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HomeMy WebLinkAboutTHE LITTLE SANDWICH SHOP - FOOD Who momi The Little Sandwich Shop 428 Main St. - HYA -- o -613 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAWNSTABLE, F.P.(Thomas)Lee,. b s 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt. Phone:. (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems 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: 1049 Issue Date: 01/01/2022 DBA: LITTLE SANDWICH SHOP, THE OWNER: DEAN WALTON Location of Establishment: 428 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 50 OutdoorSeating: 0 Total Seating: 50 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Ga� FROZEN DESSERT: Thomas'A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: I PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 01 'WE Town of Barnstable For Office Use Only Initials. Date Paid /2 .2 Aid$ ,,,CAB ): Inspectional Services MASS. �FD►y►p�A�O Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE AA FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAIC NAME OF FOOD ESTABLISHMENT��e I G P f I C'/ ADDRESS OF FOOD ESTABLISHMENT: ��� i �i" ';s4 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: O TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO '�O...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: 2- 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 508-8624644 Q:\Appfication FonnsTOODAPP 2020.doc QWNER INFORMATION: V �v FULL NAME OF APPLICANT 5�41VI � /V SOLE OWNER/ /NO D.O.B ��' W OWNER PHONE# /1'� ADDRESS p R/!D CAL f /Q /q CORPORATE OWNER: SJ7Z�/dn/ /FIZVVN� CORPORATE ADDRESS: Q ) PERSON IN CHARGE OF DAILY OPERATIONS: Y1'3 „/ 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 1-2 e 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 OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN, THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc I Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. NSTAUse, PaulJ.Canniff,D.M.D. F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1049 Issue Date: 01/01/2021 DBA: LITTLE SANDWICH SHOP, THE OWNER: DEAN WALTON Location of Establishment: 428 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 50 OutdoorSeating: 0 Total Seating: 50 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 1 ` �p1NE Tp� For Office Use Only: Initials: Town of Barnstable K Date Paid ,� $ BABNSfABLE, ; Ins.pectional Services 94' � Public Health Division Check# jDrFn Mar 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/ NEW OWNERSHIP R E N E W A NAME OF FOOD ESTABLISHMENT: �l-1�' 1/ '� a0ya/J ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: ��-1 . TLe S J )) �j6,p (9 e4 ehl f A / TELEPHONE NUMBER OF FOOD ESTABLISHMENT: O 177/ TOTAL NUMBER OF BATHROOMS: _ WELL WATER: YES NO)C ...(-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) S,o CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q\Application FormsTOODAPP 2020.doc OWNER INFORMATION:FULL NAME OF APPLICANT 0) floj SOLE OWNE •'YE /NO D.O.B OWNER PHONE# ADDRESS J „l�A14 T Abnd)y I h I WX-- e, P,'m j aq asb CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have I Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date j 1.RM 2. Loxo Pooter, 20 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 openingl! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at httv://www.townofbarnstable.us/healthdivision/applications.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.3 V each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FortnsTOODAPP REV3-2019.doc p � 1 y MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, you must mail the required fee amount (see box below). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. FEES: Bed &Breakfast Permit=$55; Food Service Permit 0-49 seats = $250; 50 or more seats $300; Continental Breakfast= $30; Retail Food (only TCS Foods) =$20; Retail Food Store—Less than 8,000 S.F. _ $100, more than 8,000 S.F. = $285; less than 1,000 S.F.; Retail Food Combo/Limited Prep. - $200.00; Cottage Food Industry= $75; Mobile Truck=$50; Mobile Ice Cream Truck= $35; Frozen Dessert License = $30; Additional non-refundable Fee for New Establishment or New Ownership= $100-$500(see staff), Late Fee= $10 Q:\Application FormsTOODAPP REV3-2019.doc f <<. Town of Barnstable BOARD OF HEALTH 1� John T.Norman Board OIt Health Donald A.Gaudagnoli,M.D. BARNST UL& Paul J.Canniff,D.M.D. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1049 Issue Date: 12/10/2019 DBA: LITTLE SANDWICH SHOP, THE OWNER: DEAN WALTON Location of Establishment: 428 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 50 OutdoorSeating: 0 Total Seating: 50 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Cd A FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: �r For Office Us-Only. Initials: Town of Barnstable Inspectional Services Date Paid amtr�I$ s"msriwx ' , �'�Eo •s`� Public Health Division Check# 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 j / � DATE 1 0 ! NEW OWNERSHIP RENEWA NAME OF FOOD ESTABLISHMENT mr Ll# Y1414' a—ilC"' � l/ ADDRESS OF FOOD ESTABLISHMENT: %PO 111,41� MAILING ADDRESS(IF DIFFERENT FROM ABOVE):: a E-MAILADDRESS: �llll�e SAAIPOI�A SIVV TELEPHONE NUMBER OF FOOD ESTABLISHMENT: - 610 711 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/ /_ TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) XFOOD 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 v OWNER INFORMATION: q1eJ4,J WA FULL NAME OF APPLICANT ��y SOLE OWNER: VE /NO D.O.B! —K-195 J 1 OWNER PHONE # 7 y goo �7 ✓/ ADDRESS 77 CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: /�La�( Jilt Rao; 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 lJf aA 1 , l 4,l 2tP . ss� o�,�s l l 2y SIGNATURE OF APPLICANT DATE i 1 ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/heaIthdivision/a1)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 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc rf Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. natea STABM John T.Norman a 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: a Permit No: 1049 Issue Date: 12/20/18 DBA: LITTLE SANDWICH SHOP, THE OWNER: DEAN WALTON Location of Establishment: 428 MAIN STREET HYANNIS MA 02601 Type of Business Permit: RESTAURANT Annual: YES Seasonal: IndoorSeating: 50 OutdoorSeating: 0 Total Seating: 50 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: ---- --- --- - MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: i PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: thelittlesandwichshop@comcast.net ' --- <.p xf� For 0 FSNE Tp � Town of Barnstable Initials: o� ` a('� , Date Paid 1 �``� t Amt Pd$ �/ BARNSTABM AUSK Inspectional Services �f sb39 �0 -1S L 1 V ATED �b Public Health Division Check# 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 14,,7 4y NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: �� /'",/�/ 5-V MAILING ADDRESS(IF DIFFERENT FROM ABOVE): Sc -� E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ��71 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO A"...... (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) 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: FULL NAME OF APPLICANT :U7Ak) WA tto SOLE OWNER/NO D.O.B C 'K-15 / OW RPHONE O741 (yDDRESS g 02E CORPORATE OWNER: FEDERAL ID NO. : V� / �✓�l CORPORATE ADDRESS: n/I PERSON IN CHARGE OF DAILY OPERATIONS: Pl1JN pvGv�V �t°fifi s'SA /�[D ,tc� 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 er en Awareness Expiration Date v),4 2.1&af� (Ptbb" i 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 openinji!! 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 1st to Dec.315`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Application FonnsT00DAPPREV2018.doc P`�F1NE rokti TOWN OF BARNSTABLE HEALTH INSPEcroRs Establishment Name: - Date �'-�Rage: of o OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARN ABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MARS 0�r HYANNIS, MA 02601 MON.-FRI. +a39• No Reference R-Red Item PLEASE PRINT CLEARLY A 8624644 'EO"""gyp FOOD ESTABLISHMENT INSPECTION REPORT 508- 14 Name Da! Tyne of Type of Inspection O er Routine � i a UU Address Risk od Service inspectio _ Level Re ai r spection Telephone Residential Kitclien Date: 14 Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast Other CP In: Inspector (1 -1 0� 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) ❑ Y- Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands � � d ❑ 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 L FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �� Critical(C)violations marked must be corrected immediately. (blue&red items) (�\� Corrective Action Required: ❑ No ElYes Non-critical(N)violations must be corrected immediately or Overall Rating J 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 Volunta Disposal Other: checked indicate violations of 1.05 CMR 590.000/Federal Food Code. ❑ 9 ❑ 9 Y ❑ Voluntary P ❑ 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils \ (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) 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 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view N Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' ' ature Prin Self Service Wait Service Provided_ Grease Trap Size Variance Letter Posted Y N /�v Dumpster Screen? Y N ` /°' �.-.,«...--.._;�-.-...`�.*.,.,:_,.t,-`.,-.�.w,..c�,e..�vP"y-r-+�...-.�, -.,Wit.+,.,...-►.o- �•.---�. «.r,-.��: .. .--.,....-........... ..--t,.^�a.d....=,,.-. .:.-�'�,-r.►'.-��.--r-s'-�:...- ;"5..- '� .. t .Tw• r'.--'�.�-•�#':-... �. ,.. ...�.�-.�.a......,r,,....s�.. �-v^ram �, r « �..�..-�-.. _ - ,- -' ^-'�...,•^^-' ,-..�.... r� .r ..^... ;:- � .....yam.�......�- _-.. � ... - �_ .-....... Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 6 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * _ 19- . - - - PHF Hot and Cold Holding 2-]03.11 Person-in-Charge Duties - 3-302.14 _ Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003 C Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F ( ) P Y7-102.11 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* Time as a Public Health Control Applicants* * P g 20 3-302.11(A) Food Protection 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 590.003(G) 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* Reporting by Person in Charge* 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 Reservior 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 Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 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 System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* 8 pP Y Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef c'i-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and 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 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* 2-301.12 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 PreventingContamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* 8 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* * 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours 9 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Forrnback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 690.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. �p IKEA TOWN OF BARNSTABLE HEALTH INSPECTOR's Establishment Name: - Date: Page: of., p`• - - - OFFICE HOURS PUBLIC HEALTH DIVISION 8:00•-9,30A.M. BARNSTABLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified a39. .m� HYANNIS, MA 02601 M-8 -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY. �.o 508-862-4644 ,EDwo FOOD ESTABLISHMENT INSPECTION REPORT n ciem Name - y Date T e of T e of-Ins ection v eratio s tine Address:L Risk Inspection AL' Level atl-'r Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation DA Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint r Person in Charge(PIC) f� Time Bed&Breakfast HACCP to In: Other Inspector Out: I Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. onpp _ 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) ❑ 14.r A Action as determined by the Board of Health. Allergen Awareness 590.009(G) s FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS C_ t ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ~�= n ❑ 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 'iA A ❑ 5.Receiving/Condition ❑ 17.Reheating - ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling n ❑ 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) y j ❑ 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 AdvisoriesVP ' 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 El 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 Restr tion/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items Embargo Emer enc Closure checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ 9 y ❑ VoluntaryDisposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 boon-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27. y (FC-6)(590 Facility .007) aggrieved by this order,you have a right to a hearing. Your request must Physical 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 y 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 8non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) receipt within 10 days of recei t of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dum ter screened from public view tP= 01-1- - Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed ip Frozen Dessert Machines: Outside Dining Y N PI ignat a Print- Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N /w 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* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * -19 _ PHF.Hot and Cold Holding. 2-103.11 Person-in-Charge Duties 3-302.14 _ Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(F) Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F * - - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F * 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-302'.11(A) Food Protection* 7-20L11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130°F* Applicants* - 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 3-304.11 Food Contact with and Utensils Equipment * 590.00401) - Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) lExclusions and Restrictions* Contamination from the Consumer 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washin Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 - - Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and 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 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME(TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System- *_ gg Not Otherwise Processed to Eliminate Equipment 590.006(A) Bottled Drinking Water* I 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* ery°"°e rnrzool 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* es- sec Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- - Ratit 165°F 15 * Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 3-401.11 2-301.14 When to Wash* 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 CommerciallyProcessed RTE Food-140°F* (Blue Items 23.30) 3-102.15 Package Integrity ( ) Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashing Facilities 3-202.18 Shellstock Identification* 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 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 3-402. * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 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 1.008 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. Op IKE roy, 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 MASS. MON.-FRI. +639. `0$ HYANNIS, MA 02601 No Reference R-,Red1tem: PLEASE PRINT CLEARLY rFOMP`A FOOD ESTABLISHMENT INSPECTION REPORT 508-862-4644 Name Any Da Type of T ns ec io J er Ro ine i Address r Risk Sery _ ection i _ Loe Level Rea Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness _ Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP R I1:4 In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the'Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �- Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more-than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-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 (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. y 29.Special Requirements (590.009) s o within 10 days f receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? ILA.,-V1W_, Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI s i natu e Print:Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N WANd Dumpster Screen? Y N V e "+ �.-t, -..-�.f`-r'-_ _ .�• .-.h. .. .-. -'..-.yr^,'+°•...�,..+r.. .�`b---..�r-. ... _ �-v rti'Y'w....... .. ♦ -+ v.. r-•- ,� -.. - �... .� - ]. -,,:'1_.. . w �- ._ Wr^ .-.• r.- �.r_.- .,•. +�.-�..Y�-ar -- n .. _.. o.. .'LCC'y^^..-'^_ Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) 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* 2-103,11 Person-in-Charge Duties Cooked and RTE Foods.* *_ 19 . _ PHF Hot and Cold Holding g 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) *- EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to _ Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers 3-501.16 A Require Reporting by Food Employees and Contamination from the Environment ( ) Roasts Held At or Above 130°F* A 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* _ Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) - Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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 HermeticallySealed Container* * Raw Seed Sprouts Not Served 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 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* 3-40].11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef ctiw 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Cbewicalr g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 scow 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 d A a 2-301.11 Clean Condition-Hands and Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED,TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 * (Blue Items 23-30) 3-202.15 Package Integrity (C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* F 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 to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction * 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 I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. P`pF THE►p TOWN OF BARNSTABLE, -HEALTH INSPECTOR'S Establishment Name: Date, - Page:,.. of OFFICE HOURS BARRsr.AR�e. PUBLIC HEALTH DIVISION 8m.19:30 P.M. - MASS 200 MAIN STREET - Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified °b, +bas• `0S HYANNIS,MA 02601 MON.-FRI. No Reference: :R-Red Item PLEASE PRINT CLEARLY lFo MPS° 508-862-4644 . FOOD ESTABLISHMENT INSP CTION REPORT Name / a o J04 D O ra Routine Address Ris i Service spection Lev ion Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS. ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) I. ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ly ❑ 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 I ❑ 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) �11 Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating I within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency-Suspension C N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipmentcand 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 if no critical violations observed,4 to 6 non-critical violations=B. Serious) Critical Violation=F is scored automaticallyif: n tip t I o 0 . Y - 26 Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 g violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N I #Seats Observed Frozen Dessei4 Machines: Outside Dining ' Y N IC's ature /!�I / Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N ` � G/ Dumpster Screen? Y N J.r• ...-• t.�n.`..� +. :�. m � �..-..... r-,.: � _, ••-.+..- _...-a.-�.-,- -.. ._-�•-.._-„ .-.. _ .�'-' -- - -. -- -y, ,-..,..vcn-'r...=�%..v.-�' -- :- - .. ._'4•,,r _ 1..ti�,. - a, -.- ......- - -_ .-a--.r ., .--._=.-_.-. _ _._.,. _- .-+,.. .. -.. - - Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 6p3-302.1](AA)(2) Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45*F Within 4 Hours* 590.003(B) I Demonstration of Knowledge* Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* * - 19 _ _- __PHF.Hot and Cold Holding g 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 Raw Animal Foods Separated from Each 7-101.11 _ Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in_Charge to Other* g g 7-102.11 1 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140*F*Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Stara e* 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 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* 3 590.003(D) Contamination from the Consumer Exclusions and Restrictions* � - 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 590.003(E) Removal of Exclusions and Restrictions 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* . 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources - g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and * - 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* - 4=501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* gg 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or _ Equipment* Not Otherwise Processed to Eliminate 590.006(A) ' Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E�cti-11112001 .._ _ 4-602.11 _ Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* • - . Shellfish* - - 4=703.11 Methods of Sanitization-Hot Water and t 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS' 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Chemical Ratites-165°F 15 sec* Sources* Mushrooms Approved By ing,mobile food,temporary and residential Authority 10 on on- anProper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and 2-301.11 Clean Condition Hands d Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail * 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29 Special 3-201.17 Game Animals Requirements. 2-401.11 Eating,Drinking or Using Tobacco* * g. g g 11 A PHFs 1 °F 1 5 Receiving/Condition 3 403. ( )&(D) s 65 5 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-40311(B) ' Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity* Y 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(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 S 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 to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel 4, FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* r' 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. pp 11HE Tpk, TOWN OF BARN.STABLE - - rv;; .-._., _,HEALTH.INSPECTOR's Establishment Name: Date:U Page:, of , 18 OFFICE HOURS BAR E. PUBLIC 0 MAN STREEET$ION - - - 8 30:-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3.30-4:30 P.M. e�: `0� HYANNIS, MA 02601 MON.-FRI. No Reference R--Red Item, PLEASE PRINT CLEARLY: TFO MAR> 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT r Name Date l U Ty a of Type of Inspection O Routine Address Risk ood Servi Re-inspection jjXaLKLevel al Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Sus ec Caterer eneral C plaint Person in Charge(PIC) Time Bed&Breakfast A In: Other Inspector Y V L Out: 1 Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) 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 ADVIS DRY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories s 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 orQA within 90 days as determined b the Board of Health. Overall Rating y y �� ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled El Emergency Suspension C N Official Order for Correction: Based on an inspect on 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 ardless of the number of critical,results in an F. 25.Eq"uipment 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 re 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 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 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8nnn-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature 1-<-5- Print: 31.Dumpster screened from public view . A/A�VZ(A,,,��Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Si ature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N f ' ,i nSS�cv7 1�� Dumpster Screen? Y N � ,.*ter. "Y:y-..+^'-.......• `.�^`. . Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* *- _ 19- - - _ PHF Hot and.Cold Holding. . 2-103.11 Person-in-Charge Duties 3-302.14 Pro[ection'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 i 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* Applicants* - P g 20 Time as a Public Health Control 3-302.11(A) Food Protection* M 7-202.1-1- _7-201.11 Separation-Storage* 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* Applica Th nt To Report To e Person In Charge* _ * 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge*. 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* - REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washin Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 8 Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources y Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* -- 4-501-111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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 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-Idiate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment* gg Immediate ery Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* e//°"°°11112001 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* 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 Ratites-165°F 15 sec* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential A 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 Authority Mushrooms Approved By 2-301.11- Clean Cl Condition-Hands and Arms* Regulatory Aut 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301:12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )(b) * 11 Good Hygienic Practices 17 i Reheating for Hot Holding practices should be debited under#29-Special 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 Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F # Within 4 Hours* 23. Management and Personnel FC-2, .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 16-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria*_ 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. TOWN OF BARNSTABLE, HEALTH INSPECTOR'S Establishment Name: Date: Page: of . 'OFFICE HOURS BARNSTABLE. PUBLIC 0 MAIN STREET 3:30-4:30 A.M. Item Code C-Critical Item 'DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 2 3:30-4:30 P.M. MASS. $. MON.-FRI. 9gp 1039.p�m HYANNIS, MA 02601 sos-as2 asaa No Reference •R-Red Item,, PLEASE PRINT CLEARLY rFD MPy FOOD ESTABLISHMENT INSPECTION REPORT - S Name Date / Type of e of n ec ion / b outine l Address Risk ood Sery Re-i ction �� Leve Re ai Previous Inspection -- Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC)7 Time Bed&Breakfast HACCP �L In: Other Inspector 4.1\ Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ -� FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling / t ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding INDlJ 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 1 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations l� Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating ry p 0 Employee ❑ p ❑ y y ❑ Voluntary Compliance Em to ee Restriction/Exclusion Re-inspection Scheduled Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25 Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dump er 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 Pri t: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N S Dumpster Screen o Y N / AAjo Z 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* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods *_ 1.9 I HF Hot and Cold Holding. _ 2-103.11 Person-in-Charge Duties - 3-302.14 Protection from Unapproved-Additives Contamination from Raw Ingredients 15 Poisonous of Toxic substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F EMPLOYEE HEALTH - 3-T02.1 f(A)(2)Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003 C Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* ( ) l� Y7-102.11 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* Time as a Public Health Control Applicants* = - - - 3-302.11(A)- 'Food Protection* P g 20 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 Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004(14) Variance.Requirements 3-304.11 Food Contact with Equipment and Utensils 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)DisRetposition Food and Reservior 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 WaterFrom-Regulated Sources y- Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and Raw Seed Sprouts Not Served 3-201.12 Food m a Hermetically Sealed Container* Sanitization Temperatures* P P 7-206.13 Tracking Powders Pest Control and g 3-201.13-- Fluid Milk and Milk Products*" - 4-501.1'12-- Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEIrEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY T 3-202:16-'_ ' Ice Made From Potable Drinking Water* - - Concentration_and Hardness* 3-401.11A(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11 A Clean Utensils and Food Contact Surfaces of * Animal Foods That are Raw,Undercooked or 5-101,11 _ Drinking Water from an Approved System* _ (_)_ Eggs-Immediate Service 145°F IS sec Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-40 1.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E-d cti-tiin001 4-602.11 _Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * - -- - - Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g. P 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23.30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* IS Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 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 I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other �. 3-502.12 Reduced-Oxygen.Packaging Criteria* -- 8-103.12 Conformance with Approved Procedures* S:590Forrnback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. pp THE r TOWN OF BARNSTABLE • - HEATH INSPECTOR•s Establishment Name: Date: Page: of OFFICE HOURS P� 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 �A o39.eel HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY, _. .. rFo MPS 508-862 4644 FOOD ESTABLISHMENT INSPECTION REPORT. Name � � Da T ebf e o section outine -�� / ✓ _ Address - �' Risk ood. -nspection LA) Leve Re Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness - Y Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP In: Other Inspecto12L') Out: 1- Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ 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 Al i / i A 't ❑ 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) e ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved.Procedures/HACCP Plans ❑ 19.Hot and Cold Holding i PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health ControlA e a - 1144 , A ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9-Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP El 10.Proper Adequate Handwashing CONSUMER ADVISORY❑ 11.Good Hygienic Practices ❑ O 22.Posting of Consumer Advisories 6 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations y� Critical(C)violations marked must be corrected immediately. (blue&red items) I� Corrective Action Required: No ..� Non-critical(N)violations must be corrected immediately or Overall Rating lit within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergo4cy 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 B=One critical violation and less than Orion-critical violations g (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.water,Plumbing and waste (FC-5)(590:006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right.to a hearing. Your request must + ;28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8rion-critical violations=C. w 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.DumY� Y' r screened from public view. Permit Posted? N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI Signature Self Service Wait Service Provided Grease Trap Size- Variance Letter Posted Y N Dumpster Screen? Y N VVV Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19_ PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - 3=302.14 Protection from Unapproved Additives " Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) * - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers 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* p g 2p Time as a Public Health Control • 7-201.11 Separation-Storage**590.003(F) Responsibility of A Food Employee or An -302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* 3 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 Reservice 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 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 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. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* _ gg Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-40 1.11(A)(2) Comminuted Fish,Meats&Game Pathogens* sg­"9e uuzooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source. 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* faces 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 * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Croper, l 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 ( )O p Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5- Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Sheustock 590.004(E) Preventing Contamination from Employees*. 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-501.14A 3-202.18 Shell stock Identification* 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70"F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 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. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 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:590Formback&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 tMF rok, TOWN OF BARNSTABLE, HEALTH INSPECTOR'S Establishment Name: - Date: Page: _ _of., ti- OFFICE HOURS ' ARNnAB�E. PUBLIC 0 MAIN STREET SION 8:00 9:30A.M. 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,6s: `0� HYANNIS,MA 02601 M-8 -4r No Reference R-Red Item PLEASE PRINT CLEARLY ,rFD MPS° 508-862 4 A4 FOOD ESTABLISHMENT INSPECTION REPORT Name L Dat Tyne of T e Ala ec ion O e a Ro ne Address Risk F e Re-I ection U29 Level a all Previous Inspection in Telephone, Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) t Time Bed&Breakfast HACCP 9 In: Other InspectorVJAJVLq/ -jC Out: Vd 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 590.0091(F) ❑ Action as determined by the Board of Health. Allorgen AwrarcnEss 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures a /� ❑ 5.Receiving/Condition ❑ 17.Reheating �uN � ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling i ❑ 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) t ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP )� e ❑ 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 Violatio ns � � Critical(C)violations marked must be corrected immediately. (blue&red items ,) �� Corrective Action Required: es Non-critical(N)violations must be corrected immediately or Overall Rating YYP within 90 days as determined by the Board of Health. ® ❑ Voluntary Compliance ❑ ETA-p oyyee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items El Embargo Emergency Closure ❑ Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC73)(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 6 non-critical violations if no critical violations observed,4 too 6 von-critical vi critical water,sewage back-up, =B. Seriously Critical Violation=F is scored automatically if; no hot C=2 critical violations and less than 9non-critical. If no 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If p,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 ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dump er screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Si atu re Print: i Self Service Wait Service Provided Grease Trap Size, Variance Letter Posted Y N PooleQw�Q I� � f Dumpster Screen o Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions - Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 6 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-]03.11` Person-in-Charge Duties - - � 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*-Working 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 7-102.11 Common Name Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003 Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* (� P ty3-302.15 .Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of F Disposition of Adulterated or Contam* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR oodinated 590.003(E) Removal of Exclusions and Restrictions 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources - g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of 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"9e 11112001 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* 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- Ratites-165'F 15 sec* Sources* ing,mobile food;temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms _ ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. $ Receiving/Condition 2 401.11 Ealing,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70'17 ConvenientlyLocated and Accessible Within 2 Hours and From 70°F to 41'F/45°F. Item Good Retail Practices FC 590.000 Shellstock Identification Maintained*3-203.12 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 Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* c S:590Forrnback6-2doc 1 .f 'Denote-critical item in the federal 1999 Food Code or 105 CMR 690.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ,. 114 r TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: ` Page: of A OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �A 039. `0 HYANNIS,MA 02601 5os-s2-4R644 No Reference R-Red Item _ PLEASE PRINT CLEARLY 'FON1A`' FOOD ESTABLISHMENT INSPECTION REPORT Name Dat 711,fType of lya&Qf Inspection O ation s outin01 Address Risk F ervice ct. Level a ai Previous Inspection n_".", Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint - all Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other P Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ _ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 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 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. 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 590.008 FC-7 be in writing and submitted to the Board of Health at the above address violations observed,7 t&8 non-critical violations. If 1 critical refrigeration. ( )( ) 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 5ignature Print: Self Service Wait Service Provided Grease Trap Size Variance.Letter Posted Y N La v�V� po() 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.) N FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* $ Cross-contamination 14 Food or Color Additives 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 75 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original,Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to * 7-102.11 Common Name-Working Containers* 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* * 7-201.11 Separation-Storage* 20 Time as a Public Health Control 3-302.11(A) Food Protection 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions��] g � ) Dis osition of Adulterated or Contaminated p ' 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and Food FOOD FROM APPROVED SOURCE * 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 3-701.11 Discarding or Reconditioning Unsafe Food 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* y * P 7-206.13 Tracking Powders,Pest Control and 3-801.11(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. 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 n rc U de o oked 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* Animal Foods That are RawNot Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3 401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eJ/cn°e 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.l l(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,rem 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 IMId Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding R qui radices 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 Commercial/ Processed RTE Food-140°F* Blue Items non-critical 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* 1$ Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 37501.14(A) Cooling Cooked PHFs from 140°F to 70°F Convenient/ 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* y * Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc `Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. k s Y` CERTMCATMN ` LAUREN POOLER for successfully completing the standards set forth for the ServSafeo Food Protection Manager Ceifificalion Examination, which is accredited by the American National Standards Institute(ANSI}Conference for'Food Protection OR 099173 5264 CERTIFICA UMBER EXAM FORM NUMBER 5/9/2 7 5/9/2022-,,,,�', DATE OF E •AMINATION DATE OF EXPIRAT'IO-N tonal laws apply.Ch k with your local regulatory ency for recertification requirements. She an Browr. P,National Restaurant Association Solutions #0655 i 'O !n aasndam w&Man6 a 2DD6,ReduionADM N 09-2013 ft"i-3 Z U-6d A3.2t O pl 02015 Naiad Ara id'a�&k-iad Finabim"AEF)AR nghts.ese,.&S—S.69 ad Rw togs am kW-64 the NRAEF. 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Almost Famous Shorty Burgers Chicken , Sandwich , Original Shorty-American cheese, pickles, fried � P Chicken Parmesan-Chicken cutlet topped onions, ketchup, on a grilled roll... 4.50 with marinara and melted provolone Add a Short Stop Patty 3 sandwich 7.50 Sub 8.50 California-A shorty with avocado, mayo, lettuce,tomato 6 Classic Sandwiches Chicken Pesto Wrap-Grilled pesto Cheddar Bacon Shorty- 6.50 chicken, cheddar, lettuce,tomato, sprouts, Boursin Bacon Shorty- with onion straws 7 on a wheat tortilla 8 Pastrami Shorty- Swiss Cheese and Deli Mustard 7 LSS Classic Italian Sub 8.50 Chicken Caesar Wrap-Tossed Lettuce, Black And Blue Shorty- Cajun Shorty, Gorgonzola 7 Steak&Cheese 9.00 parmesan,Caesar dressing and grilled Add Onions, peppers, or mushrooms chicken on a wrap 8 Make Your Own Chicken Cheese Steak Sub-Peppers, Buffalo Chicken-Chicken cutlet tossed in 6 Sandwich, 7 Wrap/Sub onions, American cheese 8.50 buffalo sauce, lettuce,tomato, red onion, Turkey and bleu cheese dressing wrap or Sub 8.50 Ham Meatball Sub- Homemade meatballs, Salami provolone, and marinara-7 Chicken Cutlet-lettuce,tomato, mayo, on Tuna Salad a grilled bulky Sandwich 7 Wrap/Sub 8 Chicken Salad Reuben- Corned beef OR Turkey, Cran-Walnut Chicken Salad sauerkraut,Swiss cheese, and Russian Gardon-Chicken Cutlet topped with thinly dressing, on Marble Rye -Corned Beef 9 sliced ham, Swiss cheese, and honey 7 Sandwich/8.50 Wrap/Sub Turkey 8 mustard dressing sandwich 8 Sub 9.50 Roast beef Rachael-Sliced turkey, Swiss, coleslaw, on Pastrami marble rye 8 Favorites Corned Beef Chicken Fingers-8 Paula- Pastrami, Swiss cheese, Russian Grilled Cheese-5 ADD Cheese .50 dressing, coleslaw, on marble rye 8 Hot Dog-2.25 B.L.T-7 Add Bacon 2.00 SIDES PB&'-4 Add Avocado .75 Tuna Melt- House made tuna salad, French Fries 2 American cheese, on grilled bread 8 Curly Fries 3 LJi Sandwich ', SALADS Breakfast Sandwiches 45 h<> P lob Greek-Tossed greens, kalamata olives, The Piggly Wiggly-egg, cheese, and bacon OR ham OR sausage on English muffin 6 red onions,tomato, cucumber, E%% LM— - _ pepperoncini feta and Greek dressing7 _..__ The Breakfast Shorty-Short Stop burger, Vegetarian Scrambled eggs, bacon, and cheese, on a Caesar- Romaine, parmesan, croutons, bulky roll 7 and Caesar dressing 7 Garden Burger Deluxe- Lettuce,tomato, The Dean- Peanut butter and bacon on a red onion, pepper relish mayo, on a Chef Salad-Tossed greens, ham,turkey, toasted bulky 8 toasted English Muffin 4 American cheese, Swiss cheese, The Greek- Egg Spinach,tomato, and feta cucumbers,tomato, red onion, peppers, The Veggie Wrap-All of our daily fresh on a toasted English muffin 6 sprouts, and a boiled egg 10 house veggies with hummus of the day 7 The Salsalitto-Scrambled eggs, sausage, Garden Salad-Tossed greens, tomato, red Portabella Melt- Portabella mushrooms, cheddar, and salsa, on a flour tortilla 7.50 onion, sprouts, cucumber, and shredded red onion roasted red e p ppers, provolone carrots 6 cheese, on grilled multi grain 8 The Whole Hog-eggs, cheese, and bacon, and ham, and sausage on a bulky 9 ADD: Grilled Chicken, Chicken Cutlet, Caprese Melt- Fresh Mozzarella, Tomato, Buffalo Chicken, Chicken Salad, or Tuna and our house made pesto...8.00 The Trenton-Taylor Ham, scrambled eggs, Salad to any salad for an additional 3.00 American cheese, on a bulky roll 7 ALL SALADS AVAILABLE ON A WRAP The Lonestar-Shaved Steak, Scrambled UPON REQUEST eggs, sauteed onions, and cheddar cheese Please inform your server of any Food ona wrap 9 related Allergies before placing your order The Mob- Eggs, hot and sweet capicola, provolone, grilled on a bagel 7 Consuming Raw or undercooked meats, poultry, seafood, or eggs may increase Plane Jane- egg cheese on an English 3.50 your risk of food borne illness Side of Bacon or Sausage 3 Toasted Bagel with cream Cheese 3 S/Toast or Toasted English 2.00 Breakfast Sandwiches The Piggly Wiggly-egg, cheese, and bacon OR ham OR sausage 6 The Breakfast Shorty-Short Stop burger, Scrambled tt eggs, bacon, and cheese, on a bulky roll 7 The Dean- Peanut butter and bacon on a toasted English Muffin 4 The Greek- Egg Spinach,tomato, and feta on a toasted bagel Sandwich The Sausalito-Scrambled eggs, sausage, cheddar, and salsa rolled on a flour tortilla 6 The Whole Hog-eggs, cheese, and bacon, and ham, and sausage 8 Sho P The Trenton-Taylor Ham, scrambled eggs, American cheese, on a bulky roll 7 The Lonestar-Shaved Steak,Scrambled eggs,sauteed onions, and cheddar cheese on a wrap 8 The Mob- Eggs, hot and sweet capicola, provolone, grilled on a bagel 7 Plane Jane-egg and cheese 3.50 Breakfast,-Lunch, & Catering Open Monday-Friday 8-3:30 Welcome to the Little Sandwich Shop. My name is Dean Walton I am the owner and working Chef at this Saturday 7-3 establishment. I bring 30 years of professional cooking. to your dining experience. I am passionate about fresh, quality food cooked from scratch at reasonable prices. Here at the little Sandwich Shop we strive to serve you 263 Stevens Street wholesome and satisfying meals. Let's Eatffl Hyannis, MA. 02601 Little Sandwich Shop T-Shirts 508 7713932 15.00 Fax: 508 7713219 Your food is so special, that it is made to order, we www.thelittlesandwichshophyannis.com appreciate your Thelittlesandwichshop@comcast.net patience Consuming Raw or undercooked meats,poultry,seafood,or eggs may increase your risk of food borne illness 4 House Specialty Almost Famous Short Stop HOT SANDWICHES & CLASSIC SUBS Burgers LSS Classic Italian Sub 8.50 Original Shorty-American cheese, pickles, fried onions, ketchup, on a grilled roll Steak,cheese, and onions 8 Single 4.50 Steak Bomb- Peppers, onions, mushrooms, cheese 9 Double 7.50 Triple 10.50 CJ's Wrap-Shaved Steak, hot banana peppers, onions, Homerun 13.50 American cheese on a flour tortilla 9 California-A shorty with avocado, mayo, lettuce,tomato 6 Meatball Sub- Homemade meatballs, provolone, and Cheddar Bacon Shorty- 6.50 marinara-7 Boursin Bacon Shorty- with onion straws 7­_ �� Chicken Parmesan-Chicken cutlet topped with marinara Pastrami Shorty-Swiss Cheese and Deli.Mustard 7 and melted provolone sandwich 7.50 Sub 8.50 The Breakfast Shorty- Shorty, Scrambled eggs, bacon, and cheese, on a bulky roll 7 Reuben- Corned beef, sauerkraut, Swiss cheese, and Black And Blue Shorty- Cajun Shorty, Gorgonzola 7 Russian dressing, on Marble Rye 8 : Turkey Reuben-Turkey,Sauerkraut, Russian dressing, Add a Short Stop Patty 3 Swiss on marble rye 8 Rachael-Sliced turkey, coleslaw, on marble rye 8 COLD CUT SANDWICHES Paula- Pastrami,Swiss cheese, Russian dressing, 6 Sandwich, 7 Wrap/Sub coleslaw, on marble rye 8 Turkey Ham Chicken Pesto Wrap-Grilled pesto chicken, cheddar, Salami lettuce,tomato, sprouts, on a wheat tortilla 8 Tuna Salad Chicken Caesar Wrap-Tossed Lettuce, parmesan, Caesar Chicken Salad dressing and grilled chicken on a,wrap 8 Cran-Walnut Chicken Salad Buffalo Chicken-Chicken cutlet tossed in buffalo 7 Sandwich/8 Wrap/Sub ; sauce, lettuce,tomato, red onion, and bleu cheese Roast beef "dressing 8 Pastrami t Corned Beef Chicken Cutlet-lettuce, tomato, mayo, on a grilled bulky Sandwich 7 Sub 8 Chicken Cordon Bleu"Chicken'Cutlet topped with thinly SALADS sliced ham and Swiss`cheese=and homemade honey' mustard dressing sandwich-8 Sub"9.50 Greek-Tossed greens, kalamata olives, red onions, tomato, cucumber, pepperoncini, feta,.and Greek Chicken Cheese Steak Sub-Peppers, onions, American dressing 7 cheese 8.50 Caesar- Romaine, parmesan, croutons, and Caesar Grilled Cheese-4 dressing 7 Hot Dog-2.25 Chef Salad-Tossed greens, ham, turkey, American B.L.T-6 cheese, Swiss cheese, cucumbers,tomato, red onion, peppers, sprouts, and boiled egg 10 Pb&J-3 Garden Salad-Tossed greens, tomato, red onion, Tuna Melt- House made tuna salad, American cheese, sprouts, cucumber, and shredded carrots 6 on grilled bread 8 The Veggie Wrap-All of our daily fresh house veggies ADD: Grilled Chicken, Chicken Cutlet, Buffalo Chicken, with hummus of the day 7 Chicken Salad, or Tuna Salad to any salad for an additional 3.00 Garden Burger Deluxe- Lettuce, tomato, red onion, ALL SALADS AVAILABLE IN A WRAP UPON REQUEST pepper relish mayo, on a toasted bulky 7 SIDES Portabella Melt- Portabella mushrooms, red onion, roasted red peppers, provolone cheese, on grilled multi French Fries 2 grain 8 Curly Fries 3 Check our Black Board for Daily Specials j SAMPLE EQUIPMENT LIST ITEM NO QUANT. LIST OFEQUIPMENT DESCRIPTION & MODEL NO Ned 3 1 Ll rt qA -roe Gaill A 9-rA G 1 � �� 5A�Ow)-el f(d } YntA ®t"C sin -27- 1 ' e� it �► ,e flue" SAS' 6 S The Barnstable Patriot BarnstablePatriot.com Friday,September 25,2015 AT . B.,USIN SS �YANNIS BUSINESS DISTRICT a 4 The. , S-andwich_ . Shop that. could which 1 north f — a., u!ak :,!r,1:,ii?n,1,!a'T,,,N I,;;as,.rl,n`I;I,,t I `t:n n,,,:u, rr ch s o li o the commer ,, :,,,;::1:,,.1...�:.:.:..:....:.t.;,;:...:,,,, `` complete and final details are town. ,;,;;I+;i,i h,e 6!�11-:...,..�.:il 1 , 1,, �,.,.;,,:J',.,. ,..,:.:,. ��aa .n„ 1., Longtime ,,,,,�, „!. ,: Il,,a.,,a,l; �, ' d u.. .1.ti.. ..i...,,,.,.. .1 ........::..:�:,,,,,.:;'^,,;":�,.:.m,,rm;,,�,.:,,.,,:;:,pit:,:,,::Itit,;v!il.:,''tut+;;:lp,_::I`::d�:a,i:, ' cial heart of Hyannis,he said. „�,rna i:,�::,,.,,1�!,;::�:,.t:::..lk::.:k'.+::,,,,..,,1„t:.,+.... I',!,t;;�`;�,,,,,,,,,,,,;;,,;,,,,w�:I:;:ti1,!,t!!I,1,.:_,,..:,:.,.t:::,:.,.,,, taken car Y ,.,, ,�.,. ,„! , ,, ;,; J,,�1 ,, .,,,.,..,,• ,,,:. e of, the will hire When asked about the com- eater movin ,�ra, +1 ,��I� „I� 1,1�;w�'II , i, 1 , I I y g The new shop, which for- a' il) �)j'+i' additional staff and make some petition he may face on bus P, ry'Ik,�! i;l l,t''1 q!,11 t1n+,+ � Y Y to Main Street merly housed Sullivan's k small changes to the menu, Main Street he didn't have any u ,�t;�, religious bookstore,is prime4 h ti1�tt, which has both a breakfast names,at the top of his.head, By Kay Keough real estate,nestled in among and lunch service and features instead just saying,in , "There's news@barnstablepatnot.com a busy stretch of restaurants "„ "�„! i�4i v;l+ best-sellers such as a chicken none like me ". and shops,including Palio Piz- pesto sandwich; handmade Walton has reason to be con- The t, +\I"tt �1' I '1 t6 1 The Little Sandwich Shop is .ze ia,Torino s Restaurant.and '` h ,�����, ;, �� , + � �1 ,t, -i 4!++ ���' "short stop" burgers; soups ' fident.Though the deli's online, making a big move.Owner d r and Ryan Family Amuse- �'I "A�4riN 4 a �'�t at 1� i,i ,ii`�'L and chowders and items�._:_ Gya „ , u 1 presence-may not be as mighty � m tl i rl , r�'�r!h '. II a�3 i\, .,,, , h1�I�tI'1,1'i 1� 1 , chef Dean Walton is excite merits. The John F. Kennedy 11 < it �� highlightedb their own fresh- as some others around the 11 � pp{` , y' ,,+�'�it+t�l l.) 1. Y tie relocating from the deli's , yannis Museu yannis �# p , „ a I,y�+, IU cooked turkeys and roast beef. Cape,the reviews are largely current off-the-beaten-path P L y are jus across Once the initial bugs of very positive,and their num- location'at 263 Stevens St.in the street. 1 opening a new storefront are bers seem destined to climb Iiyannis to 428 Main St.in the Though they do not have a p; r. i1W `� �� �n ,w a worked ut,.a re-opening will with the increased exposure it heart of the Hyannis business firm opening date at the Main y p g a �� ,� ���y, u� a,., ' ,, �. , be Held to celebrate the new . will get through the move. district: Street location, Walton and location,likely in a couple of New customers, Walton "It's abigger space,abetter his staff of five hope to move i!r' weeks,he said. said, will enjoy his shop location,I'm hoping, Walton into their new digs soon,likely Walton has been cooking on because it is a scratch kitchen said recently via telephone. during the latter half of the The Little Sandwich Shop will soon vacate this location and reopen on Main the Cape for 30 years,and pre- where mostly everything is Though the shop has been in week of Oct.5..They are in the Street.PHOTO By KEY KEOUGH viously was a partner at Persy's made in-house and nothing is its current spot for more than process of fixing up the new Place in Hyannis.His original sitting around,waiting for the seven years, "We get zero space,which had to be gutted store into a location suitable have a kitchen that people will inspiration behind opening customer. as far as foot traffic" in the and built out with new plumb- for food production,Walton le able to see into,though it The Little Sandwich Shop,he "We care about our food," tM� cked-away spot near the ing, gas lines and electrical said.The building itself is all , not be totally open. said, came from "not being he said."You order it,we make arket Place Condominiums, fixtures to turn it from a retail brick inside,he noted,and will ' After the painting is able to get a good sandwich in it." I U3I11TESS BRIEFS Gala to honor to all.For a full schedule of work- shop dates and topics,visit www. ! DM Wolf WhyCapeCod.org/Falftorkshoos. ua n A8 Friday,September 25,2015 I The Barnstable Patriot I BarnstablePatriot.com Sfl B-US11 �11 OSTERVILLE VILLAGE DAY ROAD RACE Cape Cod property transfers Aug.31 through Sept.4 - ,- � CITY BUYER SELLER ADDRESS ;PRICE Barnstable Kilroy,John E Newman,Kathleen E 39 Bayberry Ln $440,000 Barnstable Thatcher,D S Reich,Howard E 105 Hilliards Hayway $752,500 Centerville Horton,Lewellyn R SHM LLC 43 Briarcliff Ln $332,500 Centerville Davidson,Mary B Watson,Marjorie A 225 Capn Lijahs Rd $328,000 Centerville Wood,Daniel Proto,Donald G 18 Cats Paw Way $246,000 Centerville Bayside Cottages T Maddalena Manor RT 15 Elliott Rd $414,000 Centerville Bayside Cottages Maddalena,Robin 19'Elliott Rd $276,000 j Centerville Condron,Margaret M Althea E Bergtholdt T 86 Harborview St $650,000 Centerville Zaretsky,Nina S McGowan,Christopher G 88 Holder Ln $390,000. s Centerville Lopez,Thomas S Ruberti,Jeffrey W 67 Old Farm Rd $365,000 �. � Centerville Silva,Kenneth L O'Connor,James 21 Shannon Way $181000 Cotuit Howell,Mark L Westerhoff,Frank L 30 Fullers Marsh Rd $340,000 Cotuit Finigan,loseph Richardson,Jeffrey C 473 Santuit Rd $283,000 Hyannis Galvao,Marcelo FNMA 360 Bishops Ter $249,000 tannis Smith,George Sher I&Dennis RET 678 Old Strawberry Hill Rd $265,000 �pp� Ennis Si uencia,Melchor Wright,Janet A 338 Pitchers Way $297,500 I�� a HYdhnis Calabro,Bruce Naylor Hyannis NT 439 South St $265,000 nis Cammock,Donovan S Venet FT 82 Sudbury Ln $275,000 nis Joseph,Lounel W Fuqua,James R 329 W Main St#1 $130,000' nis Dasilva,Anibal V Bergeron,Robert 398 W Main St#513 $100,500 Ennis Moran,Brian L Nawaz,Robina 22 Washington Avenue Ext $215,000 ,tons Mills Walker,Jeremy S Vecchione Donna M Est 48 Black Oak Rd $327,000 Sean Doherty of Centinel Financial Group,chairman of the Osterville Village Day Road Race,presented a check stons Mills elakley,Lisa M Cape Cod Homes LLC 59 Blackthorn $ , 00 �,r tons Mills Cha lic,lohn F Mosley,William 1 57 Raspberry Lnn 309$192192,500 for$7,400-the proceeds from the race-to Osterville Library Director Susan Belekewicz at a breakfast meeting M 'pee Mousette,David Wells Faro Bank NA Tr 45 Coombs Ln $120,000 of the Osterville Business and Professional Association held at Wimpy's restaurant Sept 15. MRpee . Donohue,Me han K Ellis,Laura L 63 Dry Hollow Ln $355,000 M pee Draper,John R Gold Leaf RT 40 Gold Leaf Ln $530,000 M fibee Fuentes,Luis R Casavant,Richard W. 14 Grant Breen Dr $380,000 BUSINESS BRIEFS Oslrervil.le 281 Wianno Avenue LLC Cook,Cornelia L 42 Bates St $1,300,000 OspiYille Joan L McMahon T Louis A Moll RET 56 Farm Valley Rd $1,075,000 Ciao for another season of intimate partner violence will Named a Trailblazer O ille Scott,Stephen Brackett,William R 138 Gunstock Rd $356,000 conclude the event.The Cape Cod OOstgrville McDonough FT Lima,Christine S 5 Leona Ln $347,000 e' ' Labor Day weekend marked the Five Cents Savings,Bank Chari- Robert Maffei,the owner and 0S viIIe Thompson,William C Sullivan,Michael T 448 Starboard Ln $919,000 end of the CapeFLYER's third table Foundation Trust is the sole president of Maffei Landscape ost:nOs�?ervi llviIIe Close,Louise Bassett,Colleen M 207 Tower Hill Rd $285,000 - e Leblanc,Michael 1 Hunter,Mauro A 16 Westwind Cir $285,000 1, season of Boston/Cape Cod trips. sponsor of the event,which is free Contractors,was recently awarded Provincetown Mannarino,Dennis Nicolosi,Nina E 32 Alden St#1 $550,000 The season ended with a total but requires an RSVP by email or, the status of Trailblazer by the Provincetown O'Sullivan,Christina M Engelmann,Randal 9 Bangs St#2 $425,000 revenue of more than$223,000 phone to donnag@indhouse.net, National Association of Landscape Provincetown Callahan,Sharon F Foster,Robert B 15 Bradford Street Ext#F $810,000 and a ridership of 13,278,more 508-771-6507,ext.221.Deadline is Professionals.The award rec- Provincetown Rhiddlehoover,Loyd P Davies,Russell C 3 Freeman St#7 $357,000 p than a 5 percent increase over the October 2. 0 nizes professionals who have Provincetown 20 Pleasant Street LLC Crawley,Clifton J 20 Pleasant St $925,000 g Sandwich Dickey FT Ludden,Paul A 12 Cranberry Trl $139,000 Sandwich Chati n ,Anthony B Schneider FT 4 Fairway Cir $377,526 xt., _ t•p r a • ! C 5{' •.�'. 'a Y a} . Via,.. S "P ,°;� �•. - 4... :' R�•rr. { / t"t. 3..... ... i• Al vl Y n��• « a • i ' • Yam. � .»'y lbw .a I < + a r . 1 _ a R i t - j> ,, .. LOCUS DATA 28 PROPOSED H-20, w 1000 GALLON �Oq ��` fLo GREASE TRAP ,l F =-Tj CURRENT OWNER FERNWOOD o GAsto , STERLING REALTY' GAS/ 00 GAS N PLAN REFERENCE LCP 16371—A S� GSA w � ocus�P�� z DEED REFERENCE 155866 GA s o GAS IIN GAS GAS GAS GAS O H O !1) /.psi �oJ�t> N ZONING DISTRICT HVB o S 84'32'04"11.86' S -- S S z LOCUS MAP • .. . W FLOOD ZONE X - NOT TO SCALE: O ASSESSORS MAP 309 (n , 15-0123 PARCEL 218 ® 2 I ti OVERLAY DISTRICT NONE CONNECT G.T. FIPE TO ENCHMARK EXISTINGOUTLET IP SEWER . LOT AREA 23,963t , S.F.SF . - ' N CORNER OF LINE. INV EL=33.68 BULKHEAD a ELEV. 36.93 I GREASE TRAP / 0. SEE SH. 2 SEWER . PLAN TAl I s _ - : 428 MA IN S-•TREE T FOR DE L , h PARCEL 2/8 y H YA NNIS. 23,963f S.F. f 1 IN-, Y , BARNSTABLE MASS . I 428 #426 I ' ,#424 #422 #420 -� DATE: SEPTEMBER 12, 2015 . # W cn OWNER APPLICANT: a? Z FERNWOOD STERLING REALTY X Mr. DAVID S. DUMONT w TR I I 298 MAIN STREET, ST 7 � i�+°f�►c�ss9c N N I S M A 0 2 6 01 �a� EDW ,RD y�N N I HYAN SHEET 1 OF 2 STONE cn cn �o �N . 28 �� 54 / PREPARED BY: ss AS ,, s ��40'°°" w e3 Eo�E OF CURB (n s S EAS SURVEY, .INC. S �� S\DV P'\" 5 ' P. O. BOX 1729 TREE / . SANDWICH , MA 02563 CURB M A��J S S / 0 20 30 40 PH. (508) 888-3619 Eo�E OF s / CELL (508) 527-3600 SMH GRAPHIC SCALE: EAS.SURVEY@YAHOO.COM 1 INCH = 20 FEET RAISE COVERS TO " ,FINISH GRADE WITH VENT' HEAVY DUTY 24" s. #428 TCF = THROUGH FINISH GRADE RIONEMAN MANTER HOLE 36.18 ROOF ELEV. 36.6t COVERS x _ G PROPOSED H 20, GALLON A Y s GREASE TRAP S 4" C.I. :k INV.= KITCHEN INE MIN-3 MAX PROP 4" C.I. R, GAS C.F.=28.8 A- 35.68 INV.= `fit 34.75 12"TEE 36"TEE INV.= C.O. GAS 0 3 6' 4'-9" TO EXISTING GAS GAS oz 4'-1" LIQUID LEVEL INTERIOR SEWER GAS Gl. LINE ® INV=33.68 AS F Y DATUM: s - BOT. UTIILTY _ f" D e o e - e 7 o 30.00 ', POLE VERTICAL DATUM: PROPOSED 1,000'GALLON MSL± / BARNSTABLE SEWER H-20 GREASE TRAP SET - BENCH MARK USED: ON LEVEL STABLE BASE CORNER OF BULKHEAD j S S ELEVATION 36.93 BENCHMARK 15-0123 CORNER OF 0 BULKHEAD 0- ELEV. 36.93 CONNECT G.T. OUTLET TO GREASE TRAP SYSTEM DESIGN EXISTINGPIPE SEWER LINE. SEWER PLAN EXISTING DESIGN FLOW INV EL=33.68 42C� ` MA�/V STREET 66 SEATS AT 1_5 GPB/D 990 GPD #428 - #426 Z #424 H ),"A NN/S REQUIRED GREASE TRAP PROPOSED NEW 1000 GALLONS KITCHEN GRAIN EXISTING SEWER LINE TO GREASE IN TRAP BARNSTABLE, MASS 0 10 15 20 GENERAL NOTES: DATE: SEPTEMBER 12, 2015 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS FOR SUBSURFACE DISPOSAL OF SEWERAGE. GRAPHIC SCALE: 2. BOTH ACCESS COVERS SHALL BE BROUGHT TO FINISHED GRADE OWNER/APPLICANT: 1 INCH = 10 FEET 3. ALL COMPONENTS OF THE .GREASE TRAP SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-20 .LOADING FERNWOOD STERLING REALTY 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION OF ALLMr. D A VI D S. D U M 0 N T, TR Y -, +a► � 5. ANY MASONRYEUNIP SIOUSED TO BRI GTO ANYAVATION COVERS TO GRADE DAVF OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. 298 MAIN STREET, ,S T 7, 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER t` v F E FOOT " HYANNIS MA 02601 .. M ,. 0 1 7. GREASE TRAP TEES SHALL EXTEND A MINIMUM OF 6 ABOVE e ' SHEET 2 OF 2 � THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND "'' r �'` STE ° LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. SANIT R\PN 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN R p 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT PREPARED BY: i t °, ELEVATION OF THE OUTLET PIPE. 9. THE GREASE TRAP SHALL HAVE A MINIMUM COVER OF 8 INCHES . E A S SURVEY,- INC. CONSTRUCTION NOTES: � , � 10. ALL PIPES SHALL BE CAST IRON SEWER PIPE AND SHALL BE 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND SLOPED 1/4 INCH PER FOOT MIN. 141 R T. 6 A ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING 11. CHANGES OR REVISIONS TO DESIGN REQUIRE NOTIFICATION TO EAS WORK ON THE SITE. SURVEY INC., SEWER DEPTARTMENT FOR B.O.H. AND DESIGN ENGINEERS SANDWICH , MA 02563 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE N; REVIEW AND APPROVAL. WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT, 12. MAGNETIC TAPE ON ALL COMPONENTS. PH. (508) 888-3619 IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. CELL (508) 527-3600 - - EAS.SURVEY©YAHOO.COM " 1 ' Rn& _ � y _ i i : i p h; �,,� KN COMN 77 `,� �, Y apt, . •� - ��� ,�`• ; ! _ � Y & PAZ r�� 5A lkuf W c00 'IX X i Ix/ L-A i f - f � 23 - w -. i r r 6 � M A, tzefinam I 2.6 IT i i F _ f ' _ U ;L-41 i } i