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KARIBBEAN LOUNGE - FOOD (2)
c�DO •ppcc��� `KARIBBEAN LOiJNGE,THE 662 Main Street,Hyannis t I f IKEx Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. rsxMNMBLe, F.P.(Thomas)Lee,. p4y, A 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt. +�39 � r�aa 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: 117 Issue Date: 01/01/2022 DBA: KARIBBEAN LOUNGE, THE OWNER: THE KARIBBEAN LOUNGE LLC. Location of Establishment: 662 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: Indoor5eatin : 86 OutdoorSeatin : 48 Total Seating: 134 g g g 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: For Office Us Only: Initials: Town of Barnstable Date Paid Pd,10Z 0,:1 $ . Inspectional Services P14 1639. Public Health Division Check# Thomas McKean, Director 20C Main Street, Hyannis,MA 02601 Offic,2: 508-862-4644 Fax: 508-790-6304 �AP�PLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL' NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: 664 I'hiq 1/'!0 $' lS*UtVf S- 41,44 0- �0-1 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: , TELEPHONE NUMBER OF FOOD ESTABLISHMENT: -—CLO 7.,S TOTAL NUMBER OF BATHROOMS: _ WELL WATER:YES NO_Z... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: t SEASONAL: ,;E. DATES OF OPERATION: / / TO t NUMBER OF SEATS: INSIDE: ' `' OUTSIDE: TOTAL: f 3 l SEATING: MUST OBTAIN COMMON VICTUALLER'S LICENSE FROM LI ENSING DIV. c6• ; F ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE,DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING.,.(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-8624644 Q:Wppkation FonnsTOODAPP 2020.doe OWNER INFORMATION: - FULL NAME OF APPLICANT �I(�(. 0 @ !'6 SOLE OWNER: YES"V D.O.B D-I fW OWNER PHONE# ADDRESS jr)M C—I-Hf ak /4d&0/0 6 Z CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: ✓ �� K 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 Exuiration Date Allergen Awareness Exuiration Date 2. 14.N)" 3MfW 60 , SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by<.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 httv://www.townofbarnstable.us/bealthdivisionlabpliclitions.asy. " OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3I't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. �I Q:\Application FormsTOODAPP REV3-2019.doc i CHOKE SAVED / CPR CERTIFICATE OF COMPLETION LETION Instructor's Name: James Spencer Title: CPR Training Instructor Institution/Facility: Spenson CPR Direct Phone: 774-271-1668 In accordance with Department of Health, 105 CMR 5909(E) Pursuant to M.G.L.c.94,section 305D,this acknowledgement is awarded to, Participant Name Total Hours of Instruction It IQ5 bi I /E941021 Course Completion Date Card Expiration Date The participant listed above has met the requirements for successful completion of the Choke Saver CPR Course as taught by a licensed Healthcare Provider/Professional Rescuer and Instructor in the course type as shown above. The certification is valid for 2 years. This notice serves as proof of course completion from the course date indicated above. I verify that the information above is accurate and truthful, and that it may be confirmed. This course was taught in accordance with the American Heart Association's organizational to meet and exceed the that as set forth by the Massachusetts Department of Public Health. This course was taught by a Massachusetts EMT and Instructor for the American Heart Association. Director/Instructor's Signature: AHA Instructor I.D.#5120098181, EMT:#E0870558 V 17JGmer �hczz I CHOKE SAVER / CPR CERTIFICATE OF COMPLETION Instructor's Name: James Spencer Title: CPR Training Instructor Institution/Facility: Spenson CPR Direct Phone: 774-271-1668 In accordance with E Department of Health. 105 CMR 5909 P ( ) Pursuant to M.G.L.c.94,section 305D,this acknowledgement is awarded to, Participant Name Total Hours of Instruction t 1 Q bi li�aI la j Course Completion Date Card Expiration Date The participant listed above has met the requirements for successful completion of the Choke Saver CPR Course as taught by a licensed Healthcare Provider/Professional Rescuer and Instructor in the course type as shown above. The certification is valid for 2 years. This notice serves as proof of course completion from the course date indicated above. I verify that the information above is accurate and truthful, and that it may be confirmed. This course was taught in accordance with the American Heart Association's organizational to meet and exceed the that as set forth by the Massachusetts Department of Public Health. This course was taught by a Massachusetts EMT and Instructor fo the American Heart Association. Director/instructor's Signature: AHA Instructor I.D.#5120098181,EMT:#E0870558 'MtS S I II .. CHOKE SAVED / CPR CERTIFICATE OF COMPLETION ION Instructor's Name: James Spencer Title: CPR Training Instructor Institution/Facility: Spenson CPR Direct Phone: 774-271-1668 In accordance with Department of Health,105 CMR 5909(E) Pursuant to M.G.L. c.94,section 305D,this acknowledgement is awarded to, Xk n r.h AC-&, 9:5w& Participant Name Total Hours of Instruction LIby/�) l� �yL.?, Course Completion Date Card Expiration Date The participant listed above has met the requirements for successful completion of the Choke Saver CPR Course as taught by a licensed Healthcare Provider/Professional Rescuer and Instructor in the course type as shown above. The certification is valid for 2 years. This notice serves as proof of course completion from the course date indicated above. I verify that the information above is accurate and truthful, and that it may be confirmed. This course was taught in accordance with the American Heart Association's organizational to meet and exceed the that as set forth by the Massachusetts Department of Public Health. This course was taught by a Massachusetts EMT and I struc�pr for the American Heart Association. Director/Instructor's Signature: - AHA Instructor I.D.#5120098181,EMT:#E0870558 JG M es SL;V76cr i j rt BOARD OF HEALTH Town of Barnstable John T.Norman Board of Health Donald A.Gaudagnoli,M.D. WkRN8rA2BLL •` Paul J.Canniff,D.M.D. AfA*a} �s 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; CI-apter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 117 Issue Date: 01/01/2021 DBA: KARIBBEAN LOUNGE, THE OWNER: THE KARIBBEAN LOUNGE LLC. Location of Establishment: 662 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 86 OutdoorSeating: 48 Total Seating: 134 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Cr FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: D� For Office UseInitials. QD "'E'°'yti� Town of Barnstable Date Paid �, ZO Amt..&I$ �' BARNSrABLE, : Inspectional Services `0$ Check Do p� �Eo �a Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 10"5010 NEW OWNERSHIP RENEWAL Ll"' NAME OF FOOD ESTABLISHMENT: 71H67 _i�l � t ouffiy�ee ADDRESS OF FOOD ESTABLISHMENT: 6(" MAILING ADDRESS.(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: ,." a"f Ue_,Q4 Cj Li TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO . (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: 10 OUTSIDE: 9 TOTAL: . SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LIC ING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REOUIREMENTS. cc IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? �l IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? � TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpphcation FormsTOODAPP 2020.doc r^ f , OWNER INFORMATION: � FULL NAME OF APPLICANT 14bC^r" '/ �OD) /'1/ SOLE OWNER: YES/P D.O.B ,D—G —WW WNER PHONE# ��� --n �2 P S ADDRESS "7// -rW J 1 CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date I. P L L^0 j$'D t D �l � ,l ��' 1. /1�/ �l b l 16 /3D/ SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments, including mobile trucks must be inspected by the Health Div. prior to openinc!! 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 httv://www.townofbarnstable.us/healthdivision/ai)plications.asy. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3I't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Application Fonns\FOODAPP REV3-2019.doc a+ MAIL-W REQUESTS Please mail the completed application form to the address below. Also include copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition,you must mail the required fee amount (see box below). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. FEES: Bed & Breakfast Permit= $55; Food Service Permit 0-49 seats= $250; 50 or more seats $300; Continental Breakfast= $30; Retail Food (only TCS Foods)= $20; Retail Food Store—Less than 8,000 S.F._ $100, more than 8,000 S.F. = $285; less than 1,000 S.F.; Retail Food Combo/Limited Prep. - $200.00; Cottage Food Industry= $75; Mobile Truck=$50; Mobile Ice Cream Truck= $35; Frozen Dessert License=$30; Additional non-refundable Fee for New Establishment or New Ownership=$100-$500(see staff),Late Fee= $10 Q\Application FormsWOODAPP REV3-2019.doc f o �sT Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli, M.D. aAWN9TAnr- Paul J.Canniff,D.M.D. 4S4 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: 117 Issue Date: 07/23/2020 DBA: KARIBBEAN LOUNGE, THE OWNER: THE KARIBBEAN LOUNGE LLC. Location of Establishment: 662 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 86 OutdoorSeating: 48 Total Seating: 134 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, IRS, CHO, Health Agent i FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: r oFIMMErq� Only*For Office Use Initials: ti Town of Barnstable Date Paid =3ao'. � ,ARNSPABLE. Inspectional Services � T�� MASS. 1639. ♦0 Public Health Division Check# �f0 MAC s Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE02—II'20 NEW OWNERSHIP ✓'/ RENEWAL �,� NAME OF FOOD ESTABLISHMENT: TH jj� V-og-1,1z[5(= o LZ��(��-I0��1v ADDRESS OF FOOD ESTABLISHMENT: 66 Z /Sir H'I Aga S 1►1n 0 2.�, o t MAILING ADDRESS(IF rrDIFFERENT r FROM ABOVE): 55 S rifigi614-Tjiq�j A)/5 /n,19 6Z6 61 E-MAIL ADDRESS: ^e�C✓J)�/7�''!�✓1lOL(rl Ej�i `��I�'►'lCyt I" � 1 TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (79q) 40 - ?,6 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO ✓ ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: ✓ SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE:� OUTSIDE: .TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? , TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) ✓FOOD SERVICE __.,RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST ✓CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING .. (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpplication FormsT00DAPP 2020.doc OWNER INFORMATION:FULL NAME OF APPLICANT A UAV Prl-f `Rb:Diqq SOLE OWNER: YES tJ D.�O`BJ I© / OWNER PHONE # 97?t-t.,- 2 0 d / Z0 T 21 ADDRESS S �2— s-rY-11-( /r, �, /S rn F'f 02,(o 0 1 CORPORATE OWNER: n 1 (`� a Loafi)4-f &L c CORPORATE ADDRESS: 6 6'2v N S/, HNfiza/v f S m A- (j Z PERSON IN CHARGE OF DAILY OPERATIONS: ft'jT ()� A- 6D A rI 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. I `?3oDpkl SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at httV://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3I't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Wpplication FormsTOODAPP REV3-2019.doc I R Application Fee: $100.00($200 supermarkets)plus Permit Fee-$300.00 or$250.00-$285 for Supermarket Name of Business: Kay,t����1� ` - DATE Address: _ (��� JAAc�" 5-- Owner: . #Seats- Indoors: Outdoors*: (If seating provided,see Licensing department) *If outside dining provided,you must fill out and submit application for outside dining/sidewalk cafe RESTAURANTS Yes No Floor plans submitted �� iu-1e-z- et)—` / Staff meeting review date: ✓ Food establishment application form filled out and submitted Cut\S ec equipment sheets submitted for all food equipment) Adequate septic system or town sewer In-ground grease trap or GRD with a variance ,7 Menu submitted , -Allergy notice present tJ.Gi� �t:�p_e k C.d- 4./ -Consumer advisory resent for undercooked foods on menu Uf required) Water supply-Approved source. If well annual testing&licensed o erator Handwash sinks-location,number,design��d$igns�� �_' _ t wAr Touchless faucets see policy) Y11,'1 La_W Three compartment sink with drain boards - P4-(- Area to air d all washed a ui ment,utensils,dishes,etc. Dishwasher provided I, _ i If low temperature: ^ l/ n -Low sanitizer alarm(for new dishwashers) {hltiyr y �( -Type of sanitizer-Quats,bleach or other(specify if other) V 5 -Sanitizer log book *If no dishwasher provided,see policy Sanitizer test strips for dishwasher,3 bay sink wiping cloth sanitizer buckets,etc. „ wPre Sink-See policy op Sink-Mops to be hung to air d — Wa A liz wau. ( t/ F e(Dairy) Ventilations stem for hood Number of Bathrooms Proposed: L Touchless Faucet(see policy) 2. Ventilation Systems �. 3. Self-closing doors k_emsto 4. Soap Dispensers-Mounted 4 (,(/ i 5. Paper Towels-Mounted 6. Handwashing Signs 7. Women's Room-Covered trash bin and\or sanitary napkin receptacle Floors,Walls,Ceilings(Smooth,washable,easily cleanable surfaces) FINISH SCHEDULE SEE ADDENDUM ATTACHED Lighting-Sufficient/lighting shielded or shatterproof Refuse containers covered(sufficient number and size,durable easily cleaned,insect& rodent resistant) I _ -Dum ster impervious ground and blocked from public view ,� &d ' V„ Dry storage room location shown on floor plan 4 v\ Ca NUA •5 S Employees personal storage(i.e.coats,bags,etc)area designated. May use lockers Poisonous or Toxic Materials(storage located marked on plan,labeled containers) Screens for Windows and Doors Y,- + -Any questions,please contact the Health Inspector for your area -Plan approval shall be granted or denied within 30 days after Staff meeting review -This list is not inclusive of all Federal,State and Local requirements w,^ Revised 01/07/2016 O C� �/� t`S`�11�►�.(J�(, y Q:restaurantslnew restaurant checkiist.doc � �� �� ✓ 1 ���/��� i'_ � i pp THE Toy," TOWN OF BARNSTABLE _ HEALTH INSPECTOR'S Establishment Name: Da4t - Page: of P. o OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE, 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. $. MON.-FRI. �A 163v .0 HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY 'FON1P`' FOOD ESTABLISHMENT INSPECTION REPORT Nam Date a of Type of Inspection O irde aa: Address Risk od Service i4tion Level Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness 'A � Caterer General Complaint `� Person in Charge(PIC) Time Bed&Breakfast HACCP Other In: Inspector /lA Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. _ 69 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 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 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 l ��. Critical(C)violations marked must be corrected immediately. (blue&red items) I I Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590:004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F 6=One critical violation and less than 4 re-rion-critical violations g 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) g violation,4 to 8 non-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 viewkm,V V Permit Posted ? Y N Grease Trap Previous Pumping Date Grease Rendered Y N IC's Signature Print: #Seats Observed Frozen Dessert Machines: Outside Dining Y N 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 L 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 15 Cooling 590.003(B) Demonstration of Knowledge* � 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501. g Methods for PHFs Cooked and RTE Foods.* 19. PHF Hot and Cold Holding 2-103.11 Person-in-Chazge Duties i 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) * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se azation-Storage*Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) 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 F9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 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* Equipment* gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 1/I12001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590A06(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 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)-(J)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401..12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165'F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3'-401.I I(A)(1)(b).All bther PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the 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 Tags/Records:Fish Products Item Good Retail Practices FC 590.000 5-203.11 Numbers and CaP acities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,-Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food-Code or 105 CMR 590.000. of-ME rqt TOWN OF BARNSTABLE.. HEALTH INSPECTOR'S Establishment Name: Date: Page: of. qo -OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ` 200 MAIN STREET 3: - . FRI P.M. C-Critical Item MO DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MAC, g �p ,659,e�m - HYANNIS,MA 02601 � � -� 508-8 -s2-asaa. Item Code No Reference �R-Red Item- PLEASE PRINT CLEARLY ; 'FON1A` FOOD ESTABLISHMENT INSPECTION REPORT t Name I Date Tvpe of TypsaEjMection kA Address Risk od Service/117 - nVV a Level Previous Inspection Cam-" 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 on 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 AZI ❑ 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 j.16214A .0 LA L? ID ❑ 5.Receiving/Condition ❑ 17.Reheating 471 ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling AN ❑ 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 ADVISORYVnl Ilk ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories '/�Jvl( Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Vlolatio A �- Critical(C)violations marked must be corrected immediately. (blue&red items) n 6 Corrective Action Required: sTj Non-critical(N)violations must be corrected immediately or Overall Rating c t (JV within 90.days as determined by the Board of Health. \\ El Voluntary Compliance ❑ Employee Restriction/Exclusion Re-inspection' heduled Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items El Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than_3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4' 590.005 6=One critical violation and less than Orion-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 (F.C-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8rion-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 {A ,yA&0 k�ll Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N ►�i V #Seats Observed Frozen Dessert Machines: Outside Dining Y N C's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y.-N V 'V' toi Dumpster Screen? Y N -X/ 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.* PHF Hot and Cold Holding-' 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* 19 Contamination from Raw Ingredients 15 590.004(F) Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 3-302.11(A) Food Protection* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 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 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 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 Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145'F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg c""e uuzooi 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 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* 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 practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.11 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodbome * 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* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-002.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 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. ^ F.Ne roe,' TOWN OF BARNSTABLE- HEALTH INSPECTOR'S Establishment Name: Date: Page: of . o OFFICE HOURS •^ PUBLIC HEALTH DIVISION 8:00-9:30n.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MON HYANNIS,MA 02601 sos-as2.4R644 No Reference .R-Red Item PLEASE PRINT CLEARLY �'FDN1P�� FOOD ESTABLISHMENT INSPECTION REPORT ` Nam Da Tvue of T f Inspection O er outine' GNP Address% Risk d Service Re-inspection - Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors Red Items ( ) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009,(F) ❑ i Action as determined by the Board of Health. Allergen Awareness 590.009(G) 1 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities E A 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 )) Iff ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling r k ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding /gam y PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control C/- J`J ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ' d" QVIA ❑ 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: ❑-Ne s, Non-critical(N)violations must be corrected immediately or Overall Rating )40 within 90 days as determined by the Board of Health. ❑ Voluntary Compliance., F] Emplo ion/E lusion ❑ Re-inspection Scheduled ff Emer ncy Suspension C N Official Order for Correction: Based on an inspection today, a 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. (FC-4 590.005 B=One critical violation and less than Orion-critical violations 9 25.Equipment and Utensils )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 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 (FC-6)(590.007) 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 aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to a 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 8rion-critical violations=C. 29.Special Requirements (590.009 Y P 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Ir Dumpster Screen? Y N ._. _-Y._ _ _. - _. .-. �. ..- -i-:.;r .. y � .�_ _ ° � �--.- Y--,rc.. v .�.'x+w.. �., s �.. _�... .. ° -__ s. _. •-- -�- � � �..° eJ' 1 - � .. Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003 A Assi nment of Responsibility* S Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) g14 Food or Color Additives * * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 590.004(F) Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003 F) Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * ( p ty3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) • Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B),Compliance with Food Law* 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* Raw Seed Sprouts Not Served* in 3-201.12 Food in a Hermetically Sealed Contaer* 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 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cme uiaoor 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11 C 3 Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* ( )O p Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11. Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 * (Blue Items 23-30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* ig 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 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 5205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 - 3-402.12 Records,Creation and Retention* Within 4 Hours 26. Water,Plumbing and Waste FC-5 _006 590.004(J) Labeling of Ingredients' I Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:59oFormback6-2doc '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`"E row TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: ! Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. % BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. i639•p 0� HYANNIS,MA 02601 sos-s2�saa No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Nam Date Type of T e o Ins ection t. Zoa: Ion outine Address Risk Servi spection Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) 1 CAN a Bed&Breakfast HACCP Other `%,D _ Inspector Out: V � , Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. 4-0 Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ 014 Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.0139(F) ❑ Action as determined by the.Board of Health. Allergen Awareness 590.009(G) L FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities 4A!�eA en EMPLOYEE HEALTH PROTECTION FROM CHEMICALS �' ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives (//ry• loe .4 ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals nn FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially H �rous F d ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures VVVVVV ' ❑ 5.Receiving/Condition ❑ 17.Reheating '/`j ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling `� 1 ❑ 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 i N�/ Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations LJX Critical(C)violations marked must be corrected immediately. (blue&red items) �/- Corrective Action Required: ,.r• ❑ � � - Non-critical(N)violations must be corrected immediately or Overall Rating v within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Emplo / xclu -ins ection hed led er c ension C N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. F] Embargo ❑ Emergency Closure ❑ Volu a Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below b a Board of Health member or its agent 21 24.Food and Food Preparation FC-3 590.004 P 9 Y 9 A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more.non-critical violations, P ( )( ) constitutes an order of the Board of Health. Failure to correct violations 6=One critical violation and less than 4von-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 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 (FC-7)(590.o08) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 29.Special equirements (590.009) Y P 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dum ter screened from public view S, Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N AC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N `r Dumpster Screen? Y N (]�- Violation related to Foodborne Illness Violation Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont) FOOD PROTECTION MANAGEMENT i PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41'F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45'F 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-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) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.003(G) Reporting by Person in Charge* Contamination from the Consumer F-3 590.003(D) Exclusion's and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and * 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E(f=ca,e inrzooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155`F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) 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 g• p �' 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition Cditi -Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140'F* (Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140`F[0 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 5-203.I I Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products P 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 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. 1 Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8 103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. �p IKE Tom TOWN OF BARNSTABLE _ HEALTH wSPECTOR,s Establishment Name: Date: Page,: of, 'GYP OFFICE HOURS PUBLIC HEALTH DIVISION a:oo-s:soA.M. BARNSTABLE. = 200 MAIN STREET s:so-a:so P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified c59. `0� HYANNIS,MA 02601 MON.-FRi. No Reference R-Red Item PLEASE PRINT CLEARLY P'EDN1"p FOOD ESTABLISHMENT INSPECTION REPORT 508-862a644 Name Da t e f Tvoe of Inspection Routine - Address Ris Food S Re-inspection J ` Lev I _Retail Previous Inspection Telephone Residential Kitchen D Mobile re-operation Owner HACCP Y/N Temporary Caterer Genera 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(009 Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 59 ) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 59 ) ❑ p�Action as determined by the Board of Health. Allergen Awareness 59G) ❑ 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 F, ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories LZ Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations n, 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 ElEmbargo C] 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 B=One critical violation and less than 4npn-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 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 8 non-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 C's ignature Prit: r Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N ffi� s Dumpster Screen? Y N _ ll (�/ _. .. * . �. �: - .- ti ...� -1 -�Y,w.-..�-. --.r°....-... r x � -_ �--` . 1. - . - ' ,.. . .�-.,.�-�•" n - - _ _ Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 1 q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 590.004(F) Other* . 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* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Pelson-in-Charge to 7-10211 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation Storage** 3-501.16(A) Roasts Held At or Above 130°F* - Applicants* 3-302.11(A) Food Protection* P g 7-202.11 Restriction-Presence and Use* 20 Time as a Public Health Control Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils ( ) 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)Resumed Food and Reared or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 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 Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products*, 1 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. LL6 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* ' ' 3-001.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg crave 1/1/2001 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 * 3-201.14 Fish and Recreationally Caught.Mo_lluscan Contact Surfaces of Equipment* 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec Shellfish* I , _t )- 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* I y`_ \ Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority � 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B), Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3 403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E 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 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 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 1 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* j 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.006. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. `oF IKE Tp�'Y TOWN OF BARNSTABLE _ HEALTH wsPECTOR,s Establishment Name: Date: ® age: of P p OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. �b l'639•a e� HYANNIS, MA 02601 sos�sz asaa No Reference R-Red Item PLEASE PRINT CLEARLY F°M FOOD ESTABLISHMENT INSPECTION REPORT Name Dat Type of Type of Inspection o p Routine Address Risk nod Service R pectin Level Retai ection Telephone Residential Kitchen Date: Mobile eration Owner HACCP Y/N Temporary ness 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 599.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 009(F) ❑ All- Action as determined by the Board of Health. Allergen Awarenes 09(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities v EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives V ❑3.Personnel with Infectious Restricted/Excluded ® 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazard us o s� T ❑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 f ❑8.Separation/Segregation./Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE PO NS(HSP) C ❑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 Itemsl Total Number of Critical Violations j Critical(C)violations marked must be corrected immediately. (blue&red items) LJ� Corrective Acti equired: o ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. © ❑ Voluntary Compliance, El 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 4nnn-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 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8 non-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 h.. 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 � 5 f �'j'ADumpster Screen? Y N t Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) 1 and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41'F/45'F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH_- 3-302.11(A)(2) Raw Animal Foods Separated from Each * 590.004(F) 7-101.11 Identifying Information-Original Containers * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140'F 7-102.11 Common Name-Working Containers 3-501.16 * Require Reporting by Food Employees and Contamination from the Environment (A) Roasts Held At or Above 130'F Applicants*PP * 3-302.11(A) Food Protection 7-201.11 Separation-Storage* 20 Time as a Public Health Control 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served * P 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products 4-501.112 Mechanical Wazewashing-Hot Water Monitoring 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 Eggs Utensils and Food Contact Surfaces of E s-Immediate Service 145'F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef cdw 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) Ratites,Injected Meats-155'F 15 sec* f 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 ca[er- Ratites-165'F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen operations should be debited under Game and AutWildhority Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* RegulatoryAuthorlry 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tastin * * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3-403.11(C) Commercially Processed RTE Food-140'F Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E). Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°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 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41'F/45'F 25. Equipment and Utensils FC-4 .005 3402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 1 16-301.12 1 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6.2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 1 `oaIKE TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: n Page:, of P. Y� OFFICE HOURS BARNSfABLE. PUBLIC BZOO MAIN LST DIVISION 3:00 30-4:30 P.M. Item Code C-Critical Item 3:3o-a:3o P.M. DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 679• `0� HYANNIS,MA 02601 05 a-8624644 No Reference R-Red Item PLEASE PRINT CLEARLY rFO FOOD ESTABLISHMENT INSPECTION REPORT 19SLI Name at _yg of Type of Ins ep ction JA CAO Routine Address Risk ood S Re-inspection Level a ai Previous Inspection Telephone -7 .� Residential Kitchen Date, Mobile re-operation Owner HACCP Y/N Temporary s S Caterer General Complaint r 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. iA, Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ L Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives r ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals - FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Haz us Foods) Of j ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures A, ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling / ` 00, ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding i d PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Co rol ` ❑8..Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY S SCEPTIBLE OPU IR ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparatio for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY f/C / ❑ 11 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advis ries ® � Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violatio (� _ �� All Critical(C)violations marked must be corrected immediately. (blue&red items) O f G�Q � Corrective Action Required- o ❑ 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. B=One critical violation and less than 4non-critical violations re g 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 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 cal violations. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to a non critical violations=C. 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view mmjw�?.z A/1� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N 00, Dumpster Screen? Y N Violation 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 L14 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 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers*. 3-501.16 A Roasts Held At or Above 130°F* Require Reporting by Food Employees and Contamination from the Environment * ( ) 7-201.11 Separation-Storage 20 Time as a Public Health Control Applicants* 3-302.11(A) Food Protection* 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 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 Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g � ) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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 Wazewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 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 dness* 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* Ef ctiv 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) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and -ide itial - * Ratites-165°F 15 sec* in mobile food,tem or and residential Sources g• P aTY 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 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 Requices should be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 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 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1 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. 0 0 SaUpS & SatadS 7:00am-10:30am • .� Caribbean Chicken Soup. Seafood Ifledley. $7.25 East Coast Cake $13.$0 Chef's Special Seafood Cake, Egg & Hollandaise Sauce7TW Jamaican Jerk Chicken Salad or $9.75 Make Your Own Aimelette $10.50 � Vegetable Litwin Salad (add Shrimp$5.00) Steak, Ham, Bacon, Green Pepper, Spinach; � 0 � � � p Onion, Kale, Tomato, Cheese Where life is beautiful Meatless Dressing, Sauteed Shrimp & Chicken Bagel. Cream Cheese &Smiced Salmon Plate $12.50 &e9erVa' Strangly Recamnenaed SW771-J025 Salad with Sweet Orange Vinegarette Apples & Raisins Portuguese Sweet Mott Egg Sandwich $9.50 LwnghChoice of Lettuce, Tomato, Bacon & 11 OOam"130pm • Cheese (American, Cheddar, Pepper Jack) Sandwiches. ���� � Wraps ArpetizerS Main Street Lobster Doll $15.75 Breakfast Wrap $4.50 fried Calatmari $11.50 Egg, Ham & Cheese Caribbean BBQ Nam Sandwich $11.50 Loaded Potato fledges $0.75 Burger on Brioche Bun 10.75 Breakfast Egg Muffin $7.50 g Spinach, Egg, Onion &Tomato Caribbean Shrimp,Bruschetta $10.75 Jerk, Salmon; Veggie Caribbean Delight $12.50 Wings $9.50 Steak&Cheese Sub or Meatball Sub $10.25 Fried Dough with Island's Special Buffalo, BBQ, Jerk, Passion, Honey Mustard Kingston's Tuna Salad $12.25 Cod fritter Matter so.-IS Cocktail Beef Patties $00 Additions: Avocado, Sweet Pepper, Onion Salted Cod, Onion, Tomato & Egg Ground Beef, Herbs & spices, in flaky pastry Grilles! Chicken, Salsa, Wheat flatbread $12.25 French Toast $8.25 Glazed Jamaican Jerk Meatballs $&50 Jerk BBQ pulled Pork Sandwich $92.75 Choice of Bread: Brioche, White, Wheat Fried Pressed Green Plantain $5.25 & Confectioners Sugar LU=h SUC& Fries, Onion Rings, Coleslaw Option of Seasonal Fruit $1.50 Parmesan, Salt & Parsely Choice of two. Additional sides $2.50 each llred*St SUM Sausage, Bacon, Bacon Wrapped Pineapple Bites $5.25 rip 0 Pancake, Home Fries, Toast, Dumplings, Kabobs $6.S0/$7.50/$&50 0ds ftv Choice $7.50 Plantains, Avocado, Fruit Bowl Vegetable/Chicken/Shrimp Choice of two. Additional sides $2.50 each 1/2 Gritted Cheese &Fries Cheese or Beef Ravioli Consuming raw or undercooked meats,poultry,seafood,shellfish,or eggs may increase Cheese Burger Not Dog your risk of food borne illness,especially if you have certain medical conditions.Before placing Meatball W/Pasta Chicken Tenders your order,please inform your server if any person in your party has a food allergy. Aunt Allanah'S Mac &Cheese Town of Barnstable Site Plan Review YiAANST'ABLE, 200 Main Street, Y f H annis MA 02601 BARNSTABLE 9 MASS. 'l 0°s "sNasCQ!%awilF°ACIulg 059. ,0� www.town.barnstable.ma.us 1634-2014 'Drev r"A�a Office: 508-862-4679 �g February 12, 2020 Ms. Allanah Bodah 55 Straightway Hyannis, MA 02601 Re: The Karibbean Lounge LLC—Allanah Bodah 662 Main St., Hyannis Map/Parcel: 308/049 Zoning: HVBIAP Proposal: Applicant to reopen existing restaurant location associated with hotel.Seating numbers remain the same.No construction or renovations are planned. Dear Ms. Bodah, At the informal site plan review meeting held on February 11, 2020 the above proposal was found to be approvable subject to the following conditions. • Brian Florence:A meeting between the applicant, Architect, Brian Florence, Captain David Webb to review the updated architectural plan inclusive of the patio and capacity numbers. Final capacity numbers will dictate the requirement for sprinklers and crowd managers. • Anna Brigham: HHDC (Hyannis Historic) application will be required for signage and outside dining. Contact: Karen.Herrand(ctown.barn stable.ma.us • Captain Webb: A walkthrough will be required prior to opening to ensure all fire related systems are in current working order. Contact: Dwebb(-hyannisfire.orq • Lindsay Parvin and Richard Scali:Alcohol and Entertainment applications will be required. Contact: Lindsay.Parvin(Qtown.barn stable.ma.us • Nathan Collins: Existing grease trap allows for 114 seats. - Applicant must obtain all other applicable permits, licenses and approvals required. SMFloren BBO Chairman Cc: Site Plan Review Committee V Town of Barnstable Building Department Services Q.* Brian Florence,CBO s I � Building Commissioner 200 Main street,Hyannis;MA 02601 www.town.barnstable.maus Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section - If Usin A Builder as Owner of the subject property hereby authorize to act on my behalf; in all matters relative to work authorized by this binding permit application for: (Address of Job) "Pool fences and alarms are the responsibility of the applicant Pools . are not to be filled or utilized before fence is installed and all final in pections are performed and accepted. S' tore of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOI S Rev:09/16/17 L a' Aniela H Bodah (5 S) 810t Hyannis MA.02601. 774 10 5088088. Aniela_bodah@yahoo.com EXPERIENCES CERTIFICATES Cape Air Airlines,Barnstable MA-Cross Trained Agent and Amadeus Super User • AHA First Aid and CPR Certify June 2013-PRSENT • Tips • Check in passengers and enforce FAA security regulations. • Assist Customer Service Agent.to SKILLS troubleshoot computer problem(s). . • Strong organizational skills,ability to prioritize, • Assisted Manager with hiring and training maintain attention to detail and recognize time new employees constraints • Highly flexible and adaptable to change Ocean Edge Resort,Brewster MA- • Tean,player-with the ability to handle strong Banquet Server personalities at all levels of the institution May 2015-Aug 2017 • Ability to meet deadlines and detail orientation ; • Set up banquet area • Interact with guest • Serve food and Beveraues VOLUNTEER Golden Gardena Restaurant • Maintain Cleanliness July 2008-September 2010 • Monitor customer experience • Manage Inventory Crowne Plaza,lake Placid NY-Prep cook June 2008-June 2010 • Prepare cooking ingredients by washing and chapping vegetables,cutting meat etc. • Comply with nutrition and sanitation guidelines. • Perform other kitchen duties as assigned. EDUCATION Cape Cod Community College,Barnstable MA Present • Computer Science n Town of Barnstablef eu(+4-, S�'�L �. XL a 1111ao� Building Department v ' Brien Florence, CB 0 Building Commissioner 200 Main Street,Hyannis,MA 02601 www.towa bamstabJe,ma as Pre-application for Business Certificate Date Map Parcel 3a� Applicant Information Applicants Ad&ess- Emar1 Addirss he " i Q `' cj M�ii'Cvn Telephone Numbea � Listed❑ Uffetd la" (1 c1 E: Business Information New Business? ------------------------- Yes No Business is aregistraed corporation? ------------------------. Yes i dyes Name of Corporation �j Does business operate under the registered corporate name Yes No is the business a soleprnprietori14 or home occupation? --------- Yes If yes s Ho je O on Registration is regafred—See Binding Division Staff Name ofBusiness L( 64-6 Business Address�,(a,�_ ✓Y� l91/� S'% �/v I S o z&O Type of Business ��ft- ITT r B Commissioner Office Use On Conditions — - Building Commiss a6 Clerk Office Use Only i-• Moo.YOfeL I BIDG. •\ r � �= a f- I Wr_ °eres'v�ro ® 9 ocls*.Yore a® 1'1 ` elnc. 1 00-00-00 Ij 40 v.oi.c; REVISION�I �Npvr \�e INTERNATIONAL INN 1 \ 662 MAIN STREET HYANNIS, MA i / O PlAWA DeSi n Group, P.C.5�N� I elllrler4 erel<. ler •,��-� w�rw Consultant: SITE PLAN a- JL •100 Gh.1ked '� Issued. � 10-20-08 Drawing dle: SITE PLAN Sane:AS NOTED .q r, i Mark Patel 662 Main Street Hyannis, MA 0260E March 06, 2020. To:Town of Barnstable Health Department, The Hyannis Plaza Hotel and the Karibbean Lounge are in agreement that the hotel's staff is not allowed in the kitchen area. Hotel staff will not enter through the kitchen to do their linens, nor will hotel staffs use the Karibbean Lounge's service sink. The restrooms in the lobby area near the entrance of the restaurant and restrooms in basement (staff only) of the Karibbean Lounge is the sole responsibility of the Karibbean Lounge to maintain cleanliness and necessities. If you have any question please email me at patelm6rkl5@gmail.com. Sincerely, A Mar Patel Hyannis Plaza l 'Application Fee: $100.00($200 supermarkets)plus Permit Fee-$300.00 or$250.00-$285 for Supermarkets • �; Name of Business: bbe Lb[�j tea DATE Address: 6 6N D D4— -Z_.0 Owner: ')41-( #Seats- Indoors: !&tg Outdoors*: (If seating provided,see Licensing department) *If outside dining provided,you must fill out and submit application for outside dining/sidewalk cafe RESTAURANTS Yes No Floor plans submitted Staff meeting review date: Food establishment application form filled out and submitted Cut\S ec equipment sheets submitted for all food equipment) Adequate septic system or town sewer In-ground grease trap or GRD with a variance Menu submitted -Allergy notice present / -Consumer advisory resent for undercooked foods on menu if required) Water supply-Approved source. If well annual testing&licensed o erator Handwash sinks-location,number,design and signs Touchless faucets seepolicy) Three compartment sink with drain boards Area to air dry all washed equipment,utensils,dishes,etc. Dishwasher provided If low temperature: -Low sanitizer alarm(for new dishwashers) -Type of sanitizer-Quats,bleach or other(specify if other) -Sanitizer log book *If no dishwasher provided,see policy Sanitizer test strips for dishwasher,3 bay sink wiping cloth sanitizer buckets,etc. Prep Sink-See policy Mop Sink-Mops to be hung properly to air dry Frozen Dessert Machine(Dairy) Ventilations stem for hood Number of Bathrooms Proposed: 1. Touchless Faucet(see policy) 2. Ventilation Systems 3. Self-closing doors 4. Soap Dispensers-Mounted 5. Paper Towels-Mounted 6. Handwashing Signs 7. Women's Room-Covered trash bin and\or sanitary napkin receptacle Floors,Walls,Ceilings(Smooth,washable,easily cleanable surfaces) FINISH SCHEDULE SEE ADDENDUM ATTACHED Lighting-Sufficient/lighting shielded or shatterproof 1 Refuse containers covered(sufficient number and size,durable easily cleaned,insect& rodent resistant) ` / -Dum ster impervious ground and blocked from public view V Dry storage room location shown on floor plan Employees personal storage(i.e.coats,bags,etc)area designated. May use lockers Poisonous or Toxic Materials(storage located marked on plan,labeled containers) Screens for Windows and Doors -Any questions,please contact the Health Inspector for your area -Plan approval shall be granted or denied within 30 days after Staff meeting review -This list is not inclusive of all Federal,State and Local requirements I Revised 01/07/2016 Q:restaurantslnew restaurant checklist.doc § 322-5. Outdoor dining: Checklist. Instructions: 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: v(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 Board 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. L�(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. t/ (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 existing in-ground grease trap, after receiving the approval of the Board of Health. c/ (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. Z(7)A drainage system designed to eliminate odors will be required for all outdoor dining areas.Hose bibs with vacuum breakers 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 cont rol odors. The patio or other ground surface must be of constructed of material readily cleanable and not susceptible to dust, mud, r debris. (Brick,tile, and concrete are examples of acceptable materials.) 7(10)Table tops must be smooth,nonporous, easily cleanable and durable,and readily maintained in a clean and sanitary co71, n. )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 provided 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 dining. 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. vi (13)Outside food handlers must have easy access to handwash sinks and cleaning cloths. Facilities for preparation and disposal of sanitizing solutions must be accessible. (14) Hair nets or other effective hair restraints, such as hats covering exposed hair, shall be worn by all outside food or drink 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 p ovi ed to the outside dining area(self-service only). Q\Application Forms\OUTDINAPCHECKLIST.doc Applicant's Signature: Date: t y � �4 All Ir Af ram- 4 '�1 V 3 JU Bellaire, Dianna From: Scali, Richard Sent: Friday, December 11, 2020 2:11 PM To: 'thekaribbeanlounge@gmail.com' Cc: Parvin, Lindsay; Gallant, Therese; Gallant,Therese; Bellaire, Dianna; McKean,Thomas Subject: RE:The Karibbean Lounge Hi Aniela, I am sorry to hear how the business and of course you are not alone.While the is typically due by Dec 18th,we can give you until the end of the month. I will ask Lindsay to place you on the Dec 30"'agenda for renewal. If for some reason you need more time than Dec 30t",just let us know and we can have the Commissioners review it for you. Please update us on any changes. Richard Scali From: thekaribbeanlounge@gmail.com [mailto:thekaribbeanlounge@gmail.com] Sent: Friday, December 11, 2020 2:02 PM To: Scali, Richard Subject: The Karibbean Lounge Hi Richard, Good day, and happy holidays to you and your family when it comes. I sent out a check for payment of 2021 license, but it was returned. I'm very sorry about this, an automated charge came out of the account right in the same time. Business has been very slow since we've opened. I am working on putting this payment together. Is there any possible way I can get the time extended to pay? Even if it's possible until the end of the month? We at The Karibbean Lounge looks forward to any leniency we can get at this time please. Anticipating an early and favorable response. Thanks, Aniela Bodah Sent from Yahoo Mail on Android CAUTION:This email originated from outside of the Town of Barnstable!Do not click links open attachments or reply, unless you recognize the sender's email address and know,the content is safe!' i Men LA5 Before placing your order please note your server if you or anyone in your party has a,food allergy before ordering. The consumption of raw or undercooked meats, seafood, poultry, eggs and shellfsh could increase your risk offoodborne illness. KIDS Auntie Lana's mac and cheese Pasta.with.Marmara sauce Chicken fingers serve with fries Kids burger Cheese quesadilla Fish and Chips Kid s pizza Grilled cheese Chicken parmesan Parmesan cheese, marinara sauce; penne pasta r Appetizer Hot Wings Serve with ranch, blue cheese and celery sticks Chicken Fingers 5 chicken fingers, side of honey mustard and celery sticks Baked Potato Skin with Bacon Idaho potato, smoked bacon, mozzarella cheese, sour cream C alamari Banana pepper aioli, water crest Shrimp Cocktail Lemon wedge,cocktail sauce, tobasco Oyster Raw oyster, cocktail sauce, mignonette sauce, lemon wedge,tobasco Humus with Pita bread Feta cheese and black olives Mussels Herb butter,toast baguette,basil leaves, white wine 2 Salads Wedge Salad Baby iceberg, heirloom tomato,grape tomato,red onion, crumble blue cheese, blue cheese dressing Caesar Salad Romaine heart lettuce,grape tomato,croutons, shave parmes4n cheese, black olives, anchovy, caesar dressing Garden Salad Mix greens, red onion, cucumber, grape tomato, feta cheese,balsamic dressing Kale Salad Kale, dried cranberry, dates,goat cheese, walnuts,avocado, ranch dressing Cobb Salad Chopped iceberg, eggs, tomato, avocado,bacon, red onion, blue cheese dressing, crtunble blue cheese Farro Salad Spinach, grape tomato, roasted red pepper,zucchini, red onion, parsley, basil, lemon, garlic, olive oil Sides Grilled shrimp Grilled Steak Grilled Chicken Salmon 3 Sandwiches and Wraps Serves with a size of fries Fish Sandwich Haddock, lettuce,tomato,red onion, tartar sauce Fried Chichen Sandwich Fried chicken breast, lettuce tomato, red onion, pickle Grilled Chicken Sandwich Grilled chicken breast, lettuce, tomato,red onion , Lobster Roll Lobster salad, lettuce,lemon wedge All-Natural Burger 8oz.angus beef, lettuce, tomato,onion, cheddar cheese Add bacon or mushroom Shrimp Roll Fried shrimp, lettuce, onion,lemon aioli, lemon wedge Veggie Burger Avocado,Toasted brioche, small salad Veggie Wrap Humus, seasonal vegetable, spring mix, avocado,goat cheese Chicken Quesadilla Corn,black beans, sour cream, thousand island dressing, tomato salsa 4 Entree Shrimp Risotto Shrimp, parmesan cheese, diced tomato New York Sirlouz Steak Seasonal vegetable, potato gratin, demi glaze sauce Fillet Mignon Fingerling potato,seasonal vegetable, demi glaze sauce Flat Iron Steak Red and yellow peppers, red onion, fries, tomato salad,herb butter Fish and Chips Haddock,coleslaw, lemon wedge,tartar sauce, fries Feast Barbeque ribs, pull pork; grilled chicken, corn, biscuit, coleslaw, barbeque sauce Salmon Grilled salmon, jasmine rice, carrot, grape tomato, asparagus, lemon wedge,berlin sauce Chicken Broccoli Alfredo Sauteed chicken, penne pasta, alfredo sauce Beef Liver and Onions Asparagus, mashed potato,red wine jus sauce Lobster Bag Fresh Maine lobster, herb roasted yukon gold potato,corn, drawn butter,lemon wedge Lobster Mac and Cheese Fresh Maine lobster Surf and Turf Mashed potato,Fillet mignon, shrimp, asparagus, baby carrot, lemon berlin sauce 5 I Breakfast Eggs Benedict 2 slice Canadian bacon, 2 poached eggs, english muffin, hollandaise sauce Lobster Benedict Lobster, enghsh muffin, 2 poached eggs, asparagus, hollandaise sauce Steak and Eggs Small fillet mignon, potato confit,eggs your choice Lounge Scramble Eggs Egg white,baby spinach, tomatoes, soya beans, red onion Smoked Salmon Plate One hardboiled egg, sliced tomato onion, capers Toast Bagel with Cream Cheese Chive Belgian Waffles Caramelized banar_a compote, chantilly cream, confectioner sugar Cinnamon and Vanilla French Toast Fresh berries, vermont maple syrup, confectioner sugar Organic Greek Yogurt and House made Granola Parfait Fresh berries, clover honey Fruit Salad Omelet Veggie with goat cheese Ham and cheese Salmon with cream cheese 6 The Caribbean Blend Porridge • Monday-Coimeal • Tuesday- Oatmeal • Wednesday-Plaintain • Thursday- Peanut • Friday-cashew and oats • Saturday-Banana • Sunday-Hominey Sunrise Salted cod fritters, fried plantains, fresh fruits and toast Morning Glory Hardboiled egg, crackers, cheese and fAuts Chef's Special Serve with boiled dumpling and ground provisions Ackee and salfsh Kidney Callaloo and salfsh Stewed Chicken Sides Dried dumpling Fruit Bowls Fried green plantains Toast B anuny 7 a 7 -� • Dry �� 1 . er Owt. Gw 8w✓ C J Soups U Monday-Chicken Tuesday- beef soup Wednesday-Clam chowder Thursday- Red peas Friday-Vegetable Saturday-Chef choice Sunday-Seafood medley Taste The Caribbean Serve with rice and beans, white rice or roti and seasonal vegetable Oxtail Curry Goat Fried Chicken Jerk B B Q chicken Pork Ribs Chef's Special Steamed fish and okra with crackers Jerk Lobster Fresh Maine lobster, seasonal vegetable, any side of choice Sides Rice and beans White Rice Festival Roti Seasonal vegetable Corn bread 8 III The Karibbean Lounge (GF) Gluten free The consumption of raw or undercooked meats, seafood, poultry, eggs and shellfsh could increase your risk of foodborne illness. ase notify your server if you or anyone in your party has a food allergy before ordering Breakfast 7am- 1030am �Porridye Monday-Cormeal Tuesday-Oatmeal Wednesday- Plaintain Thursday- Peanut Friday-cashew and oats Saturday- Banana Sunday- Hominey �xrn Q..ack • Salted cod fritters, fried plantains,fresh fruits and toast Morning Glory • Hardboiled egg, cracke•s, cheese and fruits f Chefs Special Serve with boiled dumpling and ground provisions ➢ Ackee and salfish ➢ Kidney ➢ Callaloo and salfish ➢ Stewed Chicken Sides ➢ Fried dumpling ➢ Fruit Bowls ➢ Fried green plantains ➢ Toast ➢ Bammy Lunch and Dinner 1 lam-1230am Kids �41enu Chicken and Fries • 3 pieces chicken tenders with potato fries Nachos and cheese Aunty Lana Mac 'n' cheese Burger • Cheddar, lettuce,tomato f Appetizers Fish Tacos • Crispy cod, white corn tortilla, shredded cabbage,guacamole, cilantro cream and pico de gallo Baja Shrimp Cocktail (GF) • Jumbo shrimp,tomato-lime cocktail salsa,avocado and tortilla chips Chicken wingz • Tossed with your choice of homemade teriyaki garlic, honey habanero,whiskey BBQ or buffalo sauce Nacho and Dip Soups Monday-Chic en Tuesd ,a —6� Y Wednesday-Clam chowder Thursday- Red peas Friday-Vegetable Saturday- Manish water Sunday-Seafood medley Salads, Sandwiches and Wraps Cobb Salad (G'F) • Romaine heart, boiled egg,avocado,tomato,smoked bacon, diced chicken, blue cheese, red wine vinargrette. Caesar Salad • Romaine heart, olive, baby tomato, crouton, parmesan cheese, house made dressing Baby Icecerg Wedge Salad (GF) • Smoked bacon, blue cheese, red onion,tomato Grilled Veg,wrap • Grilled vegetables, spinach, red peppers,feta, pesto aiolo in a white wrap Caesar BLT • Romaine lettuce, applewood smoked bacon, Caesar, beefsteak tomato, parmesan sourdough Chicken Parmesan melt • Breaded chicken breast, marinara, mozzarella,thick cut sourdough bread. The Bodah's all-natural steak burger • Brioche, lettuce, tomato, onion, pickle, choice of cheddar, Swiss or American cheese serve with fries Taste The CariOean Serve with rice and beans, white rice or roti and seasonal vegetable Oxtail Curry Goat Fried Chicken Jerk BBQ chicken Pork Ribs Chef s Speciaf Steamed fish and okra with crackers Sides • Rice and beans • White Rice • Festival • Roti • Seasonal vegetable • Corn bread • Roti ►A• Jerk Marinated Steak 1ipS $23.00 Baked Stuffed Chicken $98.00 0 0 o Spinach, Cottage Cheese, Jerk Sauce 0g $ q�00pm-92:30am � W�r Chicken or Shrimp Scampi 78.00/$20.00 fried Calamari $11.50 0 B Where life is beautiful Grilled Chicken Brocoli Alfredo $1&00 Loaded Potato!Wedges $6.75 Baked Stuffed Shrimp $22.00 Caribbean Shrimp Bruschetta $90.75 � S*aMly�ecamo�o�aled I 508-77t-0a5 Blackened Salmon $20.00 po(nneTo (Wings $9.50 Garlic Parmesan Chicken $1&00 Buffalo, BBQ, Jerk, Passion, Honey Mustard 4:OOpom-70:OOpm DiMler We& Seasoned Rice, Rice & Beans, Cocktail Beef Patties $4,50 Curried Goat $19.00 White Jasmine Rice, Fries, Potato Salad, Ground Beef, Herbs & spices, in flaky pastry Marinated in a Blend of Natural Seasonings Baked Potato (Idaho or Sweet Potato) Glazed Jamaican Jerk Meatballs $8.50 and Slow Cooked in Curry Paste Choice of two. Additional sides $3.00 each Fried Pressed Green Plantain $5.25 Curry Seafood Malley $24,00 Dessert Coconut Milk & Natural Seasonings Parmesan, Salt & Porsely Yaad fruit Cake $7.50 . Jerk BBQ Chicken $17.00 Bacon(Wrapped Pineapple Bites $5.25 Country style Sweet Potato Pudding $6.00 Jerk BBQ Pork $1&00 Kabobs $6.50/$7.50/$8.50 With Coconut Sauce Vegetable/Chicken/Shrimp Steamed fish Fillet $23.00 Lounges Bread Pudding $5.75 Okra, Carrots & Potatoes With Raisins & Sauce Burger on Brioche sun $90.75 Jerk, Salmon, Veggie Seafood FRedley Boil $25.00 Man&Raisin Extravaganza $5.50 Seasonal Seafood with Corn on the Cob o Grapenut Buzz $5.50 ���An Choice Jerk Lobster Tail $25.00 . y $7.50 Served In-Season 1/2 Grilled Cheese & fries Cheese or Beef Itavioli 'Phe Cheese Burger not ®og Consuming raw or undercooked meats,poultry,seafood,shellfish,or eggs may increase Follow us 4m Meatball w/Pasta Chicken tenders your risk of food borne illness,especially if you have certain medical conditions.Before placing Aunt Allanah'S Mac &Cheese your order,please inform your server if any person in your party has a food allergy. �° f n 7 .= EQUIPMENT LIST ITEM NO QUANT. LIST OF EQUIPMENT DESCRIPTION & MODEL NO �6MmE�ct�C. awed, r-oob r�pl% R3ld �tlo. 101 3 4y ea pw pm c--aJ� 3 P(-w sin e r-W 0 ibq&a Ke-q-icx- S 1 PC A T 76P ic) s7ovicerm��t 3 Cc�-77 by e� ,. p Ka s Y -27- r I EQUIPMENT LIST ITEM NO QUANT. LIST OF EQUIPMENT DESCRIPTION & MODEL NO p s, cro c +3 r�+(-;-,afiArRe-cammeXC(A cb �� I Ifa�q.�t - u�►P � I��T�L. ��tc.�: i �,- I°r��6� 1� I L►►�►� C.vo L�� ` � �g � C P 5� •T r Gf�T �I o�Y� Sm-rwz tt- F ���f1� 1 y - (-LwusT r ao i �ii►�► R7�1� Y✓L(C.fLD�J�hJC ��; 1' dob o 5110 i -27- i 3/4/2020 Waring WPG250T 16"Electric Panini Supremo Large Panini Grill With Ribbed Cast Iron Top And Bottom Plates with Timer, 120 Volts 0IRESTAURANT® SUPPLY.com Home > Brands > Waring > Waring Commercial Panini Grills Waring WPG250T Panini Supremo Grooved Top&Bottom Panini Sandwich Grill with Timer-14 1/2"x 11"Cooking Surface-120V, 180OW Waring WPG250T Panini Supremo Grooved Top & Bottom Panini Sandwich Grill with Timer - 141/2" x 11" Cooking Surface - 120V, 180OW Item:#220168 MFG:#WPG250T GTIN:#00040072024627 r - tk Description Waring WPG250T Features • Durable,stainless steel body for a long service life • Controllable temperature thermostat from 140°F-570°F • Built In Timer t 1 • Removable drip tray for quick and easy cleaning • Electrical specifications: 120 Volts and 15.0 Amps with NEMA 5-15P plug https://www.restaurantsupply.com/waring-wpg250t-16-electric-panini-supremo-large-panini-grill-with-ribbed-cast-iron-top-and-bottom-plates-with-timer-... 114 3/4/2020 Waring WPG250T 16"Electric Panini Supremo Large Panini Grill With Ribbed Cast Iron Top And Bottom Plates with Timer, 120 Volts Waring WPG250T Benefits • Hinged top plate made for grilling foods up t 3 inc R E STAU P A N T O I Safe operating with heat resistant handles S U P P LY.Com • 14.5inch cooking surface for larger items Sig for o r emails and stay up to date! • NSF listed Be the first to learn about exclusive offers,new products and a lot more... • UL listed in USA and Canada JohnDoe123@Example.com Overall Dimensions: Height:9 1/2" Country (ie. United States) SUBMIT Width: 16" No thanks,I'd like to start shopping, Depth: 17-1/2" I NSF Listed This item meets the standards imposed by NSF International,which focuses on public safety,health,and the environment. Made In America 1 This item was made in the United States of America. U UL Listed ®� This item has been tested and meets safety standards imposed by the Underwriters Laboratories(UL). LISTED 5-15P WI 1 I This unit comes with a NEMA 5-15P plug. 5-15P " Specifications ; Ship Weight 64 LB Manufacturer Waring Model Number WPG250T Manufacturer Part# WPG250T Base Material Stainless Steel Color Silver i Plate Material Cast Iron Grill Type I Italian-Style Panini Grill i Overall Dimensions(HxWxD) 9-1/2"x 16"x 17-1/2" hftps://www.restaurantsupply.com/waring-wpg250t-1 6-electri c-pa n in i-su pre m o-la rge-pa n in i-gri I I-with-ribbed-cast-i ron-top-a nd-bottom-plates-with-timer-... 2/4 3/4/2020 Waring WPG250T 16"E ectric Panini Supremo Large Panini Grill With Ribbed Cast Iron Top And Bottom Plates with Timer, 120 Volts Grill Surface Dimensions(WxD) 14-1/2"x 11" Top Platg Ribbed,Hinged And Auto-Balancing Bottom Plate Ribbed Temperature Range 140-570 degrees F Temperature Settings Adjustable Thermostat Timer Included Yes Indicator Lights Yes Removable Drip Tray Yes Handles Heat Resistant UL Listed Yes NSF Listed Yes i Power Electric Voltage 120 Hertz 60 Phase 1 Amps 15.0 Wattage 1,800 Plug NEMA 5-15P i Free Shipping In Stock Call 888-575-9324 $645.00 / Each 1 ADD TO CART Quick Shipping Order by Noon Ships Same Day ■ https://www.rests u rantsu pply.com/wa ri ng-wpg 250t-16-el ectric-pan i n i-su premo-large-pan i n i-g ril l-with-ri bbed-cast-i ron-top-a nd-bottom-plates-with-timer-... 3/4 i f 1. � Project#: � + +do Item#: Medium Volume n T Amana Commercial Microwave Model RCS10TS Power Output 0 1000 watts of power. o Five power levels for consistent,delicious results for frozen, refrigerated and fresh foods-from the freezer to table in minutes. 0 o ; Easy to Use o Up to 100 programmable menu items simplifies cooking and ensures consistent results. 0 Four stage cooking option for easy one-touch cooking. Model RCS10TS shown o Multiple quantity pad calculates the proper cooking Medium Volume times for multiple portions. This category of microwave is ideal for... o User friendly touch controls are easy to use. Applications: - Pizza restaurants 0 Time entry option for added flexibility. - Casual dining o Digital display with countdown timer for simple operation - Clubs and"at-a-glance"monitoring. Deli Defrost: o Braille touch pads are ADA compliant. - Defrosts most frozen food products o See-through door and lighted interior for monitoring without All ACP,Inc.commercial ovens are backed opening the door. by our Culinary Center. Call us with any cuwy o 1.2 cubic ft.(34 liter)capacity accommodates a 14"(356 mm) question regarding food preparation, C. platter,prepackaged foods and single servings. menu development and cooking times. 1 866-426-2621.. O Stackable to save valuable counter space. �i n a Easy to Maintain c o Stainless steel exterior and interior for easy cleaning and a professional look. o Non-removable air filter protects oven components. o Constructed to withstand the foodservice environment. o Backed by the ACP,Inc. 24/7 ComSery Support Center, 866-426-2621. o ETL Listed. Eta Us Eta Intertek Intertek Part No.20154732 02016 ACP,Inc. Updated 6/17/2016 Cedar Rapids,Iowa 52404 Original Instructions ACP, 225 49th Ave.Dr.SW Cedar Rapids,IA 52404 U.S.A. 1 800-233-2366 319-368-8120 1 Fax:319-368-8198 www.acpsolutions.com ®/-m 2016 Amana. All rights reserved. Brand used under license. Amana Commercial Microwave Model RCS10TS Medium Volume . f'rorA vitro ~(door open? bm*vlew 22 32-3/4P 4 (559�� 637J 1" 102 � I 13-713" (352) 21, 17-1 t4 (533 (438) 19' (483) Installation Clearances-Top:2"(51),Sides:1"(25),Back:None Drawings available from KCLCADlog-techs@kcicad.com Specifications Specifications Model RCS10T5 IUPC Code 728028020724 Commercial microwave 10 touch pad control panel shall be Configuration Countertop programmable with the ability to program up to 100 menu items with two multiple portions. Touch pad shall include Control System ouch Braille for ADA compliance. Cooking timer shall be 60 minute, Programmable Control 10 countdown style with a time entry option and an adjustable Settings Programmable 100 end of cycle audible signal. There shall be 5 power levels,in- o Braille eluding defrost and 4 cooking stages. Microwave output shall Max.Cooking Time 0:00 be 1000 watts distributed by one magnetron with a rotating Power Levels 5 top antenna to provide superior even heating throughout the a Defrost Yes cavity.Durable door shall have a tempered glass window and ATime Entry Option Yes a grab and go handle with a 900+ opening for easy access.An interior light shall facilitate monitoring without opening the Microwave Distribution Rotating antenna,top door. The large 1.2 cubic ft.(34 liter)cavity shall accommodate Magnetron(s) 1 a 14"(356 mm)platter. Interior ceramic shelf shall be sealed Display VFD and recessed on oven bottom to reduce plate-to-shelf edge 'tackable Yes impact.Oven shall have a stainless steel interior and exterior Stage Cooking Yes,4 and be stackable to save counter and shelf space. Front air Interior Light Yes filter shall be permanently affixed to the front of the oven Door Handle Grab&Go and have a clean filter reminder. Microwave oven shall com- ignal End of cycle,adjustable ply with standards set by the U.S Department of Health and Air Filter Non-removable with cleaning reminder Human Services,UL923 for safety and NSF4 for sanitation. Multiple Portion Setting Yes,X2 Exterior Dimensions H 13'A"(352) ��14X"(M8) D*19"(483) c ��1� us ON avity Dimensions H 8 M"(216) �D`15"(381) Door Depth _ 2 3/4"(832),900+door open Warranty Intertek lntertek Usable Cavity Space 1.2 cubic ft. (34 liter) Warranty Certificate for this product can be found on the ACP Exterior Finish Stainless steel Inc.website at: Interior Finish Stainless steel www.acpsolutions.com/warranty Power Consumption 1550 W,13 A Power Output** 1000 W**Microwave m mSlery Power Source 120V,60 Hz,15 A single phase Plug Configuration/Cord NEMA 5-15 N ft.(1.5m) Service All products are backed by the ACP,Inc.24/7 ComSery Frequency 2450 MHz Support Center. Product Weight 41 lbs.(19 kg.) Ship weight(approx.) 47 lbs. (21 kg.) Shipping Carton Size H 16 5/a"(422) IW 25 3A,,-(640) D 19 3/4"(502) UPS ShippabI Yes Measurements in O are millimeters a *Includes handle **IEC 60705 Tested Part No.20154732 02016 ACP,Inc. Updated 6/17/2016 Cedar Rapids,Iowa 52404 Original Instructions AGP, 225 49th Ave.Dr.SW Cedar Rapids,IA 52404 U.S.A. 1 800-233-2366 1 319-368-8120 1 Fax:319-368-8198 www.acpsolutions.com FRIGIDDIRE9 T@p M@unt R@Yog@irator Product Dimensions Height 65-1/8" (Including Hinges&Rollers) .� Width 28" i Depth(Including Door) 29-7/8" 1 . l More Easy-To-Use Features Clear Dairy Bin Keep foods like butter,cheese and yogurt organized. .f A.D.A.-Compliant' t With accessible shelving,and controls } f that are positioned within arm's reach and allow one-hand operation,our I top-freezer refrigerator is 1 I i A.D.A.-Compliant. Available in: a White f (W) 'When properly installed,this model is A.D.A.-qualified based on the United States Access Board's A.D.A./ A.B.A.Accessibility Guidelines and the Department of Justice's 2010 A.D.A.Standards for Accessible Design. I to Signature Features Store-MoireTm Humidity- Store-MoreT"' Controlled Crisper Drawers Gallon Door Shelf Keep your fruits and vegetables fresh in Door storage gives you room for larger our humidity-controlled crisper drawers. items like a gallon of milk. Full-Width Wire Reversible Door Freezer Shelf Door can be installed to open left or Gives you a way to organize items in your right based on your needs. freezer better so you can find food quickly. frigidaire.com FRIGIDAIRE. Top Mount Refrigerator FFTR1614TW 16.3 Cu.Ft. Features Door Design Square Door Handle Design Color-Coordinated Cabinet Finish(Textured) Color-Coordinated Door Stops Yes Door Hinge Covers Color-Coordinated Door Reverse Option Yes Rollers-Front/Rear Fixed/Yes Sound Package / Toe Grille Color-Coordinated `✓ Refrigerator Features Interior Lighting Standard Refrigerator Shelves 2 Full-Width Wire Deli Drawer Wine/Can Rack Store-More'"Crisper Drawers 2 Clear Humidity Controls 2 Dairy Compartment I Clear Dairy Door Door Bins A Door Racks 13 Full-Width White Non-Slip Bin Liner Tall Bottle Retainers Gallon Door Storage 1 Freezer Features Door Bins Door Racks 2 Full-Width White Freezer Shelves 1 Full-Width Wire / Factory Ice Maker w/Large Ice Bin Optional(PN#IM116) Lighting Certifications B A.D.A.-Compliant' Yes Specifications Total Capacity(Cu.Ft.) 16.3 Refrigerator Capacity(Cu.Ft.) 12.6 Freezer Capacity(Cu.Ft.) 3.7 Power Supply Connection Location Right Bottom Rear Water Inlet Connection Location Bottom Right Voltage Rating 120V/6OHz Connected Load(kW Rating) 0.72 @ 120 Volts' Amps @ 120 Volts 6.0 Minimum Circuit Required(Amps) 15 Shipping Weight(Approx.) 190 Lbs. 'When properly installed,this model is A.D.A.-qualified based on the United States Access Board's A.D.A./A.B.A.Accessibility Guidelines and the Department of Justice's 2010 A.D.A.Standards for Accessible Design. 2For use on adequately wired 720V,dedicated circuit having 2-wire service with a separate ground wire.Appliance must be grounded for safe operation. - NOTE.,For planning purposes only.Always consult local and national Q 0 electric and plumbing codes.Refer to Product installation Guide fordetailed installation instructions on the web at frigidaire.com. CU$ Product Dimensions A-Height(Incl.Hinges&Rollers) 65-1/8" B-Width 28" C-Depth(Incl.Door) 29-7/8" Depth with Door Open 901 56" Accessories information available on the web at frigidaire.com FRIGIDAIRE USA•10200 David Taylor Drive•Charlotte,NC 28262•1-800-FRIGIDAIRE•frigidaire.com Specifications CANADA•5855 Terry Fox Way•Mississauga,ON L5V 3E4•1-800-265-8352•frigidaire.ca subject to change. FFTR1614T 04/17 @ 2017 Electrolux Home Products,Inc. FRIGID©IRE. p To Mount Refrigerator FFTR1614TW 16.3 Cu.Ft. Recessed waterline Recessed Top Yew (ice maker models only) electrical outlet ./291/e" 28„ Allow 1"min.clearance at rear for proper air circulation and 65 t/s" water/electrical connections with Allow'/e"min.clearance at sides a and top for ease of installation rollers 641A" Water with line inlet %11 location ' rollers (left When installing directly ; bottom rear) adjacent to wall,sufficient handle clearance required ; where handle may make ; contact with wall,to allow Power for 900 door opening* ; cord location (right _ bottom ------'-' �rear) 265/e" * �` When installing refrigerator adjacent to wall, 1 N" cabinet or other appliance that extends beyond front edge of unit,20"minimum clearance recommended to allow for optimum 140*door swing,providing complete crisper access and removal.(Absolute Allow 56"min. 3"minimum clearance will ONLYallow for AT door - (with doors 90°open) swing which will provide limited crisper access / with restricted removal.) Top Mount Refrigerator Specifications •Product Shipping Weight(approx.)-190 Lbs. •To ensure optimum performance,do not install in areas where •An electrical supply with grounded three-prong receptacle is temperature drops below 55*F or rises above 110o F and required.The power supply circuit must be installed in accordance avoid installing in direct sunlight or close proximity to range, with current edition of National Electrical Code(NFPA 70)and dishwasher or other heat source. local codes&ordinances. •For proper ventilation,front grille MUST remain unobstructed. •Voltage Rating-120V/60 Hz •Recess electrical outlet when possible. •Connected Load(kW Rating)@ 120 Volts=0.72 kW •Optional Ice Maker Kit(PN#IM116)available for installation in •Amps @ 120 Volts=6.0 Amps ice maker-ready models only. •Always consult local and national electric&plumbing codes. •Water recess on rear wall recommended to prevent water line damage. •Floor should be level surface of hard material,capable of supporting •Water Pressure-Cold water line must provide between 30 and 100 fully loaded refrigerator. pounds per square inch(psi). Minimum 3/8"clearance required for sides and top of refrigerator •Copper tubing with 1/4"O.D.recommended for water supply line with 1"clearance at rear to allow for ease of installation,proper air with length equal to distance from rear of unit to household water circulation,and plumbing/electrical connections. supply line plus 7 additional feet.Optional Water Supply Installation When installing refrigerator adjacent to wall,cabinet or other Kits available. appliance that extends beyond front edge of unit,20"minimum Note.For planning purposes only.Refer to Product Installation Guide clearance recommended to allow for optimum 140*door swing, on the web at frigidaire.com for detailed instructions. providing complete crisper access and removal.(Absolute 3" minimum clearance will ONLYallow for 90°door swing which Optional Accessories will provide limited crisper access with restricted removal.) •Ice Maker Kit-(PN#IM116). FRIGIDAIRE C US USA•10200 David Taylor Drive•Charlotte,NC 28262•1-800-FRIGIDAIRE•frigidaire.com specifications CANADA•5855 Terry Fox Way•Mississauga,ON L5V 3E4•1-800-265-8352•frigidaire.ca subject to change. FFTR1614T 04/17 OO 2017 Electrolux Home Products,Inc. John r ITEM#: QTY: y Boos MODEL#: Since 1887 PROJECT NAME: 011719 "E1 S8-1 D" - 1 COMPARTMENT "E-SERIES" SINKS WITH 1 DRAIN BOARD AND GALVANIZED LEGS =°�° C. .rid FEATURES: CONSTRUCTION: • 18GA STAINLESS STEEL TOP: STAINLESS STEEL SINKS ARE TIG WELDED, • TYPE 300 STAINLESS STEEL WITH#4 POLISH, EXPOSED WELDS ARE POLISHED TO MATCH SATIN FINISH ADJACENT SURFACE • 12"AND 14"DEEP BOWLS BASE: GALVANIZED STEEL • ALL CORNERS, BOTH VERTICAL AND HORIZONTAL, COVED AT 3/4"RADIUS MATERIAL: • BOTTOMS OF BOWLS FORMED FOR DRAINAGE TO 3-1/2" DIAMETER DIE STAMPED OPENING BOWLS 8 TOP: 18GA TYPE 300 STAINLESS • FULL LENGTH 9-3/4" HIGH BOXED BACKSPLASH,WITH STEEL WITH#4 POLISH, SATIN FINISH 2"RETURN TO WALL AT 45 DEGREE AND 1"TILE EDGE LEGS: 1-5/8"ROUND O.D.GALVANIZED STEEL • 1-1/8" FAUCET HOLES IN BACKSPLASH GUSSETS:GALVANIZED STEEL • ALL OUTSIDE CORNERS OF ASSEMBLY ARE BULLNOSED FEET: 1"PLASTIC BULLET FEET TO PROVIDE SAFE, CLEAN,AND POLISHED EDGE • STANDARD GALVANIZED LEGS 1-5!8" DIAMETER 12" DEEP - 1 COMP SINKS - 18GA � LTL^bQID CTu4 —r = E1S8-1620-12L18 16"X 200"1 X'1=24"If } E1S8-1620-12R18 16"X 20"X 12" E1S8-18-121-18 18"X 18"X 12" E1S8-18-12R18 18"X 18"X 12" i i 14" DEEP - 1 COMP SINKS - 18GA . . E1S8-15.14L15 15"X 15"X 14" E1S8-15-14R15 15"X 15"X 14" EiS8-1824.14L24 E1S8-1824-14L24 18"X 24"X 14" E1S8-1824-14R24 18"X 24"X 14" E1S8-24-14L24 24"X 24"X 14" E1S8-24-14R24 24"X 24"X 14" 164 DETAILED SPECIFICATIONS i L Li W C W� 03 1/2" 01 1/8" 5„ 9 3/4" 36" 43 3/4" TO SINK OVERALL ROLL HEIGHT �ADJ PLASTIC BULLET 12" DEEP - 18GA - "E1S8" 1 COMPARTMENT "E-SERIES" SERIES SINKS . . a 0 m 00 o 0 0 muem E1S8-1620-121-18 36-1/2" 25-1/2" 16" 20" 12-15/16" 6-1/2" 18" 47 E1S8-1620-12R18 36-1/2" 25-112" 16" 20" 12-15/16" 6-1/2" 18" 47 E1S8-18-121-18 38-1/2" j 23-1/5" j 18" 18" 11-15116" j 7-1/2" j 18" j 47 E1S8-18-12R18 38-1/2" 1 23-1/5° 1 18" 18" 11-15116" 1 7-1/2" 1 18" 1 47 14" DEEP - 18GA - "E1S8" 1 COMPARTMENT "E-SERIES" SERIES SINKS • a © (W 00 a 0 @ W54} E1S8-15-14L15 32-1/2" 20-1/2" 15" 15" 10-7/16" 6" 15" 36 EtS8-15-14R15 32-112" 20-1/2" 15" 15" 10-7/16" 6" 15" 36 E1S8-1824-14L24 44-1/2" 29-1/2" 18" 24" 14-15/16" 7-1/2" 24" 58 E1S8-1824-14R24 44-1/2" 29-1/2" 18" 24" 14-15116" 7-1/2" 24" 58 E1S8-24-141-24 50-1/2" 29-1/2" 24" 24" 14-15/16" 10-1/2" 24" 64 E1S8-24-14R24 50-1/2" 29-1/2" 24" 24" 14-15/16" 10-1/2" 24" 64 SOME UNITS SHIP UNASSEMBLED FOR REDUCED SHIPPING COST.ALL DIMENSIONS ARE TYPICAL.TOLERANCE+/-.500" John Boos 8 Co.is constantly engaged in a program of improving products and therefore reserves the right to change specifications without prior notice. • AQ .• . - wobh 0 0 0 0 = ® Project 0 O Lnm Item No. +n 00 IV Quantity O MODEL DFG-200 � Extra depth baking compartment-accepts five 18"x 26"standard full-size Full-Size Bakery Depth baking pans in left-to-right or front-to-back positions. Dual Flow Gas Convection Oven All data is shown per oven section,unless otherwise indicated. Refer to operator manual specification chart for listed model names. EXTERIOR CONSTRUCTION ■ Full angle-iron frame E Stainless steel front,top,and sides ■ Dual pane thermal glass windows encased in stainless steel door frames ■ Powder coated door handle with simultaneous door operation a a ■ Triple-mounted pressure lock door design with turnbuckle assembly ■ Modular slide out front control panel for easy access ■ Solid mineral fiber insulation at top,back,sides and bottom INTERIOR CONSTRUCTION ■ Double-sided porcelainized baking compartment liner(14 gauge)for easy cleaning ■ Aluminized steel combustion chamber ■ Dual inlet blower wheel ■ Five chrome-plated racks,eleven rack positions with a minimum of 1-5/8" OPTIONS AND ACCESSORIES (41 mm)spacing (AT ADDITIONAL CHARGE) OPERATION ■ Legs/casters/stands: ■ Dual Flow Gas system combines direct and indirect heat ❑ 4°(102mm)low profile casters(double only) ■ Electronic spark ignition control system ❑ 6°(152mm)seismic legs ■ Removable dual tube burners ❑ 6°(152mm)casters ■ Pressure regulator ❑ 25"(635mm)stainless steel stand w/rack ■ Manual gas service cut-off switch located on the front of the control panel guides ■ Air mixers with adjustable air shutters ❑ 29"(737mm)stainless steel,fully welded open ■ Solid state thermostat with temperature control range of 200OF(93°C) stand with pan supports to 500°F(260°C) ■ Controls: ■ Two speed fan motor ❑ SSI-D-Solid state infinite control w/digital timer • 1/2 horsepower blower motor with automatic thermal overload protection ❑ SSI-M-Solid state infinite control w/manual • Control area cooling fan timer ■ Interior lights ■ Gas hose with quick disconnect and restraining STANDARD FEATURES device: ■ SSD-Solid state digital control with LED display,Cook&Hold and ❑ 48" 1219mm hose Pulse Plus® ❑ 36"(914mm)hose ■ 25"(635mm)adjustable stainless steel legs(for single units) ❑ Stainless steel oven liner ■ 6°(152mm)adjustable stainless steel legs(for double sections) ❑ Extra oven racks ■ Draft diverter or draft hood for venting(select one) ❑ Solid stainless steel back ■ Three year parts and two year labor warranty ❑ Gas manifold(for double sections) ❑ Prison package(inlcudes security control panel and • Five year limited oven door warranty stainless steel back) For all international markets,contact your local distributor. ❑ Flue connector OPTIONS AND ACCESSORIES us ETA (AT NO CHARGE) c NSF ❑ Solid stainless steel doors Intertek BLODGETT OVEN COMPANY www.blodgef.com 42 Allen Martin Drive,Essex Junction,VT 05452-Phone:(802)658-6600•Fax:(802)864-0183 i r Au MODEL DFG-200 APPROVAL/STAMP DIMENSIONS ARE IN INCHES(MM) DRAFT HOOD SINGLE ADD 12.75(324) 7.38(187) DOUBLE ADD 16.5(419) 17 2.5(64) 6(152) 70.63(1794)- (432) 2(51) DRAFT DIVERTER� �_ of 57(1450)— 16.25 6(152)DIA 51.75(1315)— (413) 36.88 7— m 41.94 (937) SINGLE OVEN 38.56(979) 3 (1065) 8(203)DIA 3(76) 35.5(902)— 33.25(845)— o Qt L DOUBLE OVEN 25(635)— 28.38 17.38 t (721) 17(432)— (441) m 9.88 6.5(165)— (251) 1-38.25(972) 0(0)— 0(0)— TOP VIEW SINGLE DOUBLE SHORT FORM SPECIFICATIONS - Provide Blodgett full-size convection oven model DFG-200, (single/double) compartment. Each compartment'shall have (porcelain- ized/stainless) steel liner and shall accept five 18" x 26" standard full-size bake pans in left-to-right or front-to-back positions. Stainless steel front, top and sides. Doors shall (be solid stainless steel/have dual pane thermal glass windows) with single powder coated handle and simultaneous operation. Unit shall be gas heated with elec- tronic spark ignition and shall cook by means of a dual-flow system combining direct and indirect heat with a gas shutoff switch on the front of the control panel. Air in bak- ing chamber distributed by dual inlet blower wheel powered by a two-speed, 1/2 HP motor with thermal overload protection. Each chamber shall be fitted with two commercial lamps, five chrome-placed removable racks and removable crumb trays. Control panel shall be recessed with solid state digital control with LED display, Cook & Hold and Pulse Plus.Provide three year parts,two year labor and five year door warranty.Provide options and accessories as indicated. DIMENSIONS: POWER SUPPLY Floor space 38-1/4"(972rnm)wide x 36-7/8"(936mm)long 3-wire,6 Amp, 115 VAC, 1 phase,60 Hz. 1/2 H.P.,2 speed Product clearance 6"from combustible and non-combustible construction. motor, 1120 and 1710 RPM Interior 29"(737mm)W x 20"(508mm)H x 28-1/4"(718mm)D 2-wire,3 Amp,220/240VAC, 1 phase,50 Hz. 1/2 H.P., 1 If oven is on casters: speed motor, 1440 RPM Single Add 4-1/2"(114mm)to all height dimensions 6'(1.8m)electric cord set furnished on 115 VAC ovens only. Double All height dimensions remain the same Blodgett recommends a Pass&Seymour,model 2097,GFCI Double Low Profile Subtract 2-1/2"(64mm)from all height dimensions due to the use of a variable frequency drive. Must be hard GAS SUPPLY: wired in some cases. 314"NPT(Single/Double) MINIMUM ENTRY CLEARANCE: Manifold Pressure: Natural —3.5"W.0 Uncrated 32-1/16"(814mm) Propane—10"W.C. Crated 37-1/2"(953mm) Inlet Pressure: Natural—7.0"W.C. min.—10.5"W.C.max. Propane—11.0"W.C.min.—13.0"W.C.max. SHIPPING INFORMATION: Approx.Weight: MAXIMUM INPUT: DFG-200 Single 565 lbs.(256 kg) Single 60,000 BTU/hr DFG-200 Double 1130 lbs.(512 kg) Double 120,000 BTU/hr(60,000 ea.section) Crate sizes: 37-1/2"(952mm)x 43-1/2"(1105mm)x 51-3/4"(1315mm) NOTE:The company reserves the right to make substitutions of components without prior notice BLODGETT OVEN COMPANY www.blodgett.com-42 Allen Martin Drive, Essex Junction,VT 05452-Phone:(802)658.6600-Fax:(802)864-0183 Printed in U.S.A. NOTE:FOR COMMERCIAL USE ONLY P/N 35024 Rev AE(11/18) j\by 5 AREA SEAT COUNT AREA(sf) 1� .;\+ •s., SCOPE OF WORK <7. RESTAURANT 86 2610 Q Z F °`o., ' I / PATIO 48 1800 fKITCHEN 8 800 1 - � 3 D Q 3.-0`.i-0"DOOR ,n`�a Io q/RCURfgJN / _ O, - DO (E)DBL 3'-0'xT-O 2 ED 1 QJ t 6 i __ uil BUILDING 1 RESTRAURANT C1 EXIT ......_ r, DO1> 18 O (E)DBL3'-0"v7' LEp zo 6 r H t� ,Dpf Ci r' F()t4Ge"f r'l!R �l �lJ A��IP ~ �1/1� K (�R Li Id s I 21 7 a < OCCUPANCY (E)DBL3'-o.7-0 SIGN,MAXIMUM I ( �G r Y� �PI"�'v i `..RN� A1v �/ c'Rw` ( ' 98 PERSONS •I �. ���,/ S - < /•'L EXISTING LOBBY O .•�Q < I N `^�i r iv 6r- gig /-moo R PgT10 / PREPARED BY: n P Thomas alliga , E I MENS ROOM O ❑ C ET .. _. v !�n 2�v.I,g L �� PREPARED FOR J LADIES ROOM r = i T r—----i gt �' jl t� H 6G �a11- / 2 pR P075 H YA N N I S `f �t,�LJ flvbvv' (� I �acc PLAZA HOTEL ��n/K l'�Z'S 7�w' �cS.G% �� 622 MAIN STREET I 4 r�E HYANNIS,MA `/ I STORAGE RACK DISH WASHER PROJE CA /M K KAR I B I STORAGE RACK </ STORAGE RACK -0"DDDf „vC7s Pv� 57'op-A-ctC 'bF L!Q(4oA BEAN LOUNGE �`s it !� ��u 'fGm1u 'D1S HtaASHe►L S'�5>6h'] r� 1 EXISTING LOUNGE C z5 01� 622 MAIN STREET z o EXISTING KITCHEN I 36 3 I S HYANNIS,MA 9 _ - I SEAL: o PREP TABLE "�T�j� ED WALK IN COOLER F D s ED j I I a STOVE/RANGE COOK AREA L. 33 a9 i�y;j f�s` - EXIT DESIGNED BY: DRAWN BY: REVIEWED BY; • \ 1 BCALE: DATE: DRAWING NAME. b SEATING P LOAD PLAN DINING DRAWING NUMBER: FIRST FLOOR SEATING PLAN A1 .0 SCALE: 3/16" =V-0" PROJECT NUMBER: Z F � AREA SEAT COUNT AREA(sf) I RESTAURANT 66 1770 +'o, s> ) SCOPE OF WORK LOUNGE 20 840 s-' PATIO 48 1800 L ^' KITCHEN 8 800 K_ 7 �IDUj �� I S - 1 F' 3x7'-O:DOOR l 0 '-0" h rn, ni Fn a L U r., 3 3 COMPARTMENT `SINK _ _ ,_ _ _ _.... cl- (E)DEL 3'-0X7-0i^\ r u ICE BIN IC Tn BUILDING 1 RESTRAURANT C1 EXIT O �� I7�18 3COMPART T"'- r SINK l`'. CL_ � / Po l- ' ICE BIN I // 6 lr - ICE COOLER w <. OCCUPANCY - (EI DEL 3'-0"x7'-0" i — — — — SIGN,MAXIMUM `� ' ° I Coh) CCC-TC OCL'(,poD EXISTING LOBBY vo -, 1 EXISTING PATIO DO s PREPARED BY: Thomas Galligan,PE 279ummo Bln.t•Wxtelee•MAm I �� , MENS ROOM ( � ❑ C ET � .A — Cl � S �, I - (ets) a t.o to P o 6e I co ILj I _ __ —� _ I j .' PREPARED FOR LADIES ROOM Iv' I 'I HYANNIS r l I r7 �'�� O I I A N wOtt i.S '�l� """'� r RJRPLAZA HOTEL 622 MAIN STREET s 1' HYANNIS,MA I - DISHWASHER 3'-0"DOOR I L� VJ1 !r , PROJECT NAME. � I I I KARIBBEAN LOUNGE � STORAGE PACK �-0,•DC�OA - I! .. �-�=•< J — —-- ! EXISTINGLOGNGE -y « Zo _U� 622 MAIN STREET -FTF TWO COMPARTMENT J I I z ( EXISTING KITCHEN SINK - -✓ ° _ .�� //// [/wA / 1 HYANNIS,MA _ I �� SINKHAND f < �a'1/Lw•(� VaE-•V 1/ "�_`� `�1` , z m , c. SEAL: N n of Ws PREP TABLE %1 3J1 -'--- I WALK IN COOLER P STAINLESS STEEL JT4 f Ib tBD 102 COUNTER AND 1_ ' -' i ED SINK ( _= T f.,;�/� II °,. -` L V.L V ice I r �/ N DES : IGNED BY: EXIT 1 .-I I DRA - RENEWED BY: CLEANING SLE: SUPPLY FLOOR SINK �, CA 3'-0"X7'-0"DOOR J I I \STORAGE � < < I DATE: DRAWING NAME: --------------------------- A/ HOSE BIBS A2 n'Rcu" HEALTH DEPT N 1ST FLOOR PLAN DRAWNG NUMBER: FIRST FLOOR SEATING PLAN Al .Q SCALE. 3/16" =1_0 PROJECT NUMBER: t C I � SCOPE OF WORK I / e O 17ILL �n�n u BUILDING t BASEMENT C1 STORAGE vi ...._........ ..._.......... _..... __..__... STORAGE MECHANICAL ROOM �. ko Owl LAUNDRY z—.___ PREPARED BY Thomas Galligan,PE r STAIR UP - -- ummer'Ire _..._ STORAGE PREPARED FOR: LOCKERS44- 1 HYANNIS PLAZA HOTEL —' 62 'rj" _ 2 MAIN STREET 'a f CRAWL SPACE i CEMACH,ItJE C HYANNIS,MA (- m i C�y `� PROTECT NAME: J A Fr Oro if KARIBBEAN LOUNGE I STORAGE DRY BREAK ROOM RORAGE 622 MAIN NN S,(STREET n-t I:RU 1 SEAL: COOLER al'eys nTOMns �, y y OML m .._. 1 EXIT "--'--'---�--- --_-- ----"—�-----�-------"------ ... I DESIGNED BY: ..........................__................_..._..__._......._........_........ ..._.............. DRAWN BY: .......". _. ............... REVIEWED BY: SCALE: DATE: DRAWING NAME: BASEMENT PLAN SCALE: 3/16" =1'-0" BASEMENT PLAN DRAWING NUMBER: A3.0 PROJECT NUMBER: I SCOPE OF WORK J. ^� , I i u _......___-.._.._..__._......_._._...�_..............__..... _.I j BUILDING 1 BASEMENT ICI { STORAGE 10 � � � -- J>�N'A F2EE ��Dw RS•N1NC;r SI w STORAGE MECHANICAL ROOM ` A ST✓ r 0�'" ��' `Tj�`'� B " ?3�w�c�,a� � I�G� LAUNDRY ��-1 5�r1 G vIr� � � © O8 C� z ThomassGalliga STAI STORAGE np PE PREPARED FOR: LOCKERS i - HYANNIS PLAZA HOTEL y - 622 MAIN STREET �= CRAWL SPACE !--vC- Cl MACHINE HYANNIS,MA S:y PROJECT NAME: lL— 1 > J KARIBBEAN LOUNGE ..-----.....--- STORAGE DRYSTORAGE /1 622 MAIN STREET BREAK ROOM R, Y HYANNIS,MA SUB-ZERO REAL: COOLER I H or µssr TKO— EXIT N. ... .... .._..... .........._-. CSS, DESIGNED BY DRAWN BY; ......... ....... .._.. .J REVIEWED BY: SCA E: i DATE: BASEMENT PLAN DRAWING NAME: SCALE: 3/16" =1'-0" BASEMENT PLAN DRAWING NUMBER: A3.0 PROJECT NUMBER. AREA OCCUP SEAT# AREA(sf) r� 2 s, RESTAURANT 60 60 2610 F+ o•. KITCHEN 8 800 DANCE FLOOR 26 180 ENT.PLATFORM 4 50 \' SCOPE OF WORK � Q u I TOTAL ROOM 98 `�i� -1• . 3 O"x7'-0 DOOR /R Ty .._ 0 E)DBL 3 %2 L LDD t Ji, t0,J) IDED I_ I EXIT o I1 18 S I I z (E)DBL3'-0` O ED ' ED j BUILDING 1 RESTRAURANT C7 I -- 17 c. 6 OCCU NCY 26ocr (E)DBL3'-0"x7'-0" \ SIGN,MA IMUM 98 PE N O w 09 EXISTING LOBBY Z9 �v E� MENSROOM 0 `O k,i ❑ .�� __ _ ^ ` _ .. - _ a m z r __ �° __- Hl PREPARED BY: LADIES ROOM' r CABINETS ! I Thomas Galligan PE ��__1_.1�I���_�� I.,.;'+�mveaa u.ono®cm:u oom - -- ._.._ BAR PREPARED FOR: STORAGE RACK i'; - 9 HYAN N I S T -0"DOOR S _ - ��; I .�,�� .,, -• PLAZA HOTEL 622 MAIN HYANNI A STREET S M — STORAGE RACK -0"DOOR PROJECT NAME: -- Z EXISTING LOUNGE '19 EXISTING KITCHEN KARIBBEAN LOUNGE CIED _ PREPTABLE cc aI ! 622 MAIN STREET WALK IN COOLER - 71 HYANNIS,MA 102 QE µse STOVE/RANGE COOK AREAz3 L i I ,p �• � TNaM19 cam I UU- ... EXIT i:. o .. - : W ° 4/ a ......._>....::....__..._.... ..__"............._..._..._..........�.. 0 SIGNEDBY: RCURTq/ry i I I - - ORANM BY: L O REVIEWED BY: SCALE: x Q O + � z DATE: �............... I:.-_":::`::.:._.:_:.::._......_ DRAWING NAME: j SEATING LOAD PLAN FIRST FLOOR PLAN ENTERTAINMENT ENTERTAINMENT DRAWING NUMBER: SCALE: 3/16" =1'-0 /� H`/�■O t PROJECTNUMBER: