Loading...
HomeMy WebLinkAboutALEMAO'S BUTCHERY - FOOD ALEMAO'S BUTCHERY 672 Main St., HYAt4Nr`i d , rt r Town of Barnstable BOARD OF HEALTH John T. Norman ' Board of Health Donald A.Gaudagnoli,M.D. BARNgrABLF, F.P.(Thomas)Lee,. Daniel Luczkow,M.D. Alt. �$ t639. ,® 200 Main Street, Hyannis, MA 02601 a Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 955 Issue Date: 01/01/2022 DBA: ALEMAO'S BUTCHERY OWNER: CRISTIANE RESENDE Location of Establishment: 674 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE- ICE CREAM: C�� 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: APPROVED VARIANCE/NON-TRANSFERABLE: 1 toilet allowed for facility with the following condition: seating is not authorized for patrons. 04� 4 For Office Use, Ft ram,do Town of Barnstable Initials: Date PaidR3S BAMSPABLE. : Inspectional Services n ArEo,hUm 9. Public Health Division Check# Thomas McKean,Director g 10117 61 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 10 a 5 1 aI NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISH_VIENT: Rl Q,fMa iS ADDRESS OF FOOD ESTABLISHMENT: (Y)%`n 'rsk"'u J �y a T)7\AA ` P44 0.)0 0/ IX MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: G R l 5 R O Sa Nde, 16 A ho+yyvJ- (,0 M a+ TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (50S) TOTAL NUMBER OF BATHROOMS: I— t WELL WATER: YES ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: _4 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:\Application FormsTOODAPP 2020.doc 9 i - OWNER INFORMATION: FULL NAME OF APPLICANT &65-r j*A t JE ASS 15 �e sE rjde SOLE OWNER: YES/ D.O.B 01 105 1-+ OWNER PHONE# 509-3�4 6 J 0 O K ADDRESS �? N bG(�uA, f 'etnkku,*11 p- ff) O��3c2, CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: F�iiw k�C ��arJ- ' V� 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 4C IQ 5 /aoQy 1.otpifiam& 4Cr& 0q/ 08 / C2 00 y 2. VCJdo Raj-k G U Ids /aoay (Q,A�0, 11L jg-kd" 10 / �5/ c)oal 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 oyeninz!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3I't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsW00DAPP REV3-2019.doc `pp THE Tp TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: � age: of OFFICE HOURS o 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 '639• `0$ HYANNIS, MA 02601 eoa-s2-asa4 No Reference R-Red.ltem PLEASE PRINT CLEARLY - FOOD ESTABLISHMENT INSPECTION REPORT Name � Dail T e o T :g sec ion / ions uti Address Ris d spection dain Level etail Previous Inspection p _ Tele hone i ential Kitchen Date: ,r ' Mobile Pre-operation 1 r Owner HACCP Y/N Temporary Suspect Illness l Caterer. General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other v Inspector .44 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 Item-Al 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 +, , a l ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities Not Ii - h EMPLOYEE HEALTH PROTECTION FROM CHEMICALS l ❑ 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 a ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories �,� / 1� s Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 11/A/ I 4 Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ N Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 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 Snon-critical violations=C. 29.jDumter equirements (590.009) within 10 days of receipt of this order. 30. DATE OF RE-INSPECTION: Inspector's Signature Print 31. screened from public view 4 IT Permit Posted? N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature P�J nnt: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 1q Food or Color Additives 3-501.15 Cooling 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* g Methods for PHFs 2-103.11 Person-in-ChargeUnapproved Duties Cooked and RTE Foods.* 3-302.14 Protection from Una roved Additives* 19 - PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F Other* 2 590.003(C) Responsibility 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* -Storage*• Applicants* - - � - 3-302.11(A) Food Protection* 7-201.11 Separation g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits Restriction-Presence and Use*its and Vegetables 3-501.19 Time as a Public Health Control* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 - Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 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* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 - Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP y Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg crave 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 o 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* _ 4-702.11 Frequency of Sanitization of Utcusils 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 temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tem o 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 Regulatory Authority appropriate 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the a ro riate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.J2. 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 Requiepractices should be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(6) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F P Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* Temperature Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. - FINE ro TOWN OF BARNSTABLE HEALTH INSPECTOR'S Esta�ishment Name: Dater Page: of e� k1• OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. z BARNSTABLE. 200 MAIN STREET 3:30-a:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MON:ass• .0� HYANNIS,MA 02601 508-8 -FRI.62-4644 No Reference R-Red,Item PLEASE PRINT CLEARLY 8-8 FOOD ESTABLISHMENT INSP, CTION REPORT NameAV, �� Dat '� e of T s ec i ion Rq6tine yr Address Risk rv, ction Ca Level 0 a ai Previous Inspection Telephone idential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) VIA Time Bed 8 Breakfast HACCP In: Other 9 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) ry FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities �/(� EMPLOYEE HEALTH PROTECTION FROM CHEMICALS / ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives V ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods)!/za, e ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures UP ❑ 5.Receiving/Condition ❑ 17.Reheating 171 ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding .PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY I ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Itemsl Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) �1 Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ® Embargo ❑ Emergency Closure ❑Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6von-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 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 q Dumpster Screen? Y N J Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot is H Maintained At or Above 140°F Require Reporting b Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above Control Applicants** g y * 7-201.11 Separation-Storage* 20 Time as a Public Health Control PP 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 * 590.004(11) Variance Requirements 3-501.19 Time as a Public Health Control Applicant To Report To The Person In Charge* 3-304.11 Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources y Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS J * 4-501.114 Chemical Sanitization-Temp., H. Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.14 Eggs and Milk Products,Pasteurized P•,P 16 P 9 P Concentration and Hardness* 22 3-603.11, Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Not Otherwise Processed to Eliminate Equipment* 3-401.11 A 2 Comminuted Fish,Meats&Game * eg crrve 11112001 590.006(A) Bottled Drinking Water* ( )O * Pathogens 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec B) Water Meets Standards in 310 CMR 22.0* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell 590.006( _ Contact Surfaces of Equipment 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* Shellfish and Fish From an Approved Source 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* ( ,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Shellfish* 3-401.11 )O A 3 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* ing,mobile food,temporary and residential Sources* 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By P q g * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Gamea and W ildhority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to` * 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 3-202.18 Shellstock Identification Present Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* practices should be debited under#29-Special 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding >l Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* * 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.11 PHF's Received at Proper Temperatures (Blue Items 23-30) - 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* � above,canf 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed ab be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Within 4 Hours* 23. Management and Personnel FC-2 .003 Ta siRecords:Fish Products 5-203.11 Numbers and Capacities* 9 24. Food and Food Protection FC-3 .004 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 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 Supplied with Soap and hand Drying Devices 590.004(J) Labeling of Ingredients* 27. Physical Facility FC-6 .007 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1 1.009 3-502.11 Specialized Processing Methods* 30. 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. °Ft row TOWN OF BARNSTABLE "EALFFlce HouROR's Establishment Name: Dat Page: of P. °^ PUBLIC HEALTH DIVISION ,. - 8:00-9:30A.M. I A - BARNSTABLE. 200 MAIN STREET _ 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e;: `0� HYANNIS,MA 02601 MON.-1 RI. No Reference R-Red Item PLEASE PRI T CLEARLY rFD MPS°' 508-862�644 FOOD ESTABLISHMENT INSPECTION REPORT Name Da jype o Tjtjja lnspection O Routine E ess Risk a ec ion Level Previous Inspection hone esi ential 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: [JAI A 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 i•_ ❑ 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 IL ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals e FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardou 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 171 - t 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HS ) r 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP 19.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) r�l 10?020 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, he 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. o 6 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations if no critical violations observed,4 to 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 Physical Facility 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.Ph y ty (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 Requir ments, (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpst screened from public view )�nma 171 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y NVV #Seats Observed Frozen Dessert Machines: Outside Dining Y N P 's Sig atu a Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted. Y N 1 1 /J Dumpster Screen? Y N ( / Violations related to Foodborne Illness Violation Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives _ Law Cooled to 41°F/45°F Within 4 Hours* 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* Cooked and RTE Foods.* 19 PHF Hot and Cold Holding -2-103:11 Person-in-Charge Duties 3-302.14 _ Protection from Unapproved Additives* _ Contamination from Raw Ingredients 1 g 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 7-201.11 Se 3-501.16(A) Roasts Held At or Above 130°F _ Separation-Storage* Applicants* I 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* 3-304.11 Food Contact with Equipment and Utensils* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 590.004(11) 1 Variance Requirements 590.003(G) Reporting by Person in Charge* - 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reted of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Disposition of Adulterated or 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 Discaazding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and g routs Not Served* 3-201.12 Food in a Hermetically Sealed Container* � Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 ConsuAnimal Food That Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* sff-nve iorzoot 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 RecreationallyCaught MolluscanEquipment* 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec g Contact Surfaces of Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS E 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* 1 Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145 F kitchen operations should be debited under * Regulatory Authority I 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. � -301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 2 j 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* I 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements.practices 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 CommerciallyProcessed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Critical and non-critical violations,which do not relate to the 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 Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* * 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 1 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* 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. 1 pp IRE A c I TOWN OF BARNSTABLE - _ HEALTH INSPECTORS Establishment Name: Date: Page:.. of PUBLIC OFFICE HOURS pBAR E.O` ` PVB2 0 MAN STREET SION - - 3:30-4:30 P.M. : 0- :30 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS.q.°�• - HYANNIS, MA 02601 M-8 -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY `rFo MAC 508 4644 FOOD ESTABLISHMENT INSPECTION REPORT Nam Dat 7 o Tve of T c ion OZ-A% o outi e Address Risk S 'se - spection Level ;Pe-t-aiI17 Previous Inspection Telephone ential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness iA Caterer General Complaint - Person in Charge(PIC !me Bed&Breakfast HACCP ` n: Other L 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 ` z/ ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities V 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 l ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORYpy►� ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �J 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,t e 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 4non-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 no violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and waste (FC-5)(590:006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 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 Requirements (590.009) Y P 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.D±umter screened from public view (114 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI nature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination L14 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-.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* 7-]02.11 Common Name-Working 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 * 3-501.16(A) Roasts Held At or Above 130'F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Red of Food* HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1g 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* Effective 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 3-401.11(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 arY 10 Proper,Adequate Handwashing Game and�/d Mushrooms Approved B 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under y Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure*. 165'F* foodbome illness interventions and risk factors. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 3-001.11(A)(1)(b) All Other PHFs-145°F 15 sec practices should be debited under#29-Special 11 Good Hygienic Practices Reheating for Hot Holding* 17 9 9 3-201.17 Game Animals 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 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* L 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 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 * 5-205.11 Accessibility,Operation and Maintenance 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 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 596.000. `oFTME rokti TOWN OF BARNSTABLE. HEALTH INSPECTOR's Establishment Name: J 1 tmt c? Rvf- ter V Date: Page:. I of o f PUBLIC HEALTH DIVISION OFFICE HOURS 800-9:30A.M. BARN�nABLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ;'6;. .0� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY ,e A, - 508-862-4644 'FD"""� FOOD ESTABLISHMENT INSPECTION REPORT � b Name C' r Date Tyne of T f Inspection s outi -e C Address �, Risk ood Service inspection ° °'1 /� Level Retail Previou Ins ection a Telephone si ential Kitchen Date: 11�36 /7 0 Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness ^� Dr- ` Caterer General Complaint - )) Person in Charge(PIC) Time Bed&Breakfast HACCP "� u to ' Gr ldd ' In: Other r I J Inspector Vi r� S eS Out: tj 0 Each violation checked requires an explanation on the narrative page(s)and.a citation of specific provision(s)violated. 20! d^ 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/Dutiesil C ❑ 9 9 ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ci ❑ 2.Reporting of Diseases by Food Employees and PI ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures I Le t A- o / ❑ 5.Receiving/Condition ❑ 17.Reheating VW V ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY , ❑ 11.Good Hygienic.Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: o ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating G`�t �� / 19 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,th items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health..Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than 4 non-critical violations 9 if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i cal violations. If 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 ob erved,7 to 8 non critical violations: If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. viola' . 4 yo P non-critiopi violations=C. 30.Other DATE OF RE-INSPECTION: Insp or's S' n ture pitnvvjl 31.Dumpster screened from public view All, 0 Permit Posted? N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed _ Frozen Dessert Machines: Outside Dining Y N PIC' Si at re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) - and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assi ent of Res onsibilit * 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* gnln p y 14 Food or Color Additives 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 fronf 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 3402.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 3-501.16(A) Hot PHFs Maintained At or Above 140°F 590.003(C) Responsibility of the Person-in-Charge to - - -Other* 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* - - - - 7-20 Separation-Storage* 20 Time as a Public Health Control 3-302.11'(A) Food Protection* 7-202.11.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.1] 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(13) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR _ 3-306.14(A)(B)Returned Food and Reaervior 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 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* - - 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) I Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* 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* eff cri-uuzoa 590.006(B) Water Meets Standards in 310 CMR 22.0* - 4-602.11 . . Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-40 1.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g. P arY 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* - Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsrho ld 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* * (Blue Items 23-30) 3-202.15 Package Integrity* 8 g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 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 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products P 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004 Labeling of Ingredients* Supplied with Soap and hand Drying Devices (J) 9 9 27. 1 Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 1 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* I 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 THE T TOWN OF BARNSTABLE - .HEALTH INSPECTOR's Establishment Name: Nem,,jle, ? Date: 31 Page:.. .� of Pam " Ya OFFICE HOURS BARNNABLE• PUBLIC 2 0 MAN STREET 3:3030-4:30 P.M. TI DIVISION :00-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECON Date Verified �A MASS.9. .0� - HYANNIS,MA 02601 50s-862-4644 No Reference R-Red Item _ PLEASE PRINT CLEARLY 'F0N1P�p FOOD ESTABLISHMENT INSPECTION REPORT _ r AVwjo Name AADate -Type o sec io t b Operation(s) outine Address Risk F ervice e-inspection rA I ��� Level etail Previection ��Telephone esdential Kitchen Date:jIIns Mobile Pre-oa Owner HACCP YIN Temporary Suspect Illness f Caterer General Complaint 62, Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: - V• n (� y ✓l \ Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ 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) ❑ 064 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands t�N�l ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities t EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives �/ ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ri �^ ❑ 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 r ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) \ Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or y ,/ within 90 days as determined by the Board of Health. Overall Rating V" ❑ 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 b a Board of Health member or its agent 24.Food and Food Preparation FC-3 590.004 p 9 y 9 A=Zero critical violations and no more than anon-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 B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically 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)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements• - (590.009) within 10 days of receipt of this order. violation o on-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspecto s Sign u e Pri 31.Dumpster screened from public view VW 1%,;J �v. � Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N V" / #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's ig ture Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003 A Assi nment of Responsibility* 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) g14 Food or Color Additives 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-101.11 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 ( ) Applicants* 7-201.11 Separation-Storage* PP 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 3-302.15 Washing Fruits and Vegetables * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer - 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* * Raw Seed Sprouts Not Served* Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water I Monitoring* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1 g Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) 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* ery ce-uuzoor 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Shellfish* 4-703.11 Methods 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* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11 C Game and Wild Mushrooms Approved By ( )(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* ' 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 11 Good Hygienic Practices practices should be debited under#29-Special 3-201.17 Game Animals* Yg 17 Reheating for Hot Holding 2-401.11 Eating, Requirements. 5 Receiving/Condition g,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs • following sections of the Food Code and 105 CMR 590.000 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 * 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 ty, 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 I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S: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 rowti TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: _ Date: Page:__(_of OFFICE HOURS Art Eo7 PUBLIC 2 0 MAIN HEALTHT DIVISION 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. MASS. MON.-FRI. �A ,639.p HYANNIS, MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY 'FDM FOOD ESTABLISHMENT INSPECTION REPORT Name -.. Date 2 Type of I s ctio Operation(s) Routin Address ti Risk Service Re-inspection Level etai Previous Inspection Telephone ential Kitchen Date: a ;93 r� Mobile Pre-operation _ Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint '-X uS Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: / rr r,P,LL+ 1 i.- v� !/ 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) ❑ J°F-t vvJ 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) ❑ *� L I v FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands J Q wt Art- i i/� ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities J EMPLOYEE HEALTH PROTECTION FROM CHEMICALS V S e, ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives v ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals ; FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) CA l!'G F ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures _` .� 5 Receiving/Condition C I 17.Reheating r^' ❑ 9 ❑ 9 .� f I ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ! ? o r C rC,t r ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) I \ YV O t it v '"' ,' , ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP _ J 1 ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY c , ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories 164 11 dif X 7r Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by th&6oard of Health. Overall Rating Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑.Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations g )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations obsery ,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements. (590.009) within 10 days of receipt of this order. violaf o -critical violations=C. 30.Other Inspect 's Signa P, t: umpste DATE OF RE-INSPECTION: 31.Dr screened from public view V\?-7 f fI?Vt �V, Permit Posted? 9S Y N Grease Trap Previous Pumping Date Grease Rendered Y N / #Seats Observed AL-.F- Frozen Dessert Machines: Outside Dining Y N PIC's Signatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties Cooked and RTE Foods. 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 7-102.11 Common Name-Working Containers* 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage 7-202.11 Restriction-Presence and* 20 Use Time as a Public Health Control * 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* 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) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 590.003(E) Removal of Exclusions and Restrictions g Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* * 3-801.11(D) Raw or Partially Cooked Animal Food and 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and 3-801.11(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* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.IIA(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinldn Water from an Approved S stem* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* g PP Y Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* SJfecnve imaoor 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* faces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tem or and residential Sources g� P �' 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* the appropriate sections above if related to Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave 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 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* Requirements. 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F[0 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 Temperature Ingredients to 41°F/45°F 2 Equipment and Utensils FC-4 .00 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours 26.. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. zma`pttME Tp TOWN O BARNSTA LE HEALTH INSPECTOR'S Establishment Name: Date: Page: of T�, t OFFICE HOURS ' _ r PUB I E SION 8:00-9:30A.M. BARNSTABLE. ` ��i REET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. 1 Y p .63 p.0�' F 144-��� _ YANNIS,MA 02601 508-s2-asaa No Reference R-Red Item PLEASE PRINT CLEARLY TF°Ma _ OOD ESTABLISHMENT INSPgCT O�1 REPORT Name J n Date De of TVpe_ ns ection O do s 'you-tine. Address /� 1 t Risk Food Servi e-inspection Y Telephone r Level tail Previous,l�s e ti fl r 1 p C d Residential Kitchen Date:p��7T Mobile Pre-o ra n Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint , Person in Charge(PIC) Time Bed&Breakfast HACCP::2LAI (� y j� ` r In: Other !J .Ldl p / r. �I� Jers Inspector al ^ Each violation checked requires an explanation on the narrative�page(s)and a citation of specific provision(s)violated. 1 41 0 r V r 0j) Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) C 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) ❑ �' r t FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities Ab EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives v v i r / ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals i v r s ` ( - FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) r ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures 44 Ell, ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements Fq 18.Cooling �� - ❑ 7.Conformance with Approved Procedures/HACCP Plans 19.Hot and Cold Holding ,. PROTECTION FROM CONTAMINATION Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE P P ONS(HSP) 1 IT AK I A�i t ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ` V ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations I ( 41 Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No r ❑ 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,they'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 re ardless of the number of critical,results in an F. 25.Equipment and Utensils FC-4 590.005 B=One critical violation and less than 4 non-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If a 27.Physical Facility - (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements 590.009 within 10 days of receipt of this order. violation,4 to 8non-criticalolatio 's=C. P q ( ) 30.Other PATE OF RE-INSPECTION: Insp ct is Signature & Print:w 31.Dumpster screened from public vie D Permit Posted? Y N Grease Trap.Previous Pumping Date Grease Rendered Y N r #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature / Print: !� Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N � Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-WorkingContainers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reted of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and g 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 I Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-I55°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved S stem* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* g pp y Not Otherwise Processed to Eliminate Equipment* ( )O Pathogens*590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game g * e ecrfve rnrzoor 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 e ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* the appropriate sections above if related to Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004O 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) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.1 S Package Integrity Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,ran 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 ( ) 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 P Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 1.003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 IHand washing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. At pptME roh. TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: , Date: age: of A- Auk f, 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 HYANNIS,MA 02601 -�`' MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY o e, � 508-862-0644 ' rEO MPS FOOD ESTABLISHME- T INSPE TI N REPORT Name Date a of of Ins ection .-�- Routin Address- Risk ood Semi on Level Re ' Previou I s e i / Telephone Residential Kitchen Date: Mobile Pre-op r i Owner HACCP Y/N Temporary Sus pectIllness v AA Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Other �( Inspector Each violation checked requires an explanation on the narratry page(s)and a citation of specific provision(s)violated. V, Iry AA Violations Related to Foodborne Illness In mentions and Risk Factors Red Items t ( 1 Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands bt ❑ 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 Temperatures4 ❑ 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 PO S(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY i ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,theRms ❑ 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 4non-critical violations g )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 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 violations observed,7 to 8 non-y�tr 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address ral 1 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8non-critical vi 'atio , critical refrigeration. C. iolations. If 30.Other DATE OF RE-INSPECTION: In ect n tur d Print. 31.Dumpster screened from public view 1 7 L� - Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signatu Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 1q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* * 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 3-501.16(B) Cold PHFs Maintained At or Bel w 41°F/45°F t 1=515 Poisonous or Toxic Substances 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7- Common Name-Working Containers 3-302.11(A) Food Protection* 7-202.11 01.11 Se aration-Storage 3-501.16(A) Roasts Held At or Above 130*F* Applicants* P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 � Food Contact with Equipment and Utensils* � 590.004(I1) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions - Disposition ofAdulterated or Contaminated g � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* " 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.1](D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3401 it l(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* 3-401.1]A(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* E7/cti-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min Eggs* 4-702.11 Frequency r f ces 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 Sfuffin Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* - • ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave Y 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 Reheat'ing for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 1590.000 i�, Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 4.11 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* 5-20 * 5-20 .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* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formbackfi-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. oFtNEr TOWN OF BARNSTABLE.. HEALTH,INSPECTOR's Establishment Name: u-er > Date: Page:. Of / p� o OFFICE HOURS - PUBLIC HEALTH DIVISION 8:0029:30A.M. BARNSTABLE. 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p 659. HYANNIS,MA 02601 - 508-e62-4644 No Reference R-Red Item - PLEASE PRINT CLEARLY - 'FON'A�a FOOD ESTABLISHMENT INSPECTION REPORT N r Name O Date/17h T e o T sec ion 'o outin ( l ( , a n P Address Risk Food Servic Re-inspection Level A elf f Level Ret ' Previous l Ins�pection 'HA CUB 'lam Telephone Residential Kitchen Date: at:7e+raUo/� 1 rt0 Mobile P Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint r Person in Charge(PIC) Time Bed 8 Breakfast HACCP In: Other Inspector ~ Out: C r-P Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ° t� 11.Good Hygienic Practices❑ Yg ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) , I Corrective Action Required: - TO-Yes(N)violations must be corrected immediately or . within 90 days as determined b the Board of Health. Overall Rating t y y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health". Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility _ (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC77)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8 on critical viol lions=C 29.Special Requirements (590.009) y p , 30.Other DATE OF RE-INSPECTION: Inspect 's Sign r P' 31.Dumpster screened from public view � I Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N Vr 144 #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's S' ature Print: Self Service Wait Service Provided Grease Trap Size, Variance Letter Posted Y N Dumpster Screen? Y N x� 04 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 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 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* Applicants* 3-302.11(A) Food Protection 7-201.11 Separation-Storage** P g 20 me as a Public Health Control * Ti 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* - - Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* - REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 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 cnve rnnoor 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 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 A * ( )( ) P Regulatory Authority Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17. Reheating for Hot Holding practices should be debited under#29-Special 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) 3-20 .15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F * 12 Prevention of Contamination from Hands -- * Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 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 * 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 ty' Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .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 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. Alelulds ALEMAo,s 672 Main Street,Hyannis We have e verything 508.827.4632 o barbecue ' I f Y A T I THE r - TOWN OF BARNSTABLE HEALTH INSPECTOR,s 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 a39• `0� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �DrFD MPS 508-862-4644 FOOD ESTABLISHME T INSP ION REPORT Name Dat Tyoe of Ins ct•on 07outine Address Risk • Food Service R-e-lmjmcion Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness d Caterer General Complaint Y Person in Charge(PIC) Time Bed&Breakfast HACCP Other Inspector - p ITN Each violation checked requires an explanation on the narra ive )ages)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ _ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS A ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control 40 ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 6=One critical violation and less than 4non-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 t F is scored automatically o la 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 If 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 S non. ritical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. 4 0 8non-critical vio lion C. 30.Other DATE OF RE-INSPECTION: In s ignature Q Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signa ur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) i= FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2 1 11 Person in Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 03. Charge Duties 3-302.14 Protection from Una roved Additives g PP Contamination from Raw Ingredients 75 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers 3-50L16 * Require Reporting by Food Employees and Contamination from the Environment * (A) Roasts Held A[or Above 130°F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 3-302.15 Washing Fruits and Vegetables Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP ` 590.003(E) Removal of Exclusions and Restrictions g ( � ` Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served 7-206.13 Tracking Powders,Pest Control and 3-201.13 . Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 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 Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* el/°"ve mnom 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) 1 Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tem ora and residential Sources g• P ry 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 77 Reheating for Hot Holding Requiremenpractices ts Id be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 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) 3-202.11 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 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 003 Tags/Records:Fish Products P 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 2 . Food and Food Protection FC-3 .00 * 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 FC-7 1.0108 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. TOW OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: � Date:sw Page:�of S 1 OFFICE HOURS VVV PU IC HEALTH DIVISION 800-9:30A.M. BARN STA I.E. ` 200 MAIN STREET 3:30-4:3o P.Rs Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 9Q MA55. MONHYANNIS, MA 02601 508-808-8 -FRI 639'p� . No Reference R-Red Item PLEASE PRINT CLEARLY n t62-4644 rEO MPS ESTABLISHME T INSP C ON REPORT 2p Name Dat ape of ection O _ S Routine Address Risk ood Sery ection Level Ret ' Previou Ins do Telephone Residential Kitchen Date: �� � Mobile Pre-op ratio Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Ch rge(PIC) Time Bed&Breakfast HACCP Other D InspectorZ4 � O 9 Each violatio checked re uires an explanation on the narrati a 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) ❑ 00 Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ i 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 r FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION 20.Time As a Public Health Control )-t -A In,I Of, - 'I ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) / 4 ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories _ Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations i Critical(C)violations marked must be corrected immediately. (blue&red items) 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,t ems ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below b a Board of Health member or its agent 590.004 p g y g A=Zero critical violations and no more than anon-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3 )( ) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically 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)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non ritical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) p within 10 days t of this order. v n,4 to 8 non-critical v ation C. 30.Other DATE OF RE-INSPECTION: I pector s Si tur ri 31.Dumpster screened from public view Permit.Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Sig Ito ure Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N � Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont) , 7: FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* S Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 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* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties Cooked and RTE Foods. 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 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* * P g 20 Time as a Public Health Control 3-302.11(A) Food Protection 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004(11) Variance Requirements * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.003(G) Reporting by Person in Charge Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated 3-306.14(A)(B)Returned Food and Re or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ted or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.]lA(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell She/lash and Fish From an Approved Source Contact Surfaces of Equipment 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 m gg in* E s* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS _ 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave appropriate the ro riate sections above if related to 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 3-202.18 Shellstock Identification Present* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3 40L11(A)(1)(b) All Other PHFs-145°F 15 sec* 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11 A&D PHFs 165°F 15 sec* $ Receiving/Condition ( ) ( ) 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate to then the me 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 Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* * 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours 9 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41'F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .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 1499 Food Code or 105 CMR 590.000. Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. Paul J.Canniff,D.M.D. MAS& F.P. Thomas Lee Alternate 39, 200 Main Street, Hyannis, MA 02601 ' Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to, Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 955 Issue Date: 01/01/2021 DBA: ALEMAO'S BUTCHERY OWNER: CRISTIANE RESENDE Location of Establishment: 674 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: QA 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: APPROVED VARIANCE/NON-TRANSFERABLE: 1 toilet allowed for facility with the following condition: seating is not authorized for patrons. J `- Vl For Office Use Only: Initials:_ Town of Barnstable Date Paid a` . $ BARNSTABLE, ; Inspectional Services �,r�a '°'a `�� Public Health Division Check# �EDMAyp Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE �+ `� �� NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: k mLW S u*44 ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: GR 5 ges 1J AE 4 h'0 l- com TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (5(w) gad-- 463z TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO L ...(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 QAApplication FormsTOODAPP 2020.doc 47 OWNER INFORMATION: n LI FULL NAME OF APPLICANT �iF�ls-hG�i 12ENdE SOLE OWNER: YES/1)d D.O.Bnn0 1105 I-'6 ^" OWNER PHONE# 500 30' 6 g4) ADDRESS 89 Pobrd� �& I etr tAUl [P- /Y)A Ja�Q3a- CORPORATE OWNER: Fcubb {{Q.0 dv CORPORATE ADDRESS: 39 N O'O(A' ( a 10e n k,,U;q, ron ��- PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. Or►4ay-ig 05C7-ob- &ft(t 10 / 0P /-20.2y 2. Fab(O PDJ),D J oA /a5 ,aoay Q4,�kam c� 0 a 00 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 http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q:\Application FonnsTOODAPP REV3-2019.doc �► Town of Barnstable BOARD OF HEALTH QY John T.Norman Board of Health Donald A.Gaudagnoli,M.D. EMNS BU. Paul J.Canniff,D.M.D. MASS 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: 955 Issue Date: 12/10/2019 DBA: ALEMAO'S BUTCHERY OWNER: CRISTIANE RESENDE Location of Establishment: 674 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: C,i FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: APPROVED VARIANCE/NON-TRANSFERABLE: 1 toilet allowed for facility with the following condition: seating is not authorized for patrons. r J ' ` _D9 For Office Use Only* Initials: �t '�w Town of Barnstable ti Date Paid Amt Pd$ v BAMWABLE, : Inspectional Services ,�. 3q �Eo �a�°� Check Public Health Division Thomas McKean, Director — p/30 '►� l]� 200 Main Street,Hyannis,MA 02601 v ' Office: 508-862-4644 Fax: 508-790-6304 0 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE Jo a5119 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: Ntyr"is &4t4 d N 61-0 YrOO'.-f) ky �LuG ADDRESS OF FOOD ESTABLISHMENT: 0A M;YI �S�u` MAILING ADDRESS(IF DIFFERENT FROM ABOVE): _4*;� QJ E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 3a1 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/ TO NUMBER OF SEATS: INSIDE: 4-1— OUTSIDE: _Z1 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 4_RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc i OWNER INFORMATION:FULL NAME OF APPLICANT ��1$���F RSsl,s PC56 OGt SOLE OWNER: YES/NO D.O.B 011 05 -+P OWNER PHONE# 609-3�D 4 6O 18 0 ADDRESS )? WbGdIP-69 0 - CZ-o`tt`Yuij e - (Y)A Qo?&3o2 CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: Q,Ika' " 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. (y(,t '�bffw i2W 0Q a5 /o?QQq 1.&komu Aaq& f0 / 09 / OR0a� 2. FWo10 gDJWCI v Oa i a 5 i a0,2q 10 a 019 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 http•//www townofbarnstable.us/healthdivision/ai)plications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 31'each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. QAApplication FormsTOODAPP REV3-2019.doc I rtT BOARD OF HEALTH Town of Barnstable e Paul J Canniff, D.M.D. " Board of Health Donald A.Gaudagnoli, M.D. John T.Norman 7 MASS. F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 0 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems R 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: 955 Issue Date: 12/20/18 DBA: ALEMAO'S BUTCHERY 2 OWNER: CRISTIANE RESENDE Location of Establishment: 674 MAIN STREET HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 _ FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: ' CONTINENTAL BREAKFAST: ------------------ — - MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: I PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: APPROVED VARIANCE: 1 toilet allowed for facility r �trtKE toy, Initials: Town of Barnstable f ro(� ffDate Paid I L���$ MAE& Inspectional Services163 w; 9�'pjEcs�O� Public Health Division Check# 4 Cash Thomas McKean, Director P (� a.: 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fag: 508-790-6304 V91, 1 ` A(PPpLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 4 t a NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: om 5 ADDRESS OF FOOD ESTABLISHMENT: 63 y movy, s&'(4 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: _ G P,I S QF,y N de h l• corn TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: A WELL WATER:YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: X2( 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? �0 woul ` �T IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE {RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL, MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FormsTOODAPPREV2018.doc PLEASE CALL 508-862-4644 OWNER INFORMATION: f FULL NAME OF APPLICANT U0 S'f t0(re P S5)S cese Ot SOLE OWNER: YES/NO D.O.B 0110 15 1 :�tC OWNER PHONE# 54-36-"-6I 90 ADDRESS_ _39 WbCLAUK kd CORPORATE OWNER: FEDERAL ID NO. : 1. CORPORATE ADDRESS: ,,�� PERSON IN CHARGE OF DAILY OPERATIONS: �Q M ain&- List (2) Certified Food Protection Managers AND at least(1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. "ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1.QXL� r� � �a2 �a0 /coo 19 1. °�l� �a�C� !�� o� 2. (� P a �� Qa /ao /xis -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 http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC I st. Q\Application FormsT00DAPPREV2018.doc Bellaire, Dianna From: Stanton, David Sent: Tuesday, December 04, 2018 11:47 AM To: Bellaire, Dianna Subject: RE:Alemao's ,T Correct. You beat me too it, I just read the Board results and was going to send you an e-mail. Just be sure to add the variance under the restrictions (I think that's the name\area)for the variance of 1 bathroom on their 2019 permit. Thank you, Dave From: Bellaire, Dianna Sent: Tuesday, December 04, 2018 11:32 AM To: Stanton, David Cc: Bellaire, Dianna Subject: Alemao's David; Just confirming we don't need to hold the food permit on this establishment now because they were approved for a 1 toilet variance at the last board meeting? Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us 1 PERMIT NO: TOWN OF BARNSTABLE ISSUE DATE 955 BOAD;: F..,HEAET:N; . 11/06/2017 S Tg"' FQQ�� S�ABLISHMENT PERMIT TO Gltk In accordance with rk% jafibfis p;I f L�ga ed lutfer a /lior►t ,of Chapter 94, Section 395A and Chaytrr 111r,S c cif["�of the G�eiti �7 a T p rinflt is hereby granted to: CRISTIANE RESENDEIFABLO HAU,0W 4 h} :. ALEMAO'SITIER'ti( y Whose place of business is:c m£ 3AIN S�'I, nr ^ IY;i � A 02601 4 YY EI`5 Type of business and any r4trictiont F BLISHM8VT Tooperate a food establish" o'.-n t6e RESTRICTIONS IF ANY: —j , -•;i� _Tr � N- '54- 1 n�: f� k' SEATING: 0 ANNUAL: YES s SEASONAL: TEMPORARY , 0OF HEALTH RETAIL FOOD STORE: y x � 500 ` ti j - � 4 pl .Canniff, D.M.D.,Chairperson FOOD SERVICE ESTABLISHMENT: { RESIDENTIAL KITCHEN FOR RETAIL SALE: r A' , - Jy�tiichi Sawayanagi. RESIDENTIAL KITCHEN FOR BED+BREAKFAST t'' Y F Donald A. Guadaqnoli M.D MOBILE FOOD UNIT: ;:� crn # e7i31 IT » TOBACCO SALES: ram, FROZEN DESSERT: Thomas A. McKean, IRS, CHO CATERER: Director of Public Health �4 TFIE f Town of Barnstable UV Vol 1JF. � Regulatory Services ' MAN. 4Richard V. Scali, Director Bp►RN TABLE � � '�� '�� Public Health Division EDMfd6 nus usas•w ros-.sru IfiY=2ti1J Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 -� Office: 508-862-4644 Pax: 503-7.5_b-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHIVENT DATE: NAME OF FOOD ESTABLISHMENT: A 1 L'1rY� IS bu.kiq y ADDRESS OF FOOD ESTABLISHMENT: Coda Y77�.j� '� MAILING ADDRESS(1F DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: NUMBER OF SEATS*: INSIDE: OUTSIDE: TOTAL: * Note: If indoor seating provided, see Licensing regarding Common Victuallers License . TOTAL NUMBER OF BATHROOMS: ANNUAL OR SEASONAL OPERATION: A MOVA L TYPICAL HOURS OF OPERATION MON-FRI: g : 4 rn TO DAYS CLOSED EXCLUDING HOLIDAYS (I.E. MONDAYS) IF SEASONAL: APPROXIMATE DATES OF OPERATION: / / TO 1 / ***I?EN NDER*** SEASONAL ESTABLISHMENTS MUST CALL FOR INSPECTION PRIOR TO OPENING TYPE OF ESTABLISHMENT: PLEASE CHECK ALL THAT APPLY FOOD SERVICE RETAIL FOOD BED & BREAKFAST CONTINENTAL BREAKFAST *IF SEATING: ALSO, MUST OBTAIN RESIDENTIAL KITCHEN A COMMON VICTUALLER'S LICENSE MOBILE FOOD FROM LICENSING DIVISION. TOBACCO SALES FROZEN DAIRY DESSERT MACHINES CATERING OUTSIDE DINING (OVER) Q:4ipplicaiion Forniffoodapp1doc �-d dL9:6 0 L 60, ***REMINDER*** CIF OUTSIDE DlNlNGq YOU MUST BE APPROVED BY THE HEALTH DIVISION AND LICENSING AND MEET ALL OF THE OUTSIDE DINING CRITERIA IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? CONTACT INFORMATION: FULL NAME OF APPLICANT 091 S?1 ,4 NE OS.SI.5 SOLE OWNER:: YES NO D.O.B ADDRESS 30 © ecL _ ezrk'wilili— ())4 045;A-9— PHONE # ( ) 36 IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: PA WO Pi�`t- L KQW (4AUCH D�6.3 o'2-, IF APPLICANT IS A CORPORATION: '�I FEDERAL IDENTIFICATION NO. Jr' -t264 l 963 STATE OF INCORPORATION: MA FOOD SERVICE ESTABLISHMENTS CONDUCTING FOOD PREPARATION (EXCLUDES RETAIL FOOD ESTABLISHMENTS THAT DO NOT PREPARE FOOD AND CONTINENTAL BREAKFAST): EFFECTIVE JANUARY 1, 2004, EACH FOOD SERVICE ESTABLISHMENT IS REQUIRED TO HAVE AT LEAST TWO CERTIFIED FOOD PROTECTION MANAGERS. AT LEAST ONE CERTIFIED FOOD PROTECTION MANAGER IS RE UIRED TO BE ONSITE DURING ALL HOURS OF OPERATION.*`PLEASE PUT THE NAME OF THE ESTABLISHMENT ON EACH OF THE CERTIFICATES*** LIST THE NAMES OF YOUR CERTIFIED FOOD PROTECTION MANAGERS (I.E. SERVSAFE.) 1. QWi-l-cmL EXPIRATION DATE: O /O O/ o2O I�j i. Fau.o P qw-,Cw EXPIRATION DATE: Ia EFFECTIVE FEBRUARY 1, 2011 EACH FOOD ESTABLISHMENT THAT COOKS, PREPARES, OR SERVES FOOD INTENDED FOR IMMEDIATE CONSUMPTION EITHER ON OR OFF THE PREvIISES SHALL HAVE AT LEAST ONE CERTIFIED FOOD ALLERGEN AWARENESS TRAINED STAFF MEMBER. *** PLEASE PUT THE NAME OF THE ESTABLISHMENT ON THE CERTIFICATE"* LIST THE NAME OF YOUR CERTIFED FOOD ALLERGEN AWARENESS TRAINED STAFF. 1• CI')'l�, [.XJ `)') EXPIRATION DATE: +d /0 A 19 Ul aYX'- aaT&, !1 / 09/� SIGNATURE OF APPLICANT AND DATE QftApplication Fo:msVoodappldoc Z'd d89;60 L 6 60^ON F . PERMIT NO: TOWN OF BARNSTABLE ISSUE DAT I 955 BIIAR6OF-F15A TIJ 12/28/20 PERMIT � FQ `R�1rI1Op -ETIBLISHMENT �I In accordance-with regik- i at�th`oKit of Chapter 94, Section 395A and`Chater I € Sec2ifln :S.bf theeerAl _zes,`apermit is hereby granted to: _ _ z CRISTIANE RESENDE/FABLO HAUGH : F / � �E911A0' 1J i RFY _ _ Whose place of business is: = ^_ `s?4 MAIN �7_; Fifi( MA 0260 �E '= Type of business and any fe�trictiops: TABLISH'MENT To operate a food establish rpenf,irVthe ITABLE E RESTRICTIONS IF ANY: SEATING: U ANNUAL: `_YES_ -' t- s-'F� �t j . ._S SEASONAL: TEMPORARY: RD OF HEALTH RETAIL FOOD STORE: ; haul J. Canniff, D.M.D., Chairperson FOOD SERVICE ESTABLISHMENT: - �� Junichi Saway ana9 i RESIDENTIAL KITCHEN FOR RETAIL SALE: 4 �•-�fir` -.;fT =_ RESIDENTIAL KITCHEN FOR QED+BREAKFAST l`<� t�=�_ -.t:_ �; �'` -�� Donald A. Guadaqnoli M.D MOBILE FOOD UNIT: es TOBACCO SALES: 1 2 -"�^I 2 0 1 7 � FROZEN DESSERT: Thomas A. McKean, RS, CHO CATERER: Director of Public Health �2 Town of Barnstable Regulatory Services 0� a Richard V. Scali,Director Q �# g"$"' �' Public c Health Division � BARNSTABLE Thomas McKean, Director 200142in Street,Hyar-nis,?vIA 02601 Office: 508-862-4644 Fzx' 508-790-6304 AP"PLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE: Of 1131,11 � 4 . I_c NAME OF FOOD ESTABLISHMENT: n Ikm�� (Aj ru ADDRESS OF FOOD ESTABLISHMENT: frn i) S L E-MAIL ADDRESS: C R i. 9 E S E tl 0 6 46 61A h0- rnot'J- corn TELEPHONE NUMBER OF FOOD ESTABLISHMENT: NUMBER OF SEATS*: INSIDE: OUTSIDE: TOTAL: *Note: If indoor seating provided, see Licensing regarding Common Victuallers License TOTAL NUMBER OF BATHROOMS: ANNUAL OR SEASONAL OPERATION: A mrJ U A L T17PICAL HOURS OF OPERATION MON-FRI: U rn TO DAYS CLOSED EXCLUDING HOLIDAYS (I.E.MON-DAYS)_ wk p IF SEASONAL: APPROXIMATE DATES OF OPERATION: / / TO 'REMINDERS" SEASONAL ESTABLISHMENTS MUST CALL FOR INSPECTION PRIOR TO OPENING TYPE OF ESTABLISHMENT: PLEASE CHECK ALL THAT APPLY FOOD SERVICE RETAIL FOOD BED&BREAKFAST CONTINENTAL BREAKFAST *IF SEATING: ALSO.MUST OBTAIN RESIDENTIAL KITCHEN A COMMON VICTUALLER'S LICENSE MOBILE FOOD FROM LICENSING DIVISION. TOBACCO SALES FROZEN DAIRY DESSERT MACHINES CATERING OUTSIDE DINING (OVER) �-d dog:60L10 Uef ***REA'lMER*** IF OUTSIDE DINING,YOU MUST BE APPROVED BY THE HEALTH DIVISION AND LICENSING,AND MEET ALL OF THE OUTSIDE DIlYING CRITERIA IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AST AIR CURTAIN PROVIDED.AT WAITSTAFF SERVICE DOOR(S)? 'CONTACT INFORMATION: FULL NAME OF APPLICANT a1 SAGS, -A S515 eCX N d� SOLE OWNER: NO ADDRESS 3 `C hG d l l (1-nitAL)t Alt. (Yl _ Od b 3c2 PHONE 4(509) _- ro 18� IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: FABLO PiTTEL KOuJ 00CA M U0bD&A, 2d, I an j mA X63a- off-,304-9510 IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. 45-o?G+ 1963 STATE OF INCORPORATION (Y1 FOOD SERVICE ESTABLISHMENTS CONDUCTING FOOD PREPARATION (EXCLUDES RETAIL FOOD ESTABLISHA'IENTS THAT DO NOT PREPARE FOOD AND CONTINENTAL BREAKFAST): EFFECTIVE JANUARY 1, 2004, EACH FOOD SERVICE ESTABLISHMENT IS REQUIRED TO HAVE AT LEAST TWO CERTIFIED FOOD PROTECTION MANAGERS. AT LEAST ONE CERTIFIED FOOD PROTECTION MANAGER IS REQUIRED TO BE ONSTTE DURIIIG ALL FOURS OF OPERATION.***PLEASE PUT THE NAME OF THE ESTABLISHMENT ON EACH OF THE CERTIFICATES*** LIST THE NAMES OF YOUR CERTIFIED FOOD PROTECTION MANAGERS(I.E.SERVSAFE.) EXPIRATION DATE JL c Q i - -- . 2._ �ri S- a S�r�d� EXPIRATION DATE: La t a 01 Qa 19 EFFECTIVE FEBRUARY 1, 2011 EACH FOOD ESTABLISWlENT THAT COOKS, PREPARES, OR SERVES FOOD INTENDED FOR IMMEDIATE CONSUMPTION EITHER ON OR OFF THE PREMISES SHALL HAVE AT LEAST Or-E CERTIFIED FOOD ALLERGEN AWARENESS TRAINED STAFF MEMBER *** PLEASE PUT THE NAME OF THE ESTABLISHMENT ON THE CERTIFICATE"* LIST THE-NAME OF YOUR CERTIFED FOOD ALLERGEN AWARENESS TRAINED STAFF. EXPIRATION DATE: Oa.I c�013 Z'd dog:[0L6 £L UPr M a CERTIFICATE OF ALLERGEN AWARENESS TRAINI NG Name of Recipient: Cristiane AResende C`.ertificate•Number: CW85710 � Date of Completion: 12/03/2014 Date of Expiration: 12/02/2019 i Issued By: 'Ihe above-named person is hereby issued this certificate iNorltS Sfor completing an allergen awareness training program ` .•.... + recognized by the Massachusetts Department of Athlic Health CompuWorks Systems,Inc. in accordance with 105 GMR 590.009(G)(3)(a). 591 North Avenue,Door 2 Wakefield,MA 01880 P:791-224-1111 This certificate will be valid forfive(5)years front dale of completion. R 781-224-0504 o www.compuworks.com l -- ----- - -- - - - - -- - --- --- - -- to e - - EXAM FORM NO. 5010 r- Q�i¢.•,:.'+ Slur = ..'...'.,L:• r� I .:,�.,'.' CERTIFICATE NO. 11879559 ry afe CERTIFICATION . In FABLO P HAUCH for successfully completing the standards set forth for the ServSafe"Food Protection Manager Certification Examination, which is accredited bythe American National Standards Institute(ANSI)-Conference for Food Protection(CFP). .q.,7 t:` DATE 0 141*1* 12/20/ DATE OF EX Local laws apply.Ch@1�>ffdo ry' Tlroy'for recertification requirements. ,. . Q AAA LP L' �Na.�514�rw�iCll X�i7dll1tiU11Y . *2014 0655 Natto naI Rcak, P t C 7heloge f + a� i'YA:fb .#radematk of the tirtAEF.used under license by National Restaurant Association Salutlorts,LLG In accordance with Maritime Labour convention 2006, (p � tkP��I�' uFd + nesotutlon ADM H 06e-2013(negulatien3.2,St-&M —7 A3.2)of the Maritime Labour Convenllon.2006. rhl y 14 Boy?Ott 91r Ariptered .,..... .. .. �. . ..f...rwi .. _..._. .. L K� ■r _# *,` �. t =x EXAM FORM NO. solo CERTIFICATE NO. 11879557 1 r"• M. •f.ii" jam '\t-_r.. t ,,,:.. �. 1 ;„w ry afe ­111-*.......... -y :•n'!,X ��.��� CERTIFICATION TO CRISTIANE RESENDE for successfully completing the standards set forth for the ServSafe'Food Protection Manager Certification Examination, which Is accredited by the American National Standards Institute(ANSI)-Conference for Food Protection(CFP). DATE OF r l�(111k'l r'1 .1!0 12/20/2���'r ry. :w DATE OF EXRIi:, Local laws appl, i tfor recertification requirements. •,. ` . LP a N O i ® e :.,a'g+,> geiq�'Ignnitrtinnv �a k)2014 National Rester QjL I g ey 's' i�d;GSdemark of the NRAEF,used under license by National Restaurant Association Solutions,ILC. In accordance with Maritime Labour Convention 2006, l}iCloEgg f •iE�Qiiadsurq h�. Q 115t{ Ruolviton ADM N068-a0r3(Regida(Ian3a,Standard CU AU.)of the Maritime Lebonr Cvuvenllnn,2W6. a�� r rlr'�}rRh1�A'eaYu7aI�� � -- -- .,. ., _ ... .. .�_.... . _. ,-• -----,. .. ._._. _ _ . yY.•ns.... uv.. .:s,i1+i. PERMIT NO: TOWN OF BARNSTABLE ISSUE DAT w 955 January 1, 201 PERMIRMM HMENT f_— a In accorda e fh g .10 u rr of Chapter 94, Section 395A a e 1 e n f the Gen _�, it is hereby granted to: CRISTIANE RESENDE/FABLO O's Aj- Whose place of business i i'l MAIN 3rT r A 026ff. Type of business and any tristigns: - -011 TABLISH11 Ef�T 4; C. To operate a food establi r e ir(the ' ~�~ VLE x r HU RESTRICTIONS IF ANY: �w € •r `ra r" rt SEATING: 0 ANNUAL: Eli*q ., SEASONAL: TEMPORA :� r z r � D OF HEALTH i; r �. RETAIL FOOD STORE: ra yne Miller, M.D., Chairperson FOOD SERVICE ESTABLISHMENT: - _ Paul J. Canniff, D.M.D. RESIDENTIAL KITCHEN FOR RETAIL SALE: �' z� tcx. RESIDENTIAL KITCHEN FOR BED+BREAKFAST ' �' a Junichi Sawavanagi MOBILE FOOD UNIT: TOBACCO SALES: December 31 , 2016 FROZEN DESSERT: Thomas A. McKean, RS, CHO CATERER: Director of Public Health i Town of Barnstable `� 1 �WME to Regulatory Services -A MA Richard V. Scali, Director ) 'BARNSTABLE * L►RNSTABLE. • erunnae,F•mt,Exmue cmvn rrcaxxa MAS& Public Health Division. 163�>• �� ;>,r�t ,>.,y� 1`4 .,ey.+kid;�p sf�'+ i tki�'yli'V%�k ��.x�£';�„ti�h-a4 ,�•_�;,r•��,�"xIW-?, '4"')is3 r � r.F. 'j" .....--�``:�;�: :�a �.�'",6r� �fi 3u_i="a ' 'rv.+,F� ,�t`•.�*:sti,�'S? '�"?�:�u�r" a�3`# •,tas'rS:��+" +.+;,..+.. rY .c.1' +�+'�'ma's ,„'h''r"��5� c., ,qc'.. xs y v,af�K t"+ . t} �4`' #, +'`a }> p-'4( , ix '.�.,�p � r �ck1, y E� y ,?y� i �: •' sr, R"" tki t � �t'4*=F'� ,v4.l,t.ik�$k,+:`a`F.,a,•,rat-t'- . -. - .... 'r, 0ffice: 508=862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE: 411,015 NAME OF.FOOD ESTABLISHMENT: I1,tin a0 5 B(.4CJi ADDRESS OF FOOD ESTABLISHMENT: E-MAIL ADDRESS: G216 g'se Nc s :6 Cyr hod-'moA 1 Co mi TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( 5p9) 8:� NUMBER OF SEATS*: INSIDE: OUTSIDE: TOTAL. * Note: If indoor seating provided, see Licensing regarding Common Victuallers License TOTAL NUMBER OF BATHROOMS: ANNUAL OR SEASONAL OPERATION: A-NNQ1kL TYPICAL HOURS OF OPERATION MON-FRI: Am TO DAYS CLOSED EXCLUDING HOLIDAYS (I.E. MONDAYS) Qol je IF SEASONAL: APPROXIMATE DATES OF OPERATION: _/ / TO / / ***REMINDER*** SEASONAL ESTABLISHMENTS MUST CALL FOR INSPECTION PRIOR TO OPENING TYPE OF ESTABLISHMENT: PLEASE CHECK ALL THAT APPLY FOOD SERVICE _RETAIL FOOD BED & BREAKFAST CONTINENTAL BREAKFAST *IF SEATING: ALSO,MUST OBTAIN RESIDENTIAL KITCHEN A COMMON VICTUALLER'S LICENSE MOBILE FOOD FROM LICENSING DIVISION. TOBACCO SALES FROZEN DAIRY DESSERT MACHINES CATERING OUTSIDE DINING (OVER) ***REMINDER*** IF OUTSIDE DINING,YOU MUST BE APPROVED BY THE HEALTH DIVISION AND LICENSING, AND MEET ALL OF THE OUTSIDE DINING CRITERIA IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? CONTACT INFORMATION: FULL NAME OF APPLICANT e s+cAric Ass l S ESE (J de SOLE OWNER: lJ ADDRESS 38y�'tlt__. A 0�63� PHONE # L__) - IF APPLICANT IS A PARTNERSHIP, FULL NAME AND'HOME ADDRESS OF ALL PARTNERS: FA BL0 Pi TT-F L KOW 14AUcH 3g Rd IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. �5-o'`�oll L363 STATE OF INCORPORATION m FOOD SERVICE ESTABLISHMENTS CONDUCTING FOOD PREPARATION (EXCLUDES RETAIL FOOD ESTABLISHMENTS THAT DO NOT PREPARE FOOD AND CONTINENTAL BREAKFAST): EFFECTIVE JANUARY 1, 2004, EACH FOOD SERVICE ESTABLISHMENT IS REQUIRED TO HAVE AT LEAST TWO CERTIFIED FOOD PROTECTION MANAGERS. AT LEAST ONE CERTIFIED FOOD PROTECTION MANAGER IS REQUIRED TO BE ONSITE DURING ALL HOURS OF OPERATION.***PLEASE PUT THE NAME OF THE ESTABLISHMENT ON EACH OF THE CERTIFICATES*** LIST THE NAMES OF YOUR CERTIFIED FOOD PROTECTION MANAGERS (I.E. SERVSAFE.) I. EXPIRATION DATE: [a /40/ 020/9 2, g'l a Y. &),d, EXPIRATION DATE: 102 /a 0/ o2019 EFFECTIVE FEBRUARY 1, 2011 EACH FOOD ESTABLISHMENT THAT COOKS, PREPARES, OR SERVES FOOD INTENDED FOR IMMEDIATE CONSUMPTION EITHER ON OR OFF THE PREMISES SHALL HAVE AT LEAST ONE CERTIFIED FOOD ALLERGEN AWARENESS TRAINED' STAFF MEMBER. *** PLEASE PUT THE NAME OF THE ESTABLISHMENT ON THE CERTIFICATE*** LIST THE NAME OF YOUR CERTIFED FOOD ALLERGEN AWARENESS TRAINED STAFF. Qom, �C�Q, EXPIRATION DATE: � 9 SIGNATURE OF APPLICANT AND DATE Q:\Application Forms\Foodapp2.doc PERMIT NO: TOWN OF BARNSTABLE August.24, 2015 955 BOARD OF HEALTH PERMIT TO 0 _TABLISHMENT In accordan,.e wi a I,o o8.1atf � ority of Chapter 94, I Section 395A and C p ti s #e( r 4, aermit is hereby granted to: CRISTIANE RESENDEIF _ Ift 'S BUTCHERY N Whose place of business is rJJJA 0269 Type of business and any sIrl��: O EI _ .� A B L I S H` ~' Y To operate a food establisinfeRt, in he T _ ABLE Et RESTRICTIONS IF ANY: � �- ,tyw7�- > SEATING: 0 `�' �62ALRIAMa . � ANNUAL:aY S �, & �, c SEASONAL: TEMPOR� • , ES [ OF HEALTH RETAIL FOOD STORE: 2 00 FOOD SERVICE ESTABLISHMENT: i - Miller, M.D., Chairperson . F J. RESIDENTIAL KITCHEN FOR RETAIL SALE: Canniff, D.M.D.-'�'�>1 , � c r RESIDENTIAL KITCHEN FOR BED+BREAKFAST ' sue : nichi Sawavanagi MOBILE FOOD UNIT: TOBACCO SALES: FROZEN DESSERT: Thomas A. McKean, RS, CHO CATERER: Director Of Public Health A SU7 �� I SIN i UgH • • ' Y I � *Town of Barnstable °FTHE lok, Regulatory Services ti Richard V. Scah, Director BARNSTABI,E sA MASS. LEA " Public Health Division o,Rena6PIIU F- -V157Bi-STAR Y MASS. nxs*on;rws-osrem�u�-cis nnnxsrnea i639 1639-1014 HIED MA'S A 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: NAME OF FOOD ESTABLISHMENT: A L E m A 0 5 &4-C e ry r ` ADDRESS OF FOOD ESTABLISHMENT: 6-V (Y)Ctt E-MAIL ADDRESS: CR(S XSE Ok ho�mo_t (. TELEPHONE NUMBER OF FOOD ESTABLISHMENT: NUMBER OF SEATS*: INSIDE: OUTSIDE: TOTAL: *,Note: If indoor seating provided, sAeLicensing regarding Common Victuallers License TOTAL NUMBER OF BATHROOMS: ANNUAL OR SEASONAL OPERATION: kjw6 L TYPICAL HOURS OF OPERATION MON-FRI: TO DAYS CLOSED EXCLUDING HOLIDAYS (I.E. MONDAYS) DPe n Wt red &Y IF SEASONAL: APPROXIMATE DATES OF OPERATION: / / TO ***REMINDER*** SEASONAL ESTABLISHMENTS MUST CALL FOR INSPECTION PRIOR TO OPENING TYPE OF ESTABLISHMENT: PLEASE CHECK ALL THAT APPLY { FOOD SERVICE RETAIL FOOD BED & BREAKFAST CONTINENTAL BREAKFAST *IF SEATING: ALSO, MUST OBTAIN RESIDENTIAL KITCHEN A COMMON VICTUALLER'S LICENSE MOBILE FOOD , FROM LICENSING DIVISION. TOBACCO SALES FROZEN DAIRY DESSERT MACHINES CATERING OUTSIDE DINING (OVER) ***REMINDER*** . IF OUTSIDE DINING YOU MUST BE APPROVED BY THE HEALTH DIVISION AND LICENSING, AND MEET ALL OF THE OUTSIDE DINING CRITERIA IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? CONTACT INFORMATION:FULL NAME OF APPLICANT ettA c4T\S- &Y SOLE OWNER: YES /NO ADDRESS 3� WSADCU k D . &y)l .Yyl 1je _ mA Da 63o2_- PHONE # /F0 IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: 39 MO-Weea Cd - an�uuiffs , MA 0632, IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. y 5-cX 4 1963 STATE OF INCORPORATION MA FOOD SERVICE ESTABLISHMENTS CONDUCTING FOOD PREPARATION (EXCLUDES RETAIL FOOD ESTABLISHMENTS THAT DO NOT PREPARE FOOD AND CONTINENTAL BREAKFAST): EFFECTIVE JANUARY 1, 2004, EACH FOOD SERVICE ESTABLISHMENT IS REQUIRED TO HAVE AT LEAST TWO CERTIFIED FOOD PROTECTION MANAGERS. AT LEAST ONE CERTIFIED FOOD PROTECTION MANAGER IS REQUIRED TO BE ONSITE DURING ALL HOURS OF OPERATION.***PLEASE PUT THE NAME OF THE ESTABLISHMENT ON EACH OF THE CERTIFICATES*** LIST THE NAMES OF YOUR CERTIFIED FOOD PROTECTION MANAGERS (I.E. SERVSAFE.)/ 1. 'W�1'lflY1Q, �1ot�. EXPIRATION DATE: to? 00/ d0f 9 2. F(WO +► -C� EXPIRATION DATE: to? / do/ oZ 019 EFFECTIVE FEBRUARY 1, 2011 EACH FOOD ESTABLISHMENT THAT COOKS, PREPARES, OR SERVES FOOD INTENDED FOR IMMEDIATE CONSUMPTION EITHER ON OR OFF THE PREMISES . SHALL HAVE AT LEAST ONE CERTIFIED FOOD ALLERGEN AWARENESS TRAINED STAFF MEMBER. .*** PLEASE PUT THE NAME OF THE ESTABLISHMENT ON THE CERTIFICATE*** LIST THE NAME OF YOUR CERTIFED FOOD ALLERGEN AWARENESS TRAINED STAFF. EXPIRATION DATE: 0 / 0.24 a019 09 /01 / a015 SIGNATURE OF APPLICANT AND DATE Q:V\pplication Forms\Foodapp2.doc L ' �►-ernes ;� �tlos Town of Barnstable s" MASS. ' Board of Health i v 639, � 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D FAX: 508-790-6304 John Norman Donald A.Guadagnoli,M.D. January 11, 2019 Ms. Cristiane Resende 38 Nobedeer Road Centerville, MA 02655 RE: Variance to Operate a Food Establishment with One Restroom Facility Alemao's Butchery, 674 Main Street, Hyannis, Dear Ms. Resende, You are granted a variance to provide one toilet facility for the operation of a food establishment 674 Main Street, Hyannis, Massachusetts. The variance granted is as follows: Section 322-4 Toilet Facilities To utilize one restroom in lieu of the requirement to two provide separate male and female employees. The variance is granted with the following conditions: -- --(1) ---Seating is not authorized for patrons.- - (2) This variance decision letter shall be posted on the wall adjacent to the food permit in an area which is easily accessible to be read by a health inspector anytime routine inspections are conducted. (3) This variance is not transferable to anyone other than the applicant. In the event that this business is sold or transferred, both the owner of the building and the licensee have the duty to inform any and all potential purchasers of the existence of these variances and the fact the Board has explicitly made them non-transferable. Sincerely yours PaulWCi D. Chairman Board of Health Q:\WPFILESWIemaos Butchery Toilet Variance 2019.docx i �F INE)r,. DATE: $95.00 FEE*: } BARNSTABM 9� MASS. Town of Barnstable C.BY: �� 1639. ♦� RFD MA'1 a -711 SCHED.DATE: I1 : -r. Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 -- Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. John T.Norman �oD VARIANCE REQUEST FORM LOCATION �J P _ Property Address: / �J j �RtE--rr Assessor's Map and Parcel Number: Size of Lot: i Wetlands Within 300 Ft. Yes Business Name: b—myqo No Subdivision Name: APPLICANT'S NAME: Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: Name: C k 1 s'T i PdJ e- Address: Address:" g No 6,,+6 e-ciZ M Phone: Phone: -50$-3W— 12c) 0 3� EMAIL: VARIANCE FROM REGULATION(Incl.Reg.Code#) REASON FOR VARIANCE(May attach separate heet if more space needed) J -to 1, FQlzr o NATURE OF WORK House Addition House Renovation LJ Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as 5 collated packets r/A. Five(5)copies of the completed variance request form _ B. Five(5)copies of MA DEP approval letters for Innovative/Altemative septic system(when proposing an I/A system or secondary treatment unit(S.T.U.). C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health@town.bamstable.ma.us D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version. A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or R.S. Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu-Five(5)copies of full menu submitted(for grease trap variance requests only). Fee Submitted*$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance"). Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Cannifl Chairman NOT APPROVED Donald A.Guadagnoli,M.D. REASON FOR DISAPPROVAL John T.Norman Q:\Application Forms\VARIREQ Rev APR 4-2018.docx ti (; DATE: �r pQ $95.00 FEE*: BAANSfABLE, MASS a,�� RE C.BY: ��P� o Town of Barnstable -711 SCHED.DATE: I, a: =r Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 _ Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. John T.Norman VARIANCE REQUEST FORM LOCATION _ Property Address: 4/7 H�i; 13rKeT-r y% Assessor's Map and Parcel Number: Size of Lot: i Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: l A� Name: C i1 s-rl PdJ e_ ' \e,. e-Jel Address: Address: .3 8 No 6.*b em Phone: Phone: 509-3 W— 1 2D EMAIL: C S (Rec VARIANCE FROM REGULATION(Incl.Reg.Code#) REASON FOR VARIANCE(May attach separate heet if more space needed) j to ( an iie_u d-F -2 i5-E0-W.rW4D _'o] I-e C,i � Ictiuc2, a d NATURE OF WORK House Addition M House Renovation LJ Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as 5 collated packets. v"A. Five(5)copies of the completed variance request form B. Five(5)copies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an I/A system or secondary treatment unit(S.T.U.). C. Five(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health@town.bamstable.ma.us D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version. A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or R.S. Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). Fee Submitted*$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance"). _ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Donald A.Guadagnoli,M.D. REASON FOR DISAPPROVAL John T.Norman Q:\Application Forms\VARIREQ Rev APR 4-2018.docx 1�012080 iffio � r ' pC. le w irk; <Yr �40 80=' 0. 20O 0 OF 7 Memo T , r. „4 i GNU E, fl2 `t i I 1 — _ - truft auNpr l{e0 'Tne perlsnab 1pp a rIc ltu�41 tne�sto[`f4O'�tuf a�Lpmmoolt es CUBE plpe <fes��f° 1�;naba�g i� WtIGHI oy sec. pn i n° < ine°se co° 4�omachese WHS6 TOTAL ecc. t9�0 l7 U.S C. rust latm 000ucts aer� the sofa of FFZ2 R�S — c mmpolt fes rota lns a p�ner Or eeos rpm. FiZ COOL — ------- a41 In€ntprles pt tppo pr —=ecel 3,512 Ar cpmmool fes, ono anY r c Iv btes or prp 35 tnese co— mR°=lttes a=tt�S °l� aav"Knt Is ^ 16 �_887 THIS 16 AMOUNT CUgpENCY AIPAYMNT N h n j, M s � R t V o. - S. i .Hl +^ •� IN — z r y. y , x ,�'� �'^�• � � z, 'c , r �� . . •�. � o �u �z��� 5� � � � it 1 �5FA � r p' 4 • �p 1ps i { aka a, ff 4 t I W r,r ,— - �� tit �'�..''��o�,E•.�':';, r. r I s . -. � +mod' � s� ': � y.. •i } ��� "q7�e Ad 24 In choe x 2,000 r��t v i�tODUe�l+tvU + � 610mmx610m i. t (372 Sq,meterxl ° ,. ��++ �y ��+p+�{ rr n f a ! nue+a I (�RGRBV SG�4M� 1r��� SU 1 F wItem# C.S.I.Section 11420 _ 350 SERIES VACUUM PACKAGE MACHINES ❑ 350 One 17" seal bar -- ❑ 350D Two 17" seal bars STANDARD FEATURES ■ Tabletop models with a stainless steel housing and single 18" (457 mm)x 18"(457 mm)x 61/2" (165 mm)chamber. ■ Model 350 includes a single 17" (425 mm)seal bar; Model 350D includes two 17" (425 mm)seal bars; provide tiu u " high integrity double sealing with electric cut-off. 1 y � �Y ■ Powerful,high quality 21 m3/h Busch pump and vacuum k� dial guage. ■ 1-speed, 1'/4 H.P.motor,totally enclosed, permanently lubricated ball bearings,thermally protected. z ■ Model 350 furnished in 115/60/1, 14.2 amp,AC, ETL listed; Model 350D furnished in 115/60/1,20.0 amp,AC, ETL listed. ■ Vacuum intervals of 1 to 99 seconds. Model 350 ■ Gas flush for the addition of an anaerobic gas mixture X and/or pillow-pack seal. ■ Simple to operate electronic,touch pad controls with nine (, storable programs. U' ■ Attached 6-foot,flexible,3-wire cord and plug for US n,( � grounded receptacle. Intertek Intertek OPTIONS ❑ Liquid control system FEATURES Berkel Models 350 and 350D are reliable tabletop vacuum package machines designed to meet most mid-to high- volume foodservice portion control, product storage and food retail needs.The units offer a spacious stainless steel chamber, powerful, high quality pump and single 17" (double on 350D)seal bar providing a high integrity double seal with electric cut-off. Both models offer an anaerobic gas flush to maintain product color in the vacuum package, extend shelf life and/or to provide a pillow-pack seal to protect the product. The units are simple to operate and maintain. ® a division of i7W Food Equipment Group LLC P.O.Box 696 ■ Louisville,KY 40201 ■ Toll-free:1-800-814-2028 ■ Local:502-778-2791 ■ Quote&Order Fax:1-800-444-0602 BK45727(12/10) Berkeiffl-' 350 SERIES VACUUM PACKAGE MACHINES SPECIFICATIONS Finish/Construction: Tabletop models with stainless steel Gas Flush: Provides for the addition of an anaerobic gas housing and single chamber. mixture and/or pillow-pack seal. Pump: Powerful,high quality 21 m3/h Busch pump and Controls: Simple to operate electronic,touch pad controls vacuum dial gauge. with nine storable programs. Electrical: Model 350 furnished in 115/60/1, 14.2 amp,AC, Motor: 1-speed, 1'/4 HP,totally enclosed, permanently ETL listed. Model 350D furnished in 115/60/1,20 amp,AC, lubricated ball bearings,thermally protected. ETL listed. Cord and Plug: Attached 6-foot,flexible,3-wire cord and Vacuum Chamber: Single;stainless steel 18" (457 mm)x plug for grounded receptacle. 18" (457 mm)x 61/2" (165 mm)chamber.Vacuum intervals of Warranty: All parts,service and travel coverage for one year, 1 to 99 seconds. excluding wear items. Seal Bar(s): Model 350 includes a single 17" (432 mm)seal bar; Model 350 includes two, 17"(432 mm)seal bars; provide high integrity double sealing with electric cut-off. A B - - o C 0 0 000 0 00000 O MLODEL CHAMBER SIZE F ; SEAL SEAL BAR ; PROD�UCTDIMENSIONS E 4 # :NUMBER WIDTHS ` 'DEPTHr HEIGHTBAR L' Y LENGTH WIDTHiA DEPTH B HEIGHT C�` 3 350 18' 18" 61/2" 1 17" 21" 24" 201/2" (457 mm) (457 mm) (165 mm) (432 mm) (533 mm) (610 mm) (445 mm) 18" 18" - 6'/2" 17" 21" 24" 201/2" 350D (457 mm) (457 mm) (165 mm) 2 (432 mm) (533 mm) (610 mm) (445 mm) MODEL rU.;,PUMP r -, �r� �`a ;ti 3 �H� r � BOX DIMENSIONS -2 I NUMBER y =m3/h: ';ELECTRICAL Z . fw WEIGHTS r_ WID.THI x E DEPTHS HEIGHT 350 21 115/60/1 Net 171 lbs. (78 kg) 32" 25" 30" Ship 231 lbs. (105 kg) (813 mm) (635 mm) (686 mm) 350D 21 115/60/1 Net 184 lbs.(84 kg) 32" 25" 30" Ship 244 lbs. (111 kg) (813 mm) (635 mm) (686 mm) ® a division o/17W Food Equipment Group LLC P.O. Box 696 ■ Louisville, KY 40201 ■ Toll-free: 1-800-814-2028 ■ Local:502-778-2791 ■ Quote&Order Fax:1-800-444-0602 BK45727(12/10) NOTE:As we continually strive to improve our products,specifications are necessarily subject to change without notice. ��0.lty�JW NM 3 � f Y 20 3 MIL STD BARRIER s NYLON / PE VACUUM POUCH s - QTY- : E-- 00 MADE IN THE USA { . ITEM # DOCKET JF 75001867 111 _ 031 i Thunderbird TTD-308 Meat Tenderizer http://www.yourdel om/thunderbird—meat—tenderizer—TTD-308.htm t Thunderbird TTD-308 Meat Tenderizer YoUrDefight Appliances THUNDERBIRD MAIN PAGE Thunderbird TTD-308 Meat Tenderizer s w � I Thunderbird TTD-308 Meat Tenderizer that is HIGH quality standards! Specially designed with multiple, razor sharp, heat treated, high strength, stainless steel knives that tenderize meat by surgically cutting through the connective tissues that cause meat to be tough!" Features: • Tenderizes meat without loss of nutrition, freshness or loss of shape! • Compact size well suited for medium or large meat processing shops, steak house restaurants, butcher shops or even at home! • Powerful motor,yet quiet and vibration free! • Waterproof electrical switch provided for safety. • Tenderizes meat up to 1.5 inches thick!! • Multiple Heat treated, Stainless Steel Knives. Specifications: 1 of 2 7/1/2011 2:12 PM Thunderbird TID-308 Meat Tenderizer http://www.yourdel om/thunderbird—meat—tenderizer—TTD-308.htm • Motor: 1/2 HP,20 Amps • Electric: 115 Volts, Single Phase • Dimensions: 20.1" x 11.5" x 20.8" • Capacity: 50 Lbs per minute • Approval: CE,NSF, ETL • Cutting Group Std. #12 • Shipping weight: 68 Lbs Thunderbird TTD-308 Meat Tenderizer LIST PRICE $2,600.00 YOUR PRICE $1539.00 ' YourDelight Appliances Click Sun To Go Home Free Shipping On Order Of$600. 0 Or More Shipped Within The Continental USA 2 of 7/1/2011 2:12 PM My Smart Chef Co. +S http:/*.mysmartchefcom/rest—equip_�HLS-I 650A.html •1 NI j HOME ABOUT US PRODUCTS RECIPES CONTACT US FEEDBACK Restaurant Equipment - HLS-1650A-Zica Bone Saw ZICA. Bane Saw F ' HLS-1650A ® it rtw Conforms to NSF Standard 8 Features Cleaning *Polished anodized aluminum magnesium alloy body. *The lower wheels have cleaning devices *All of the internal metal parts including the upper insuring improved durability and sanitation wheel, lower wheel upper wheel hinge and the lower *The installed scrap box is easily remove bearing housing are made with stainless steel. for cleaning. *Electrical control system,it provides safty through dynamic braking and automatic overload protection Limited Warranty *All frame and food contact parts are made with One-year, limited parts&labor warranty.. either stainless steel or polished anodized aluminum providing improved durability and sanitation, *A hand guard provide safe and sanitary operation. Wel'bon Smart Chef Co. If the door opens during operation,the Installed W05 Rush St.LOW AS El Monde CA 91733 USA sensor will alltomatically Cut off power, Ta.t-6M-442-6698 Fax,1-82"42-6819 *The scaled shaft of the thickness adjusting plate allows a standardized and consistent product cut- 1 of 2 7/1/2011 2:10 PM My.Smart Chef Co. http://*.mysmartchef.com./rest—equip_HLS-I 650A.htn1 r �. local' HL -1650A Dimension: A Overall width: 18" B Overall length: 171" '= C Overall height 34" Footprint: 11 1/2"x15"(WxL) Shipping information: Net weight: 85LBS Shipping Weight: 107LBS .-' Shipping Box dimensions: 20"x21"x37"=8.9CBF Specifications:. Construction: Motor: AC115V/60Hz/1Phase/1.5HP Polished anodized aluminum,. Power Voltage: AC-115V/60Hz/1Phase And Stainless Steel frame, Length of Saw Blade: 64,96"(1650mm) Internal parts made with stainless steel. Saw Blade Speed:2300Ft/min Working Table: 18"x17" Switch: (Red)Off and(Green)On switch Safety Hand Guard, Stainless Steel Wheel: Stainless Steel Legs: Non adjustable 1Melbon Smart Chef Co. 9205 Ru&h St,UfRl A S El t.1onle CA 91733 USA Tel.1<626,442-MBNu,1.626AAM10 Back Privacy Policy I Terms&Conditions Site Designed by abledesigner.com, Hosted by 2giobalmart.com 2 of 2 7/1/2011 2:10 PM 3 Door Reach-In refrigerator STR 72 • http://www.jroeys.com/3-door-reach-in-refrigerator_str72.htm1 i' . iMCURLEYS.COM Restaurant Equipment & Refrigeration 6 Prospect Street Kingston, MA 781.585.5186 mom. ,-o ';n•' . W7" s r t � Y STR-72 REFRIGERATOR (Also available as a Freezer) 1 of 3 7/1/2011 2:16 PM 3 Door Reach-In refrigerator STR 72 • http://www.j*eys.com/3-door-reach-in-refrigerator_Str72.htmi '77.5'82.E I F MVEW 13F TCPYM h— sir �__...__.,� __ a IDE VIEW RO' I, NEMA 5-15 Model Doors #of Shelves HP Amps Weight WDH STR-72 3 9 1/2 9.9 753 81" x 32" x 82.5" 9 Adjustable Interior Shelves The interior shelves sit on adjustable mounting brackets to allow for height adjustments shelf by shelf to accommodate different sized products. 4 Casters They include 2 front locking casters and come pre-installed for easy set up. Also allows for easy moving during cleaning or maintenance. Stainless Steel Interior& Exterior High quality 430 stainless steel exterior and 304 stainless steel interior provides both durability and beauty to the unit. Also includes incandescent interior lighting. Bottom mounted Compressor Allows for easier access while loading and unloading. This compressor location is ideal rather than to mounted style due to the temperature difference between the bottom and top of a room Also allows easier access for maintenance and cleaning. Self Closing Locking Door(s) 2 of 7/1/2011 2:16 PM 3 Door-Reach-In refrigerator STR 72 • http://www.j*leys.com/3-door-reach-in-refrigerator_Str72.htmi Self closing locking door keeps energy costs down by not allowing as much cold air to escape the unit while opening. The locking door also has an auto stop feature that keeps door open when at 90 degrees to make for easier loading and unloading. Digital Temperature Controls The LCD display allows for temperature control and wasy visual read out. Cooling Temperature Range 32-50 OF Refrigerant R134a Maximum Ambient Temperature Rating 100.4 F Defrosting Automatic Temperature Display Yes Temperature Controller Digital H/P 1/2 Dimensions Exterior Dimensions (WxDxH) 81" x 32" x 82.5" Interior Dimensions (WxDxH) 76.25" x 27" x 60.25" Net Volume (cu. ft) 72 cu. ft Net Weight 753 lbs. Packaging Dimensions (WxDxH) 56.25" x 34.5" x 83.5" Construction Exterior Material 430 series stainless steel Interior Material 304 series stainless steel Insulation Material Foamed in place polyurethane Shelf Material Plastic coated steel Shelf Load Capacity 120 lbs. Electrical Voltage 120 Amps 9.9 HZ 60 Phase 1 C J. M. Curley's All rights reserved. Unauthorized duplication of website content forbidden. jmcurleys.com 3 of 7/l/2011 2:16 PM SGM49RS • http://coolguyfridge.com/SGM49RS.htmi v _, Visit our sister site: 1-888-524-2582 Th5 �► fi , Double Door Reach In Glass Door Refrigerator d � ' 2 Bottom Mounted Compressor Allows for easier access while loading and unloading. This compressor location is ideal rather than the top mounted style due to the temperature difference between the bottom and the top of a room.Also allows easier a � access for maintenance and cleaning.. Spartan Self Closing Door(s) Self closing doors keep energy costs down by not allowing as much cold =� air to escape the unit while opening. ;x4, d 8 Adjustable Interior Shelves The interior shelves sit on adjustable mountain brackets to allow for height adjustments shelf by shelf to accommodate different sized products. ' 4 Casters Two front locking casters and two rear free swiveling casters are included and come pre installed. Anti-Fog Glass Door(s) Fully insulated glass doors helps with energy savings while providing '° g ` r clear visibility of products inside. Interior Lighting Lighting provides high visibility for customer viewing. $1,895.00 PLAN VIEW C(p. NSF. v; s8� A. 1 of 2 7/1/2011 2:14 PM I SGF27 • • http://cooiguyfridge.com/SGF27.htmi A yt Visit our sister site: 1-888-524-2582 Single Door Reach In Scw� Glass Door Freezer 4 � �� Bottom Mounted Compressor Allows for easier access while loading and unloading. This compressor location is ideal rather than the top mounted style due to the temperature difference between the bottom and the top of a room.Also allows easier access for maintenance and cleaning.. 3g `a Spartan Self Closing Door(s) fi ■ 3k,. £Ta� Self closing doors keep energy costs down by not allowing as much cold air to escape the unit while opening. { 4 Adjustable Interior Shelves The interior shelves sit on adjustable mountain brackets to allow for height adjustments shelf by shelf to accommodate different sized products. 4 Casters x Two front locking casters and two rear free swiveling casters are included and come pre installed. Anti-Fog Glass Door(s) t Fully insulated glass doors helps with energy savings while providing # clear visibility of products inside. Interior Lighting ' #4 44.° Lighting provides high visibility for customer viewing. $1,695.00 TECHNICAL DATA Dimensions Cooling Extenor Dimensions(NO.,Wp 27`x 25'r 80W Tenuperoavo Range C'-61 F !'tenor Dimensions rPtxpxHl 2115 x 19.25 x W R..efrigeran: R404a Net vowme tea t,l 13 cu,{t, Maximum Ambient �F Nei Walght 242.E lbs Temperature Rating Packaging Dimensions nviox.aq 25'x 26'x 7o, oo'rosting Automatic 00O cal Cold length 84, Temperature Display Yes Yompaiatum Controller D'gital (}��� Kip 1f2. PLAN VIEW cWe. "SF Construction Electrical Utor w mateeol Palolod Steel vollage 120 ('---27A'---{ ��--26k'---�•� DoorAid Material Glass Door .A+nps 7.8 r' lnsutation Material Foamed in pinro polrirroEhanq HZ 60 L.._.._J she;Material Katlic coated steel Stsoll Load CapactlY 90 in 1 of 7/1/2011 2:15 PM SGM72RS . • http://cootguyfridge.com/SGM72RS.htmi d mr � t� f Visit our sister-site: 1-888-524-2582 Triple Door Reach In Glass Door Refrigerator Bottom Mounted Compressor Allows for easier access while loading and unloading. This compressor location is ideal rather than the top mounted style due to the temperature „t` difference between the bottom and the top of a room.Also allows easier access for maintenance and cleaning.. Spartan Self Closing Door(s) Self closing doors keep energy costs down by not allowing as much cold ' air to escape the unit while opening. 12 Adjustable Interior Shelves The interior shelves sit on adjustable mountain brackets to allow for ' height adjustments shelf by shelf to accommodate different sized ' t` products. 4 Casters Two front locking casters and two rear free swiveling casters are included and come pre installed. Anti-Fog Glass Door(s) Fully insulated glass doors helps with energy savings while providing clear visibility of products inside. Interior Lighting Lighting provides high visibility for customer viewing. R $Z595.00 PLAN VIEW ���� NSF TECHNICAL DATA. Dimensions Cooling � Exte,iar Dmensions,v xa,n; 78'x 30'x 80.75' TenV.,attrre Range 32`-5V F Inledor Dimensions(Wx4),.� 71.5'k 215'x 55.25` Retngeram R134a l #�) �'—; l Net Volume o,.s8 69 Cu.ft. Maximum Ambient 90'F Nei etgh, BIStbs 70"iti roturo Riling Tpackaging aiivensions hv...a.q, 82'x 05*x 69' OWITrsting Auip!wk, TenTenitim Dispaay Yes ---�(((((( yi Temperature Controller olpAl Construction Electrical �.'� k;. 4§II u �C 1 BPTS ice. Exterk9r ldasorf$I P�atntaQ$1001 Vatciga 120 II t...,. D6os11-ia Mmefi.l Glass poor Amps 13.1 lift ulaGon Material Feamed in place patyumthane tlr. 80 !604 it,lk }3j Ilk�k lk Shelf Materiel Waarc canted stool . i Shelf toed Capadty 90 ibs 1 of 2 7/1/2011 2:13 PM ! out I walk 45z-� ,w'in?. Owl _4 "Now A r:.. „ <w ni "§� s 'e,�8 ram, ✓ >e. a **,- /� r lava'n /i ;` n�n�dr/ai7�H/Mrir;y#/ ,� ,av �iry< •"'! ,H' °' .. r'J„� a "'1fRgF Alt �rYI fi �x x " 1 i, jyyy 4 �' *; S H 04, 'ra` 1" w''�= �yy .,� ����pp ,,• € .t •� y y F�d� .:n- ace t W w, ¢/;F%�.. `�. vu A .0 } ' this 41 ►d=; r_ E { , A4 a^4 :,F' kN .+f _ n 1 i « c 1°nn „ate + "' / ,�", N b MPo ¢ ,.� Y k [1101fr11 r pp ' r : *1 ° � t is a 13 A }` �r d x fi fi ate" AV, d 4 tiWAS -kit" ' V W n a' `19F1� �41�'�51�Tf i � � a a Lifht 11AHF1' � ti .< rill w '-* `WxP'A"' 4" jv ) .1 M/ **,Jj�. Tarp d+ FtIC Wttti tv �y 1 _ �ldaT 4HE4e�nc#r 'BOLsi! 4 a E -MI 50 , 700 Ox ii Commercial Display Cases!Deli Cases!Meat 40s-MarcRefrigerati... //www.marcrefrigerafon.com/hs_series.php 7453 NW 32nd Avenue Miami,Florida 33147 v Tel:(305)691-0500 ManaEactures Im¢rd.,refrigerator Fax:(305)691-1212 HOME I REQUEST CATALOG j TERMS OF SALE j WARRANTY j CONTACT US __........_.. ...... ..... ....._...._.._ ..... . .. __. ._ _.. . ....._.._. ....... Product Line HS Series, Remote&Self-Contained, Curved Glass, Double Duty, Meat&Deli " Merchandiser Curve Glass Display Cases Counter High Deli Case Remote& - Features Self-Contained Hundreds of Color Co-ordinated Exterior Panels Meat&Deli Case Self-Contained Full Vision,Triple Pane Curve Glass Front Meat&Deli Cases Remote Hot Display Cases 'x` -a 'b Mirror Finish Stainless Steel Exterior Trim Reach-In Coolers Medium Temp I, Heavy Duty Construction for a Longer Life Reach-In Freezers Low Temp Full Length Lighting for Maximum Visibility Open Dairy&Produce Cases yYtll 0 Main Deck Plus Two Mezzanine Shelves for More Display Bakery Cases Fish Display Cases Fully Self-Contained,Operates 115V 115V Convenience Outlet for a Scale Internet Specials a Condensate Evaporator Eliminates Need for Drain on s/c Models Curved Glass Adds Dramatic Display Potential Marc's HS Series Curved Glass Merchandisers MODEL HEIGHT i LENGTH j DEPTH Top Access Doors I Installed Condenser Unit HP Electrical volts&amps i Approx.Shipping Weight .. . .......... _.,.....-.__...,_...._...._...+......_.........____..............._......__.<......_.. HS-0 SIC 55 50" I 36 2 j 1/3' i 115/1160-12 amps 625lbs. ....................... ..... . HS-6 SIC j 55" 72' 36" 2 .........,._l........„. 1/3,.., 115/1160-12 amps I 725 tbs. HS 8 SIC 55 ...... ._..__._._.._ ...._�......._�....__..._.....__...___.... 96 36 4 1 1/2 It5/1/60 14 amps 900 lbs .__..-.... .,.. ...r... ... HS4R 55" 50" ! recommended „ ,....... , _...... .. ..... ..._.. . _ , 36 2 i 115/1/60-1.7 amps i 550 tbs HS-6R 55" 72, 36 2 f 1/2" 115/1/60-1.4 amps , 6751bs. ___._._.'__.---..--.--._,,. _.... HSBR 55 - 96 36 ;„ 4 1/2" 115/1/60-3 0 amps ? 825lbs. - HS-IOR 55 120 36 4 3/4 115/1/60 2.5 amps 1 1000 lbs. ._....... ._....._.., ,. HS 12 55 144 36 4 3/4" 115.. ........ ... .1.. .....t. .,...-........ a ............ ...,... .. ................. ... I1/603.6 amps 1100 tbs. NOTE:Designed for use in locations with air conditioning where temperature and relative humidity,do not exceed 75%F and 55%RH. (")This size condenser unit is installed on this model. (")This size condenser unit is RECOMMENDED for this model.Consult a competent refrigeration mechanic to determine the appropriate size for your specific application.The appropriate condenser size will vary depending on length of run,indoor/outdoor use,etc. Click here for more on our intemet Specials Only Marc offers these kind of features STANDARDIIHI Contact Us Your Choice of Decor Matched Exteriors,FREEIII -- - -- - -- - You can't name a color that is not available:brilliant blue,green marble,honey maple,black....Marc offers hundreds of decor matching exterior panels at no extre i Name costl Call us with your choice.We'll match it from our enormous collection of finishes,FREEHI Email Curved Glass Adds Dramatic Display Potential The unique curved glass display area adds tremendous impact to the traditional deli/meat case,this case is the perfect solution to lagging sales.Ideal for prepared salads,meat,deli,seafood,pastries,or the specialty of the house,Marc s Curved Glass Merchandiser is a traffic builder for any business! Condensate Evaporator Eliminates Need for Drain on SIC Models For the self contained unit,the automatic,electric condensate evaporator and automatic defrost clock provide worry-free control of condensation.Together they eliminate the need for plumbing or drain connection on self contained models.(+) High Visibility Merchandising Features The triple pane,thermoglass curved front is perfectly angled for the least amount of glare.Full length lighting offers exceptional merchandising opportunities.In .... ......... .,._.... addition to our full deck,two mezzanine shelves are included to maximize the display area. Mailing List Quality Construction Insures Dependable Service Mirror finish,stainless steel trim beautifully accents the decor matched exterior panels.A bright white aluminum interior provides for maximum light reflection for the Join Our Free Mailing List highest visibility.The stainless steel bottom pan,along with a heavy gauge steel frame,insures years of dependable,rust resistant service. Gravity Coil with Low Velocity Blower Coil Refrigeration for Proven Performance The heavy duty top gravity fin-coil refrigeration system insures uniform product cooling.The lower storage area has its low velocity blower gravity coil to ensure Wr even air performance underneath main deck. 1 .. . .. __................"..._.........._...... Your Email .......... .......... 1 of2 7/1/2011 2:30PM | � C0000eruia} CuaoaDdiCao�a0�u����Np' W://www.marcrefrigerafion.conVhs_series.php ' ' ' ���' ------ '--� ����p^'~~~^^"""^"ep'""°`^" V'"_"p'em.pup ' Gravity �Fluorescent | � | Coil Lamps | | | | +c | ! -- � | � | ' | 7� Sliding veaning | ' _-....... ' -. ' PVC FlooriN ! | Condensing ' } ~ ~~~~ .~of eit ' We reserve the dght to change the specifications without notice. Extreme high humidity conditions may require direct drains on S/C��^ . — i Horne/m,=^Conditions/Contact L's/ste=' 0 Copyright Marc Refrigeration Manufacturing,Inc. Designed by Soft System nolutio^co° � � � 2of2 7/1/2011 2:]O9M ITEM NO. f-A' - HARM® EU2SYS -48 SERIES HEATED DISPLAY SYSTEMS •HALO HEAT ... a controlled, uniform heat source that gently t1 - holds and surrounds food for better appearance, taste, and longer holding life. " •Holds and displays hot food fresh and moist for hours— without adding water. EU2S" FRONT -48 F VIEW *Expandable system to meet your specific requirements. FRONT x SHOWN WITH *HOT DISPLAY CASE OPTIONAL.CASTERS — Curved. glass styling. — Displays hot food without condensation on glass. Protected with a environmentally friendly bumper, made of = 1 93',, pre-consumer polycarbonate waste and is 100'W1 recyclable. Tempered sliding glass doors reflect heat back into the products and mirror the display to enhance merchandising effect. .Holds a full range of standard (gastronorm) pan sizes, full-size or half-size sheet pans. ` — Standard. stainless steel front and black painted end panels. — Thermostatically controlled heat source radiates from the base 00 of the display case in multiple heat zones. Overhead light zones with shatterproof coated bulbs. �= t •DECORATOR BASE t u Z — Designed to accommodate your choice of. equipment (750-TH-II, 750-TH-II/D, 750-S, 500-2D) or optional shelf.. EU2SYS-48 — Stainless steel, distinctively framed in black as standard and BACK VIEW SHOWN WITHbrushed stainless or custom color as alternate choices. 750-TH-11 COOK& HOLD OVEN • SELF-SERVICE HOT DISPLAY AND OPTIONAL CASTERS — Customer self-service opening is available across the full length of case. — Front mounted heat-guard provides customer protection. The display case is constructed of 18 gauge, non-magnetic stainless steel. A curved, tempered glass front encloses the display case and can be lifted to a 90 degree angle for easy cleaning.. Removable, sliding glass doors on the operator side are included. Sliding door tracks have a "clean sweep" cutout allowing for easy cleaning and crumb removal. Framed end clear glass with rubber gasket material protects glass edges from chipping and breakage. The base is divided into two (2) individually managed heat zones with each. zone controlled by a separate thermostat with a range of 1 through 10 and heat-on indicator light. Overhead lights are controlled by ON/OFF switches in two (2) light zones. Two (2) 125V plug outlets are available as an option on 120/208-240V units only. ❑ EU2SYS-48- 48" (1219mm) length, with BU2 base ❑ EU2SYS-48/P -48" (1219mm) length, with BU2 base 47-5/16" (1.202mm) self-service opening across full length of case front `The system base is not sold as a separate item. Order the full EU2SYS model to receive the base. FACTORY INSTALLED OPTIONS • Electrical Choices • Panel Color Choices • End Glass Choices ❑'Temperature Gauge, 'A• Specify Voltage: 1•► Specify color: Specify choice optional ❑ 120/208-240 ❑Black, standard ❑Clear Glass, standard ❑230 ❑Stainless Steel, optional ❑Solar Bronze Glass, optional ❑Custom Color, optional HAL W164 N9221 Water Street • P.O. Box 450 • Menomonee Falls,Wisconsin 53052-0450 • U.S.A. AT PHONE: 262.251.3800 800.558.8744 u.s.A./CANADA FAx: 262.251.7067 800.329.8744 U.S.A.ONLY www.alto-shaam.com PRINTED IN U.S.A. � DUE TO ONGOING PRODUCT IMPROVENIEN"I',SPEC.IFICA'CIONS ARE SUEIEC:'I'TO CHANGE.tV1"I'HOU'I'NOTICE. 469 - IUlIU �4t es EMSYS-48 SERIES 44-5/16'(1125mm) HEATED DISPLAY SYSTEMS r DIMENSIONS (H x W x D) EXTERIOR, WITH BASE: Ee 58-3/16" x 48" x 44-5/16" (1477mm x 1219mm x 1125mm) °_.,_.�_. �, WELL DIMENSIONS (W X L X D): E E= 27-3/16" x 45-5/16" x 4-1/2" (690mm x 1151mm x 114mm) o = ELECTRICAL m �- �, a a m --------- -- VOLTAGE PHASE CYCLE/HZ AMPS kW 5-112° (140mm 1.20/208-240 (AccY) 1 50/60 13.8 3.3 r--Jj 32-1/2'(824mm) EU2SYS-48 Profile at 208 1 50/60 11.6 2.5 BARE END,NO PLUG F'EE - at 240 1 50/60 13.0 3.1 230 (AGcY) 1 50 12.6 2.9 BARE END,NO PLUG E eE- 230 1 50 12.6 2.9 C.. ©o.. l —1 PAN CONFIGURATION* �?E 26-1/4'(666mm) e q No OPENIKGWIDTH o a ma3 Eta PAN SIZE DIMENSIONS QTY. m ml FULL-SIZE & ONE-THIRD""' 12" X 20" X 2-1/2" (GN 1/1) 3 " w w E 12" x 6" x 2-1/2_ -(GN 1/3) 3 m w a j — _ _ _ _ _ _ _ _ _ 5-1/2' HALF-SIZE & ONE-THIRD": 12" X 10" x 2-1/2" (GN 1/2) _ 6 smei Sxivel (140mm caz�e. ca,:.. 48'(1219mm) — — — — — — — — — — — — — — — TM 12_X 6" x 2-1./2Y - -- 1/3) 3 EU2SYS-48 - - FUI,L-SI1_F. SHEET PANS: 18" X 26" X 1" — 2 INSTALLATION REQUIREMENTS MAX. CAPACITY/VOLUME: 48 lbS (22 kg) 30 qts (36 L) Display case must be installed level. The display case must not be installed in any area where it may be affected by ' Pans are not included with display case. steam,grease,dripping water,high temperatures,or any *' Will also accept 4" (100mm) deep pans. other severely adverse conditions. Do not install a heated display case near a cold air source SPECIFICATIONS such as a freezer,air conditioning vents,or in any area where •Six (6) overhead lights with two (2) light zones. outside air fluctuation can affect performance. • Two (2) base heat Zones with. two (2) adjustable thermostats with WEIGHT a range of 1 through 10, and two (2) heat-on indicator lights. MODEL NET SHIP • Two (2) tinted, reflective, tempered glass sliding doors on operator side. EU2SYS-48 397 lb (180 kg) 472 lb (214 kg) • One (1) 10" x 36" (254mm x 914mm) operator-side work shelf. EU2SYS-48/P 397 lb (180 kg) 472 lb (214 kg) •Self-serve model EU2SYS-48/P has a self-serve pan insert CRATED DIMENSIONS: L X W X H 26-7/16" x 45-3/16" X 2" (672mm x 1148mm X 51mm) and EU2SYS-48: 45"x 52"x 82"(1143mm x 1321mm x 2083mm) includes two (2) Wise Pan Grids. FACTORY INSTALLED OPTIONS ❑ INDEPENDENT ELECTRICAL OUTLET 50017 11 ❑ TEMPERATURE PROBE 5004916 ACCESSORIES ❑ CARVING STATION 5001874 PLATFORM SCALE ❑ LEFT-HAND 5001308 ❑ CASTERS, PLATE 4007 ❑ RIGHT-HAND 5001307 (Includes 2-5"(127mm),RIGID and 2-5"(127mm),SWIVEL WITH BRAKE) ❑ SHEET PAN DIVIDER BAR PACKAGE 5002802 ❑ LOW PROFILE BASE ❑ SHELF, STAINLESS STEEL 5005786 OVERALL HEIGHT REDUCED BY 4-3/4" (121mm) 3043328 ❑ THERMOSTAT GUARD COVER PLATE 5007660 ❑ PAN INSERT, SELF-SERVICE 4" (102mm) DEEP 1001990 ❑ WORK SHELF WITH GRAVY LANE 5005638 AU HAAMe W164 N9221 Water Street • P.O. Box 450 • Menomonee Falls,Wisconsin 53052-0450 U.S.A. PHONE: 262.251.3800 800.558.8744 U.S.A./CANADA FAX: 262.251.7067 800.329.8744 U.S.A. ONLY www.alto-shaam.com 969 - 10/1.0 uUE TO ONGOING; PROOUur w1'ROvEIVIE.NT. SPECIEICA'I IONS ARE SUBJGC"I"rO CHANCE WI"rHOUI' NOTICE. VRIN'I'I:U IN U.S.A. 1 4 I 4 i , I Q E I - j (iCk" � ' VjA i j, r, III . ff I uWalk lam_ i d ' t . YYi # r - _ OYLJ , , � cs NJ F I s 11 i - ------------ troy t . 6 U I _ I I : , �I i _ ��-r- � .���� --:4� ice•'B'`�: • d. e : I { - tb - I I : I a i Eras r b�ty ff WAlk+j I i i I s I L; I , ILI - a II r . ' 1 j . �y���y - - r _ I USG I, L ' I i s : Y)' cOLt - Cam II I I : I I I i Jv I � it � - • J T-T i Y,e II WA C7 VvICA C),5 �6�A c,�ie, LA . i i i a 'I I { , 1 S i I, � I _-__._�_ I � F, j a 4 rYG7�C �*� ► 1 ao f b2y"'v Ij 1 Fu�� `I t 1 I a t E �51 Vti1L r . �ccs m b � }Yt s bone �7 �. aA& «..a `^:er If AIN [—TV 2—E 00 74 M _ 3 i : 4 �`