y, That the Individual Sewage Disposal System constructed ( or_Repaired ( ) Installer at. - -- -------- --•-- a�C�-•---------------- .----- --------------------------=-` ..----•------•--._...---------./...-- -•--•--•----......-- has b �n installed in accordance with the provisions of T r ` The State'Sanitar Code s ed in the appli ion for Disposal Works Construction Permit No._ �_..- �_______________ da.tedy�� ��._____ _-----_-_-___._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. r - DATE.--------•.............••---•--•--- Inspector..................................................... ..._._..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T 3 S /'L� �r^� L � O w 1l/ OF...----- 5.... ................................... ►/ " No.._•.`._......`........... FEE........................ WoVosai Works T ,itrnr#ion pamit' ' -" Permission is hereby granted ------------Aq -------------------•-------•----------- ------------........-----................ to Construct ) ' eta r ) ..Individua Sewage Disposal System �y 1; atNo. ........ %,lccm` GG .................----- -------------------•---------- -_- ---------------------......-----... Street c t as shown on the cation for Disposal Works Construction Per --- .........---- D --------------------------------- ........ -------------------- ----------•-------•-- �! Board of Health DATE------------------•-•--- -•-•---•--•-------f- FORM 1255 HOBBS & WARREN. INC., PUBLISHERS Town of Barnstable Board of Health 2002.Main Street, Hyannis MA 02601, Office: 508-862-4644. Susan G.Rask,R.S. FAX: .508-790-6304. Sumner.Kaufman,MSY Wayne Miller,M.D. May 5,2003 Mr.Jonathan Magasanik Backyard Barbecue.Inc.. 8 Tech Circle Natick,MA 01760. Dear Mr.Magasanik,. You are granted a conditional variance from the.Board of Health Regulation,.PART li SECTION 1.00, which requires.minimum 1,000 gallon capacity grease traps at all establishments preparing foods. This variance will allow you to.operate a business.selling grills,cooking accessories,and other outdoor entertainment products.at 790 Iyannough Road,.Space#15.Route 132 Hyannis with the following conditions: (1). The applicant shall obtain a food permit from the Board of Health prior to opening for. business. (2). The person in charge shall be.onsite all times the store is open for business.. This,person shall be properly trained and certified in food sanitation and safety(e.g. ServSafe.certified). (3). Further,an alternate shall be available and onsite anytime the primary person-in-charge is not available..The alternate person shall be.properly trained and certified in food sanitation(e.g. ServSafe certified). (4). The.business.shall not be converted into a frill scale food service.establishment business(e.g. preparing and cooking meals for patrons)without first obtaining written approval from the Board of Health..The selling of grills is the primary business as proposed. (5) This variance is not transferable to.another owner or lessee of this establishment. Sinc ely yo41D. Wayne ill Cha' Ili BackBarbecue �� � • DATB: PER: RARMASM use. "C. BY Town of Barnstable S CID. DATE: Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORINI LOCATION r� Property Address: 110 :r e)A Mrj0 U 4 k So a'D - S pae-c*15 Assessor's Map and Parcel Number: Size of Lot: 1 Wetlands Within 300 Ft. Yes Business Name: tea.bAe kyatd lay D!Lwe- . MIC'. No Subdivision Name: APPLICANT'S NAME: TONA' MI-1 MA&ASA Ai-- Phone 508— (oS5 •102.3 L;K+10 Did the owner of the property authorize you to represent him or her? Yes >C No PROPERTY OWNER'S NAME CONTACT PERSON Name: CAge. LLC, !•& UfaN Name: - " .' 3 ` 1J T0•%Mt%-AV%mOt�tSR„tk Address:4 C o p le-1 ace- &ps tw AAA Address:"TV--c,a c,-and—bl� -Inc- 8 -Tea, C Phone: (p)7-37s-`��9 Phone: ��t,<<. A- t dE AAo' o (05 5•-1o23 VARIANCE FROM REGULATION(Lot Reg.) REASON FOR VARIANCE(May attach if more space needed) • C r ae set NATURE OF WORK: House Addition ❑00000 House Renovation ❑ Repair of Failed Septic System ❑ Checklist(to be completed by office staff-person receiving variance request application) _ Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e g.septic system plans) ` _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) s Full menu submitted(for grease trap variance requests only) _ Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) _ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. Q:\HEALTH\WPFILES\VARIREQ.DOC i-BACKYARD • Where cooking out is always in. March 25, 2003 The Board of Health Town of Barnstable 200 Main Street Hyannis, MA 02601 Dear Members of the Board of Health, The Backyard Barbeque is a new retail store focused on selling grills, grilling accessories, outdoor furniture, and outdoor entertaining products such as torches, tableware and serving pieces. The company is opening two stores this spring—the first in Hyannis at The Capetown Plaza located at 790 lyannough Road next to Kmart. The second location is opening in Framingham, MA. Each store will be approximately 4,000 square feet. The Backyard Barbeque will attempt to create an entertaining environment geared at attracting customers through the use of an indoor working grill from Thermador. This grill will also be used to demonstrate the use of accessories, cooking techniques, to perform live cooking demonstrations by local culinary experts on select weekends; offer cooking classes to aspiring barbequers; and allow for the sampling of prepared foods on a periodic basis. The demonstration effort is being led by Chef Steven Bianchini. Chef Bianchini has been retained by The Backyard Barbeque based on his extensive experience in opening and managing restaurants in the Providence, Rhode Island area. Additionally Chef Bianchini is trained and certified in food safety and handling. The menu that will be used for demonstration and sampling will include many items with the prerequisite that they can be prepared on a grill as there will be no cooktop or oven in the store. These recipes may include beef (both steak and ground meat), pork, chicken, Iamb, fish and vegetables. The store has been designed and will be operated to insure compliance with all fire, safety and health codes associated with cooking including food handling certification of store associates. Immediately adjacent to the demonstration grill area is a hand-wash sink, and in the storage/preparation area are a refrigerator, freezer and three compartment sink. There is also a mop sink in the back of the store. Additionally, most sampling will be done using disposable items including toothpicks, plastic cutlery and paper plates. Given the limited cooking that will be going on in the store, and the fact that it is a store and not a restaurant with limited grease discharge, we respectfully request a variance of 310 CMR 15.05 of the State Environmental Code, Title V requiring an in ground grease trap. It is our intention to install a grease interceptor in the storage/preparation area underneath the triple compartment sink in compliance with 248 CMR 2.09 (2) of the State Plumbing Code to capture the minimal discharge that may occur. 8 Tech Circle Natick,MA 01760-1029 tel:508-655-1023 fax:508-655-2063 www.thebackyardbarbeque.com —2— March 24,2003 I have enclosed copies of the floor plan of the store for your review. I look forward to meeting with the Board of Health on April 15`h 2003 to review this matter. Should you have any questions in advance or require additional information, please do not hesitate to contact me. I can be reached at 508-655-1023 ext 10. r Sin erely, Jon than D. Magasanik President The Backyard Barbeque, Inc. No. .1. �........ ...�..... THE COMMONWEALTH OF MASSACHUSETTS T BOARD F HEALTH ............. .. .......OF........ .. ............ .. .....•--- ....................... ApVftra inn -for Bispaaiittl Workii Towit urtion Vautit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Indivi 1 Sewage Disposal System at: : ddYessLocation C ormoo.i _ 44 / ner ..........................•.................Address / nstall Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms---------------------------------------_----Expansion Attic ( ) Garbage Grinder ( ) -1 r— aOther-Type of Building l_1} �E7----___ No. of persons---S,?-ZL:............... Showers ( ) — Cafeteria ( ) dOther fixtures .. - -:----------------------------------------------------------------------------------------- Desi n Flow.. ................ gallons per person per day. Total daily flow._....._ gallons. w g X &4 yY WSeptic Tatlk 4—Llgtlld capaCltt$�d -gallons Length................ Width................ Diameter_-.__....-....__ Depth-------- x Disposal Trench—Nf -----------____________________ Width. --------- Total Length_-_--__I-----�__.. Total leaching area....................sq. ft. Seepage Pit No.---_..V--------- Diameter..._....l.L..._... Depth below inlet_"---G......... Total leaching area------------------sq. ft. z Other Distribution box ( ) Dosin tank (. ) 2- 7S" a Percolation Test Results Performed by._.- _akAI.�_....� .._no.2........................ Date.../..R. y�.�.b_..___._..... a Test Pit No. l................minutes per inch Depth of Test it-.-_____-___-_____-- Depth to ground water...._--_.__.--_--.-___- L14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......_..-------___. --.. Description of oil-- -- �"" 6 3 �f ..... ---------- U :. 4- 4Z� �� z U Nature of Repairs or Alterations—Answ when applicable..--------------------------------------- ------------------------------------------------------------------=------- --------------------------------------------------------------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in. operation until a Certificate of Compliance has been issu. by the b and h- alth. Sign - --•-- -- -------• - ----------- 0�.-7s-•-- Dat Application Approved B ____________________ ,2 __ d.._ ___7--d1 Y------- --- - -- ------- - - - ---Ill---V -� -- Da Application Disapproved for the following reasons:........-•-•--...----•- ------------••-•-------•----•-•••••••--....._....-----------•-----._....-------- --.......---•.............'---------......------...-----------...... n Date Permit No......................................................... Issued.....r�-.--c -�►" AC........--•------- Date I.... No..- Y Fps. ...:.. ........ THE COMMONWEALTH OF MASSACHUSETTS BOA RD - F H EA T _......... -----...OF...._.. ... .. .. ..... .: .. .....------ ........'..... ,�.rvfira iutt -for Uiiplaiitt1 Works Tonstrnrtinn Vrrniit Application is hereby made for a Permit to Construct ( ) or Repair )� an Indivi:u 1 Sewage Disposal System at: Location.Address or Lot No. lor ner Address ..._.__.. _ _4 ... _....... -. _. .. _ __T............. ...................`.-_`-_.,.._..._.........._..._...__...:....................................... nstala Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms-------------------------- ---------:.___._..Expansion Attic ( ) Garbage Grinder ( ) p, Other Type of BuildingTH0li_-_.____ No. of persons... q---------------- Showers ( ) = Cafeteria ( ) Q' Other fixtures ____ W Design Flow------------ :.. 1 _�......� gallons per person per day. Total daily flow-------�9, I _ gallons WSeptic Tank)-Liquid capacit• ______gallons Length---------------- Width-----.---------- Diameter................ Depth._..-_-----...:. x Disposal Trench—IV . ..... .........:.... Width....__ .7_--_____-- Total Length____.__.o__...�._.- Total leaching trea_-....____--._____sq. ft. .}� _} - Seepage Pit No._..__=!_----------- Diameter--------ll.----- Depth below inlet� -__ ........ Total leaching area..... ............sq. ft. Z Other Distribution box ( ) Dosin tank Percolation Test Results Performed by. ._ .... Date........................................--_-.._.A .. ................. a ;: Test Pit No. 1-----------------minutes per,-inch Depth of,.Test ,rt.................... Depth to ground water--------------_.......... (4 Test Pit No. 2................minutes per inch Depth of Test Pit--------------------- Depth to ground water.........._.--__-------- ti '`' - f Description of Soil .� -- ------�-•' -�--- -- �rws, t✓ 1,1 a.` 1� V Nature of Rep irs or Alterations—AnswcF,_wPien�applicable ------------------------------------•---------------- --.: :.. == ---------------- ------•---..---------------------•-----•-----------------•------ Agreement: r . The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in r' operation until a Certificate of Compliance�^ltas been iss by the b ar Ith. Sign 1 Imo► /...1..4 Dat i �f +w 77;& . A l cation Approved B x ----- * ' = PP PP Y Dat Application Disapproved for the following reasons:. . -- -•---'- -------•-------------------•------------•......................--------------.--.-.----------•-----------•--------_-------------------•--•----------.------- Date PermitNo........................................................ Issued......................... Date #; , THE COMMONWEALTH OF MASSACHUSETTS a �Iti BOARD­.OF ALTH w ... `.....�� .�.........O F............... ........................:.. %;�Irrtifiratr of TIOmphaurr TP40 I TO C RT That th Individual Sewage Disposal System constructed ( or Repaired-( ) by - . '--'-- Jilnstall has b n installed in accordance with the provisions of A '�fi X1I/of he State Sanitary Code a described in the application for Disposal Works Construction Permit No._..............7_ +�a" >S"'� _ ._. dated ---... •---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE'CONSYRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATLSFACTORY DATE . •. 5 In peat '�x x r w w 7 ,y5 tv - r�r��;; ..r �+.G�t�:;��y��� �s1� s�,rn�" �.w�"-�..�.�'•.�,�.-�..,r.�,._���-,x,.�}Y�i�..,`x;�;.�,..��.w?�,r.x��=_� �ri.,..s�ri��:'.�r�+�--_...1._. .. . .. - THE'COMMONWEALTH OF MASSACHUSETTS _. r, Ile � BOARD, O HEALTFL S �1�•�d` w N J s �, FEE --�� ................ t Permission is hereby granted .. . :____ .: to Constr t ( ) o e}7siir ( ) an dividual ew Dis al System ; I "' f d/fij at No �- :. as shown-on the application for Disposal Works Construction P i No D ited 3d ...... ----------------------- _ ' Board of Health DATE ;. ,Ago"• •� f ��K t FORM - 55 HOBBS & WARREN. INC.. PUBLISHERS , h.y h a , April,4, 1984 t �tr f R 0 '+ of _L .p Mr. Jeffrey•`Levy, "f f Hyannis Cinema, Inc 5151 Coolidge"'Avenue k Watertown, 0 Ma. f2i72 h •M .' •..' '1 Re: r Hyannis 'Cinema ,Capet`own Plaza,` Route ,: yannis 1. r� 'L `� s; ' 4:, ' ' 132' MH , '7, k •..; ,, x t k - a a•; ' Dear "Mr. Levy - n a v e a�° � ,. - - Y e 'fir`" a .r.d•" -s You are granted a;'conditional deviance to,.install an,Yonsite sewage disposal system at _the Hyannis C a etowri:,Mall ' R x ' y Cinema*' C p , outs-132 H yannis ' •in lieu of > y , connectT ng':ao tlie.Town. sewer' as``.re4u_ffed=by the =Town of Barnstabie Ground,Water; ; + t, Protection 'Regulation requiring any, commercial building`ta- connect if within , "3000 °.feet .of,-thii To wn sewer, with f g''conditiob4; ti. An onsfte,sewagey"disposal,engineering- plan.meeting all requirements #Y:t z ' gfA Tit1eY,5,` o£-=they State,Environmental Code;;'and tall Town"of' Barn"s:table 5 ••Healthrt Regulat ions' approved aby the Board " a must be ,. . .(2) ,'The designif engineer2must be, present on,site4and,•supervise,`the. construe tion of :the' septic syseem4and must :certify "in'.writng to the Board<'that; r., :the.system. was constructed. in. strict accordance with his design '(3) The"on site system must be inspected••and .a Certificate of 'Compliance ' 'issued prior to any�occupancy ,� _ ! w 1raa�R'ra• x +A w' �•`,w.' yr,R�Y # k 4 _, �`;, a a w v ,,,t -. { 'M-- It should be.-€ele•arly .under''•tood 4'thai,,you•'a,re proceeding•at .your: own." s ':; ` risk.","You must connects to_ Town,sewer.when it is. available: . Availability" v tr for making .the connection yi'll,be determined by th`e-Board. tL� _i t a� e ♦.::�a !�",�" y �� s3,�f5;i i° �' t S•y' �.,' z. � c 4 �;�. •t •.. +E } a` r r a'a" T'ou are'granted thRis 'coreditonal''vari�dnoe because its is "`anticipated'At'at sewer', } ' " . .i 8 • -. l nes.'w 11,•be..,constructed-in'your..geneial,area:•in It ' ea r!'. future a !, '-,' t E' +ya' ;y '^•' 4,.i i d:.A 'C g a t; ` R1 l5 f ✓ S^ ' • .Ve rours.,, ., - a ram. re�i •2 $k a.• tr a.. a ` awf RO rt L. Chl1d8, .1 Ch$irman y ryt i 1 ; r+ b$An Ja .^,,. t S ',a t„$';!'?'.{i.�y t+tar•.w+e. fs#n :.4 s r �'-:A., "d' r S��&aY R`,1,e r �f# ;4H F_Inge M: .D BOARD OF=HEALTH:" TOWN'OF BARNSTABLE;n h rr ac .y t - y .f S '.r •q' � " •¢ � ` `t ,�s. � s R k ,.; 4s mn.� c -,a• '3• a ` •r ♦n yi k � NO. DATE -� FEE y FS Er�w TOWN OF BARNSTABLE OFFICE OF BARIS _ n KA86. BOARD OF HEALTH s�GA�1639-k`0 367 MAIN STREET OR HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variance requests must be submitted five (5) days prior to the scheduled Board of Health meeting. NAME OF APPLICANT �yQ�,n�J Ci�+et•+• ��c_ TELEPHONE NO. ADDRESS OF APPLICANT f J'l Co oli Jg �ve. Mk 9a;z y- '7 60 I I NAME OF OWNER OF PROPERTY LOCATION OF REQUEST /)4 za 4" j-r /,?X j VARIANCE FROM REGULATION (List regulation) C•-ay.s WL W-W ;t7.., VARIANCE REQUESTED (Specific request) t7;o Ttw�s T 6 a a. L I.r.nr s _� ••s s-t a. s/ Q. 6 7 S- it c r-C Gr'.s • Z o y 1 jtt REASON FOR VARIANCE (May attach letter if more space needed) 4 3 S PLANS - Two copies of plan must be submitted clearly outlining variance requested. i VARIANCE APPROVED NOT APPROVED i REASON FOR DISAPPROVAL 4 Rob re L. Childs, Chairman Ann Jane Eshbaugh H. F. Inge, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE OCAT I O N X&AJ -&S /L / 3 Z * NO. IL LAG E i DATE 3 7� P" PPLICAN FEE DDRESS R;-&- TELEPHONE NO. ' (Non-refundable ) (ENGINEER 7-0- /�//+/ZG�LLb, �,� TELEPHONE NO. 3$S-2P7 DATE SCHEDULED -�30��� z (A licant' s signature) o . . . . . . . . . . o o . o . . . . . . . . o . . . . . . . . . . . . . . . . . . . . . . . o . . . . . o . . o . . . . . SOIL LOG �v UB-DIVISION NAME DATE 3/3 TIME 10--/1 EXPANSION AREA: YES NO _ TAT �ja2ey�LLU_ A E. ENGINEER rOWN WATER �/ PRIVATE WELL BOARD OF HEALT /r+V e-AZY960L EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes ) NOTES : XisTiiv C, FkcPrv�} rv�2- l�I LL 24B/NSorJ /LUivG� f'sVA.) id -J;P2 -A_/2_ 4z' � i � PERCOLATION RATE: TEST HOLE NO: p ELEVATION: TEST HOLE NO: ELEVATION 1 1 2 Poo2ty 3 3 G�2gDBD 4 a VArL, 4 - 5 C��'�'^'�Y G Ad:•Qt ) 5 6 S-lo7 , G LPiY C.6r3s 6 b=► �T t A 7 . 8 8 9 r�10 5 � �� 9 10 r k4—a-r4od r E%X 8-D 10 12 12 13 N O 'fL£�a2, 13 14 1 -t" 14 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE . REASONS; > C�/V NOTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P . F . AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT _ vl OCATION 1-1)14—Aj Ajl S f�l ' / 3 2 NO. ILLAGE _ DATE 3 7,d F4 PPLICANT A1)e,4oe_,r FEE ,DDRESS 12;-A,- i32, / yf}'NavG,fi 12_L7 TELEPHONE NO. (Non-refundab :NGINEER % /�I�/ZG�LG—�-/,-,7 TELEPHONE NO._38S--2R 3 / )ATE SCHEDULED 3136! P-4 (A licant' s signature) . . . . • • o 0 o 0 o o • o • o'o o o e • o • • • . • e e e • o • • • . • • o • e • • • • . . • o • • • • o • . • • • • • • • • o • • • • • o • • o • . SOIL LOG ?U _ UB-DIVISION NAME DATE_?/3<)/ TIME ry- y-- ,XPANSION AREA: YES NO _ 7-S /t j,�1,o frL4,0, 14E ENGINEER ?. 'OWN WATER 1/ PRIVATE WELL �jp,G,i,r� ZPre d I? I. BOARD OF HEA �20ypooL g'ar&U bGE5 EXCAVATOR ;KETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) NOTES : . �X/ST/iv�, FkGffiVR-Tp✓L - ��L(, (LOB/N,Sor ��/L.UivGiff' s v� 42 _AIRPO/z TAl AZ2 - PERCOLATION RATE: PEST HOLE NO: 0 ELEVATION: TEST HOLE NO: ELEVATION 1 1 2 P002iy 2 — 3 G1ZAfle0 3 4 4 _ 5 5 �S�1'^'�Y G ru�l vt�L, 6 �.. S:!0 7 ° G LFt-/ L 6 vra� 7 7 8 8 9 N�Cs�O r V M S kw4D 9 i 10 c �� r•,�Lra-D 10 -- - 11 12 12 13 N O w f� 'rC�i'L 13 14 1 � T IZ, � . 14 15 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE : LEACHING FIELD -LEACHING PITS LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE . REASONS. eNLe NOTE : ENGINEERING PANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P . F, AND RETURNED TO BOARD OF HEALTH ....... ___jk V\vn T1 L]V 7%I n? T1111 A.IT aTION ffyg,�/.cJ/S fL / 3 NO. _ ,LAGE — DATE -3 LICkNT_ FEE_ (Non-refundable )RESS 12;;-4- /3.2- / y&- Qaa a"v /Zd7 TELEPHONE NO. JNEER %,- /t'//4/Z4__ /> TELEPHONE NO._38S--2R3 / '£ SCHEDULED -/30/P- 4 (A licant' s signature) . • • • o 0 0 0 o e • o • o 0 0 o e e • s • • . e e o o e o • • • . • • . • o • • • • • . • • • • • . o • • • • • • • • • . o • . • • • o • • o . . . • . SOIL LOG �fJ i-DIVISION NAME DATE /3U/�"� TIME )ANSION AREA: YES NO _ 7-.� �.j,�}��-, -��T�I ENGINEER IN WATER 1//PRIVATE WELL .J`"pl-1,w zpr�c)I BOARD OF HEALT EXCAVATOR :TCH: (Street name, etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes ) NOTES : �f� G�SPcr�L SIFYLI�/G[� f X/J7/" f'sU,v N a - az' -�c✓��'•MA s3 _ RCOLATION RATE: ST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 1 1 2 P002.ty Q S ra�,c�S ,�<}X 2 3 3 4 4 _ 5 �r^'�Y G MAuC�L� 5 6 SS!07 c LNY LEr)S 6 8 8 I 9 ��r0 fVM SPc�p 9 10 ,4Fs rzs�p 10 11 12 12 13 N O W '1'C�a'Z, 13 14 1 i 14 1 ' 15 5 16 16 ITABLE FOR SUB-SURFACE SEWAGE : LEACHING FIELD LEACHING PITS LEACHING TRENCHES SUITABLE FOR SUB-SURFACE SEWAGE . REASONS : TE : ENGINEERING PLANS MUST SHOW NU,IBER ASSIGNED ON PERC TEST APPLICATION IGINAL: COMPLETED IN ENTIRETY BY P . F , AND RETURNED TO BOARD OF HEALTH PY: RETA.INED ..BY_ APPLICANT - H 0 SENDER: Complete items I,2,and 3. c Add your address in the "RETURN TO" space on 3 reverse. w 1. They;.fi flowing service is requested (check one). s- Show to whom and date delivered------------ 150 ❑ Show to whom, date, & address of delivery.. 350 tO ❑ RESTRICTED DELIVERY. Show to whom and date delivered_____________ 650 RESTRICTED DELIVERY. Show to whom, date, and address of delivery 850 z 2. ARTICLE DDRE E TO: r Ricar fit. DeBenedictis r arcia,Hanack,Richard Eng.Corp = 75 Tarkiln Hill Rd. W7 eta fti9=Ua —. 02360 �_ 3. ARTICLE DESCRIPTIOTI: REGISTERED NO. I CERTIFIED NO. INSURED NO. . 833565 IMI to (Always obtain signature of addressee or agent) rnI have received the article described above. m SIGNATUR ❑_Addressee) ❑ Autho ized agent 4. m DATE OF ELIVERY /�. ST RK 20 176 5. ADDRESS (Complete only if requested m 6. UNABLE TO DELIVER BECAUSE: CLERK'S O INITIALS LP GPO:1975-0-568-047 ' •r-I UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS PENALTY FOR PRIVATE USE TO AVOID PAYMENT SENDER INSTRUCTIONS OF POSTAGE, $3oo 5j W Print your name,address,and ZIP Code in the space below. (� A L Complete items 1, 2, and 3 on reverse side. rcl • Moisten gummed ends and attach to back of article. ,� j ,(d RETURN '; da TO x Town of Barnstable ns Board of Health 397 Main St. - Box 534 HYANNIS MA 02601 rt r January 12, 1976 Re: Cinema 1-2-3, CapeTown Plaza, Rte. 132, Hyannis Mr. Richard R. DeBenedic-A..s Garcia, Hanack, Richard Engineering Corp. 75 Tarkiln Hill iW. New Bedford, Mass. Dear Mr. DeBenedictis : Your request to install leaching pits six feet from a property line in lieu of the required ten feet is granted. Construction shall be in strict accordance with State approved plans, Title 5, of the Environmental Code, and Town of Barnstable Health regulations. This variance will expire January 12, 1977. I Very t ly yours, Ro L. s, Chairman Ann Jan u Gerald W. Hazard, M. D. BOARD OF HE�iLTH JMK/mm cc: Southeastern Regional Office, Lakeville - Uo nn GARCIA - HANACK - RICHARD ENGINEERING CORPORATION 75 TARKILN HILL ROAD,NEW BEDFORD,MASSACHUSETTS 02745 TELEPHONE 617 995-5136 THE MILLWAY,BARNSTABLE, MASSACHUSETTS 02360 TELEPHONE 617 362-4343 PLEASE REPLY TO: New Bedford CL-6 70 3 January 2, 19 76 Job #19 72B Board of Health Town Hall Barnstable, Massachusetts Reference: Barnstable-Request for Variance for Proposed Subsurface Sewage Disposal System to Serve Cinema 1-2-3 - Capetown Plaza. Dear Board Members: The Massachusetts Department of Environmental Quality Engineering (DEQE) has approved (letter dated December 22, 1975) the above-referenced project sub- ject to an issuing of a variance by your Board, from Regulation 3.2 of Article XI of the State Sanitary Code. The variance requested would allow leaching pits to be located six (6) feet from a property line rather than ten (10) feet. The property line divides two paved parking lots. In accordance with State policy, a copy of the approved plan and letter of approval has been sent to your Board. It is respectfully requested that your Board grant the requested variance so that a Disposal Works Construction permit can be issued to our client, Hyannis Associates. As required in the Mass. DEQE letter of approval, GHR Engineering Corp. will inspect and provide written Certification of Construction of the subsurface sewage disposal system to your Board, with a copy to the Mass. DEQE. Very truly yours, GHR ENGINEERING CORP. cRt Richard R. DeBenedictis Director, Environmental Services Division RRD:ps Enclosure cc: Hyannis Assoc. MEMBER-CONSULTING ENGINEERS COUNCIL .. � C�.� David Standley COMMISSIONER GHIP 'nir cr_llig Carp a.t1 RI.,: ilnp* Di:Dos2.1 75 Tarl,iln hill T- _r_Ioosed Tri-Cinema at Canetoti�rn M9 .11 e- Bedford, rT ss r ?74�r_ T r J.a.,.,ac._uaetts J > J�)o ATTEIITTIOI': Richard )^Benedictis Gentlemen: The Depart.lent of Environmental duality :erl:_ir. print=, in res;Ponse t-j your request, has had one of its enc:in`ers cxan?i-e the soil.. at the above-_roteI site and has reviewed a ,)1an title'-: 11 C�TTpS R 1 E r .Tn�vTn TJ(�n '(' oy::fl-•,? :J V174)l.�I.l�'.�IiVJ :J-LY71"�� l :JIJ�\..J:1L l:l CIlVElrl. 1-2-3, C1PEI'0;'r` PIZ :, RT 132, ??Al'Ir3`.t'.^BLP, PfASS. CLI}?DIT: 1 YAT7IS ASSOCIATES 1.133 Ave. of the Americas T i We-.r Y.,r'r l�tl� floor; i;etiT Yor., , � i CIL CKT-D' R.J.R. DATE: NOV. 3, 1c75 SCt^:LE: AS NOTED JOB NO: 13 5-C DRAUN: R.S.C. d GARCIA 111PHACK RICT;AU') E-r,Tr_ nTT,, 1 Tr COR?np 4 TTO T i 02775 TAR.ILN HILL ROAD N0,T B i'�__ORD, I1. 4,�i ft Soil- examinations conducted at the su')IJect Site on DeceY.^_ber 45 1-1 in the area proposed for subsurface scT, e disposal in?_icate that the natural soil, beneath a shallow layer of fill, consists of clean medium to coarse sand which has a percolation rate of less than 2 minutes per inch. (Ground water was not encountered. ) The plan proposes to dispose of 4,02!-4 =_gallons per da; o:� sewage from the subject project by ::Weans of an 8,000 €.;alloy. concrete septic tank, a c'istribution box, and 4 leaching nits with a total available leaching area of 2,653 square feet. - 2 - The Department of Environr:ental Quality Ea-ineerin�,Y hereby approves the _plan with the following provisions: 1._ A variance from the Barnstable Board of IT ea1_th r_ust be obtained to locate the leaching pits within 6 feet of a rr.-)crag lire. 2. A manhole, with a cast iron frame and cover at finish grade, must be provided over the outlet tee of the septic tank. 3. Construction shall be in strict accordance Frith the approved plan and Title 5 of the Environmental Code formerly Article XI of the Mate Sanitary Code) and no furthe changes will be :made in the approved plan without the prior . ritten approval of this Department. 4. A Disnosa.l Works Construction Perrlit n ust be r-)btaine'd from the Barnstable Board of ' alth prior to the star'; ^f any construction. 5. N itten certificati_on that the dis nosal facilities have been constructed in accordance T,rith the approved clan and Title 5 of the E?vironmenta .. Code must be sub-mitted to the Barnstabble Board of Health with a copy to this office by your engineering company prior to the s«ster bein.? back-filled.. 1Iothing in this provision is intended to interfere with the right of the Board of Health to inspect the disposal facilities at any ti.,ie during construction. No environmental assessment form is re^aired to be submitted for this project since it is exe:ipt under the ? vironmental .rotecti-on Regulations of the !;,.ecutive Office of Environmental Affairs, and_ the project has therefore been determined to cause no significant damage to the enviror,lent. The Tri-Cinema shall not be occupied until. a. Certificate of Compliance is issued by the Barnstable Board. of Health. Please be advised_ that since the total sera e flow at the Capetown Mall exceeds 15,000 gallons per day, no further addition'- ti*il.l'be a_p_ -roved by this De.peTtment unless sewage treatment facilities are r ro-rid.e . Enclosed herewith are stamped approved conies of the plan; a copy of which must be .Kept on the site and be used for construction purposes. Very truly yours, For the Commissioner Fred L. DeFeo, n.E. Rer,iona.1 Sanitary ��,ineer outheastern Hicalth Region Lakeville Hospital Lakeville, Massachusetts 02.346 De/Edw,/RAD ip- or, - 3 - cc: Barnstable Board of Health ILy-annis Massachusetts Barnstable County Health Department County Court House Barnstable, Massachusetts Hyannis .Ass-ociates 1133 Avenues of the Americas. 19th Floor New York, New York 1006 y ' .. b -David Standley)DLMLXXXXXXXXXXXXXXXX , , " u WILLIAM J. BICKNELL M.D:., - COMMISSIONER - December :22, .1975 . n ` GHR En. er .ng•Corporation. SARFS�LEr Subsu.face Sewage Disposal 75. Tarkiln 'Hill, Road _ r Proposed Tri-Cinema at Capetown Mall New Bedford, Massachusetts 02745 •: Job #SE75'30 ATTENTION: . Richard Detenedictis - Gentlemen: 6 f The Department of Envirdbmental. Quality Irigineering, in response to your request, has had ,o2e-of its engineers examine the-soil at the above-noted. site � and has reviewed a-plan titled r A " - SUBSURFACE SEWAGE DISPOSAL SYSTEM .s , C INEMA=1-2-3, CAP)d0i K PLAN A,, RT 132, BARNSTABLE, MASS,. F ?k. CLIENT HYANNIS'ASSOCIATES .1133 Ave. of the Americas. a lgth Floo'r',•New York, New, York w (DATE+ Nov. 3s}"1975 Y CHECKER: R. SCALE. y.AS-TOTED - JOB NO: 1395-C 3 GARCIA HANACKPICHARD ­ - ENGINEERING•CORPORATION 75 TARKILN HILL -ROAD NEW BEDFORD, MA. 02745 ' ;; " ,Soil-,6xaminations• conducted at the subject site o: 73ecerrir�er 4, m1975 -in,the k area proposed for, sgbsur`face sewage disposal'indicate that-'the"natural soil,, s beneath* a- shallow,layer.-of,fill, -consists of clean medium to coarse -sand wllichw iias a percolation rate of Less_ than 2 minutes per inch. ' (Grourid,water was not encountered. ) The plan.proposes to dispose of 4;944 gallon- per day,of`sewage from the l subject project by means of an 8,OOa gallon concrete septic tank,..a distribution box; 'and.l� leachr pits with a total available leaching area of 2653` square .feet: , a > w r + • 4 • ♦x ` The 'Depart refit 'of Environment&.) Quality. Q.lieerane hereby approves the plan ' with 'the following pxovisons.; ,• l.. A.variAnce from the Barnstable •Board,of Health must be obtained' to locate - the e .):caching pits within.& feet +cif a•property line. ` t 2. ( ;manhole; Sri th a Y cast' iron-,frame and 'cover _at finish grade dust be , • `pipvided over. the.,nutlet` tee of 'thE septic 'tank. yp Y 1 Y•� 'AConstru tlona <y ! YA •+ a ,. :. �,. ., � 4 'i A. '} # •i . 3• c shall be"'in strict accoraance"ter th the approved plan and h• Y.; Title 5 of 'tire Eaxvironental Code (formerly Article XI'af the State Nanitary Code) `and no changes will be -made in the approved plan rthout'the,prior written approval of this Department': k . =A Disposal-Works r donstruction Permit must be ,obtained from. the Barnstable ' Board of Health prior_to the',start of ahy constructioh. s . 5. Written certification that ,the'! disposal facilities ha•'ve been constructed in-accordance with the approved plan arid-.Title -5 of;The-Mvironmerital Code• • c "mush be submitted to :the Barnst able Board,of health 'with a copy to this office by,'ynur engineerifig company.prior to the '.syste-m being; backfilled:• 1 othii in this provision is. intended.* anterf ere .wit_h the right.of•the Board of Health to inspect the disposal 'facilities at tany time during construction'. No,environmen£ai assessment form is required .to be sub:riitted for this project since it' is exempt under .the' Environmental. Protection Reg, l.ations of the Executive Office,,of Eaviromu6ntal Affairs, •arid'-th' project has ,therefore"been 'determined to, . , , cause; no significant dariage .to the`environment. . Thee Tri-Cinema4 shall not be occupied until a Certificate-of Compliance is issue,d•by the Barzist4bl.e Board' of -Real.th. k Please be :advised" that, since the to tal s6wage flow`at 'the ICapeto��n Mall, exceeds . . ;,. 15,000 gall per day,;"no further additions wail be approved by ,this Department . • . unless sewage treatment facilities :axe provided. Enclosed herewith are stamped'approved copies of,`the pi an a copy of t,�hich must be kept on;the 'site and be used for construction;purposes s Very truly Kyours, e. t • F a. For he Commissioner , . {+ •,_; k, Y ' 'Fred..L. DeFeo;- P.E. g Regional 'Sanitary al ineer. Southeastern .Health Regrn orw} Lakevil1 e'-Hospital { Lakeville, ,Mas, sachusetts. 02346 • w~ £ . •t 't •c .t a f,�i �` 3 .y cF S'�4e ..r � f" n «, .. .e C: �3aZ'IIyS� a�} .f'.,` 3t1aY't Of' i, � k• -'�C�.�311 r5' ;'�d i '?,� W. '_ £� EFL�.1�+�'� � t§ � 4 Barnstibie 06ant3 :Health tDopaxtment Y .� ii 1• cCR+/4Lf,Jt V4J lAJ.t House . Ba'rnstab16 °-Jjqass�c wssetts; '- • .{.J Avialii2e#]• of the, 41 J.4 as, i }i'e TpIJh i 19k,1.�i.kTY }y •*f�•'� di /' E <. tl w `.0 ' -It'-E 100'5j47 t a s r C .N « �� ;� �, f , .fY •i. .tom. T - J � k ,�. f 0.r P f' ��! ". AV r. r •`�.� Eva i. i > � p �.- M , "`r1 r °" ,.. Va'.� r.,� � .,�,� 4 � 5 4 r �.[ �>` ♦ h�j 1 § �J _ r � 4 �N ry'` t p�. 9 ry ',A tF� ' , •"r L } e''. „ �•Y :x •� ..' ap4tif s � - d 3 1 i 1. 41 3 f l ti . x.: K L.Y + �• r _ 'q` N sti£ S i i >t } '} v �d..{ £4_?. r 3,i. .* ' . . r " � ap . ark *� „ - .. • ' • New Bedford -October`30, 1975 ' 3.• Y a Job #1395C Fred.L.± Ddie©,°'P. Regional Sanitaryngneer - : Southeast,+Regional Heilth office { Lakeville'H6SpItal ' Lakeville.,- Massachusetts 02346 t ' r �.r { , . Reference. 23arnstabla - Proposed- Tri-Cinema at 'Capetova p1a , Flgaxwis=Y - ' 4 Dear Mr. Lei eoi thiefirm has been retialned by..the opco' Co m y..to design a subsur€ace sewage disposal,,system fair a'.prpposed- in ich is to -he :housed 'in an existing 'buildint gt Cape' r► Plaxa, Ryanh, asachusetts: '''Accorciiizg to our, telephone C.0aversation of' W c r129, 1975 the'existin ;system will have to be,'evaluated by from office. , 'It is, +therefore, , .requested that such an ar'rau ent be,ma as s , as possible. Please•aoti�fy me as to the time' and aate'4o inspection„ that'I may accompaAy' your e�giaeer. °'. Very„truly:gourd, F ., GHR kNGINEE'RUNG C€1 Richard R. Derma di�t.is , • ,, 'Director, '8n#ira' tal k t . 'Services Divisioai s F cc: Hyannis `Associates s '! 1133'Imeauue€t 6f .the Americas• � .f 19th P1oor , New York, Kiev York 10036.* cc: Board of Sesl.th Barnstable Massachusetts r z (C) No..... ;3 �..... Fss . ...l�Q............ THE COMMONWEALTH OF MASSACHUSETTS ,-.._..BOARD OF HEALTH ...................Town. --......OF............Barnst.able.-------•--.......------------------=-------- App ira#ioit for Uiipnsal Workii Tomitrurtion Permit Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: Aireax t...pla za.t...Hyam,17.].z.o...i1&*..................... .................................................................................................. Location-Address or Lot No. P_•.... ... 4 .xt oZ7:,._-_C.Q P. .................................... irport laza yann s_:. Mk,............... Owner Address a A & B -Cesspp41 Serv1ce..-•-•-------------••....----------- ............. ��3 shops_-terrace:...HY_annisj.Ma• Installer Address Q Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms................................ .Expansion Attic ( } Garbage Grinder ( ) ►� aOther—Type of Building ............................ No. of persons............................ Showers ) — Cafeteria ( ) Q' Other 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 ( ) Percolation Test Results Performed by.......................................................................... Date......................................... aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---------- -•--•--•---•----•---------------------------------•--•---------•---------•--........................................................ 0 Description of Soil-------------------------- ----------------•---------•---.........-------•-••-------------------------...----------------------.....-------•••---------•--•-•---••-•-- W ----------------------------------------------------------------------------------------------------------------------------------------------•--•- Nature of R airs Alterations—An wer when a licable._ __. . .s-tallatlor�---4f..a-.1. 004---4-on.e------- thousand gallon grease Trap & sewer Ii�i�. r ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'ITT is 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. ined-----------------•---------------..--•-----•----------------•---------------------- V2.51 a----••-•-.-- /� _ Date Application Approved B �/�l ._.l Y -.�`� -ram PP PP y--•-- �! � ... - Date Application Disapproved for the following reasons----------------•----------------------------------------------•----•----•-•--•--••--•-•---. -•---•----•--•----- ---------------------------------------------------------------------------------------------------------.....------------------------------------------------------------------------------------------. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......................TAwn.......OF.....Barnstable............................................... %Trr#ifiratr of Toutpliattre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (X) ...RI hQpa T rrac. _�_..Hyanni s.a....QaF........................... Installer at_Air_poxt...Elaza, Ice_areas �'arl-or "'' X.91an ­_been installed in accordance with the provisions of T 5 of The State Sanitary Cade as described in the application for Disposal Works Construction Permit No........_.. :k_6............... da.ted_9�25.17.� 8-________-__---_-_.__._.-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.....................--............................................................. `D✓ No....... ..... FERS.5w.00............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH T0.wn..........O F............Barns.t o b1e--------.................................... ApplirFation for Bwvv i al Workii Tnnitraartion ramit Application is hereby made for a Permit to Construct ( ) or Repair ) an Individual Sewage Disposal System at: A, r.p Qrt_.Plaza*...Hyann a.,...X&&...................... .................................................................................................. Location-Address or Lot No. P.....R..:. . x�....�axe...................................... ....Airport... laza.,...Hyaan a.s...K?...............--- Owner Address a .. ... ..q.ap 9Q .. 0rVIC..................................... 1$a....Ma• Installer Address dType 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.....................--. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ --------------------------------------------------- •----------------------- ••---•-----•--------------------------------------------- •----------------------- 0 Description of Soil-•......................•--------...........•-•-------------------•-----•--•-------------------------------------------------------------------•----••---•-------------- x U ------••-••-•-----••-- ....--•------------•----•----•----••----•--•--•-------------•-----------•------.......•-•--•-•---------••-----••------•--•----................--------•-----••-----••-•..._...... W -•---------------------------•----.....--•-•---•-•----••---•-•------•-------•--------.........•---•------••••-•----------•---•--------•-----------------•--------•--•--•--••-•-••-•---•---•-.._...---•-- x ature of airs Alterations—An wer when a livable U P Btu ll-at-i•cn---�f-•-a---1-,-44O----(�8- t ousanc) galcn grease trap `� ewer 1i • 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. P+ > ne -------------- =-------------•----•--........................••• °/2 5 I $ Date Application Approved By_i !// �Jr= .f. -----• - h x � ' '•. � �/f Date Application Disapproved for the following reasons:....................-=`.......................................................................................... --------------------------• . ••-•••--.................-••--•----...•--•.------ ----•- --------------•--f- . Date PermitNo..Z -•---------------•....-------•....----------.. Issued ...................................-.................. t % Date THE COMMONWEALTH OF MASSACHUSETTS rz BOARD OF HEALTH .....................!,VAn.........OF.... rps.t4le................................................ �rifirtt#r � f �1�m�r�iaanrr THIS IS TO CERTIFY, That the Individual sewage Disposal System constructed ( ) or Repaired (X ) by A...Bc..�3.. e 1 2:ct�zl...�e. y .. 1 Bi hQA6..Terrace.,..�ann�.a� Ma. Installer atA rp rt 1? a. .a...By n s s• Igo Cr. .............................. has been installed in accordance with the provisions of j of the State Sanitary Code as described in the application for Disposal Works Construction Permit No---- ------ - - -------- dated- /2-5/7$ ._.-.__-__-__--_--.- --.-_ 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 .........T. n....................OF..................... ax']1n.t.able...-------.......-----......... No...� r�>ar ................... FEE%5.. 0Q.--.----- Dis os al nrkii Tong rnrtuan rrmit & B Cesspool Service, 128 Bishops Ter. , Hyannis;_Ma _: Permission is hereby grant ----------------------------- ------------I--••--• ----••-•---•--------- . • •-•'—.......•--•••......--•--•....... ---------- to Co struct ) Re air e.wag > o irpo�r a , �Y�Awiwiiviwos, -- �tr °g parlor Nolan atN .--------•----•••---•-•-----------------------------------------------•---•.......-------- .--•-•-•----------•-•--••-----•--------•----•...----••••-----•---•------•-•-•-•---•---••-....... Street as shown on the application for Disposal Works Constr Dated....9/25/78:.................� --- ---- cn L Board of FI DATE...." 47 ._Ztf—!............................................ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS ZVv... ,�........... FEs .. 0, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ��'`�...............o F.. 11. Appliratiun for Disposal Works Tonstrurtiun 1krutit Application is hereby made for a Permit to Construct ( ) or Repair ()6 an Individual Sewage Disposal System at: .....••••-••••-•______...................................................................... ......................................................................6........................... Location-Add ess ............. rd-t1 N-o - . :0P.-- •---- i► A:LS . Address A v2C .. �..... ......... . . .... . .... .4.4 ...... Installer Address Type of Building Size Lot............................Sq. feet U 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 day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.tMP..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. 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........................ (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ..............................................•-----••----.......--------------.............--------......................................................... ODescription of Soil........................................................................................................................................................................ x ------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------ x ---•------------------------------------•---•-•••.......•••-----............----------•--•--.......----- T V N re of Re airs or Alterations— -nswer when ap 1 ble_.-l.q_�9--'r!4'�.._.�_."__ ....0�__.._ r___ ............... .._ice Z-........0 ....................U.Mr.. ...._ 1S[�._ l/ _1.; �> 7 ..............---------•------------... Agreement: The undersigned agrees to install the afor scribed Individual wage Disposal System in accordance with the provisions of iIIL LE 5 of the State Sanitary, ode—The under her agrees not to place the system in operation until a Certificate of Compliance has issued by th a health. D e ApplicationApproved By....... ....... -• ----•...................••-... ..__.._.._............---------------- /._. ..---••---- Date Application Disapproved or the ng reasons:.............................................................................................................. ........................................................I.............................................................................................................................................. Date PermitNo......................................................... Issued-.....................................................- Date I� � �-� o Imo, l � � f Jf:�-��;��� 3 7�/�� �u f�1� � �� y 1 ��� �� n /� � �1 1V( c � �`'� S. ` i C ` ����3 C) Fzz THE' COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 76 Vj ki 0 .9 UE................................. .............................................. Appliration for Disposal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct or Repair ()6 an Individual Sewage Disposal System at; ............................................................................................. ......................................................................•........................... 0 Location Add Ltl III-Artu- C_--(Z ............ ..... .....RtAti_Ar.!A!Ze...&).Q�...... Address Installer ................. C:K Wt.Ir........................ ...... ress Type of Building Size Lot............................Sq. feet 1-1 Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder aOther—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ....................................................................................... .......... --------------------- WW Design Flow..............'........"...................gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity.tOAO..gallons Length................ Width___..._........_ Diameter__.__.______.._. Depth..________._._.. 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_..._____..........................._... 1.4 Test Pit No. I________________minutes per inch Depth of Test Pit___._..._..__..._... Depth to ground water..______________........ r;:1 Test Pit No. 2................minutes per inch Depth of Test Pit...______...._...... Depth to ground water..._____._...._.______.. .............................................................. 0 Description of Soil......................................................................................................................................................................... W ......................................................................................................................................................... -----------------".....*.....­-----I, ................................................I.............................................................f..................................................... I................................ U Nature of Repairs or Alterations—,Answer when applicable.....!�!C—T-A-LL .I 'Z-0.... ..—.. 00.....GST-...A ............ .....<;................ .... .... ...5.�.........r;..t&e........ ....�.Y�Mv.......................................... Agreement: The undersigned agrees to install the afom(die'scribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary k. ode—The und6 rs e -' her agrees not to place the system in operation until a Certificate of Compliance has issued b thebl . �i health.,oar ..................... ... ... ..... ......... -- ------ ?e---------­- ApplicationApproved By......... ...... .. ..............................7...................................... ........ ....... .......... Date Application Disapproved r the I reasons:.......................................................................................................... ...................................................................................................................................................................................................... Date PermitNo................................................. IssuedL................... . ............. Date THE'COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...............OF........ -C.......................... ... V Tntifiratr of Tompliatur THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired b .........a.4&.... ................. y 7............ .................................................................................................................................. at........ .... 444-�. Installer provisions of TITLE has been i a I in accordance with ry 0 as scribed in the 1 . , �Qf The State Sanita, "I ;7e3 applicati for. isposal Works Co ruction Permit No...I..............r/ dated......A 7 ..................... .................................. TH SUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILC FUNCTION SATISFACTORY. DATE... .... //�_� .. ..................................................................... Inspector.----.... -•--•-----•--•------•--•......-----•----... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OF.......................................... ............................. Av N 0.1j.. L FEE........................ Permission is hereby granted.......R,-51 7- .. .... ...... .. ........ ............................................ to Construct or Repair V) an Individual Sewage Disposal System at No.---- ------4'sa",az Str6et as shown on the application for Disposal Works Construction Permit No,,,_.�_ �;.. Dated..___:...... ........................... ............................... ........................................................ Board of Health DATE.............................................................................. FORM 1255 HOBBS & WARREN. INC., PUBLISHERS i OFFICE OF THE BOARD OF HEALTH 0� R OF THE o BAMNSTAM% o TOWN OF BARNSTABLE, MASS. 90� 6 9 �� -------- r------- ----------- 19 ADD°N SEWAGE DISPOSAL ERMIT F _ ketch $e.' Permission is granted to- _*' __F______ to construct S Upon the Premises of ,r� --` .��_✓__e1__±.±ra_------�'—t--f—"r '-!--- - In the village of 75 or more feet from any 56urce of vA`ter su'Mly j 20 feet from building 10 feet from property lineZe -- _ ` r "` +L' V Health Officer. , 1,r C) Tc F—t> E— CD /-\T P—le- I's -5 F T H F-- 4 6' P E-T i�lb �,D e)11-15cr> CQ ^t>,5u "al=> t-z� -T P-F- S;:� r-L C s� 12- cl.t LP-,1-3 V,F, tf 5!��,7 5 /�,,Q E-L-, 6 T-5 t)P,,5 C To" F e-D a e-.j cD 5 C> e 1> L OP L-lTlc W C�1::z��< A-K > a EV( C) 1p7H C- f F:-L C) H cz N"�� t-J 5T/sL-Lr-lz- E Lx�, r--ILI m I K3-E� (-A a L L -3 P-- 75 To br E�- -j TL 'T vy 0 n I-t I-- N-1 Pp AIN r=� 0 L) -T;z u 1p E-V>-\/ 5- e-6 ,,a n (n V,� �,j tz 7f� -t-', Tt *"'S F_ 2 oy t.) rm- a;Z- 7 -TH 1,,5 J>C---5 1 T—, L 'T j F-EL,>u L C) 7--sT me_ A-L C-H . I - -) -T 1"l Q:, E ' p,w-I- r (L-�F.� 70c TH flYs T -T Q51 PN 1,- �-17 10 N-A "P T t)71 A\- N �� -T b I-I- 's TE-- L Tlc- V- -:kul P. 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I �� . �, \ I I . r r SECTION A-A I I � . li . � ! -4 - --- I I J I I , , \ � I . � I 1, I �. _�� I I � ;�,_ �r � �1- (!�_, .��IQ :W_ I 1_�.'_­J I . . -- - -_ — I I r � . � I 11 ", I I . I � \ 0 � -50-c- ! I I � 11 1� - I . I �Q <i � -.1 I � � I : 1� r � 1, (� 00 , � r I I r I 1;� I ; I A // I I I I I ; \ i : I - I r r' I � I I \ I I . I I : � � I � ; e_ --- � I � I -IT'It'14 -�,5�L,6;-_ r I��, . ! I I I I 1, I =_/// , I It � I I /// i � I TOSEPAZ4:17-97 , ,�P!5 - ­ I - ! .I t I �, ! I 1. am - �1. � I � r : I .,- ­ . 6 7 1 ,­ I ; � . I i 11 I I 1�_ , r � � __ I I � I . I I � � : I I 13YSTEM � MA,1T\J __ . . 11 �_ I r ., I r LOAM, . ! I r -, TYPICAL DISTRIBUTION L 130k � � I I - � I to 1 � I Ir- I � I - I _`� I _, 1 . � �, . I-N, , � I ,� 1 14' 0 ' r � I -1 __1 I ­ 11 I . I I I I I I I - I � r . 11 V - I NOT TO SCALE . - ,. I I � I I I \ r I I �,_1_1, �� �_;1)b S.2!I- � I "I I I I I � I ; 11 r SECTION A-A � � , . I � I " I - -0, �� I ; , I I I I � i I I 1 . r � I : I I � I � � I I � - �. 0; - � . - I I I r I r. I ­ ,�� � I ! I . I � . � � __­__,__ _____,__.____,_,. I I \ 4�0 . I I �,:, I , � � , 1, I r r I I � I. , I I � � r � � ''I, . — ____ — : I I . I � I . 1. I I . I I � . I � T I ,P"�b I 4r-3 __416 1 r :_ � I I . _ . 3 TYPICAL LEACHING PIT I I - , _1 , �,,�, � 4 �'_Pc I I I I I I � I I � � ,�,W I I 1 �, I I � : I - I I � I r I � I I I ; I . I I - I � I r r r r I � 001f, , I ') I I - . r I I I - . I N ,�\F I r I � I I I I NOT TO SCALE 1� .. I I I I r 1 �4, , \ : PE T,1 G M _2A - � I I I � I - . I r � I I : � 11 QJ4 " r . 11 ­ �, T�N�_ I I . I � I ! 11 I - � ,III I � I r , i � f - I I I " GENERAL IVO TE S 1 1 1 11 . I � - - t V� '' I I.- /";,- - L�CA C's�r_ I . - I � I I . , . r I . I I ; I . I I t I I I I � �: , . - � r _ I . � ,C& G�,�-/---.-_/I 7-') - 4-,'��,i 6�',C> � I � I I � I � I I � 1 - � I � .I - r I � I i r - 1 .�/" I ,, , (,-�5'Z4 �-,,,EAT�5 - I I 11 � , � � I I I I i � r I I � . r I r . i� I , " r, -r I I . ,A / � r, (4?44�5,P-�;D -,�/, 90 = . 74h�,6-14) 1 � and GHR i i I I � I - � �O , � ; I `� 1`111'�W I I � I 'I . I -, -1. -,_,,- I \ I Z rh e tractor shall notif I I . � I I -­ , I - ,�,'�,V,V,- I - I q017 y the Afassachaserls De�k o�Envir. Ouol Engin. , the town Board of Health., I I . I I I I I-, � I 1 OC4�'10�., or'�,�<(,�`,"I,,4�11 0­11�-ifif,� Al -5440iPi C, r �.)5,-,z,f � � . r . I . I � i I I - I ,;COO 6rAZ-. T,��K,4 , i ' - ; � . ! �'0� 11- \ I . ,�� I Ineering when the system is ready for lilspection as outlined in the Massachusetts Dept. of En Pf r. OuoZ Engin. . - -r , e ­, . I Z- .Apry _r - . I I , ,,T6 - - � ,�!CA,�11��, � (4q4, r I 6P,D), _::_ SF"/�,� )= . I , I I i - , 'r \ A OX-t M/ , OIJI,V. 'r4F. (,0P,_),7'_AK�16P �444A, . �<�, _ VO 'I-4 1)2 S F, .,'�Ii__,Q:�> � i , � I I I I -1-, � 1, - .I � � I , �,11 � �� _ ,_)�Z _ 2 _0.3 S.F _,,.,,r,,,,,. I � I I . r , I I . I I I I i It - I --� , � 11 , I . . , 11" .- rr,12 vt�Qts�q]6 - O' i 76, __ _ ,> I ; I I � . I ­­` . 1, I \1 I f)p 0�wr�tr),,)J.A, , �,)116" . ,,E, 4 P!T!� ,14'P,,A .?,Ilat, .P �� � P& I I letter of design approval - . . I I ,_ 11 � � - i r ,- � ! -- - I . I I I - . I � . � I I I 1, : I i . -I ? � � - 11 I ,-- I I \ 106n�'o,^A r. r I i I I I I I . � i I 11 I I - i -1��. ­" I I ­ � \ r � . . I 1 2. Washed crushed stone shall be free of a// dirt, dust, and fines. . I I I I � " I r - 1_� � . I � � I I I � � r : .I. - I r Vati I I I r � � , - � I I I 0 1 i - -1 . I" � � I . I - ­ - I ,­ , ­ \ I . I . � .��, � . I . � . I ,, I ,- a � I , �1 �_� .,��_ I . I � . I I . S C .5 G. ale n datum. I �� I I 11-1 ? I _____ �-/ I ! r I__,� "- .;".,- � �� \ , - I . I � 11 4 1 1 J. All elevations are based on U imits of the- sewage disposal sotems during the course r I � � ", I � --- I I � 1, /_2)21 —.- L_____J —_ 474?� 4. Heavy equipment shall not be allowed.to operate over., the / I � " r , r ,> � ��, I I , I I : . I � __,,�­_ 11. I I I . I 11 . I . �".%\ , ,1 I I I � I I I . I � ., I �b . I I � . . I I I I ,_ � I I ) I, I I -1 I I --- of construction of .t e systems: r � I . ,- I . I I � I I I I ­ 11 "-, r I I I 1� I 1, . I ;� � I I . " ...� _ I li- k 1� _10, - 1 I . - I I I , . - isposal system shall be made without prior written approval of the I . . I _J � � 5. No field modifications to the sewage d I - ­ 14N �\\/ / \ I � . Tac,-7 F'/7 K10, L::5- ' I � ; : I N I I I � _ I 1�0 - - r I ---�-----,--,---�.---,�,��----�--,�--�� " � � I . , , I I �0:/ I ., � , , I r I I engineer ,and' the State Department ofEnvironmental,Ouality Engineering. I I I : I , r I r I I . � � � I I I � - I . I �, I I ,� I . � I P, I, �, I . . I � r : � I 'N � I � : r I I I ! I I I . r I . r . I � I � I � . : , L "I " q ,�(k--�" I I I I . I I r 11, �� 6.Unless rfhe'rwlse noted all system components shallbe installed in accordance with Article X/ of the State I . . � � . , 11­ 161\ . � &I . I r T,�e- -//;,(�,s,'� �,! �P:;'F�!-5 APOL 12,:q,'V I � I � "I r � I r I __� - il " � I I � I I � � . -u/ I I - � I : . I I - , . � SOnitar a , do/ o'bplicoble /Oca/ I as. � � r ­ I I I I -, I \ I f - �,,,',_L) ;F.),-Yl r4;,��,Fl � f Ar;1�14 11 y Cod ad August* 15, 1966, and an . - - ,y I I . - \ , r . I � t��,�r!:',,'!,!�_;�_'11_ I I � ., , i"� : ,­ I �_ 11 ,A . - I I - jp I - , I I., I I I , ,� "I :;f���,f � r I I 11 � I -1 I � ,;� � I ---;1��;'," -/!'r'­`f. ,­' /,�,) �114.1 � r I I I r -_ � . . �r -1- I , I I I . , , ", --IV, �, 7 At allpoints-of intersection of water lines and sawer lines, machoni al joint cost iron pipe shall be installed . _'__ , I`" I �, 1, I I ,�, � r, , I � I 1,AA,__`-`.T, PJ?�t, �_-N",i­,�"/'�,-� � -Z,, I ,I- ,�p7 1 -_ I r r � .-I�­­ , I � ­ Ic - I � I I I � � . - / " i ­ \ � I I -­­ " � I I � , � . - I . � -_ - - � � 1 - "� - 1,�; I;- __ I Ir- I ­­ - I . -,--- __ I'— I ­ - I . I I � � I I ­ I r- --- - -_-.11 ­ OS IU' eit 6 'd ntersection oint, - .1 I I I for ,both ftnG - I � - r ' ­ . .�:__ �I ­_ - I I - " , � - � 4* h p . r - I_ -, . __ ­ " - /­ I 11 � � I r .10 - \ \ ), , —_r"--_ I � � ,-,-,, r sl e .of the i I . I � `_r -1 -_ - . I -- � '? , I � t , �i, I r I . I r � . . I I -, I � 'r ,,,, I 1;� 61�1 *­\�)�fi I \ ,�k �, --1, � 1 4 1 1 ­�,, / 11 I I � \�9\ I "� V\ _ (, , It ,\ -- � r � I t� I �:, I � � I I - � 8 Septic tank,distribution box, ,and leach pit shall be as manufactured by A. Rotondo 8 Sons- I _ I \ " , - - I I I I I . I . . I , , i� \, , 11�ZP34, , I -�, I . I . I �__ I . / % I - "�� I \ r,Vz_4_Itll:,� . I I r/ , � ;1 - I I . I I I I __ � � I I I I I . I I I - . � I I � - ­ , - I I . 1� � _. 11 ., . r " r 11 . I � I ' � � - ,� __ I I I I, 11! I 1Z! , I", I i \ � I r I � I ' - ­ � I , - , I I �9. �Grout :to'be used, at allpoints where pipes enter or leave - all concrete structures in order to provide a, I i i .f I . I I I I I I I I I I I ',,,r r . 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Finish ground � I I . � 1. - � I I— "-I'.,, r I 11 I ,,r I I I ' 'I r � ! _. ,______J --e r I � � I �'f,,'., -, r � I I'' I r � I ­ . r r I I 1� I � , I - . r , I I .1 1, I I —_ , -_ ---I't 1��7­­­­_ 1 1 � Pipe invert elevation r I I I " I I r ; � � I r � . _:_-, i � : I`_­1_ . I � /O.P.561, 1 �. r � I . I . I I I . I I I I 1 r r � I ­ I— . � I 11. - . . - - I I I .I I I.- I 'L r I I I - ' I -I ' � � I I I ,I I � I I I I I r � I I ­ I . ­ 11 ­ I I .11 I r . I �.e7 � I I � . � � � I 0 � rest pit location r r . � 417, A._�.�_ . � I ­f�A r �,A r I I., 11� � � � I r I I L:E. I I � �, � � I � I I ll .-,, K-r -P -Q�Tt�b t�A /A I I ----r'- , ---­­ ­­­ -­ I . b I I — I . I r —'-,-.:r--' 6) ­­__­:t_ � I I � � I C I_4MEMA I -2 - 25 CA-f 1 E_r0\Vf1A-:- [7L 113 - , . � I I . � I � I 11 �r " I I . ) I o I �, � I'll I _CO--O:)- Se fie tan* I . I., I I JI .L � " � I � I . � � I P � I I t - I 11 .11." , I . , i � � I I . . 1� I I ­ 11. I I "' � I r � I I . � , ' '' I . , ­r , I . - � I - � — � I � 11 - I r r * I ,j�k-'1!2�,��114 '� " - I I � I � I . , I r _ _� A,� i . I I - I .1 .......----'----I'­­­-_..__________­_, __ ____ _,___._,,,._ , � 1, r . � . I I � ­0 '7 ' ' Distribution box , ,,, -_ F p , -I I . I � � I � I''--r " . ,-L----- I ­­__ I—. ­ I __- -I -_ ....'r ­­­­­ I � I I , I I I . I ;1.1�, :,. " � 1111;1 ,�,�k 0 . ,! " I . i ! I �� Lr I 1�11 - RICHARD � ,,, --:1 `,. . I r I . � I I -1-::_- I � r I I I - HANACK V.I ,\1 ,,, ,� ", ,", , I � . __,-�- I , 6ARCIA . � - - � ­­ I , , , I I � ---,----,- I I . � I . I r I ­IL-D . r I � 1� I 'I, I �_r I I . � I "I I- �, " I 1 1, I -V�, 'f� 1P 1, 11 � - . . r ! - ­_ ­- ­1­­ ,­ ­­­- � � I L I : .Leach pit I - ,r � i . I � ­ � I I ,� 11��11 " I � . I .I,� .­­-__ I : I I . I I 11 �L­ I .1, : I , '. � r r I . I I I I . I - I I �I L) U G �� r I . . ­ - I . r I . ­ I� -1 r ; I 1. I I I Ir I :,� 'r ,11 . ... 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Q BY G.C. m CLOSET >SE RUBBER - 3 VINYL I— VINYL 2 r BACKED 3 - - - - -� -i- - - - i .�, CPTI CL q`�ry _ d % . „ - ' �f' C T _� (NIC) t- L r 6� � x, 12" x 12" VINYL I CPT 1 m VINYL BY OWNER AND GINSTALLED CPT -' X m Q 0 mN MOP SINK `,' G.C.SHALL BE RESPONSIBLE BY G.G. a Q a FREE 3 04 in VINYL I �PARTCHING AND RE ALL FLOOR PAIRING RING 1 VINYL 1 t 0 AS REQUIRED BY POWER o Rg=_{d" 30" PROFESSIONAL COOKTOP ^ m o 3 Q FEEDS INCLUDING DATA AND ELIMINATED !� arc 06 PHONE.G.C.SHALL PROVIDE 0 FRIDGE 05 �"; (I)ADDITIONAL EMPTY 1" 4� - �- Y VL;'Kd Fir G.C.SHALL BE RESPONSIBLE 0 R u_ CONDUIT WITH PULLSTRiNG `'' t♦,, x1 rt l :;. FOR ALL FLOOR TRENCHING, CPTI PATCHING AND REPAIRING AS r I� FOR FUTURE. RE R � o w 4 ;� ��.3962 F D. 4 0 ( A REQUIRED BY NEW FIXTURES A$ 3 �' 8R*1A55 N VINYL 2 SHOWN ON PLAN.TRENCH SHALL m o� 3 a D f TD EXTEND TO REAR OF SPACE TO u Ps�P cv I I REFR DGERA R TIE INTO EXISTING PLUMBING COUNTER TOP V.G.T. I - }' 38 V.G.T. I _ ELIMINATED 0 >L G.C.SHALL INSTALL -, I I LINES.(V.IFJ FURN. t INST. 0 FLOOR DRAINS, 0 SINGLE SINK R-7 S BY G.C. 0 r' HAND WASHING _4d F.D. F.D. (TYP)AS SHOWN. II m FREE ZE C� F-2 F-2 F-2 F-2 F-2 F-2 F-2 F-2 ° :� o F 1 F-1 F- 1 F 1 F-1 F F O , LID I'7vmwm TRIPLE BAY SINK 11 11 1 11 1 11 - - i 29 3 4 1 4 -5 it -2 - -- SPEC_ T.B.D,. FURN. t _ INST.BY G.G. CL -0" 16'-3111 1,_01 4'-III 9'-8311 32'-1311 ° 19'-SS11 0 L d w r a O CONSTRUCTION PLAN Z lu N �GJ it WALL, PARTITION T i ON TYPE V .2 Al SCALE : 1/4" = I'-O" o yU FURRING CHANNELS - 6" MT_ STUDS AND SO' m SIZE AS REQUIRED TO G.W.B. AS REQUIRED TO M ALIGN WITH COLUMNS, 12'-0"A.F.F. WITH 5/8" G.W.B. TO i�- 12'-0" AFF. � O DOOM` 6CHEDUL- O DOOR TYPES FRAM TYPES 0 0 DOOR DESCRIPTION FRAME e HDWR. DOOR DOOR KEYING 3'-�0" VARIES L VARIES L __ SET REMARKS FURN. INST. INSTRUCTIONS NO. FROM TO STYLE WIDTH HEIGHT THIGK'N MAT'L TYPE MAT'L TYPE BY BY _- - EXISTING WALL SEE _ _ o O i SALES EXTERIOR EXIST S G.G.SHALL VERIFY HARDWARE IN FIELD KEYED ALIKE , , N FLOOR PLAN EXIST EX15T DOOR'I 2 SALES STOCK FLUSH 3'-6" 6'-811 1 3/411 MTL A MTL i 1 PAINT DOOR AND FRAME P-1 G.G. CG.G. 1 Q ` d 3 STOCK CLOSET FLUSH 2'-6" 6'-8" 13l4" WOOD B MTL 1 2 PAINT DOOR AND FRAME P-I G.G. G.G. °0 y� d; Y `ALL T I I E I Y ALL T*I- r � L � � z � FLUSH " 1 " " PAINT DOOR AND FRAME P-I � 4 CORRIDOR KITCHENETTE 3-0 6-8 1 3/4 WOOD 13 MTL 1 ` 3 G.G. G.G. Z I II 7 FLUSH 3-0 6'-8" 1 3/4" WOOD B MTL 1 4 PAINT DOOR AND FRAME P-I G.G. G.G. " " i PATCH AND REPAIR ANY v L DAMAGED G.W.B. ABOVE n M 5 CORRIDOR RESTROOM \ Z ❑ e � to CORRIDOR RESTROOM FLUSH 3''0" 6'-8" 1 3/411 WOOD B MTL 1 4 PAINT DOOR AND FRAME P-1 G.G. G.G. KIGKPLATE �\ 12'-0" AS REQUIRED. t 0— ra z r- 0 I STOCK EXTERIOR EXIST G.G.SHALL VERIFY HARDWARE IN FIE]D KEYED ALIKE iA '1/8" FURRING CHANNELS g EXIST EXIST DOOR I H.G. METAL S.G. WOOD 16 GA.. K.D. METAL AND 5/8" G.W.B. TO 12'-0" PAINT PI BIRCH VENEER ° l PAiNT P-1 FRAME AFF. j i PAINT PI is va,, FURRING CHANNELS AND 5/8" M.RG.WB. TO 8'-6° EXISTING WALL WITH :15`'i Si AFF. STUDS TO U.S. DECK ij - EXISTING G.W.B. cc EXTENDS 6" +/- ABOVE 3 11 6 11 - EXISTING 3 5/8 MTL. STUDS 1(o CEILING. ADD V) O.C. W/ 5/8" G.W.B. TO MATCHING G.W.B. TO 4-0 8'-6" APP. M.;P_G1UB. ON EXISTING STUDS TO U.S. o BATHROOM SiDE AS DECK ON SALES AREA FLOOR F i I � I a H 5CHEDULE REQUIRED. SIDE ONLY. c to 0 o FINISH FINISH _-..._ LOCATION FINISH REMARKS o o 1 ABBREV. SPECIFICATION 2 M 1 ARMSTRONG PERSPECTIVES 33205 t HARDWARE 5 E T 5 4 CJC H E D U LE VINYL FLOORING VINYL 1 SHEET VINYL,COLOR:SMOKE GRAY o 3H1 } 3 j NALL TY�r 5 MALL TYPE � d v SET NO. I SET NO. 2 SET NO. 3 SET NO. 4 SET NO. 5 HARDWARE SCHEDULE SALES AREA F.r (STOCK ROOM) (GL05ET) (KITCHENETTE) (RE5TROOM) (REAR SERVICE) 1, " VINYL FLOORING VINYL 2 ARMSTRONG PERSPECTIVES 33204 SHEET -� `* I/2 " PR BUTTS BUTT5-STANLEY 4 1/2 x4 1/2 VINYL,COLOR: WEATHERED SAND 11' _ I1 I = I' H D. CLOSER 1 1/2 PR. BUTTS I i/2 PR. BUTTS H.D.CLOSER G.G. TO VERIFY B.B. SERIES N 5Ca fie: ,�$ NOTM FLOOR STOP SILENCERS H.D. -LOSER WALL`STOP EXISTING HARDWARE CLOSERS - 5ARGENT RICHMOND - THE AMERICANA SERIES sA HEIGHT TO 12'-0" AFF, s Date: 2/10/03 KIGKPLATI= "STOREROOM" WALL STOP SILENCERS IN GOOD WORKING 1231 SERIES FLOORS CARPET CPTi SILENCERS KEYED LOOK SILENCERS SILENCERS CONDITION AND WALL STOPS-IVES 4oZ i/2 2800 cOttoN CLUB 0 HEIGHT To 8'-6" AFF.; ro" Q Drawn Sy KM STANDARD LATGHSET OFFICE PRIVACY GOORD. WITH OWNER V PU5H/PULL PLATE *GORE VV/KEY FUNCTION FUNCTION FOR NEW GORE +E FLOOR STOPS-IVES 456 KITCHENETTE V.C.T. V.G.T. ] EXRC�ELON �5192� FIELD GRAY STANDARD METAL STUDS, m C�tecked 5stw - BRUSHED S.S. LOGKSET LOGKSET SILENCERS-IVES LocKSET KiCKPLATE5 - 34NIO" 5.5. ARMSTRONG IMPERIAL TEXTURE STANDARD g Job Number: 202230 REQUIREMENTS RESTROOMS V.C.T. V.C,T. 1 EXCELON - '51921 FIELD GRAY �o LOGK5ET5 - L Drawing: SGHLAGE O.A.E. STOCKROOM EXISTING EXIST EXISTING TO REMAIN ` O -CYLINDRICAL LEVER - -- a j tY fV i O ; > - 1 O LADY GRACE r RADIO SHACK WART 16 94,500 SF I Z tL N N LL- LO V) WO 00 O W l_ ONO �O O^ N O v�y�yO�. r7-' •O— .— Ncv �. N N U�L�U�o�- zO� M � t ON Z z WN - u Q� Q(y<t 0u`70 r FILENE'S BASEMENT o f- 0 6 v 36,600 SF o ,t> pEPR�E HOYT S CINEMA 17 20,640 SF. zi , r r- p O O r O N Q W I r - Moll and Tenant Building USE INTERNATIONAL HO 19 ` (Gross Leasable Area) OF PANCAKES BANKBOSTON 4 276 SF IA Si 052 sf 2�j 20 TENANT G I 2,600 SF _ 414 SF TIKI PORT D ANGELO SUBS WART 94,500 sf _ 18 fILENE'S BASEMENT 36,600 f RESTAURANT , 1,160 SF HOYf S CINEMA 20,640 sf IYA N o U G H R O A D R T. 132 TOTAL 232,792 sf LEA SING : P LAN T LEASING & NORTH , MANAGEMENT 01020 50 100 200 MAN AGENTS , , GRAPHIC SCALE URB AN i VACANT CO. _ RETAIL PROPERTIES ; ur o :le *Place fo C p y ._ i 400 Suite Boston. MA 0211 617.375.4452 • • , , , , , I i 1 , 2" ON & RISE (504) , > i f lh RC11�i Ws1ER __ 2" W DN dt V RISE-011} Hv.A_rE' r(-. I✓li">f' STNX. ,r '_ W DN St � RISE �1 J6) .� iO1LET Ri3C}AA EXiS7IML, ~ _"_ Mi ti ;N &^ RI;E (101) — � W DN & `•' RISE 111) " W *! 1171 , » V DN & RISE (FC3 j is` TO RFMAMI. J ( . \ GREA E tRAP fSEE DETAIL ON P—�} � V DN do RASE (FCi) Ak'\n_ i _ ry ... w » iK' i . i 01 _Ii _ YN +Y! o flit • ! Y A!! 06 s°Y i1rl' 1pYf Y•1M 41 4. op It FCO - ws ... .... are► ..� �" `�" f -Q �� 2" It ` )!q i 1 II 2"4 -1 � f I:l) (` 1 i A I } ilt it LLJJ It' - jl�..: ` � - ,►�--._ /-` .�"`� ,;. ..vim " '`•a•, 'g`y z"` .. 2" V DN & RIS£ f,FL? ---- ----------- `" V RUN NEW 4„ WCA:s[ f —_ _ _...___— __— — _ ---_—•—•—--— ----- 15M GALL EASE FCC 'Cjq_ 1 !.i{, .:1 ! � e �E F .I�, i ( r _ ,.,;4^.'»...r.. s _ ,,, •c�Q' J 2/ L Cam.`9Z i i hYi•P. i:,. { ?�? 5.,. __-'---_ ._..-- G ,.. i°t: f r..; i r i:. m„ei i +j1gl'} f' _... '00 +yi rp f 'Q 2 ` U v? �d`° i ° '' ! Y.`. °. ..pa'F• + `t� K - a`' Y - ? �.. i $ u. 'LL! Q � F-• Q 24 44 CDQ _ �''� cr) .--2" 4 . ! � I t �► l 11 _ a W DN & V FRIS�E (OV) . .^ •��x F.a� >` * � ' ` `d" S DN (ARC) I V ON & RISE (WC) - t a S , 1 , .. VDNdcRISI:E (UR -4 v DN & RISfE rD , \ ' 2* u DN & RISfE �FD)' FU I n �1 FG " V N (W RiSEE : " & WC _ S � (vac 2- v DN e� WSW (WC) ,s 11 - M , P awr saw ter. c �i t . ..n •� +,.. - - --', - � i , s r_ . s . " ... � ?y < !rzl I CONNECT TO EXISTING SAN+TARP S A�, 'i,H NEW ANITARY. VERIFY ' EW, 4 ' EXACT L O'CATKDN 'N PF-LD. _ HEAVY L1UT( 24" ntH ICI-,NMNEY OF SEW FRAME &. COVER IN FULL `OR", r21 CJUR ''I-S MORTAR BED-?YPICAL MIN#MUM--YYP(CA)- PLUMBING-- SANITARY PLAN ` __ - �• ---- -- - - Tt7tLt-T Rt?C}#iA tktSTltdG f SCALE- If f-r-0' 00.1 CHIMNEY OF SEWEu ' 24' ....24'.__. I BRICK, (2) COURS* _.� •..:..: .- MINIMUM—TYPICAL + t. OPEN END S AN I' "' !TEE—TYPIGAL. ---6" TYPICAL A� J INLET " OUTLr I —,� WATER'tGHT SEAL I AT OPENINGS (TN' ) .. . r• _ A .i I(2� LAYERS OF `TER ON AL I -�" © EXTERIOR St;kf:A.. S nv JLl 0 IUD%; UNDISTURBED EAi '!-I �.�. . �... S" POURED—IN— .. .. _ -------- ._.__._ . .. __ F _ •_ _ - __----_ _._ _. ___- . PLACE CONC. ,4 "( t 't /'.! . .: i . 'fit;.:. , S.♦21::' \\..;1,y .. V''.[:a c.}:: LEVEL ,��li��k�.+ ;Gf.�6 •t�`, >�.`�§•�*�•;�� i '�. a�,` 1���..��- K ......,, X_. ,;°, , .::.� � ,tN PAD THE PRECAST SHALL BI` t.APABLE OF WITHSTANDING H-20 LOADING. � DRAWN P�i3 ... APP4 LAW GA rE 10 09- 1,998 }( AR EAS E ! NTERCN EPTGR DETAIL t"?f FILE JOB 1.40- _ r SHEET Lngineeving a (:( 21,"-A 29 Mdt n Sue t, E� `A f E Lon Z 0 '48 58 52 1 49. 50 46 44 43 42 40 cc (D U) r) C'4 V_ W POO) (o 0 n Ill q 6 CL F X4X X4X 1. AD p 0 701 xtx xtx c 0 x .0 0 m c (L>J-- 0 0 0 (D 0 --r-777 a. LL :�9:X X Z 0 C-4 C35 1 —L-A I _+_ - - �__ / -+- N�7-r u WALK IN COOLER 13 54 VOW MEN DIES x (D 31 -E. T. (37) 4- -N. 17 co 16 n 59 F= Lm IN N v e e - e eL I 62 'jK JC__ 13 UTILITY ROOM 63 'iv 63 OFFICE 0 61 UJ > 24 25 27 Lm 0.1241 'SALSA + BAR n \lx" t =+ LL "u, u , .1 --1 r > Lm (D co DATE DESCRIPTION z 0 F 0 0 D S E R V I E E Q U 1, P M E N T S C Hn E D U !L E STEAM MANUFACTURER MODEL REMARKS MK. MK. QTY DESCRIPTION ELECTRICAL WATER WASTE GAS V) LLJ LLJ w CL �2 < < LJ LLJ W (L 3: W _j 0 0 N DO 6/2/00 PEVISED LAYOUT 3: m Al F U- a_ 0 a. 0 m 25 z on :2 _3 a. a,,: DATE% 05-11 2000 1 11 1 ICE FLAKER 11 .71 11201 1 X 11T HOSHIZAKI F-800MAF/B-500 BIN 2 2 11 1 WATER FILTER JEVERPURE, INC 9324-01 INSURICE SIN DRAWN BY, R.D.C.3/B.J.D 1 POT SINK I ADVANCE INC. 94-63-54-18RL ALL S/S W/FAUCET AND LEVER WASTES 3 SCALE, 1/4�' =l'—Y' 4 1 POT/UTENSIL RACK ADVANCE INC. SW-84 ALL S/S, 84" LONG 4 5 1 HAND' SINK 11T l/T 1-11T AD-VANCE INC. 7-PS-50 W/FAUCET, P-TRAP 7 LEVER WASTE 5 6 ­­ . 1. .,:-..TQMATQL SLICER. -4.0 l 2Dl, X1 GLOBE FP-500 RK TABLE. ADVANCE INC. KSS-304 S/C 7 7 11 WO 8 11 1 REACH-IN FREEZER 9.0 1p) 12D I X TRUE T-23F 8 JEDLUND S-11 9 9 1 CAN OPENER I ADVANCE INC. SS-306 AILL S/S, 30"X72" 10 10 1 WORK TABLE -SPARE NUMBER- 11 - -SPARE NUMBER- 12 - -SPARE NUMBER- -SPARE NUMBER- 12 13 2 TRASH RECEPTACLE RUBBERMAID 2632 13 LIMBER- 14 14 -SPARE NUMBER- -SPARE N KOLPAK P7-068-CT-L TC)P MOUNTED, S/C UNIT 15 U) 15 1 WALK-IN COOLER 14.7 1/2 12D ix AMCO �AMCO 11 ZR 16 1 HELVING UNIT ' I 1 1 , 16 LOT S 17 OP SINK E.L. MUSTEE 19F/93.600 PLASTIC UNIT W/FAUCET 117 11 M AMCO AMCO 11 Zp MIOBILE W/CASTERS 18 118 11 SHELVING UNIT METRO METROSEAL FWR TERS 1­1194 EPDXY COATED 19 19 ILOT WALK IN SHELVING -SPARE NUMBER- 20 2D - -SPARE NUMBER- -SPA 21 RE NUMBER 21 - -SPARE NUMBER- -SPARE NUMBER- 22 22 - -SPARE NUMBER- - -SPARE NUMBER- SPARE NUMBER- 23 23 N.I.C. 24 24 1 SERVICE COUNTER N.I.C. 25 25 1 TRAY SLIDE TYPE W/FAUCET 26 1 DROP-IN HAND SINK ljT 14- 1-1/2" JADVANCE /6-1171 DROP IN 26 -WI-0-2 27 F4 27 1 2ROP-IN COLD PAN 3/4" ATLAS 0 28 1 ICE & SODA DISPENSER N.I.C. 28 36"LONG 29 1 SNEEZE GUARD UNJTED SHOWCASE 405S 29 J CAMBR 8R 30 30 1 CONDIMENT RACK 31, 31 2 SMOOTHIE BLENDERS 120eo 1 X VITA-MIX 1227 E­­4 E-4 3.0 1/4 12D 1 X KELVINATOR KDC-27 S/C UNIT 32 32 11 1 OPEN TOP FREEZER z -SPARE NUMBER- 33 33 -SPARE .NUMBER- 34 co N.I.C. 34 1 JUICE DISPENSER x X1 X1 �D 35 1 CASH, REGISTER x x N.1.C. 3M5 X 31 36 1 FRONT COUNTER N.I.C. 37 1 ICE CADDY CAM13RO IC175L FEDERAL CGR5042DZ 38 1p 12D 1 X E Of 38 1 1 REFRIGERATED DUAL ZONE CASE 18.0 S)/c u N I 39 1 1 MERCHANDISER 8.0 1/3 12D 1 X ITRUE GMD-23 T N.I.C. 1 40 w 40 1 ESPRESSO MACHINE x x X X _j N.I.C. 41 41 1 x x X' COFFEE BREWER IHATCO HDW-2B 42 42 1 ROLL. WARMER 12D i I X1 w 43 I RANDELL AIR VIS SERIES WJMAKE UP AIR 56" x 10'-6" W/3" AIRSPACE 43 1 EXHA!UST HOOD 2 12D 1 X1 I w RANDELL'AIR 43A XHAUST FAN 20B i Xf 1 0 w 43A 1 4,M 1 MAKE-UP AIR FAN 208 1 x RANDELL AIR 43B cc a- CUSTOM 10*-6" LONG x f)'-6" HIGH 44 RANDELL AIR 44 1 S/S WALL-PANEL -SPARE NUMBER- 45 -SPARE NUMBER- 45 T4 110 -S TANK CAD FILE NAME- PITCO, INC. SG14 W,/ S/S 46 46 1 FRYER OUNTERTOP GRID LE jl�T 35 VULCAN-HART MGG24 COUNTER MODEL 47 BURRITO/32206 47 1 c TOP 48 1 COUNTER CHARBROILER 11/2�' 72 VULCAN-HART MGC634 COUNTER MODEL 48 VULCAN-HART 36L W/STANDARD FINISH 49 3/4" 191 49 1 (6)BURNER RANGE W/OVEN RANDELL .20060SC S/C UNIT W/(2) DRAWERS 50 50 1 REFRIOERATED EQUIP FNT STAND 1/2 120" 1 X KSS-303/TA-31 ALL S/� 30" x W/BACK AND LEFT SIDE SPLASH 51 c_ 36 CL 51 1 WORK QLE , AD-VANCE INC. 52 25,5 1 ITOWN FOOD TCR-50 GAS FIRED COUNTER MODEL 52 1 RICE .WARMER. cn 53 1 - 1 -SPARE NUMBER- -SPARE NUMBER- 53 r_ 54 1 FOOD. STEAMER 2.5 1 .5 12D, 1 X1 LINCOLN 4000 54 55 -SPARE NUMBER- zl� 55 - -SPARE-NUMB.— 1 56 156 1 HOT FOOD TABLE 12.48 2,15 1 208! A 3/4" RANDELL 3613 NIT 57 TRUE TSSO-48-18M S/C u 57 1 SANDWICH UNIT 9.0 1/) 1201 1 X1 58 58 1 FIRE SUPPRESSION SYSTEM 12D 1 X PYROCHEM CUSTOM -T 59 WAYMAR SM 59 4 TRASH RECEPTICALS WAYMAR LAMIINATE COUNTER/WOOD EDGE 60 11 30"X,30"TABLES 160 THESE DRAiMINGS AIRIE THE SOLE PROPERTY 61 36 CHAIRS COUN R/WOOD EDGE 62 OF UNITED DESIGN GROUP, AND UNITED IWAYMAR L)AMPNIATE TE 4 30"X30"CRONEY TABLES EAST FOODSERVICE SUPPLYCO. AND ARE 63 NOT TO BE,USED IN WHOLE OR IN PART 63 12 STOOLS WITHOUT THE WRITTEN CONSENTOF UNITED DESIGN GROUP. DENOTES EQUIPMENT NOT IN KITCHEN EQUIPMENT CONTRACT 01 AND ALL CONTRACToi CHECK AND VERIFY EXISTING DIMENSIONS AND CONDITIONS IN FIELD BEFORE STARTING CONSTRUCTION AND TO NOTIFY UNITED cm DESIGN GROUP OF ANY MATERIAL OR DETAIL CHANGES. CHECKED BYI C) cc SHEET Wo cn CaL uj Z: K ,6 co cn C 'o 0 TT T T T T T TTT T T T C) 00