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Home My WebLink AboutDUCK INN PUB - FOOD DUCK INN PUB 447 Main Street Hyannis,30?-0'3i-00 i t I Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. UARMFAoLe, F.P.(Thomas)Lee,. May, Daniel Luczkow,M.D. Alt. 1539. , 200 Main Street, Hyannis, MA 02601 A Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 30SA, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 294 Issue Date: 01/01/2022 DBA: DUCK INN PUB OWNER: THE MILL STREET TAVERN INC. Location of Establishment: 447 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 41 OutdoorSeating: 40 Total Seating: 81 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: t • Initials: Town of Barnstable DatePaid� - $ , BAMSTABLE. : Inspectional Services "ASS i66 9Check# gfpppp�a Public Health Division Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 1g APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE �sl.+u yG� NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: CK j4 13 ADDRESS OF FOOD ESTABLISHMENT: g4-r rlp4t� MAILING ADDRESS(IF DIFFERENT yF�R,OMg ABOVE): �( E-MAIL ADDRESS: roc ��q p,j!7bN j 2?J TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (5� ✓g 7- TOTAL NUMBER OF BATHROOMS: 31 WELL WATER:/YES NO Y .. (ANNUAL WATER ANALYSIS REQUIRED) S ANNUAL: P/ SEASONAL: DATES OF OPERATION:6 I/.01/22,TO )2 /-j NUMBER OF SEATS: INSIDE: OUTSIDE: �TOTAL: ® I 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? ` e5 IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOORS)-: TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) V FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q\Application FormsTOODAPP 2020.doc . i OWNER INFORMATION: FULL NAME OF APPLICANT n�u SOLE OWNER: YES/ VO OWNER PHONE# 6e)(9 ?jw�I 14g63 ADDRESS_ 441 -"M_ ky� .b—A 14*p -4t tcs , MA- &Z;o ) CORPORATE OWNER: .�SE7t�N 1� Z : C 1 ( � CORPORATE ADDRESS: �--� :'J CZ.$) PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2.0 I�k1 r�� rt az /Z4 SIG RE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/heaIthdivision/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. 3Ist 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 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARNSTlBLE, =' Paul J.Canniff,D.M.D. MA ' F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 294 Issue Date: 01/01/2021 DBA: DUCK INN PUB OWNER: THE MILL STREET TAVERN INC. Location of Establishment: 447 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 41 OutdoorSeating: 40 Total Seating: 81 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: L SINE Town of Barnstable Only:For 0 se Initials: y Date Paid 1 02A Amt Pd$ &AMMSTABLE, : Inspectional Services I I prEo�.�a Public Health Division Check# Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ff APPLICATION FOR PERMIT TO OPERATE yA�FOOD ESTABLISHMENT DATE F' .Q ' Z 0 NEW OWNERSHIP RENEWAL !� NAME OF FOOD ESTABLISHMENT: DcAcK zlo� ADDRESS OF FOOD ESTABLISHMENT: !4!51 MAILING ADDRESS(IF DIFFERtE�NT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (� )8rr- -1 3q 3 "X TOTAL NUMBER OF BATHROOMS: 3 WELL WATER: YES NOX ..(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: G 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 WAIT STAFF SERVICE DOOR(S1? 4— 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*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application Forms\FOODAPP 2020.doc OWNER INFORMATION: _ FULL NAME OF APPLICANT � �1 � V t �. 0 dr/�xC. � .1 SOLE OWNER: YES/0 D.O.B OWNER PHONE# ADDRESS I CORPORATE OWNER: QLLL cGI'R �0 0 IQc- i CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: :Sa"fy `%' .tle 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 A,%jtk�/`1 3 I/ Z_t / Z`O �' IGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering nctice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cocking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FonnsTO0DAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAMSTAs"': Paul J.Canniff,D.M.D. mmm 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: 294 Issue Date: 12/10/2019 DBA: DUCK INN PUB OWNER: THE MILL STREET TAVERN INC. Location of Establishment: 447 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: Indoor5eating: 41 OutdoorSeating: 40 Total Seating: 81 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: of For Office.Use • Initials: ti Town of Barnstable Inspectional Services Date Paid' a n, •� Health Division R _/ ;' ED�IIAy Public e Thomas McKean, DirectorCX 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 f APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 1 " �q NEW OWNERSHIP RENEWAL 1 NAME OF FOOD ESTABLISHMENT: FLAff oh w ADDRESS OF FOOD ESTABLISHMENT: 447 t jLj6"' A i4)L4rn4Kjy5 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: �� ®�� G 1-�'R� -4a^ 9 TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ULA- '�3``F3 TOTAL NUMBER OF BATHROOMS. xZ 0 WELL WATER: YES NO (ANNUAL WATER ANALYSIS REQUIRED) ? ANNUAL: '� SEASONAL: DATES OF OPERATION:.12/alb TO IL/3` / Zh r NUMBER OF SEATS: INSIDE: _ OUTSIDE: 4q TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? Nry TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL.MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 QAApplication FormsTOODAPP 2020.doc i �yP OWNER INFORMATION: ,/ S FULL NAME OF APPLICANT SOLE SOLE OWNER: YES/NO D.O.B OWNER PHONE# ADDRESS CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: :�( 1-) (;r List(2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date [ � I S ATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/heaIthdivision/analications.asD. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Wpplication FormsTOODAPP REV3-2019.doc t � Town of Barnstable BOARD OF HEALTH Paul 1 Canniff,D.M.D. A.Ga Board of Health Donald A.Gaudagnoli,M.D. oARX,rx�s�e, John T. Norman .t'30 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate b}� ° A Phone: 508 862-4644 Fax: 508 790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with,regulations promulgated under authority of 105.CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 294 Issue Date: 12/20/18 DBA: DUCK INN PUB OWNER: THE MILL STREET TAVERN INC. Location of Establishment: 447 MAIN STREET HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 41 OutdoorSeating: 40 Total Seating: 81 FEES (� FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - ----- - - - ------ ---- MOBILE -FOOD: MOBILE- ICE CREAM: C,�� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: I PERMIT lS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: MUST POST VARIANCE LETTER. August 23, 2012 - Granted toilet facility variance, 3 toilet facilities in lieu of 4 recluried for the 81 seats. , t IIJO �FTHE Town of Barnstable Tn.Mor ce s QWy— Initials. , o� Date Paid Amt Pd S 9'^ IA&IL Inspectional Services �AtFG 1639. A�0 Check# i Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,Na 02601 LD Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATED.'z3"16 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ci( v�w fCk6 ADDRESS OF FOOD ESTABLISHMENT: 4q I M MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (""" TOTAL NUMBER OF BATHROOMS: 4k -3 WELL WATER: YES NOX�__ ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: _ SEASONAL: DATES OF OPERATION:_L/,_/jj TO JL/ t/ NUMBER OF SEATS: INSIDEA1 OUTSIDE . TOTAL: 'V5 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? 96 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) LQAApplication OBILE FOOD ROZEN DAIRY DESSERT MAC HINES ... (MONTHLY LAB ANALYSIS REQUIRED) ATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) OBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL, MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED FormsT00DAPPREV2018.doc PLEASE CALL 508-862-4644 OWNER INFORMATION: 1 �! , FULL NAME OF APPLICANT_ t'L(, �1� ,�;C'1 ,,ice', (,L�,V, ` SOLE OWNER: YES/ V� D.O.B OWNER PHONE ADDRESS 45, CORPORATE OWNER: --Via�z, S t 3 FEDERAL ID NO. : �� J CORPORATE ADDRESS: j3`�-� PERSON IN CHARGE OF DAILY OPERATIONS: 1 � List (2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have I Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date AUergen Awareness Expiration Date 2. IGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at htti)://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1st to Dec.3I't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q:VWpplication FonnsTOODAPPREV2018.doc oF. row TOWN OF BARNSTABLE HEALTH INSPECTOR-s Establishment Name: Date: Page: of ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00--9:3oA.M. BARNSTABLE, ' 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 639. �•� HYANNIS, MA 02601 M-8 -FRI.62-4644 No Reference R--Red Item - PLEASE PRINT CLEARLY �p ' n 508-8 FOOD ESTABLISHMENT INSP CTION REPORT Name y_ Date` , T e of Tyne of Inspection p REAddreSs Risk od Service spection Level ection 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 specificprovision(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 ot ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating VVV within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension-or revocation of the food B-One critical violation and less than non-critical violations if no critical violations observed,4 too 6nnn-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007). aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-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. violation,4 to 8non-critical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view G Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N WhQ440 #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y TN Dumpster Screen? Y N ^r+...�--.+.•+� ^-,�..•'�"a.-.. '..:--.:•w�l ---:-w� « �..._:. .ems. ^....ti-...� -.Y�-��.r-. ..T _,,�^_.. e^ ---�� ,-- +.s=. ....---..---.. 7 �. �. r � -r.i.. -:�^ ��..7_..� .--^'e.1.r...."�y.�_ ^��r �+,e a51�.....,�.�,=ti+.._+.--`... ..f-r`-„_._ - _ ,....� e..- - Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 6 Crosi-contamination 14 Food or Color Additives Law Coaled to 41°F/45°F Within 4 Hours* * * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives . Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 590.004(F) * • - - 7-lOLll Identifying Information-Original Containers* * Require Reporting by Food Employees and Contamination from the Environment Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 590.003(C) Responsibility of the Person-in-Charge[0 7-102.11 Common Name-Working Containers* * 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants* - 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.1] Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) q 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* t 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* I Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B) Compliance with Food°Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( P 4-501.111 Manual Wazewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* - 4-501:112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* 1 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 * Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* ( ) Eggs-Immediate Service 145°F 15 sec Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens* 590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game g * Effective uuzom 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and -{D)in cater- * Ratites-165°F 15 sec* in mobile food,tem o and residential Sources 10 Proper,Adequate Handwashing * g' P Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome 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 practiceRequirements.sshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* - 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 PreventingContamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g 3-403.11(C) Commercially Processed RTs Food-Roast 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* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°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 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients" Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 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:590Forrnback6-2doc *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. pp THE rq TOWN OF BARNSTABLE HEALTH iNSPECTORs Establishment Name: - Date Page: of OFFICE HOURS BARNSTABLE. ` PUBLIC HEALTH DIVISION �.� 8:00=9:30A.M. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 039. �•� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �PrFG M 508-862-4644 FOOD ESTABLISHMENT INS ECTION REPORT UK Nam LA2Dat Type of T Ins ec ion e s utine e Address ` Risk d Servi ction 4772 Level revious 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 51 Out: l Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. all, 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 .y 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 Asa Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP V � ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories 0 -Ft-1 - _U__ - Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �f O" Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No es Non-critical(N)violations must be corrected immediately or Overall Rating �� within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ 9 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 re ardless of the number of critical,results in an F. 25.Equipment and Utensils (FC 4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4non-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 i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials. (FC-7)(590.008) 9 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpst 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 Sig at r Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45'F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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* g g * 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* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 590.003(F) 7-202.11 Restriction-Presence and Use*Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 14 Variance Requirements * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and - - 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a 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* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System _ * gg Not Otherwise Processed to Eliminate Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective//11200/ 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* - 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 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 10 Proper,Adequate Handwashing g' P Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 t - Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices - 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Ealing,Drinking or Using Tobacco* r * Requirements. 5 Receiving/Condition g� g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y 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�03.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 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°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 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * E6-301.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 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/ Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 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. oFTKE TOWN OF BARNSTABLE HEALTH INSPECTOR•s Establishment Name: Date: Page: P do PUBLIC HEALTH DIVISION OFFICE HOURS8:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � 63v. `0MASS $ HYANNIS, MA 02601 M -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY , prFQ MP+e, 508-8-862-4644 F OD ESTABLISHMENT INSPECTION REPORT Name ` '. Date T e of 3)gp@M Inspection er outine Address Risk d Service a ion Level a al 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) ❑ a 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 elfa r ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 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_'J Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined b the Board of Health. Voluntary Compliance Employee Restriction/Exclusion Re-inspection Schedule Emergency Suspension Y Y � ❑ ry P ❑ EmP oYe ❑ P d ❑ 9 Y P C N Official Order for Correction: Based on an inspection today,the items Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. El ❑ 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 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 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 al the above address violations observed,7 to 8 non-critical violations. It 1 critical refrigeration. 28.Poisonous or Toxic Materials FC:-7 590.008 9 29.Special Requirements ,,(590.009) within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 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 I gna re Print: Self Service Wait Service Provided Grease Trap,Size Variance Letter Posted Y N Dumpster Screen? Y N �.e, y o�rx �-..-.---...v. ..._ ._.-.. �- -. ..-._... . _. _ " _ - --�. w. - � -r._ _ +L. ./s 4.r .. � n- ,�-.r-.�.."..,ti^F_�- �-yl ��'-\ , �eti1.'r.'w .��.._ c w.� � � .- ��T• �_-.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) fAssignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 5 590.003(B) Demonstration of I{nowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12. Additives* - " 3-501.1 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 _ PHF Hot and Cold Holding J 2-103.11 Person-in-Charge Duties � 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F 590.004(F) * - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 590.003(C) Responsibility of the Person-in-Charge to 7=102.11 Common Name-WorkingContainers* Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(13) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) - Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food . 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 - - Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.1](D) Raw or Partially Cooked Animal Food and P 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Pe 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* ? TIME(TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. I 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155'F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are..Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E.ff"nee 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR"22-.0* _ Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency r f Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 1 p Proper,Adequate Handwashing g' P �Y Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* fodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g� g g 3-003.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140*F* (Blue Items 23.30) 3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the Foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsticed 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 Handwashing Facilities 13 3-202.18 Shellstock Identification* 3-501.14(A) Cooling Cooked PHFs from 140'F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. ' Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 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. oF'IKEroy TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: Page: of OFFICE HOURS BARNSfAB�E. PUBLIC 0 MAINLSH DIVISION 3:30-4:30 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /P N OF CORRECTION Date Verified 3:30-4:30 P.M. mnss. g -FRI. ,bav HYANNIS,MA 02601 s08-8s2�saa No Reference R-Red Item - - PLEASE PRINT CLEARLY 94, �+ oe-a 'FD1A"'' FOOD ESTABLISHMENT INSPE TION REPORT Name Da t ` Type of -Type of Inspection s j=eln.pectig: Address �� Risk pod Servic Level ection Telephone -Residential Kitchen Date: (Z,- .T-Da Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed R Breakfast HACCP Lt In: Other �j Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ _ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS '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 JA 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 LD 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories ,t+�L Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations l(J� Critical C violations marked must be corrected immediately. qj ^�- ( ) y (blue 8 red items) i �( Corrective A n Require ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating I within 90 days as determined by the Board of Health. ® Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspectio eduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6rion-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to 8rion-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.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 S rp nature f Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N ' Dumpster Screen? - Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) i FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 590.004(F) 7-102.11 Common Name-Working Containers Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* P g Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 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)Resumed 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 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 I Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 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 3-401.11 A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cti-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source3-401.11(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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec*Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(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 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbore 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand�Yin Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S: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. /7/KWE roKr TOWN OF BARNSTABLE HEALTH INSPECTOR's Establishment Name: Date: Page: of 7 r0 OFFICE HOURS �.R E. PUBLIC 2 0 MAINLTH DIVISION 8:00-9:30 A.M. STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified `4�, 639• .0� HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY rFo Mn+°' 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT r Nam Dat Type of Type of Inspection Operation(s) Routine Addres Risk Food Service Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: al .� Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP C In: Other A Zxr L ,sy ( Inspector 01 Out: If �i Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. ll 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) ❑ Q Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands e ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities pw. EMPLOYEE HEALTH �'` PROTECTION FROM CHEMICALS 0 C❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives TNA AN ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals 11/ / FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ,ifwf ' ❑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 r ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP U A low 6(i ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories L Ll AA 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. rElEmbang Volutary Compliance ❑ Employe Restri ion/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. o ❑ 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 if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) y p 30.�K_N DATE OF RE-INSPECTION: Inspector's Signature Print: 31. screened from public view Permit Posted? Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers*2 EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control*_ Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 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 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 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 Surfaces of Equipment* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in.cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* in mobile food,temporary and residential Sources* 10 Proper,Adequate Handwashing g' P �S' Game and Wild Mushrooms Approved By . 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g• g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked and Fr from*17 to 1'7/45 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 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. FINE i� TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. z BARNSTABLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified t�6}9• `0$ HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 'lEo MPS° 508-862A644 FOOD ESTABLISHMENT INSPECTION REPORT d Name Da t Tvoe of T s ecti O erat' outine Address Risk Service c ionon Mill( 44 ( L� Level Previous Inspection N Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary. Suspect Illness - Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from HandsAI G ❑ 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 e ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous oods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures 'd lei ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records I 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( ❑ 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: ElNo ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ® Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ® Embargo Emergency Closure ❑ Voluntary Disposal El 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 B=One critical violation and less than 4non-critical violations g ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. w 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted • Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions ° Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) +Dem, ssignment of Responsibility* 8 Cross-contamination 1 q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) nstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH-, 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to * Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* 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 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11 A Clean Utensils and Food Contact Surfaces of * Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* ( ) Eggs-Immediate Service 145°F 15 sec Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cti-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 590.009 A - D Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( ) ( ) Ratites-165°F 15 sec* in mobile food,temporary and residential Sources* 10 Proper,Adequate Handwashing g' P � Game and Wild Mushrooms Approved B 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority y 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g. g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity Y Critical and non-critical violations,which do not relate to the 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 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 * 5-205.11 Accessibility,Operation and Maintenance 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans &301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* I 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. W d _ r OP tit, i pT pi r .I �f l r oF. roy TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: Page: of 1. 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 .Aq_q59- MONHYANNIS,MA 02601 08-8 -FRI. No Reference R=Red Item PLEASE PRINT CLEARLY +679• �� 508-862�644 `rf°Mm" FOOD ESTABLISHMENT INSPECTS N REPO.RT . Name Date f f Tyne of Inspection O r n s Routine Address Risk od Service pection Level Telephone ' Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities �- EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HS P � ❑ 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) O Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ® Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6.Water,Plumbing and Waste. (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6npn-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 2 2 .Physical Facility (FC- )(590.007) aggrieved a 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 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008 9 violation,4 to 8npn-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y IN #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' Signat Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N b Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions - Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501'15 Cooling Methods for PHFs Cooked and RTE Foods.* - Additives* 19 PHF Hot and Cold Holding - 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or'Below 41'F/45'F 15 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g 8 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Pelson-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* . 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145'F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens*,eg°i-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* i mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing n g' P � Game and KriId Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under RegulatoryAuthorily 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 3-401.11 2-301.14 When to Wash* A 1 All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( )( )(b) 3-201.17 Game Animals* 11 Good Hygienic Practices 1 7 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial) Processed RTE Food-140`F* (Blue Itents.23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations;which do.not relate to the foodbome * 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated �) g illness interventions and risk factors listed above,can be found in the 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling PHFs 8 Tags/Records:Shellstock 9 of following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F, 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC'-3 .004. 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. �F IKE r TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: Page: of �.. . q OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30A.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 ;'a m� HYANNIS,MA 02601 MON.-FRI.-862-0644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT 508 Name Dat T e f woe of Inspection do s ' Ro ut' Address Risk pod Servi ctioLeve i .-1.111 IF Pnspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP / ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY i �./v�'� > ` ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories D/I Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations U Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005 B=One critical violation and less than 4npn-critical violations 9 ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation.of food establishment operations. If Seriously Critical Violation t F is scored automatically 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 i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to Snon-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y IN #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI 's Signatu Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11, Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH.- 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other*. g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Pelson-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Reared or of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an 88 d Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 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* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* 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 Held Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g� g g 3-403.11(A)&(D) PHFs 165'F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C CommerciallyProcessed RTE Food-140°F* Blue Items 23-30) 3-202.11 Package Integrity ( ) Critical and non-critical violations,which do not relate to the foodborne * 1y Prevention of Contamination from Hands 3 403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated (E) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Lu Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A g 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 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* 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. °FINE.° TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: e-? ( 0 Page: of OFFICE HOURS / PUBLIC HEALTH DIVISION 8:00-9:30 A.M. ennNSTneLe. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified mass. - MON.-FRI. HYANNIS,MA02601 5oa-8624644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT 4L Name Dat f� Tvoe of T f Inspection kit outin Address Risk < Z=Oe. spection Level Previous Inspection V MIA AATelephone AIQ ; Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time l�a� Bed 8 Breakfast HACCP t In: Other OVInspector Out: , Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ✓ ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(H P) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for H P ai ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY big t ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Adviso,es 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: In No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ® Embargo ❑ Emergency Closure (] Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically lack of 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 non-critical. . If critical water,sewage back-up,infestation of rodents or insects,or la 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address yiolations observed,7 to 8rion-critical violations. 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC s Si ure Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* L 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 79 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45°F 590.004(F) EMPLOYEE HEALTH.. 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage*Applicants* 3-302.11(A) Food Protection* P g 7-202.11 Restriction-Presence and Use* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdultereted or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( P * 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1 g Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Egg_s-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed W Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 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 Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10K2-301.14 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 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* Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 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* 11Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Eatin Drinkin or Usin Tobacco* * Requirements. 5ReceivinglCondltion g g g 3 403.11(A)&(D) PHFs 165°F 15 sec3-202.11 PHF's Received at Proper Temperatures* . 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 foodbore 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 205 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Coolie Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) g 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000• *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. y ✓� Date: 2- .21 Page:THE r TOWN OF BARNSTABLE HEATH INSPECTOR'S Establishment Name: vC /� l n� P g _ of OFFICE HOURS 'N E oi PUBLIC 0 MAIN STREET 8:00-9:30 A.M. AR 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p 659;a 0� HYANNIS,MA 02601 - MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY. rFo P. 508-862-4644 M. FOOD ESTABLISHMENT INSPECTION REPORT F Name V Lk �� Date a of T Ins ec ion a Address q K 7 �l u�n c-� Risk ood Servi Re-inspection IJr2JA am Q f J '� r Level7etait� Previous Inspection Telephone Residential.Kitchen Date: rc� Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness j W� 2 f 6 e r /, Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP i J -}v �.�'-t In: Other Inspector W- �� Out: -9- 7 Q v k. / ; vj Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate 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 I Critical(C)violations marked must be corrected immediately. (blue&red items) l 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. 0,Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590:004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. .5 E ui ment and Utensils FC-4 590.005 6=One critical violation and-less than 4non-critical violations 9 q P ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if no hot 26.water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of X 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you'have a right to a hearing. Your request must )( ) be in writing and submitted to the Board of Health at the above address violations observed, to 8non-critical violations. If 1 critical refrigeration.. 28.Poisonous or Toxic Materials ... FC-7 590.008 9 violation,4 to 8 non c itical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 1. 30.Other PATE OF RE-INSPECTION: Inspe is Signature Pri t: 31.Dumpster screened from public view c S 0 'V- Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N ignature Pr Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N \D �- 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* 8P3-302.11(A)(2) Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH Raw Animal Foods Separated from Each * 590.004(F) 7-101.11 Identifying Information-Original Containers 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 11 Restriction-Presence and Use* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility of A Food Employee or An 7-202. 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* i 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* � 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR i 3-306.14(A)(B)Resumed 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 I 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11 A(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 crave uvzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency r f Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan I Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS z Stuffing Containing Fish,Meat,Poultry or 590.009 A - D Violations of Section 590.009 A - D in cater- . 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( ) ( ) ( ) ( ) Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(I)(b) All Other PHFs-145°F 15 see* Other 590.009 violations relating to good retail � 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g� g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23.30) 3-202.1 Package Integrity Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands * 3-101.11 Food Safe and Unadulterated 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction Temperature Ingredients to 41°FAFF 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* ' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 - Reduced-Oxygen Packaging Criteria* i 8-103.12 Conformance with Approved Procedures* S:590Formback6 2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.0010. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. °p THEA TOWN OF BARNSTABLE HEALTH INSPECTOR's Establishment Name: OciLk T,14 /�✓�/ Date: 1. Page: of 'YI IOFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. 8. MON.-FRI. .ew• .• HYANNIS,MA 02601 soa-862-46aa No Reference R-Red Item PLEASE PRINT CLEARLY �'FON1P�� FOOD ESTABLISHMENT INSPECTION REPORT _ Name _ vh Date a of f Inspection r outi r- Address ' Risk Food Servi inspection Am Level � Previous I spe ion VA1,( Telephone Residential Kitchen Date: ��y[O 6 �� C Mobile Pre-oper do Q Owner HACCP Y/N Temporary Suspect Illness G V� Caterer General Complaint rL Person in Charge(PIC) Time Bed&Breakfast HACCP u1,,da In: Other Inspector Out: r n/ V • S of �� rV � Zce- ik 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 n�C o T ) Anti-Choking 590.009(E) ❑ ( Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ I ,,4U"? L-P-C(Q WQf-,e O Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ t d,t d d s7ev, FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities r EMPLOYEE HEALTH PROTECTION FROM.CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ) ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories (J Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No Non critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the Items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,.results in an F. 25.Equipment and Utensils 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 t if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (F.C-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violat' 8 o -critical violaions=C. 30.Other DATE OF RE-INSPECTION: Inspect 's Sign Pr 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 Sig r Print, r Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT -PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding_ 2-103.11 Person-in-Charge Duties - - - 3-302-.14 Protection-from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) * - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person in-Charge to - _ Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* _ 7-201.11 Separation-Storage*P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15- Washing Fruits and Vegetables _ 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements - 3-304.11 Food Contact with Equipment and Utensils * ( ) 9 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR . - 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) I Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* 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* l Concentration and Hardness* 3-401.11A(l)(2) Eggs-155`F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 1112001 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g. g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 Conformance with Approved Procedures* i S:590Fonnback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. r „ 1 rW IKE tp Barnstable bl t f B Town of y� 0� N-Ame9cacity BARN MASS. • Board of Health 1 I 9 ASS. � PrFD MAt A' 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. February 29, 2012 Mr. John Green Duck Inn Pub 447 Main Street Hyannis, MA 02601 RE: Variance to Operate with three Restroom Facilities — Duck Inn Pub Dear Mr. Green: You are granted a variance to utilize the existing toilet facility for the operation of a food establishment at Duck Inn Pub, 447 Main Street, Hyannis. The variance granted is as follows: Section 322-4 Toilet Facilities To utilize three restrooms in lieu of the requirement to provide four separate toilet facilities, one each for male and female patrons and one . each for male and female employees. The variance is granted with the following conditions: (1) Seating is limited to 81 seats. (2) This variance decision letter shall be posted on the wall adjacent to the food permit in an area which is easily accessible to be read by a health inspector anytime routine inspections are conducted. (3) This variance is not transferable to anyone other than the applicant. In the event that this business is sold or transferred, both the owner of the building and the licensee have the duty to inform any and all potential purchasers of the existence of these variances and the fact the Board has explicitly made them non-transferable. Sinc ly yours W; yn Mill r, M.D. Chair an Board of Health Town of Barnstable 0:\WPFILES\Food Var Toilet Duck Pub Inn 2012.doc • ��ps Toyy Barnstable Town of Barnstable + BARNSrABLE, + 9�Pr 63S. A`eg Board of Health fb 39. 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. September 10, 2011 Mr. Sandeep Patel Duck Inn Pub 447 Main Street Hyannis, MA 02601 RE: Variance to Operate with three Restroom Facilities — Duck Inn Pub Dear Mr. Patel: You are granted a variance to utilize the existing toilet facility for the operation of a food establishment at Duck Inn Pub, 447 Main Street, Hyannis. The variance granted is as follows: Section 322-4 Toilet Facilities To utilize three restrooms in lieu of the requirement to provide four separate toilet facilities, one each for male and female patrons and one each for male and female employees. The variance is granted with the following conditions: (1) Seating is limited to 81 seats. (2) This variance decision letter shall be posted on the wall adjacent to the Mood permit in an area which is easily accessible to be read by a health inspector anytime routine inspections are conducted. (3) This variance is not transferable to anyone other than the applicant. In the event that this business is sold or transferred, both the owner of the j building and the licensee have the duty to inform any and all potential purchasers of the existence of these variances and the fact the Board has explicitly made them non-transferable. Sincere yours, Wayne Miler, M.D. Chairman Board of Health Town of Barnstable Q:\WPFILES\Food Var Toilet Duck Pub Inn 2011.doc ^41 t 0 DATE �Z '�� // OF tHE TOE o FEE PD. - h Town of Barnstable BARNSTABLE ' CHKLST(1-14) 9�0 039. �� Regulatory Services Department prfb MA'S A 200 Main Street,Hyannis MA 02601 APPLICATION FOR OUTSIDE DINING/SIDEWALK CAFE LOCATION Name of Establishment: Establishment Address: M g/*I Ibla tuns !V►o APPLICANTS NAME: � PS„ � Phone# SEATING � .j FACILITIES/EQUIPMENT Total#of Seats Existing #of Restrooms Provided .3 Size of Grease Trap sp 1-4 f Total#of Seats Proposed °'�°"� Air Curtains(Yes or No) VAS (Total means overall number of seats indoors plus outdoors) Hose Bib (Yes or No) Screens (Yes or No) Brief Description of Seating Arrangement,Type of Furniture Proposed,Hours of Operation,Projected Opening and Closing Dates 1-�-�� n�id.l2 e�rv•-s of 3-�� s .-)-�-'�t _ O^JL- "I' C(e tioad LV e n A -eS'J wd4( /04 Z Uwe the undersigned certify that the above information which Uwe provided is correct. Uwe have read and fully understand the Town of Barnstable Code Chapter 322 and further understand that fail-Lire to comply with said procedures may result in the immediate revocation of this permit. Signature ofApplicant(s): Date; Date: IMPORTANT-PLEASE RENfEMBER TO INCLUDE: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation Distances to Curbing, Trees,Rubbish Containers and any other Obstacles in Pedestrian Walkway . 3 Copies of Pictures of the Proposed Outside Dining Location(Front and Side Views) 1 Copy of the Menu FOR OFFICIAL USE ONLY Town Manager Approval: Public Health Division: Licensing Board Approval: Certificate of Insurance: License Agreement: Comments: Q:\Application Forms\OUTDNAP.DOC A. r� 32'-5. Ouidoor dining: Checklist. Instntctions: Please read the following requirements for outdoor dining. Place a checkmark on each line next to the number which you meet the criterion of. If you do not meet the criterion or if you are unsure,leave it blank. A. No person, corporation, or firm shall provide outdoor dining or an outdoor cafe at a food establishment until after all of the following requirements are met: (1)The applicant shall file a written request for outside dining or for an outside cafe on a form prescribed by the Town and shall submit plans of the proposed dining area.The seating capacity shall be determined by the Board.of Health after a determination is made whether requirements of Subsection A(2)through(14)below will be met and after a visual inspection is conducted by an agent of the Board of Health. A replacement food establishment permit shall be issued by the Board of Health indicating outside dining is permitted and listing the overall seating capacity, only after it is determined by an agent of the oard of Health that all of the requirements Subsection A(2)through(14) of this section are met. (2) A menu shall be submitted to the Board at the time of application. (3)The dining area must be appurtenant and contiguous to the restaurant property. The dining area must be mentioned on the described premises as in the case of a common victualler's license. (4) Sufficient restrooms,both for customers and employees,must be furnished counting the additional outside seating as required by the State Plumbing Code and Town of Barnstable Health regulations. (5) A grease trap shall be of sufficient capacity,based upon 15 gallons per seat, as required by the State Environmental Code,Title V, and Town of Barnstable Health regulations.A grease recovery device may be installed to supplement an exis ' g in-ground grease trap, after receiving the approval of the Board of Health. 6)All entrance and exit doors used by food service personnel and customers must be screened and provided with air .curtains meeting National Sanitation Foundation standards.All windows or openings used for the transfer of food will be screened and provided with air curtains. Food cannot be stored or kept outside.All food must be prepared inside the facility's kitchen and kept inside until served. (7)A drainage system designed to eliminate odors will be required for all outdoor dining areas.Hose bibs with vacuum br;��Ie rs must be available for washing down the dining area. 8)Trash dumpsters shall be situated no closer than 50 feet from an outdoor dining area. If such a dumpster is in the line of sight from the dining area, it must be hidden from view. The area around the dumpster and stockade must be kept clean and free of litter.Dumpsters must be closed with adequate covers designed to prevent entrance of rodents and birds and sealed to con 1 odors. V (9)The patio or other ground surface must be of constructed of material readily cleanable and not susceptible to dust, mud, or debris. (Brick, tile, and concrete are examples of acceptable materials.) —u-60)Table tops must be smooth,nonporous, easily cleanable and durable,and readily maintained in a clean and sanitary condition. c/ (11)Food-service personnel must constantly police the dining area for wastepaper, garbage and other trash. Placement clips, cup holders and other such devices must be utilized to prevent blowing paper. Covered trash receptacles must be provi ed in close proximity to the dining area and must be emptied as needed to prevent overflowing. (12) Strict cleanup practices must be adhered to.Waitstaff and buspersons must clean up after each patron as in indoor 3ining. Each establishment must abide by all regulations contained in Article X,Minimum Sanitation Standards for Food Service Establishments, of the Commonwealth of Massachusetts, Department of Health Sanitary Code. ✓(13) Outside food handlers must have easy access to handwash sinks and cleaning cloths.Facilities for preparation and iU14)H 1 of sanitizing solutions must be accessible. air nets or other effective hair restraints, such as hats covering exposed hair, shall be worn by all outside food or irink handlers. Beards and mustaches must be neatly trimmed. B. Exemption from doorway air curtain requirement in Subsection A(6) above: The Board of Health may waive the requirement to provide air curtains_at the doorways only if no waitstaff services will be provided to the outside dining area(self-service only). Q:Application FormsIOUTDINAPCHECKLIST.doc 154 Sf.Ft.0 2 Occupants � 7 .695 SF.Ft.0 1 5sf.-42 Occupants �.i t 7 o Sf. 0 PL•9sf.-96 occupants 4- 71, 1 Q Egress Path 96'dear IL Gq Total Occupants Interior E Z PATIO 1 680 5f.Ft.0 1 5sf.-44 Occupants • I y- L EJC... I 1 ® 'C �•. V I/ Table t 000.1.3 Maximum Floor Area AlaWances per Occupant Q ° ® r I'— Assembly u4thout fixed seats: Standing Space' 3 s f:net e Concentrated(chairs ome-not fixed) '1 s.f.net 't V. Unconcentrated(tables and chairs) 15 s.f.net m Illuminated Exit sign �- -.;,:;;-- ..:: --i 1 5�:.. Z "I.Ffi�.. V Q /.w.q• ^b 4 r 1 l'�•s w 4tii.r 1 -..I- r+S-' y y. 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Lq A rPUP �—�--- IL ----------------- �- caota"i' r----------- --- LL N � J 6y, soup Crab Cakes-Two hand-made crab cakes filled w/ Grilled Chicken Sandwich-Fresh chicken breast New England Clam Chowdah-$5.99 fresh crab meat,and our own secret blend of minced marinated and grilled to perfection w/ lettuce, Lobster Bisque-$9.99 vegetables and seasonings, beer-battered,fried tomato, onion and basil sour cream on a fresh and presented on a bed of baby spinach w/a spicy ciabatta square-$9.99, add cheese-$1.00 SALADS remoulade sauce-$12.99 Traditional Caesar Salad-Crisp romaine lettuce w/classic Caesar ingredients.Anchovies?just.ask!- SANDWICHES $6.99 Add:Chicken-$4.99, Lobster Salad-$9.99, Served w/lightly seasoned curly fries, or red bliss potato PAN I N I Shrimp-$7.99 Steak Tips-$6.99or Crab Cake-$6.99 salad and our own hand-made tole slaw on your Hand-pressed on freshly baked sourdough and served Walnut Chicken Salad-Walnut-encrusted chicken choice of bread:Kaiser roll, white sourdough, w/lightly seasoned curly fries or red bliss potato salad breast over crisp mesclun greens,red onion, bleu wheat, or a ciabatta square and our own hand-made tole slaw cheese crumbles,fresh sliced Granny Smith apples& The ABC-Crisp sliced Granny Smith apples, The Cape Cod Reuben Panini-Fresh local juicy strawberries w/ balsamic vinaigrette-$13.99 applewood-smoked bacon and Wisconsin cheddar haddock fried'til golden topped w/ house-made The Wedge Salad-Crisp iceberg lettuce,Gorgonzola cheese-$8.99 coleslaw, imported Swiss cheese and thousand island cheese,grape tomatoes,applewood-smoked bacon Lamb Gyro*-Rosemary and garlic roasted Iamb w/ dressing-$11.99 and red onion served w/ bleu cheese dressing-$7.99 creamy cucumber&garlic tzatziki sauce,chopped The Cuban-Pork, ham,chorizo,Swiss cheese, Thai-Chicken Caesar Salad-Topped w/crispy oriental onion,diced tomatoes and Feta cheese on warm pickles and our own zesty house-prepared mustard noodles&Thai-peanut chicken skewers-$12.99 hand-stretched flat bread-$10.99 sauce-$9.99 The Main Street Hot Dog-100% beef w/ natural Roast Beef Panini-Hand-sliced-to-order roast beef STARTERS casing on a grilled buttered bun w/ pickle-$4.99 w/Wisconsin cheddar cheese,tomato,applewood- Cooked-to-Order Shrimp Cocktail-w/home-made The Big Ham and Cheese-Sliced-to-order smoked smoked bacon and barbecue sauce-$11.99 cocktail or spicy remoulade sauce-$1.99(each) ham, Provolone cheese,applewood-smoked bacon, Grilled Buffalo-Chicken Panini-Grilled-to-order sliced pickles,drizzled w/clover honey-$8.99 fresh chicken breast tossed in our own buffalo sauce Pork&Vegetable Potstickers-Steamed or pan-fried Lobster Roll-Succulent fresh lobster meat tossed w/ topped w/Gorgonzola-$9.99 in sesame oil served w/a soy dipping sauce-$8.99 light mayonnaise and our own blend of seasonings California Turkey Panini-Fresh sliced-to-order Baked Brie-Deliciously baked Brie cheese topped served on.a grilled buttered hot dog roll w/fresh field turkey breast, ripe tomatoes, imported Swiss cheese w/caramelized maple walnuts and roasted garlic greens& pickle chips-$14.99 and avocado-$10.99 served w/warm seasoned pita bread&fresh fruit-$11.99 A huge double order only-$25.99 Stuffed Quahog-A local favorite chock full of fresh The Duck Burger*-A massive 10 oz. 100%certified- chopped quahog and New Bedford chorizo. Angus ground-beef hand-pressed patty grilled to The rest is a secret!Served w/ butter& lemon-$4.25 perfection and served on a grilled Kaiser roll w/field ENTREES Fried Pickle Chips-Every once in a while a genius greens, ripe tomato, red onion & pickle chips-$8.99 Fish&Chips-Fresh local haddock beer-battered'til move in food history happens.This is one of them: , Add cheese, bacon, baby portabello mushrooms, juicy and golden brown on a bed of lightly seasoned fresh crisp beer-battered dill-pickle chips deep fried sauteed onions or peppers(or anything else)-$1.00 each curly fries w/ house-made tartar sauce and our own til golden.Served w/a home-made honey-mustard Fresh Mozzarella&Tomato Sandwich-On toasted coleslaw-$13.95 horseradish sauce. Not to be missed!-$7.99 sourdough w/oil, pesto and baby spinach-$8.99 Sirloin Tips*-A huge 1 pound portion of 100% Wings over Buffalo-A full pound of our soon-to-be- The PLT-Prosciutto(imported Italian thinly sliced certified-Angus beef tips grilled to perfection and famous wings,deep fried'til golden and served plain, cured ham) ripe beefsteak tomato and fresh field prepared the way you like:barbecue, bourbon,or mild, hot,four-alarm or Cajun garlic-$8.99 greens served on a toasted ciabatta square w/a side smothered in Gorgonzola cheese sauce and served w/ Boneless Chicken Tenders-A heaping portion of of our own pesto-infused mayo-$8.99 curly fries&tole slaw-$17.99 Grade-A chicken tenders breaded, deep fried and The Cape Codder-Only the freshest local haddock, served plain,mild,hot,four-alarm or Cajun-garlic-$8.99 beer-battered and traditionally prepared served s: Lobster Deviled Eggs-Six hard-boiled egg halves golden brown on a toasted Kaiser roll w/fresh field filled w/our own lightly seasoned egg yoke and fresh greens,tomato and a side of our house-made tartar *Consuming raw or under-cooked meats,poultry,seafood, lobster center topped with fresh caviar-$10.99 sauce-$9.99 sheltIish or eggs may increase the risk of food-home illness. KIDS MENU o s Grilled Hot Dog, nrle �}d Hamburger*, Cheeseburger*, A Kid's Fish & Chips, Grilled Cheese, ci�d`a § ._ Chicken Fingers, or aFluffernutter Each meal comes w/ your choice of apple slices, curly fries or red bliss potato salad I 6 sf= I l a 0 and includes a soda.—$6.99z900 N [ . .j Please inform your server of any food allergies. An 18%gratuity may be added to parties of G or more. Prices and menu items are subject to change. In the heart of Hyannis on the center of Main St you'll find the newly renovated Duck Inn Pub. Relax on our ' x spacious patio overlooking Main Street and enjoy one ; A I if l E d LA C01 do Y&I of our 8 draft beers,a tasty cocktail or something from our all new delicious menu. we have Keno all day but the Duck Inn Pub is the place to be in the evenings with a late night menu, great local bands and our popular i trivia night! Be sure to check our website or follow us Cape Cod's only upscale dive bur! on twitter for information about entertainment and special events. Our casual atmosphere, friendly staff and great prices are sure to keep you visiting the Duck Inn Pub again and again! Check us out on facebook, Google+ and twitter! Open 7 days a week from 8:00 am to 1:00 am ' Lunch begins daily at 11:30 am www.duckinnpub.com 447 Main St, Hyannis, MA 02601-3905 L/ twitter,* @duckinnpub.com 508-827-7343 affiff, Version 1.1 G.12.12 www.duckinnpub.com lit ,Ott ew England Clam Chowder Bowl Made with cream and butter, simply the best ! 4.95 6 Chicken Tenders or ctiv Wing Dings 7.95 Plain, Buffalo, Ranch, BBQ or Honey Mustard ' CC Half Rack Baby Back Ribs a Slow-cooked and double basted with our 8.95 Jack Daniels smoked BBQ Sauce ct-V Beer Battered Onion Rings 3.95 Served with our Honey Mustard Sauce ctJJumbo Coconut Shrimp 7.95ota" Served cocktail sauce r ; 6 Fried Mozzarella Sticks 6.95 ' Served with Marinara Sauce 3 Pork Wings 6.95 � Served with BBQ Sauce 2 Maryland Crab Cakes 1:95 Served with Tartar Sauce and Lemon ctiv__ r Basket of French Fries 1.50 House Garden Salad Mixed Greens .with Tomatoes, Cucumbers, Green Peppers, Red Onions and Croutons 3.95 Choice of Dressings u Ranch, Italian, Honey Mustard, Caesar, Russian, Raspberry Vinaigrette or , IER Bleu Cheese (add 50t for blue cheese) z � ,• .../' y � ' Z i tel u �€ itl _ thel Caesar Salad a Ronnie ham IJmnss aWS Crones; P'awed is Caesar Oreargt Ir .S� l Fu1I Rack it 6. 95 of Ribs r ` 18 . 95 Grilled Chicken Caesar -=- 1 8. 95 1 /2 Rack of ~'4/ y Lobster Caesar Ribs Market Price 1 2 . 95 '` 8 oz. Sirloin Steak /vk�; Island Bay Caesar 12.95 _ -' 10. 95 Marinated Tenderloin Tips it 12.95 u Cobb I$ a a d Above served wits fresci frier r Grilled Ciicfes tossed isto.. and Cole flaw /� Mixed Greens, Tomatoes, Cromhled Olne ,*kl a Cieese, freei Avocados, Onions, and 1 ' Ciopped Bacoe - QQSS .: 1os add vY ess eer favorite dris a SQSQ//F / nd Duckwt'-- / b / 9. 95 Peanut Butter and Jelly 2 . 95 ' 'kP, Fish and Chips d'X d . 0 o.0 9. 95 i ti _ - . � Hot Dog '= ^ 417 Maryland 3 . 99 Crab Cake Dinner " 0 14. 95 j Served wits fresci fries and Grilled Cheese Cole Slaw 3 . 99 r % Fried Clam Roil Fried Scallop Roll Macaroni and Cheese ' Only is Season and wies Arailahle 3.99 llarhet price is Served wits french fries and Cole Slaw Kids Chicken Tenders 3.99 '. Broiled Seafood Osr lick Dick!leak u �'- with Casserole "' "'. Freon Fries , Scrod Lobster, Naotochet Scallops, Small benrAle and Si ri m pAu add bda dessertf 14. 95 Check our Chalkboards for a'f our daily specials t aGt It- ll lr 1'4 l7 U U ti- lI A-71 U U ., �1 t-5 to- Wd1w A ._ specialty Just the Burger j, ` our SP 7 . 95 of the best ,s lb* sirloin b++rgers Cheese Burger Till ed / hid pack time �. fo110vj extra orders 8 . 95 a 0 well doneDouble Decker " 11 . 95 L Lettuce, Tomato & Onion available upon request =LL choice of Arceritao,Swiss.or meddu cheese . U Burgers tpme with Fred Fries Add 50¢for additional toppingsQ V Bacon , Mushrooms or Grilled Pepper and Onions �.Grilled Reuben tn 6. 95 Grilled Ham and Cheese •�ram' I` 5 . 95 Sliced Roast Turkey C - 6. 95 r Grilled Hot Pastrami 6. 95 Fried Fish Sandwich i . to 6 . 95 Grilled Jumbo Hot Dog , 3.95 Grilled Chicken Sandwich % Choice of Honey Mustard, BBQ, Cajun , Raspberry, Caesar or Teriyaki 7. 95 , !' d BBQ Pulled Pork Sandwich tk k l u 7. 95 Steak and Cheese Sub ` 7. 95 a Steak Cheese Bomb ( peppers , onions and mushrooms ) u 8 . 95 z Fresh Lobster Salad Roll t Ai ( Fresh Maine Lobster Meat in I d Mayonnaise , lightly seasoned and served in a s geilled New England Hot Dog Roll) Market Price and when available t' All Sandwich ' s come with Pickles and Ca Potato hi pe Cod P o a o Chips Side of French Fries . SO( ' Side of Onion Rings . 75f !" r. Bread Choices fh 4 �. Kaiser toll. White. Wheat or Marble Bye - �. .. ' t�r�r; t L t \j STARTER NDw,UnBland Clam ,Dyed-gT Made with cream&butter-Simply the best! Cup 3.50 / Bowl 4.99 b 'Chic -pn Tpndfl?-q or Wing Dings Plain,Buffalo,Ranch,BB Q or Honey Mustard 8.99. I aff Race:of-Sabg Back RIbe Slow cooked and double basted with our Jack Daniels smoked.BBQ Sauce 10.99 Pgc-T Paflgr-cd Onion Ringq Served with Honey Mustard sauce. 3.99 5 JUm,bo Cueunui gh7lmp Served with Cocktail Sauce 8.99 L FTIpd" A -ofla -2 -kg Served with Marinara Sauce 7.99 a? � 3 ab C2kgs Served with Tartar Sauce&lemon 8.99 Ba Dn 1,11/rappgd gp-alkps Served with homemade Teriyaki dipping sauce 8.99 i FTI Pd IamarI RIngP. Served with Marinara.Sauce 7.99 � � � I n Served with Sour Cream 7.99 9t6d Quahog Served with butter&lemon 3.99 PUB BURGERS SANDVUICM A X pound of the best hand packed sirloin. . All sandwiches come with pickles and Cape Cod Potato Chips Ali burgers come with a side of fries. Jugf 1hig B- UTgQr 7.99 CriNgd Ro—ubGn Served on Rye bread 7.99 ' �P-Qgo- BuTTgQY 8.99 'TI � � � 7.99 Duubho- D,,P-kPT 7.99 9]jP-,Qd Rose' Tu1Tkpg with lettuce&tomato 7.99. 7 I�J7 2andYOeh Served with French Fries 7.99 fonsumption of raw of uncooked meat ruh,pail/try of eggs may fnaease your risk of food home dines. Before plating par order please inform your server If anyone in your party has a food allergy DUCK I�1N R]ESTA T & PUB PUB BURGERS & DOGS FROM THE CHAR BROILER A X pound of the best hand packed sirloin. All served with seasoned fries&coleslaw All burgers&dogs come with a side of fries. Just the Burger ti ry Marinated Tenderloin Tips Cheese Burger Veggie Griller Grilled Jumbo Hot Dog e FROM THE GARDEN Garden Salad ; . Caesar Salad Romaine lettuce,parmesan cheese, _ croutons& Caesar dressing Your choice of dressing,:Ranch,Honey Mustard,Caesar,Russian,or Raspberry Vinaigrette.Blue Cheese available for-$Q- ><TTLE DvcxS & DUCKEWS Our little duck meals com&WIth fries, small soda&`kid's dessert. i Kid's Hot Dog 4.99 Grilled Cheese 4.99 Macaroni:& Cheese 4.99 y m, Kid's Chicken Tenders 5.99 Hainburger or Cheeseburger 5.99 :D w ter_' •: �r Coaruoplion of raw of narnoked mrat, firh,poultry or eBg may krfeme year rok of food borne Amu �Q Before plaanq your order plaue xform your terrer if amone moor party hay a food allerty U CK INN REST. `T' ---------------- STARTERS New England Clam Chowder Made with cream&butter—Simply the best! Cup ^ / Bowl =� 6 Chicken Tenders or Wing Dings Plain,Buffalo,Ranch,BBQ or Honey Mustard Beer Battered Onion Rings Served with.Honey Mustard sauce . 6 Fried Mozzarella Sticks Served with Marinara Sauce .Potato Skins Served with Sour Cream Homemade Fries � a SANDWICHES WRAPS All sandwiches come with pickles and Cape Cod Potato Chips. All wraps come with pickles and Cape Cod Potato Chips. Bread choices:White, Wheat or Rye Grilled Ham& Cheese Tuna Wrap Sliced Roast Turkey with lettuce& tomato BBQChicken Wrap Fried Fish Sandwich Served with French Fries Buffalo Chicken Wrap, Steak& Cheese Bomb With peppers,onions, mushrooms Honey Mustard Chicken Wrap ` Turkey Club Wrap Duck Inn BLT Wrap Ham & Cheese Wrap Consoapflon of raw or mcmied meat, &h,poultry or eggs qy i azue year rick of food borne Amu. Before phane yoor order please mlbnn your wirer if anyone in roar early hat a food alkerey Y DATE �fTHE Tp�,_ Town of Barnstable FEE PD. aaxiv SUBM ' CHKLST(1-14) 1659. �0m Regulatory Services Department 200 Main Street,Hyannis MA 02601 APPLICATION FOR OUTSIDE MING/SIDEWALK CAFE LOCATION _ Name of Establishment: -D" `t �tJ'4 cV 'Zz' Establishment Address:__ 4q M Ei 4 St. M/AlJ1'J S APPLICANTS NAME:14E rb i.(` '`a«21=E i fRil Cos, Phone# SEATING FACILITIES/EQUIPMENT Total#of Seats Existing -�j #of Restrooms.Provided Size of Grease Trap Total#of Seats Proposed _ Air Curtains(Yes or No) '1(E5 (Total means overall number of seats indoors plus outdoors) Hose Bib (Yes or No) Y 1_S Screens (Yes or No) DES Brief Description of Seating Arrangement,Type of Furniture Proposed,Hours of Operation,Projected Opering and Closing Dates �iTLt�i yZ CYt"�2tyi2 Fi.(iZiJ i+ �� g — ( NIL _I"I OtRTZS Ylt� 1\tic eV t� I/we the undersigned certify that the above information which Uwe provided is correct. Uwe have read and fully understand the Town o ode Chapter 322 and further understand that failure to ly with said procedures ma in the ' diate revocation of this permit. , Signature of Applicant(s): - Date: Date: IMPORTANT-PLEASE REMEMBER TO INCLUDE: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation Distances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedestrian Wall way M 3 Copies of Pictures of the Proposed Outside Dining Location(Front and Side Views) 1 Copy of the Menu FOR OFFICIAL USE ONLY Town Manager Approval: Public Health Division: Licensing Board Approval: Certificate of Insurance: License Agreement: Comments: MIIIYr �IFI. ■If s � ..•. 4l� Wltlr� -i' .. Mf1YMY' iAlriF .._ •, _ - - • i !i 1.. � � i �� !- � 1 - ti li ! !- t ■■ ti ! IN an Bill MIN IN IBM li Nil `, t �, -: - � M 1�r ,��."�� 1: �� M el�. - - ,•-1�11� 1:� � iL-i!. 1�—tl�11IMIN a ! �� a ... �l-�� .�► a:./-i� � �:��:: �- �! ,. .- /-N�itl �i �. 1.. �i!��`Ih'!1i1�i �:' liI•�' "t ! 1.� - 1.�� M.. 1.. ►.. 1 1 �t�-I:r�t �i'1�. 1 � i i ii t �..� -� ! r/�.�t,._;_..�li� �"',�1 ��! ■M.."�l..■ ■ ■��■!� �,��••■ ■ ! .�'1 �li 1.. lip -..af'1r,1:$; ..� iq cn t?a 'r if lk....:�..a� F.x:;.,„3 ....�i:i.a... ,;y W:a. � _x,...:,.1_t,..a r L4„.M,�a. .t"a:-�-- x':` _ -I sz•_•x: .y� :-.,ia:�..k.- �.�.,."�14_.ii-. -m.%.c Ste. � — '-y 1 DATE oftwe rp� FEE PD. Town of Barnstable • BMWSTABLE. ' CBYLST(1-14) 9$ 16 9. �� Regulatory Services Department .200 Main Street,Hyannis MA 02601 APPLICATION FOR OUTSIDE DINING/SIDEWALK CAFE LOCATION Name of Establishment: 3Ju.Ctit -IjVcy Establishment Address: 447 j 6 i -G�!- ; 1 Y/A.&)io 15 s APPLICANTS NAME:#£ t11 LL �«2 6 i fi�LSrig oi~e Phone# '56 S SEATING FACILITIES/EQUIPMENT Total#of Seats Existing #of Restrooms Provided Size of Grease Trap Total#of Seats Proposed Air Curtains(Yes or No) -I�L'5 (Total means overall number of seats indoors plus outdoors) Hose Bib (Yes or No) Y 1=S Screens (Yes or No) -1 E5 Brief Description of Seating Arrangement,Type of Furniture Proposed,Hours of Operation,Projected Opening and Closing Dates .s 71 C�t c�iZ �cr'�Rta2 Fu2+J t LAJK - 4—)L)o-O ES ~ I/we the undersigned certify that the above information which Uwe provided is correct. Uwe have read and fully understand the Town of B �Code Chapter 322 and further understand that failure to comply with said procedures may re t the ' to revocation of this permit. tt Signature of Applicant( . Date: 7 Z f Z Date: IMPORTANT-PLEASE REMEMBER TO INCLUDE: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation Distances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedestrian Walkway . 3 Copies of Pictures of the Proposed Outside Dining Location(Front and Side Views) 1 Copy of the Menu FOR OFFICIAL USE ONLY . Town Manager Approval: Public Health Division: Licensing Board Approval: Certificate of Insurance: License Agreement: Comments: l� Bellaire, Dianna From: McKean, Thomas Sent: Wednesday, October 02, 2019 12:06 PM To: Bellaire, Dianna Subject: Re: Duck Inn Pub It can be removed. From: Bellaire, Dianna Sent: Wednesday, October 2, 2019 10:16 AM To: McKean, Thomas Cc: Bellaire, Dianna; McKenzie, Marybeth Subject: FW: Duck Inn Pub Tom; Please read this variance below for the Duck Inn and let me know if it should stay on the permit. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire @town.barnstable.ma.us From: McKenzie, Marybeth Sent: Tuesday, October 01, 2019 8:40 AM To: Bellaire, Dianna Subject: RE: Duck Inn Pub Same thing- I think you need to speak with TM and see what he wants to do. From: Bellaire, Dianna Sent: Monday, September 30, 2019 11:56 AM To: McKenzie, Marybeth Cc: Bellaire, Dianna Subject: Duck Inn Pub Hi Marybeth; This is also another one with a toilet variance. Please let me know if it needs to be on the permit. MUST POST VARIANCE LETTER. August 23, 2012 -Granted toilet facility variance, 3 toilet facilities in lieu of 4 requried for the 81 seats. Dianna Bellaire Permit Technician Town of Barnstable t A' �Pyo T ETo�o TOWN OF BARNSTABLE m OFFICE OF Daa!lTSDL i BOARD OF HEALTH MMl naY 167 MAIN STREET HYANNIS, MASS,02601 p V,;d J July 12, 1990 ram^ �jc� UfrH�� Burton H. MacLeod Candlelight Motel 477 Main Street Hyannis, MA 02601 Dcar Mr. MacLeod: You are granted a conditional variance from Regulation 14, of the Town of Barnstable Health regulations, to have outside dining at Candlelight Motel, 477 Main Street, Hyannis, Ma., with the following conditions: (1) You must submit a plan of the outside cafe' area including locations of seats, sinks, screen doors, air doors, hose bibs, and drainage areas. (2) The dining area must be set back at least ten (10) feet from the sidewalk, driveway, and parking lot. (3) You must meet all of the criteria contained in paragraphs A through O, of the Board of Health criteria for variances for outside dining. 'Failure to do so will result in revocation of your outside dining privilege. (4) You must install air doors and screen doors on all doors and apertures used in serving food or drink. (See paragraph a of the criteria for variances.) (5) The overall seating capacity cannot exceed 66 seats. (6) You must receive approval of the Town of Barnstable Licensing Authority. The Board reserves the right to terminate your outside dining should any unsanitary conditions be observed. A copy of the criteria for granting variances for outside dining is enclosed. Strict compliance with this criteria is required. Very truly yours, Orover C. M. Farrish, M.D. Chairman O 7 1 (. ARU OI 1lEALTH TOWN OF BARNSTABLE 9I GF/bs i?nclosure F, �p;THE rti DATE: FEE: f + BARNSTABIZ 9 MASS. i6gq. REC. BY �E039 & Town of Barnstable SCHED. DATE: Board of Health 367 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: 441 N..f�r u•• ' ��'� -(roc P 06j t,S Assessor's Map and Parcel Number: ?0 g-U3-71 ace) Size of Lot: �� 5 Wetlands Within 300 Ft. Yes Business Name: SS Subdivision Name: — •v.�u..pu �{ow4� h � APPLICANTS NAME:BA-A. �p��tol) u,g J.�w� Phone Z 71 Sol 6 m Did the owner of the property authorize you to represent him or her? Yes ✓ No PROPERTY OWNER'S NAME CONTACT PERSON Name: %C-1A iLb L 0AskQ°"- k�0 JA%, VU�tA h Name: Ak j ,-. l I-tD 61�JLO Address:��o (2 �a, `.��}.y�tr+ S Address: Phone: :> I —Sy(a, Phone: 1 b VARIANCE FROM REGULATION(List Res.) REASON FOR VARIANCE(May attach if more space needed) Ro 1rl ti3t`t Co... sF a�a.01�G.• �t-i�_ C+�k >n o e� ,�Ru ict 1✓S is�v�. i a•• •C3 vs �lc 't�we or.e�..a,3�a A�.S 0. o lie a o 9 cs o .,a, L,*.:. s.)b VVIL' 3 ova -1A- a o0 r,J tea. Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of engineered plan submitted(e.g.septic system plans) to O P P ( g P plans) Four 4 copies of floor plan submitted e. house tans or restaurant kitchen Sianed letter stating that the property owner authorized you to represent him/her for thi sir equest Applicant understands that the abutters must be notified by certified mail at least ten days prior to r et d date at applicant's expense(for Title V and/or local sewage regulation variances only), ' Full menu submitted(for grease trap variance requests only) MAR Variance request application fee collected(no fee for lifeguard modification renewals, tease variance renewals'same'ownedleasee only), "d q PP 4u s P [ Y].outside dining variance renewals[same ownedleasee only],and Gy. to repair failed sewage disposal systems[only if no expansion to the building proposed]) TOVN OF BARNS LB E ` HEALT4 CtP. Variance request submitted at leastprior to meeting date f VARIANCE APPROVED Susan G. Rask, R.S., Chairman ✓ NOT APPROVED Sumner Kaufman, M.S.P.H. REASON FOR DISAPPROVAL Ralph'A. Murphy, M.D. -'Q:/WP/VARIREQ L Assured Corporation Duck in Pub REQUEST FOR VARRANCE TO SMOKING REGULATION OVERVIEW ASSURED CORPERATION HAS TWO HBXs HOWARD JOHNSON's EXPRESS INN AND THE DUCK INN PUB WE WERE THE OLD CANDELIGHT INN WE ARE ABOUT 40 YEARS OLD WE HAVE AND INNKEEPERS LISCENSE WE HAVE ALWAYS BEEN A SMOKING BAR WE ARE NEXT TO THE HOWARD JOHNSON'S INN i OUR FOOD IS MOSTLY FREE OUR KITCHEN IS TINY AND SUPPORTS THE HOTEL FREE BREAKFAST THE PUB HAS ABOUT 50 SEATS WE HAVE AN OUTSIDE PATIO THE HOTEL HAS 40 ROOMS a � C A R L S O N & ASSOCIATES Financial Planning & Management March 17, 2000 Town of Barnstable Board of Health Town Hall Hyannis, MA 02601 To the members of the Barnstable Board of Health: We have been preparing the taxes for Assured, Inc. for approximately twelve years. The company owns and operates the Howard Johnson Inn and Duck Inn Pub located at 447 Main Street, Hyannis. In 1997, in order to stabilize the management and financial position of the corporation, the major stockholder transferred part ownership to his nephew and his wife. Both of these individuals have extensive management and finance backgrounds. Changes have been made especially in the restaurant area. Lunches are served only during the peak season; continental breakfast is during the week to guests only and weekends a breakfast buffet is served to guests only. It is an ancillary operation and is used only to support the hotel. Over the last three the years the pubs annual gross income is approximately $400,000 with beverage at 44%; lottery at 43%;tobacco sales at 9% and food at 4%. Food is a lost leader and it is used to develop sales in the pub and to service hotel guests. A significant amount of the food is given away in the form of snacks and appetizers to support the growth of other sales. Should you need any additional information regarding either the owners or financial status of the corporation, please do not hesitate to contact me at the number listed below. Sin erely, Toni G son 90 Route 6A • Sandwich, MA 02563 • 508/888- 2994 • Fax 508/833 -0312 f lottery ' "� � beverage I , tobacco food- food : j tobacco i paid for e ` ,'. : bar free I Assured Corporation Duck in Pub CUSTOMER PROFILE 65% MEN 20% WALK TO PUB 60% ARE SINGLE MOST ARE OF MODERATE INCOME MOST ARE OLDER ENGLISH/IRISH PUB WITH ENTERTAINMENT SPORTS MINDED WE HAVE 10 TV's OVER 300 REGULARS 50 VIEW US AS HOME AWAY FROM HOME LIVING ROOM ATMOSPHERE FOR MANY WHO HAVE SM APTS. FOOD IS MOSTLY FREE CHRISMASS WE SERVE A FREE FULL COMMUNITY MEAL THANKSGIVING WE SERVE A FREE FULL COMMUNITY MEAL OTHER HOLIDAYS WE SERVE A FREE FULL COMMUNITY MEAL SPECIAL SPORTS EVENTS WE SERVE A FREE FULL COMMUNITY MEAL BIRTHDAYS CELERBRATIONS EVERY NIGHT OF ENTERTAINMENT EVERY AM FREE HOTEL BREAKFAST EVERY PM FREE PUB APPITIZERS 4� nonsmokers f� 4r `' smokers r '4 4 YA Assured C9TPomtion Duck in Pub OUR AIR QUALITY PLAN HAS THREE COMPONENTS 1. SOURCE CONTROL WE LIMIT PIPE AND CIGAR SMOKING. 2. WE VENTILATE WITH NEW AIR WHERE WE CAN. 3. WE ENDEAVOR TO CLEAN THE EXISTING AIR. l. VENTILATION Rheem air cleaning system installed about 5 years ago by All Temp Plumbing and-ventilaxien temp ny-systern-with-44.--feet-of-duck wor-k-and six 8"vents. This system is directly over the south side of the bar. 2. AIR CLEANING Five Honeywell HEPA AIR-Cleaners; A. HEPA FILTERS HIGH EFFICIENCY PARTICULATE AIR FILTERS B. 360 DEGREE HIGH VELOCITY AIRFLOW C. 3 SPEEDS MOVES AIR TO 350 CFM OR CUBIC FEET PER MINUTE D. AMERICAN LUNG ASSOCIATION APPROVAL FOR AIR QUALITY EDUCATION E. CERTIFIED FOR 0.3 MICRONS ( TOBACCO PARTICLES ARE 1.0 MICRONS IN SIZE) F. CERTIFIED TO HAVE A MINIMUM EFFECTIVENESS OF 99.97%IN CAPTURING PARTICLES OF 0.3 MICRONS IN SIZE. G. FILTER EFFECTIVENESS 99.97 % H. AIR CIRCULATION 6 COMPLETE CHANGES PER HOUR I. 80% TOBACCO SMOKE REDUCTION VIA DETROIT AND PITTSBURGH TESTING LABS USED BY (EPA-NIOSH-OSHA-MANUFACTURIORS) J. RITER RESEARCH 1995 PHYSICIAN PREFERENCE STUDY 94%HEPA IS MOST EFFECTIVE- 73%RECOMMEND AS TREATMENT OF RESPIRATORY PROBLEMS- 89% RECOMMEND HONEYWELL _ . n1 ILA do 4 yv Apo �. CDoL EJt l b 8 m AOWA.Twerts-7 a � A� ExcST.rtri�. R. E,4- _ S�$" c`4kye of �/SCRip � i,Lpd Ai.�c✓ APP��rPn` ryN o o O O 010 SAC. ao, ,Pd. -,,OE f S FipE Ex►T3 .� O r 0 NC� v0 A rJ •9 a 7/ki Tog, P*apasr.D 'q O(CII-roN i Sc,97k ,b MAI&l v Tou.PEsT r2gn,p UP 6gdd Sceuot , duck Tivnr S/DEVALk NowgRD TONMsoro s i Please insert heading and ending. On March 7, 2000, you filed a request for a variance from the provisions of the Town of Barnstable Smoking Prohibition Regulation, which was adopted by the Board of Health on February 10, 2000 and becomes effective April 3, 2000. (See copy attached hereto as Attachment 1). In your request you stated that you believed that the Duck Inn Pub was a smoking bar within the meaning of the Board's Regulation. Pursuant to Section VI of the regulation: "[a]ny smoking bar in existence as of the first date of publication of the notice of the public hearing regarding this regulation may apply for a variance before the Board of Health from this regulation." Under Section III of the Board's regulation, a smoking bar is defined as: "An establishment whose business is primarily devoted to the selling of tobacco products for consumption by patrons on the premises and in which the serving of limited foods are incidental to the consumption of such products. An establishment which serves full meals is not considered a "Smoking Bar" for the purposes of this regulation. An establishment which serves appetizers and snacks may be considered a "Smoking Bar" for the purposes of this regulation." On March 20, 2000, a public hearing was held before the Barnstable Board of Health, at which time the applicant was given an opportunity to provide the Board with information in support of the request. The applicant presented information indicating that "(o)ver the last three years the pubs annual gross income is approximately $400,000 with beverage at 44%; lottery at 43%; tobacco sales at 9% and food at 4%." . (See copy of letter from Toni Gleason dated March 17, 2000 attached hereto as Attachment 2). The applicant also stated that full meals were served on the premises, including lunch during the peak season. The applicant stressed to the Board that the service of full meals on the premises was not a money making enterprise. Based on the information presented, the Board finds that the applicant failed to demonstrate that the Duck Inn Pub is "[a]n establishment whose business is primarily devoted to the selling of tobacco products for consumption by patrons on the premises." Rather, the information presented demonstrates that only a small percentage of your annual gross income is from the sale of tobacco products. Further, the Board finds that that full meals are served on the premises. Upon review of the evidence presented, the Board finds that you do not meet the criteria for consideration of a variance under Section VI of the Board's regulation. Accordingly, your request for a variance from the provisions the Town of Barnstable Smoking Prohibition Regulation is hereby denied. Sincerely, etc. Town of Barnstable " Board of Health i s # BMMSTABM 367 Main Street, Hyannis MA 02601 RFD MA'S A Office: 508-862-46" Susan G.Rask,R.S. FAX: 508-775-3344 Ralph A.Murphy,M.D. Sumner Kaufman,MSPH Richard Lindstrom Mr. Burton MacLeod Duck Inn Pub 306 South Street Hyannis, MA 02601 RE: Duck Inn Pub/Howard Johnson Express Inn Dear Mr. Lindstrom and Mr'.-MacLeod: Your request for a variance to provide an indoor smoking area at the Duck Inn Pub/Howard Johnson Express Inn after April 3, 2000 at 447 Main Street, Hyannis, is not granted. On March 7, 2000, you filed a request for a variance from the provisions of the Town of Barnstable Smoking Prohibition Regulation, which was adopted by the Board of Health on February 10, 2000 and becomes effective April 3, 2000. (See copy attached hereto as Attachment 1). In your request you stated that you believed that the Duck Inn Pub was a smoking bar within the meaning of the Board's Regulation. Pursuant to Section VI of the regulation: "[a]ny smoking bar in existence as of the first date of publication of the notice of the public hearing regarding this regulation may apply for a variance before the Board of Health from this regulation." Under Section III of the Board's regulation, a smoking bar is defined as: "An establishment whose business is primarily devoted to the selling of tobacco products for consumption by patrons on the premises and in which the serving of limited foods are incidental to the consumption of such products. An establishment which serves full meals is not considered a"Smoking Bar'for the purposes of this regulation. An establishment which serves appetizers and snacks may be considered a "Smoking Bar" for the purposes of this regulation." On March 20, 2000, a public hearing was held before the Barnstable Board of Health, at which time the applicant was given an opportunity to provide the Board with information in support of the request. The -applicant presented information indicating that"(o)ver the last three years the pubs annual gross income is approximately $400,000 with beverage at 44%; lottery at 43%; tobacco sales at 9% and food at 4%." . (See copy of letter from Toni Gleason dated March 17, 2000 attached hereto as Attachment 2). The applicant also stated that full meals were served on the premises, including lunch during the peak season. The applicant stressed to the Board that the service of full meals on the premises was not a money making enterprise. Based on the information presented, the Board finds that the applicant failed to demonstrate that the Duck Inn Pub is"[a]n establishment whose business is primarily devoted to the selling of tobacco products for consumption by patrons on the premises." Rather, the information presented demonstrates that only a small percentage of your annual gross income is from the sale of tobacco products. Further, the Board finds that that full meals are served on the premises. l Upon review of the evidence presented, the Board finds that you do not meet the criteria for consideration of a variance under Section VI of the Board's regulation. Accordingly, your request for a variance from the provisions the Town of Barnstable Smoking Prohibition Regulation is hereby denied. Sincerely yours, 4usan G RJ, R.SV � Chairperson Board of Health Town of Barnstable Town of Barnstable Planning Department M Staff Report-Appeal No. 1994-99: MacLeod-HoJo-Duck Inn Pub 26 9. P PP Variance-Bulk Regulations-Front Yard Setback Date: November 02, 1994 To: Zonin oard of Appeals From: Robert P. Schernig,Director Art Traczyk,Principal Planner Dave Palmer,Assistant Planner Petition Summary Appeal No. 1-994-99 Petitioner/Owner: Burton MacLeod/Howard Johnson/Duck Inn Pub [Represented by Steve LeBaron] Address: 447 Main Street,Hyannis, MA 02601 Property Address: 447 Main Street,Hyannis.MA Assessor's Map/Parcel: 308-081.001 (0.65 Acres) Zoning: B-Business District Applicant's Request: Variance to Section 3-3.1 (5)Bulk Regulations,Minimum Front Yard Setback of 20 feet. Activity Request: To permit a 12'by 20 foot addition to an existing building that will intrude 14 feet into the require front yard set back from the property line on Main Street,Hyannis. Procedural Provisions: Section 5-3.2(3): Variances Filed: October 3, 1994; Hearing Scheduled November 16, 1994. Background Information: The property,identified as the Assessor's Map 308,Parcel 081.001,was formally known as Candlelight Inn on Main Street Hyannis. The lot contains 0.65 acres and is developed with a two story,40 unit motel plus cocktail lounge building with 16,310 gross sq.ft.of floor area. The structure was originally built in 1957. The site is served by public water and sewer The petitioner is requesting relief from the required 20 foot front yard setback and is seeking to reduce the front yard setback to 6 feet to permit a 12 ft.by 20 ft. addition to the first floor only. The design plans of the addition are titled-"Duck Inn/Howard Johnsons,467 Main Street,Hyannis Mass. 02601, Proposed 12'X 20' Addition" by S.M.LeBaron,Designer,W.Yarmouth,MA and dated 3/8/1994(see attached plans). Site Plan Review No. 10-94 has conditionally approved the plans as stated in the Building Commissioner's letter of March 16, 1994 to the Petitioner's agent (see attached letter March 16, 1994). The applicant Burton H.MacLeod(dba Candlelight Inn)holds Special Permit 1990-27 for a reduction of required parking of 83 spaces to 38 spaces based on the property abutting the Town's Candlelight Parking Lot. Said lot has 77 spaces to the rear of the locus. The Special Permit was conditioned upon certain improvements to the approved 24 foot driveway. Additionally there was a restriction that the"outside dining area(fronting on Main Street)shall not now,or in the future,be enclosed in any way;" (see attached Decision and Notice 1990-27). The Board of Health also granted a conditional variance from Regulation 14,Town of Barnstable Health Regulations,to the outside dining area(see Health letter July 12, 1990). DEPARTMENT COMMENTS: Front Yard Setback: The application states that the request is to vary the front yard setback from twenty(20)feet to six (6)feet. The existing building is only eighteen(18)feet from property at present. According to staff measurements from the Plot Plan submitted, the proposed addition although 6 feet from the property line,will be 1 Staff Report-Appeal No. 1994-99: MacLeod/Howard Johnsons/Duck Inn Pub Variance: Bulk Regulations-Minimum Front Yard Setback: only 4 feet from the edge of the public side walk. The sidewalk infringes approximately 2 feet into the applicants property. Parking and Seating: The Special Permit 1990-27 issued by the Board documents and permits outdoor seating of 18 seats and the Duck Inn Pub at 30 seats for a total of 48 seats. According to the applicant's presentation at Site Plan Review,the present seating capacity is 18 outdoor and 42 inside the pub room for a total of 60 seats. This capacity exceeds the permitted capacity in the 1990 Special Permit by 12 seats. The applicant will have to satisfy the parking requirements by an addition of 4 off-street parking spaces or reduce seating to that previously approved by the Zoning Board to be in conformance with Zoning. The Addition: The structural addition is proposed to be utilized by patrons only during the summer months and is proposed to be closed-off during the winter and used for storage of outdoor fiunishings. From information supplied and from the minutes of Site Plan review,it appears that the applicant is also seeking to construct a canvas canopy over the existing out door seating. If this is the case,the applicant needs to make it clear to the Board and supply information as to its proposed height and size. Additionally,the applicant should be made aware that the Architectural Review Committee for Downtown Hyannis Commercial Area Redevelopment District(CARD) . recommended that all awnings and canvas canopy structures consider a coordinated Hunter Green color. Site Plan Review has also recommended to the applicant that the window style be in keeping with traditional Cape Cod architectural style. Section 5-3.2(3)of the Zoning Ordinance and Section 10 of Mass.General Laws(MGL)Chapter 40A,require that the Board be provided with facts which justify the granting of the relief sought. The petitioner should be prepared to present the circumstances relating to soil,shape,or topography which justifies the granting of this relief and should also be prepared to substantiate that the granting of the relief will not be in detriment to the neighborhood nor derogate the intent of the Zoning Ordinance. SUGGESTED CONSIDERATIONS: If the Board should find to grant this request for a Variance,it may consider the following suggested conditions: 1. The permanent structural addition is limited to 12 feet by 20 feet,one story addition as proposed to the Board in plans presented. The structure shall not intruded more than 14 feet into the required front yard setback as measured from the property line. 2. Window treatment shall match that which exists on the second story of the existing structure to assure compatibility in style with the surrounding neighborhood The proposed sky lights shall be eliminated and all windows shall have screening. 3. Seating capacity ca aci shall conform to the requirements of zoning. The applicant shall not seek any increase in seating capacity beyond the 18 outdoor seats and 30 indoor seats as determined in Special Permit 1990-27 without providing additional off-street parking in conformance with zoning. 4. Covering of the open air patio shall be limited to a portable cloth or canvas canopy and shall be permitted only during the months of June to September. It shall be removed during the remaining months. The color and design of the canopy shall be approved by the Commercial Area Redevelopment District(CARD)Architectural Review Committee. Any signage on the canopy shall conform with the requirements of Zoning. Attachments: Application Copies: Owner/Applicant and Agent Site Plan Review 10-94 Plans Building Commissioner Assessor field Card Health Board and Department SPR Approval Letter March 16, 1994 Hyannis Fire District Special Permit Decision 1990-27 Zoning Board of Appeals File No. 1994-99 Plot Plan of Land,dated April 13, 1.990 Board of Health Variance dated July 12,1990 2 TONN OF SB;taTBTABLS toning Board ,:of-Appeols Application to BatitYon`foi=a"variance Date Received For office Use onlv: Town Clerk office 'g _3 ; :1 peal # tearing Date !� Decision Due The undersigned hereby applies to the zoning Board of Appeals for a Variance from the zoning ordinance, in the manner and for the reasons hereinafter set forth: Tverou mpclty �tAO Petitioner Name: ,[/oed ThNLoN .wci-1-ow ?Ub Phone .4�"'3Oy0 Petitioner Address: Of AV IV AP&P T Property Location: A.410 SMPe7- A10AM-114 , /Ili, OfbO/ Property owner: I?yR—/OV fl PAC /ZVJ , Phone 36-f -J?L 2 Address of owner: JW9 Agile 7. w. 14RN- -nbl If petitioner differs from owner, state nature of interest: Number of Years owned: Assessors Map/Parcel Number: 30 Zoning District: Groundwater overlay District: Variance Requested: 3- 3• �S) Cite Section t Title of the Zoning ordinance (A KO Description of Variance Requested: "Qe 'PouT AeF SeT 2? ck " ` � e v4R Y �R�►. Za � '�► . Description of the Reason and/or Need for the Variance: cvr..v�y�r Gll. - ltl2x &.4- Discretion of Construction Activity (if applicable) : IS y 2,0% A.VD-t�o..: -M Existing Level of Development of the Property - Number of Buildings: / Present Use(s) : Ao7e� /�kh Gross Floor Area: S 'l$ ` sq.ft. Proposed Gross Floor Area to be Added: 140 a4t Altered: /"0,�v a Application to Petition for a variance , Is the property within a Historic District? Yes [] No; Is the property a Designated Landmark? Yes [] No For Historic Department use only: Not Applicable .......... .. ... [] oxs Plan Review Number Date Approved Signature: No Have you applied for a building permit? Yes [I [] Has the Building Inspector refused a permit? Yes ( ] No [] All applications for a variance which proposes a change in use, new construction, reconstruction, alterations or expansion, except for single or two-family dwellings, will require an approved site Plan (see section 4- 7.3 of the Zoning Ordinance) . That process should be completed prior to submitting this application to the Zoning Board of Appeals. For Building Department use only: Not Required .. . .. .. .. .. ... . . . [] Site Plan Review Number Date Approved Signature• The followings information must be submitted with the Petition at the time of filing, without such information the Board of Appeals may deny your request: Three (3) copies of the completed Application Form, each with original signatures. Five (5) copies of a certified property survey (plot plan) showing the dimensions of the land, all wetlands, water bodies, surrounding roadways and the location of the existing improvements on the land. All proposed development activities, except single and two-family housing development, will require five (5) copies of a proposed site improvements plan approved by the site Plan Review Committee. This plan must show the exact location of all proposed improvements and alterations on the land and to structures. see "Contents of site Plan:' section 4-7.5 of the Zoning ordinance, for detail requirements. The petitioner may submit any additional supporting docu nts to assist the Boa i makin its de rau ation. r�( Signature: /'� � � Date: Petitioner or Agent Signature 54 1ff,9A/TA9✓e Agent's Address: Phone: Fax No. y TGVBUILDING DEPT LE MAR 9 '1994 �D 0 1,4 - FM i I sRccK I ....--•.............•_-•-•-•--••---.............................._^\ ri i ❑- , / �; I BRICK / I , BRICK 'I {� 3053 FRONT 52"d" , I �-- /• rl V m �e/n�+U1(I'�� e�G��v►y', C OS �e 1S �1 ��I�� F RN5 FM DUCK CK I�NoNYa n P:U S/HO W RRD JOHNSONS 967 MRIN STREET YR 6Hv s NNIS, MASS- 0201 QVW S.1 LESRRN SI OMD10�9y DEGNER HUOTH0RR 3 001P 0.Y " 267 0 3969E 19X23gWNING 4 ' 2 '�C 1 �� y TOWN OF BAA,VSTABIE BUILDING DEPT. MAR 9 1994 0 9 4 CUT MCKS AND LE90 ELRSH UPPER W i W INOO'd LINE SKYLiGz- I SKYLiGT. T T SIiV-17 -- I n X _ 906R0 REMOVE EFlY WINDOW I _ 2 X 20 SE!CEF CL-ID 90im FRO.; I CL9] 90 ] I i G54 G54 G54 354 I G54 i II f SLIDE Ii 2 X 4 I Cu37 - - L:RC] Ci7NacL C. LOOR 2F,;E II -..r�- 12— ? - --— ' S�LS 9 -T 'ice• cuV]fl"iON --- E^d= - - 12'e•l 2e-ell ® --- ----------=---- EAST VIE`d VIEW CD 2-iZ SOFT. 90DED I WEST ViEd 2" CONCP.ETE FLOOR — G99DE LINE 01-9NS FOP: DUCK INN PUB 775-3000 .z 5 REBAR 967 MAIN STREET FONDAT ION DETAIL HYANN IS, MASS. 02601 sME:l/4"=1"6 g000J'EJ 7P9iN 8! S.M.LEB 2X1 SCALE S.M.L_E39RON 1994 � � 90PUSED: - X 20" ADDITION :� I• I I � 12 �-q o SONAR TUBE W•YARMOUTH,MA. 02673 0P.9YI.V6 i+UMEE? �9" 394-8146 SEASONAL USE 001 DUCK I � R�Gh. rimf =Lj s • — / J ca r � Ir Sad" -,, �.� ,.� � r•• �� ,1. mot. � t. � I � ''' , I } •Nod, 1 1l � IF 1 il , �1 •tiL V ., _ •�. it ±: ,1 II I III �� it 1 II �l Notes - Site plan Review Meeting 6, 1994 /D jpresent: Joseph DaLuz, Alfred Martin, Gloria Orenas a Kathy Maloney, Building; Robert Schernig, Arthur Traczyk i David Palmer, Planning; Robert Burgmann (portion of meeting) i Thomas Marcella, DPW; Thomas McKean, Health; Lt. Chase i Lt. Hubler, Hyannis lire Department. Also in Attendance: For SP-27-94 - way-no �. partme Kurker; For OP-10-94 - Attorney Ford, Michael DeBarros i Paul Downey, First For SP-10-94 - Steve LeBaron. t union stave cioiosa , citizens Credit • SITEC• SP-10-94 Burton H. mcLood, 447 Main Street, Nyaaais, Ma Mr. LeBaron, project builder, explained proposed changes to the Duck inn Pub, part of the Howard Johnson complex. He stated the applicant wanted to remove the bay window in the front and build an addition to. enclose an existing patio, hoping to create a more family oriented look/atmosphere and increase the walk-in tourist trade in the summer. There would be no increase in total seating (currently 18 on the patio and 42 inside). The proposed addition would not be used in the winter. Patio or folding doors would probably be used to close the area off as no heat would be installed in the addition. The applicant also wanted to install an awning over a second existing patio. Mr. LeBaron said that the original site plan listed incorrect setbacks, that__ there were actually 16 feet to the beginning of the sidewalk. (He thought the property line was the center of the sidewalk.) He proposed shrubs and a picket fence to be installed between the addition and the sidewalk. Be stated that the ZBA approved off site parking of 77 spaces in 1992. in 1987 the owner granted the Town a right of way for access to the public parking lot. .., Mr. DaLuz noted that the setbacks must be dealt with by the ZBA. He advised the applicant to show the proposed landscaping on the plan. Mr. schernig explained that in order to obtain a variance, the .applicant must be able to express to the ZBA what is unique about the Mr. McKean recommended approval for purposes of review by the ZBA be granted with the following requirements and recommendation: All windows, doors and other apertures to the outside shall be screened. A total of 60 seats is authorized. The new window treatment should reflect the historic character of the area. The plan was signed. i -OPERTY ADDRESS I I ZONING IDISTRICT CODE SP•DISTS.I DATE PRINTED CSTATE RCFL IDENTIFICATION NUMBER LASS I PCS I NBHD KEY h 0447 MAIN STREET 07 B 400 07HY 12/18/93 3011 00 C006 R 8 081 001 2205 L ago By Da LANCIOTHER FEATURES DESCRIPTION pn ADJUSTMENT FACTORS Ty UNIT ADJ'D.UNIT M A C L E 0 D, 8U RT ON N - M A P— LOC.'YR.SPEC.CLASS ADJ. COND. a PRICE PRICE ACRES/UNITS VALUE Dexnption co FFoe mAues E #BLDG(S)-CARD-1 3 783,100 CARDS INACCOUNI 30 3SITE 1 X .6i =10 128 188999.9 241919.9 .65 157200 #LAND 3 157,200 01 OF 01 #PL 447 MAIN ST MOTEL/HOTEL U x = 100 *786870.0 786370.00 1.00 786900 B #DL LOT PARC 1 LC16565-8 MARKET PV1 PAVING S x = 100 .4 .45 8000 3600 F *HOWARD JOHNSONS INN B INCOME 9403Q RP5 POOL GU S 16 X 32 198 8= 80 24.4 24.6 512 12600 F *DUCK PUB USE AD SHED S 8 X 12 1975 C= 84 10.5 8.86 96 900 F #RR 0952 0097 APPRAISED VALU iI C 940,30 UI PARCEL SUMMAR LAND 1572 S T BLDGS 5020 0-IMPS 171 M TOTAL 6763 E - N CNST N DEED REFERENC Type DATE Recora.a PRIOR YEAR V A T Book Pepe 1na1. MO. Yr.D Set-Pric. LAND 1572 S C96526 1 I105/84 614000 BLDGS 7831 C821400 : I:06/80 348000 TOTAL 9403 1 1 I 1 1 I BUILDING PERMIT 3 Numbs Date Type Amount LAND LAND-ADJ INC ME SE SP-BLDS FEATURES BLD-ADJS UNITS 157200 1710 786900 833808 6/90 AC 38000 11 Class Consl. Total Base Rate AOI Rele Vear Built Age Norm. Obsv. CND. Loc. M R.O. Rem.Cost New Adj.Repl.Value Sldiss NeIpM Rtwrl. Rtne Batba 1 F4. PaHsn.W Fac. U nns Units A I Depr. COnO. 20C 001 000 001 57 68 23 71 125 80 63.7 786900 502000 2.0 1 1 123.0 1 Des—pt— Rate Square Feet Repl.Cost MKT.INDEX: 1-00 IMP.BY/DATE: ' / SCALE: ELEMENTS CODEJ CONSTRUCTION DETAIL BAS 100 .00 6950 6ROSS AREA 1631U MOTEL CNs GP: ' i 820 60 .00 6950 STYLE 0 0. 1 OPO 60 .00 1396 OZSfGR ADJMT _0 _ _ 0- ;* FSF 90 .00 612 EYI'ER.WACCS 0 4 CIS NCREfE BLOCK---0. HEAT/AC-fVPit- 0 --0. FSF 90 .00 1798 +--------------------------+ - - - ------------------ I .- � NTER.-FfNISN -T. -ffYGAL1/C-Bi:K-_-_-Q= r ! CANDLELIGHT ! INTER-LAYOUT 12 VER:1N4RRA- Q: ! MOTEL ! INTER.Q _ 1JACTY 023AAE AS ExTER: 0: T ! FMIR-STROCT -0 -------------------0. ! FLZf(YR-t-UVER-- -04 )UPET------------(I —� ` E Total Areas I.u. 1396 ease_ 9360 RDVF-TYPE---- _OT lfBC_E__IFS_P__H__�a____U_ BUILDING DIMENSIONS ELFCT RI C-AC O 0• T * 40 TOTAL UNITS * FDUNOATTOR--- -0 - -- - - -II. A -------------- - --- ---------------------- * COCKTAIL LOUNGE L T L -----CO1I1WFRC C-A EA-CUU6------------- LAND TOTAL MARKET PARCEL 157200 676300 AREA 34470 VARIANCE +0 +1862 STANDARD 50 . TOPOGRAPHY 1 LEVEL * TOPOGRAPHY * UTILITIES 1 ALL PUBLIC * UTILITIES * UTILITIES ST FEATURE 1 PAVED * ST FEATURE 5 CURB 8 GUT * ST FEATURE 6 SIDEWALK * ST. COND. * TRAFFIC 1 LIGHT DWELL LOC. * LOCATION * AMENITIES * AMENITIES * NUISANCES NUISANCES * * : 1 yoF i N c roF t�' = The Town of Barnstable 1 IARIf7A/19 Inspection Department ' 367 Main Street, Hyannis, MA 02601 �0 YLY A' 508-790-6227 Joseph D. DaLuz Building Commissioner March 16, 1994 Mr. Steven M. LeBaron 54 Montague Drive - West Yarmouth, MA 02673 Re: site Plan Review Number SP-10-94 Burton H. MacLeod 447 Main Street, Hyannis Dear Mr. LeBaron: The above referenced site plan has been reviewed by site Plan Review staff and deemed conditionally approvable for purposes of review by the Zoning Board of Appeals based on the following requirements and recommendation: 1. All windows, doors and other apertures to the outside shall be screened. -- 2. A total of 60 seats is authorized. 3. The new window treatment should reflect the historic character of the area. Enclosed please find a Certificate of Review and a copy of the conditionally approved plan. Please be informed that you must comply with any requirements the Zoning Board -� of Appeals may impose in addition to the above, and that a building permit is necessary prior to any construction. Upon completion of all work, the letter of certification required by section 4-7.8(7) of the Town of Barnstable Zoning Ordinances must be submitted. should you have any questions, please feel free to call. Peace, /Jos ph D. DaLuz y) `B�ilding Commissioner JDD/km cc All site Plan Review staff zoning Board of Appeals enclosures (2) S940316A 1 s� ol � - t 4A \ 1 t � 1 N Q - d - .._. .. _... - .... .. .. .. LoT L ,� ! 30,34 S SF d , _ _ _XLSTIN6. i CMbf-FU64T! PLOT P!AEI OF !A 1 MOTEL 0 1!J 4 s BAIZWSTABL;-:- LC.PceU tGSGSH GceT• aJ. 9b52L — j' 18 : BAKTEM t Nye lor- 26645MWO LAND SUW4MW2S Q D9TETLVILL� .MASS• .: .:. .... .. .. - ' x! ft ia,e mAr 9A3. RL.a1=1. TOWN OF BARNSTABLE ZONING BOARD OF APPEALS SPECIAL PERMIT DECISION AND NOTICE ------------------------------------------------------------ APPLICATION : 1990-27 APPLICANT : BURTON H . MCLEOD , DBA CANDLELIGHT INN ------------------------------------------------------------ At a regularly scheduled hearing of the Barnstable Zoning Board of Appeals,,_= held- on May 10 , 1990 , notice of which was duly published in the Barnstable Patriot and notice of which was forwarded to all interested parties pursuant to Chapter 40A of the General Laws of Massachusetts , the applicant , Burton H . McLeod , through Attorney Phillip Magnuson , applied to the Board for a Special Permit pursuant to Sections 5-3 . 2 and 4-4 . 2 of the Zoning Bylaw and Section 6 of MGL Chapter 40A. The applicant ' s property , known as the Candlelight Inn and the Duck Inn Pub , is located at 477 Main Street , Hyannis and is shown on Assessors ' Map 308 as lot 81 -1 . It is in a Business Zoning District . The applicant is proposing to enclose the existing drive through to provide an additional dining area and space for a motel office . The drive through intrudes into the front yard setback as currently required by the Zoning Bylaw. The applicant is also constructing a 9 ' x 9 ' 1 . 5" entry foyer located to the front of the building and a 22 ' x 30 ' patio for outdoor food and liquor service with seating for eighteen ( 18 ) persons . This construction will also intrude into the front yard setback . An approved Site Plan entitled "Candlelight Inn" prepared by Newtown Remodling , dated 10/ 10/89 was submitted to the ------ -Zoning Board of Appeals file . This Plan was approved by --- - --- Site Plan Review on April 13 , 1990 . The applicant also submitted a Plot Plan entitled "Plot Plan of Land in Barnstable (Hyannis ) Mass . for Burton H . McLeod" , prepared by Baxter & Nye , Inc . , dated April 13 , 1990 . Attorney Magnuson presented the application to the Board . Mr . Maanuson stated that the property contains 30 . 000 sq . ft . , is about 300 feet deep and has 96 feet of frontage on Main Street . Assessors ' records indicate tnat the motei structure was built in 1957 . In 1964 , the present owner and applicant , Burton H . McLeod , purchased the property . i Mr . Magnuson stated that at the present time the building contains thirty-eight ( 38 ) guest rooms , a manager ' s apartment , and a bar and dining area operating under the name "Duck Inn Pub" . The pub has seating capacity of thirty ( 30 ) persons . The site does not comply with the parking requirements as set forth in Section 4-2 . 7 of the Zoning Bylaw. The applicant is required to provide eighty-three ( 83 ) parking spaces for the site . Attorney Magnuson stated that there are thirty-eight ( 38 ) parking spaces on the site . In addition , a seventy-seven ( 77 ) space Town parking lot abuts the rear of the site . In February 1985 , Mr . McLeod gave the motel an easement over astruip of his land to provide pedestrian access t.o _ -he Town parking lot . The Board discussed the ingress/egress and the width of the driveway as there was concern over - the need to provide adequate access for fire and rescue vehicles . Attorney Magnuson stated that one of the concerns of Site Plan Review was that a twenty-four ( 24) foot driveway be provided and the applicant intends to comply with this request . The Board was presented with several letters from abuttors who are in favor of the application . FINDINGS OF FACT: Based upon the information provided , the Zoning Board of Appeals made the following findings of fact : 1 . The submitted Plan , as approved by Site Plan Review, is not substantially detrimental to the neighborhood ; 2 . The proposed improvements are compatible with Main Street , Hyannis ; 3 . Due to the present parking situation , in particular the under utilized parking lot abutting the rear of the site , The Board may vary the parking requirements without detriment to the neighborhood ; and 4 . The structure , as presented to the Board , is a legal pre-existing non-conforming structure . The vote on the findings of fact was as follows : AYES : BLISS , JANSSON , LALLY , MCGRATH NAYES : NONE ABSTENTIONS : BURMAN DECISION : Based upon the information provided and the findings of fact , at a meeting held May 10 , 1990 , by a motion duly made and seconded , the Zoning Board of Appeals voted to grant the requested Special Permits with the following conditions : 1 . The construction will be as per the Site Plan which was approved by Site Plan Review; 2 . The applicant shall seek approval from the board of Health for the outside dining area ; 3 . The outside_ din.i_ng area shall not now, or in the future , be" enclosed in any way ; 4 . The planting boxes along the_ driveway' shall be removed and a twenty-four ( 24 ) foot paved driveway shall be provided ; 5 . The driveway shall be unobstructed , marked with striping and posted with signs prohibiting parking so that rescue and fire vehicles can gain ready access at all times ; and 6 . The center Fine of the driveway shall be marked to indicate the" entrance and exit lanes . The vote was as follows : AYES : BLISS , BURMAN , JANSSON , LALLY , MCGRATH NAYES : NONE ' 10",Ju rU TOWN OF BARNSTABLE � OFFICE OF { ""' a BOARD OF HEALTH �� 167 MAIN STREET HYANNIS,MASS,02601 July 12, 1990 Burton H. MacLeod Candlelight Motel 477 Main Street Hyannis, MA 02601 Dear Mr. MacLeod: You are granted a conditional variance from Regulation 14, of the Town of Barnstable llealth regulations, to have outside dining at Candlelight Motel, 477 Main Street, Hyannis, Ma., with the following conditions: (1) You must submit a plan of the outside cafe' area including locations of seats, sinks,. screen doors, air doors, hose bibs, and drainage areas. (2) The dining area must be set back at least ten (10) feet from the sidewalk, driveway, and parking lot. (3) You must meet all of the criteria contained in paragraphs A*through O, of the Board of Health criteria for variances for outside dining. Failure to do so will result in revocation of your outside dining privilege. (4) You must install air doors and screen doors on all doors and apertures used in serving food or drink. (See paragraph a of the criteria for variances.) (5) The overall seating capacity cannot exceed 66 seats. (6) You must receive approval of the Town of Barnstable Licensing Authority. The Board reserves the right to terminate your outside dining should any unsanitary conditions be observed. A copy of the criteria for granting variances for outside dining is enclosed. Strict compliance with this criteria is required. Very truly yours, O rover C. M. Farrish, M.D. Chnirman HOARD OF HEALTH TOWN OF BARNSTABLE OF/bs Enclosure f yQi INC Tp` The Town of Barnstable NA1117A16 .A Office of Town Manager /lAY 367 Main Street,Hyannis,MA 02601 790-6205 Office 508-Xffl)t1Ak Warren J.Rutherford FAX 508-775-3344 Town Manager August 28, 1990 Patrick M. Butler, Attorney At Law Nutter, McClennen & Fish Route 28 P. O. Box 1630 Hyannis, MA 02601 Re: Candlelight Petition for Special Permit Article #17 - Town of Barnstable General Bylaws Dear Attorney Butler: Thank you for your correspondence dated August 20, 1990 relative to application for a Special Permit pursuant to Article #17 of the Town of Barnstable's General Bylaws. Pursuant to your request, it is determined by the Town Manager, that failure to approve this Special Permit would cause an undue hardship to your client, The Candlelight Motor Inn, due to previous approvals granted by Site Plan Review, the Board of Appeals, the Board of Health and the Town Licensing Autt.ority. A Special Permit, therefore, for a variance from the twenty five foot setback, is hereby authorized from the side line of Main Street in the amount of seventeen feet and nine inches (17' & 9"). I thank you for your continued pursuit in this matter and will, by this correspondence, notify the Licensing Authority, Board of Health, Board of Appeals and Site Plan Review Committee. Very truly yours, WJR.ab Warren utherford, Town Manager cc: Licensing Authority Town of Barnstable Board of Health Board of Appeals Site Plan. Review Comm. r Handed TO: (Man ` As Own of Establishment: t�. 1. PA 8 -� - Acting Manager RE: NOTICE TO ABATE VIOLATIONS OF 105 CMR 590.021, INSECT AND RODENT CONTROL REGULATION, OF THE STATE SANITARY - CODE---FOR - -FOOD ESTABLISHMENTS, ARTICLE X You are hereby notified to remedy the conditions observed below upon receipt of this notice: CA V K1 % .r�ce (A� 1�i r DO 13' � � '•.�; � (�w1.\J ,.�7�_.. T !"c;; �.i t:;1 J �c�, � s t r. >6r e ti-Q You are directed to utilize effective measures to minimize the entry, presence, and propagation of rodents or of flies, cockroaches, and other insects. ` The premises shall be maintained in a condition that prevents the harborage or feeding of insects or rodents. All openings to the outside shall be effectively protected against the entry of insects and rodents by tight-fitting self-closing doors, closed windows, screening ... screen doors shall be self-closing, and screens for windows, skylights, transoms, intake and exhaust air ducts, and other openings to the outside shall be tight-fitting and free of breaks. Screening material shall not be less than 16 mesh to the inch. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days. Failure to comply with any order issued pursuant to this and any other provisions of the State Sanitary Code for Food Establishments may upon conviction, result in a fine of not more than one hundred dollars ($100) for the first offense and not more than five hundred V' ($500) for a subsequent offense. Each day's failure to comply with an order shall constitute a separate offense. By Order of the Board of Health Inspector �..... . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Apphratilaaa for Di-nVngal lVar1w Tomitrurtion rrrit C�Rec4ep Application is hereby made for a Permit to C'ortstruct ( ) or Repair (�O an Individual Sewage Disposal Ad System at ................-- ress o Lo o. �n gang.._ Owner - dd •- a -------•-..��R1e. ----- n-e1.-----••----------------•-----•--- I- c111 � Installer Address UType of Building Size Lot.................... Sq. feet -, Dwelling— No. of Bedroom____________________________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building � �2_E No. of persons____________________________ Showers ( ) — Cafeteria ( ) 04 Other fixtures W DJ�oo��FJ�o� gallons per person Ver day. Total c�ailyflow..........................................dons. C e t?ic anTc q>id capacity)00L1_galIons Length�___� VVidthy___�Q--... 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........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit.------------------- Depth to ground water......................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit__.__.-.-__-_______- Depth to ground water-_-___..___--___---.___. P4 ---------------------------------------------------------------------------------------•------.-------------------------- •---------------•-------------•----- 0 Description of Soil........................................................................................................................................................................ x U w U Nature of Repairs or Aerations—Answer when applicable.._____L-//C�v---�_( ___..�/4{1bQ-�...__ .._- crr1............ - - ...............................------------------------.---..------------......-----------------.......---------------................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed -- - -------- --------- -- -- --------------------------- - ��t�i "...�� Application Approved By ... a-------------- --- ---- ----------------------------- -------------------------------------- Date Application.Disapproved for the following rear n . ..................._......-------------------------------------------------. � ......_ ..._....._.. .__ .._[e......�..........Date...._.---------- ......... Permit No. .... ------- --- ......... .... Issued ..... �-- t �.. 'r! FaO THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ��rlirtt#i�Yt fur �li��u�ul �dnrlt,s C��t.s�r�r�ilatt �prl�,t# _____. Application is hereby made for a Permit to Construct ( ) or Repair (k) an Individual Sewage Disposal System at: i ena;5 -------------- Owner �_ ddr .......................... W ••----CY �R l ............2 n f�••-•---------•----•--•--••--•-.... 11, . installer �y UType of Building Address (/ a yP g Size Lot............................Sq. feet a Dwelling— No. of Bedroom,____________________________________________Expansion Attic ( ) Garbage Grinder ( ) Q, Other—Type of Building ___(O C1 - No. of persons....------------------------ Showers ( ) — Cafeteria ( ) Other fixtures ---- -•-•----- W Desig�} ��' -------gallons per person $er day. Total gailyi/flow-------••------...--••---•----•--•-•------..�lons. f Septic an k—Liquid capacity-�O0-U._galIons Length. � --- Widthy.__h----- 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 ( ) aPercolation Test Results Performed by-------------------------------------------------------------------------- Date..............-•-•-•--•---•--••----- . Test Pit No. I________________minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ GT, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water....................... a •-•--•--•-------------••----•----------_------------------•-••--•---•-------•----------•----•--------------------- •------------ •........ •--------------. 0 Description of Soil......................................-.............................................................. U -------------------------------------------------------------------------------------------------------------------------------------------------------------------------•----------•---•••------------- W x -----•--------------- ------------•----- • ......... --------------------------------------------------------- --------------..._,_.y-, - ----•-......----•--- V Nature of Repairs or Alterations—Answer when applicable._._. /� v�.!7.��'_.__�..'�15Pwe-_--•-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed .... - -� �:---- - -------------------------- -- j— //jj .� ----_-. -Dam .--P:..-._ Application.Approved By Q ✓. -..--- ..... --.... - i y Dace Application.Disapproved for the followinglreas n .i ----'--------------------------------------- --- ------------ ------------------------.......------ - .-'-----...--._..................'-- ......---- - ---r---� ....... '' ------------------------------------- -`--------.......... --` f t-, Permit No. - ..-.-... Issued —/ Da[e F �D re .�,�._.:��__�_ •...,__�.r.�.,�,.._-.-.a:...�.._.�...�-„_..__�;y.�:._:.._.._..-..,..,;ems�-ram._.. .. - .. - ___. .—_�,.� ___ — _. -. .- .-x.. � _�_..�. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of (%L z' littlnce THIS IS TO CE T FcY, Tha�t,�hye Individual Sewage Disposal System constructed ( ) or Repaired ( ) .......- ------ ------ at ....... .-... f f ;. " = - P:F-14 .�l..;f�i�---..._---------------------------------------------------------------------------------------------------------------------------------------------- has been installed in accordance with the provis�ns of ITLE of The State Environmental Code as described in the application for Disposal Works Construction Permit No. --------_---.--------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT EONSTRU AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....... -............. -'-�-- ------------------ ---- Inspec ---- ,%�.. THE COMMONWEALTH OF MASSACHUSETTS Y BOARD OF HEALTH TOWN OF BARNSTABLE .. No.--.a:,,r-. ......-----•- FEE..S39...... t Disposal rhii T nlitrudMY16k rrmi# Permission is hereb ranted. 1� ' JY.. �. Yg to Construct r hepai ( an Inc�ividual Se wa e Dis oSystem J ��f at No... LC' j �,.. .. . � ----- / Street as shown on the plication for Disposal Works Constructio er ,'t No. ✓______________ ated ._ ____ _-._.----..-...._........_... h T t DATE-------- Board ealth,.�•�. ..-� ---- -�-•/---------------------------------------------- \ FORM 36508 HOBBS&WARREN INC..PUBLISHERS /I Flcs THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for giopoottl Mirks Tonotrnr#inn f rrnti# Application is hereby made for a Permit to Construct ( ) or Repair (L_)_ f Individual Sewage Disposal System at: ......... .__..... !!!:o r naa�e5 ............._........... , ............ _ �v �'v """'"'Lot No.---•-•--••------......___................ lion •---.... �_ :w_.:-A�:_3...................................... ..................��..1i ..e . --........---•---........----------- -- owner Address a —.L_t4-✓Y�.. —5` r r --------•-- --------------------/` -....x�F - ....................................... Installer Address �• t Type of Building � Size Lot............................Sq:.feet V Dwelling No. of Bedrooms.............................. .._..Ex anion Attic a g— -•----••• p ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther, fixtures .-------•--....-•-------•----------------------•---.......----••--•---•---•---------------=----------.....---•-----•---------•----•----•......-----_.. L Flow.........................................._._._..gallons per person p-e-r---day. Total .... flow.............................................._._....._........._........gallons. d� 4�a Tank-Liquid ca acit /.G " allons Length._-.�..... Width... ..... Diameter..-------------- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY.......................................................................... Date_.. :-.. . Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water....:................... =.; f34 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....:.................... 9 ... •...... •--------------------------- ............•------•--•---------•••--•••-•----••--•--•------•-------- •------ ----------------- •--•------••-•_..._....... 0 Description.of Soil.-•---•-•.............•---•-----•--------•---.........--•---._.....-•-•---•----•---------------------...------------...-•----•-•----•-----••••------•--•••••-------•--- V ......-•--•-•.................................................•-...--------........-----••-•--••---.......------------•--•----------••--............--------- -•............_••--=--•-----••-__-•---- -----------------------------------------•-•------------------------•-------------------------.-.--------------•--------------------- t . U Nature of Rep irs or Alterations—Answer when applicable...._.... t -,!k.-.-..__..f --c- /Q. J'Z?...:.......... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ` the provisions of iITiLE 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 b��oa++r health. / Signed '... ..Q._---•-- ---•---- . ............... .... - Date Application Approved By-.. .. . ---. -- •--•••---••-------•-- a..... ..................... .................. Date Application Disapproved for the following reasons- -------------------------------------------•----••-----.....-------------•-------........................... ........................................................ .............. __ ........................................................................ ------ ...... •------------ Date Permit No.... ... Issued-...................... Date f.:.a::wr•`pia`w..•._.�.�ys1�:,.�:i.s�•-.�s...�-i,,.-.- .. ,.,, .._..-.-,:'�^. L;r.. ,.,,fs�.r�..._�.t" � -ti_.... � ,.-•..-•� - -.�...-v-.-^_' `j �-•..,�...-�.--..��,. .._..>.-.•--•----. --.�.may_ -.r.....•_ d FEs THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Applutttion for Biopoottl Works Toustrnr#inn Prrntit Application is hereby made for a Permit to Construct ( ) or Repair (c-),an Individual Sewage Disposal System at: c ��__...... ti StY--- Location-Address or Lot No. .._.......1 � _ .r!:+:�-•-•-A�--�.5-...................................... .................�rr..tg?rrl!`.e�.------•--••---.....-•-----.....---•--........._........... �} Owner Address — `C ...--�`G �•l_�........... --•--•---------•____ y� ris..X`` !^.E, .............................................. ..............•--- Installer Address q Type of Building 1 Size Lot.............................Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 04 Other fixtures . WW esign Flow............................................gallons per person per day. Total daily flow............................................gallons. LASSep.tic Tank—Liquid*capacitytUl alIons 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........................................ 0.4 0.4 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ............................................................ _..................------------------------•...---------------------------------------------- ___-- 0 Description of Soil........................................................................................................................................................................ W W ...............•---••--••-•-----.........--•-•-___--•-•--•-----•--.........•------•...___--•---------......_--------........••---------___•--••-•-•----•-•-............___--•-........----___--__------ x _____....•-------•---•--...-------•••-------------••-----•-•-•••-••----------••-•-----...-••-•--•-•----•••----•----•--••-------------- ---•----------------------------------------- ---... . U Nature of Repairs or Alterations—Answer when applicable.........ETA-� --------!i tN----_j-- .............. _..-•-• . . -1 .t,�_..... __ ._ _ -�..__I n. ... �-a � ------- 5. ti --------------------------- 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. - t Signed........ T t' G Date Application Approved By-.-A.. ......� -✓ �� Date Application Disapproved for the following reasons:........................V..................................................................................... ---•-••-------------•--.......---•-•-•--..._________-----•---___-••. - .......... Date Permit No.__Z �.4�/- �n ..._.�._..._..-•--- --------•------. Issued.--•--•---•--------------•-•--._.........---•--•--...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....•..i.....5�.r!.Yj.---..�..-._...OF. �.12-1�:.��.�..:�b`..e-................... Trrtifirate of (anntpl aurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (C—)___ by-•••-•........................... .-1_...Y,....�-lQc -�?` a -------.._........_....................-•---•---•--......-•-----•......•-••--•-••-•...-•------- - Installer at....................L.•t� ..... .... ....-•---- _ has been installed in accordance with the provisions of TITL j of Tliie State Sanitary Code as de �ribed e the application for Disposal Works Construction.Permit No...��__ �' _?�__ _. dated_.. ........... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. ff `" DATE........----••..........::..1....._.... .....__---•----•--•-•-- Inspector. --......... -- •- ........................................... THE COMMONWEALTH OF MASSACHUSETTS l BOARD OF HEALTH No.. .............. FEE.... �.. I Disposal Works Tonstrnrtion "nutit Permission is hereby granted..._ -----5.Z.e -✓'�-_----•..........................:........•-,•----•- to Construct ( ) or Repair,( ''...)-•=--rftdividual Sewage Disposal System at No.-------- +J. ......... "`' VQ-` -10_•----------_ -IV-�------ �4 !`'J Street - I as shown on the application for Disposal Works Construction Pe mit No�; gnba,4ated..__... DATE......... - ---- --------------------•-•--•---•-•------=. TOWN OF BARNSTABLE LOCATION A4,1?- SEWAGE # 7j-" VILLAGE / . 0?-4 f'/ s�o/ ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.� �Q,�S aArj,,p s A ANK CAPACITYEWE' LEACHING FACILITY:(type) / �n �c�Li�P (size NO. OF BEDROOMS !I 4 PA4**IPE WC+L OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No Y v TOWN OF BARNSTABLE SEWAGE #- -�—�, -- LOCATION �S F VILLAGEa�F,;; ASSESSOR'S MAP & LOT ° INSTALLER'S NAME & PHONE NO. v3 �'>c_ 6r�a e�v7 -r►/?�C�' _ SEPTIC TANK CAPACITY a- p LEACHING FACILITY:(type) ��v�'Epac`�.u�:•r�. (size) NO. OF BEDROOMS PRIVATE WELL O L1C_rW�1 �-ER-X-" BUILDER OR OWNER DATE PERMIT ISSUED:�� DATE COMPLIANCE ISSUED_ VARIANCE GRANTED: Yes No q Y? c G CA i 4 � I .� - U NET _F:T- sv-f--AT t Nc:; ! I /24 t . ch•jAUt'LAN'� {2�O lam . 1 + ( �ovmh 4 '? 1�iO _ r1A��Rc►.s�h�Ts __ _ _ ___ _ - -----_ --� IT --�_-a $ UCLI►�JAtrh .' Naav:.e '1 �? 40N \ f LAV5, 112. kV I ANT , r -t r1 ��Ah �AatcyE a gVLiylb bW i r Ah p i t. li!Z G ! E GZ rg v►+' -- 1— 1 44 *7 ;".mot L ,aj''fL ". :hY(.`.iAhH,t.jy •r 4 1 i K, t._ f'©. i_. ' :.. ,�,f'f' ... . 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