Loading...
HomeMy WebLinkAboutOCEAN STREET MARKET - FOOD Ocean Street Market 50 can St. I3yannis 3 1 FORMERLY DUNKIN DONUTS r Of �( Town of Barnstable BOARD OF HEALTH t John T. Norman Board OI Health Donald A.Gaudagnoli,M.D. aAu [s�� F.P.(Thomas)Lee,. 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: 642 Issue Date: 01/01/2022 DBA: OCEAN STREET MARKET OWNER: TASTE OF TWO CHEFS INC Location of Establishment: 50 OCEAN STREET HYANNIS„ MA 02601 Type of Business Permit: RETAIL WITH FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: — Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: �al 61L L,( For Office Us Initials: Town of Barnstable rr C ,� Date Paid 1 AmtJM$ . ,AMRr M . Inspectional Services F°; p``� Public Health Division Thomas McKean, Director ?� I?-J 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE�V O6 a0al NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: OCeq 6j ADDRESS OF FOOD ESTABLISHMENT: 51D OG-!:::'�h %t6-,z-e+/ �yqj& MA 0-9-6V1 ' AX MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: f�C11'1 ® ' C °` 1 TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: '1 WELL WATER:YES NO -... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL, MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc I 'OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YES OWNER PHONE # ADDRESS �� h S • OC9,8� CORPORATE OWNER: +--- O T CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least(1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. Qn -qiq-0, -col 0+/SO /5290, 2. 2,-LI"Ar Tf / 30 /A°C90 V 2) -qlm l ��� c9� i3 zw SIGNCTtfinO 4PLICANT 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 httn://www.towno.ft)arnstable.us/liealthdivision/anplications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC ist. Q\Application FormsTOODAPP REV3-2019.doc art , Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAw4grABm " Paul J.Canniff,D.M.D. '$ +sip , 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508)862-4644 Fax: (508)790-6304 , L6-2S Z 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, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 642 Issue Date: 01/01/2021 DBA: OCEAN STREET MARKET OWNER: TASTE OF TWO CHEFS INC Location of Establishment: 50 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IncloorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: —— --- - MOBILE-FOOD: MOBILE-ICE CREAM: CA FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: S» BOARD OF HEALTH Town of Barnstable John T.Norman Board of Health Donald A.Gaudagnoli,M.D. R.AMNSTABLE, Paul J.Canniff,D.M.D. M.A. 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: 642 Issue Date: 01/01/2021 DBA: OCEAN STREET MARKET OWNER: TASTE OF TWO CHEFS INC Location of Establishment: 50 OCEAN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: G?/ FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: • For Offli.c.? • Initials. �`"� � Town of Barnstable d _i Date Paid 0 Amt Pd$ &MMSTABLE.); Inspectional Services 1639.' ``� Public Health Division Check# ArfD MA't 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 RENEWAL NAME OF FOOD ESTABLISHMENT: -Vq► ` 0,f ADDRESS OF FOOD ESTABLISHMENT: �GeA" � / �r�Mh��s! /'►�/ ©t�( + MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: �`q�` � �I TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO_)�,... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: " SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: 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)? cTYPE 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*** REOUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc -6WNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YES/(NO/ OWNER PHONE# �y ADDRESS fi� L 1t{� Aq E7 ( D 1 CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment, Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2.$ O , gip, 0-7 S10 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 openiny,!! 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/api)lications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3 V each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Application FormsT00DAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Guadagnoli,M.D. BAW X t F.P.(Thomas)Lee M. 200 Main Street, Hyannis, MA 02601 Daniel LuczkowAW Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Sell Tobacco In accordance with regulations promulgated under authority granted by Sections 5,31 and 127A of the General Laws of the Commonwealth of Massachusetts and Chapter 371 of the Town of Barnstable Code, a permit is hereby granted to: Permit No: 642 Issue Date: 1/1/2021 DBA: OCEAN STREET MARKET OWNER: TASTE OF TWO CHEFS INC Location of Establishment: 50 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: Non-Flavored Annual Seasonal FEES YEAR: 2021 TOBACCO SALES: $85.00 Permit Expires: 12/31/2021 Thomas A. McKean, RS, CHO, Health Agent Restrictions: PLEASE POST CONSPICUOUSLY AJ For Office Use Town of Barnstable Initials: Dateaid P Amt Pd S Inspectional Services u �.. asses I, Public Health Division A��b.kdA't� Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 TOBACCO ESTABLISHMENT PERMIT APPLICATION(Non-Flavored) DATE NEW BUSINESS OWNERSHIP RENEWAL NAME OF TOBACCO ESTABLISHMENT: 0C�q 7fill ` n �— y� ,r ADDRESS OF TOBACCO ESTABLISHMENT: . T2O / - c� .'I l._► I �' I'`>1 _ "` D 1J MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: 10C—�� � l "'►Qr� l ��`"� 9 i TELEPHONE NUMBER OF TOBACCO ESTABLI HMENT: OWNER'S NAME: � ``' 1����5 �Ik � j OWNER'S PH# cl OWNER'S ADDRESS: V I"� S I ''1f 0� OI / CORPORATE NAME: T` Of CORPORATE ADDRESS: G CORPORATE FID# ANNUAL: SEASONAL: DATES OF OPERATION:_/_! TO DAYS CLOSED EXCLUDING HOLIDAYS(EX.MONDAYS).. TOWN OF BARNSTABLE CODE/MA GENERAL LAW INTERNET LINKS: y TOWN OF BARNSTABLE TOBACCO CODE LINK FOR CHAPTER 371-9: h"ps://www.ecode360,com/33996392 MA GENERAL LAW CHAPTER 270/SECTION 6: https://malegislature.gov/I,aws/Genera.lT aws!PartIV/TitleYChai ter270/Section6 ***NEW BUSINESSES AND NEW OWNERS ONLY*** REQUIRED TO CALL HEALTH DIVISION AGENT FOR AN INSPECTION PRIOR TO PERMIT BEING ISSUED. PLEASE CALL 508-375-6621 ALL APPLICANTS ARE REQUIRED TO SUBMIT THE FOLLOWING REQUIRED DOCUMENTS: ) 1) MA State License to Sell Cigarettes 3) IRS Federal Tax ID#Document 2) MA State License to Sell Cigars and Smoking Tobacco 4) Payment of Fee(s) -see page 4 SIGNATURE: PRINTED NAME: DATE: Q:1Application Forms\TOBACCO APP-NonFavor 12-18-19.doex q i t -ocean � � ESTABLISHMENT'S NAME TOBACCO SALES Employee Signature Form a This form is for official use to indicate that the employee(s)of this establishment received and understood Chapter 371 of the Town of Barnstable Code and Chapter 270 Section 6 of the Massachusetts General Laws which describes the penalties for selling and/or giving tobacco products to any person under the age of twenty-one (21). Below is Section 371-9. of the Town of Barnstable Board of Health Regulation: 8 Sales to Minors— 371-9. Sale and Distribution of Tobacco Products. 1. No person shall sell or provide a tobacco product,as defined herein,to a person under The minimum legal sales age. The minimum legal sales age in the Town of Barnstable is 21 years of age, 2. Identification: Each person selling or distributing tobacco products,as defined herein, shall verify the age of the purchaser by means of a valid government-issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person under the age of 27. i The employee(s)below received and understood Section 371-9 of the Town of Barnstable Board of Health Prohibition of Smoking Regulation and Chapter 270 Section 6 of the Massachusetts General Laws: t IA �Qv Sign a Printed Name! DatecjLj x Signature Printed Name Date, Cj Si a � Printed Name Date:A4 . rh ctv II Signature Printed Name Date 't Signature Printed Name Date x Signature Printed Name Date Signature Printed Name Date Q:\AppGcation Forms\TOBACCO APP-NonFavor 12-18-19.docx ago Commonwealth of Massachusetts Letter ID:L0932251968 Department of Revenue Notice Date:December 1,2020 Geoffrey E.Snyder,Commissioner Account 1D:CGL-18593675-007 �?Vt mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARETTES �n4�Ilnllrll; llllhll �ll���lll���llll��ll��l�itl ll�llllll TASTE OF TWO CHEFS INC o OCEAN STREET MARKET o— N= 50 OCEAN ST s HYANNIS MA 02601-4006 Attached below is your Retailer License for Sale of Cigarettes(Form CT-3). Cut along the dotted line and display at your business location.At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license,call us at(617) 887-6367 or toll-free in Massachusetts at (800)392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ------------------------------------------------------------------------------------------------------------------------------------------------ ctius 1VIASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3 Retailer License for Sale of Cigarettes N. of This license must be posted and visible at all times.The sale of tobacco products to anyone under 21 years of age is prohibited. TASTE OF TWO CHEFS INC Account ID: CGL-18593675-007 OCEAN STREET MARKET License Number: 321390592 50 OCEAN ST HYANNIS MA 02601-4006 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date; December 1, 2020 Expiration Date: September 30,2022 Commonwealth of Massachusetts Letter ID:L 1644381760 v Department of Revenue Notice Date:July 28,2020 Geoffrey E.Snyder,Commissioner Account 1D:EDL-18593675-014 Ico mass.gov/dor ANT LICENSE FOR SALE OF ELECTRONIC NICOTINE DELIVERY SYSTEMS I�dl�ld�ll�"I���:hlIll�yl�lll ���l�I��I��11�1'1(I'll'��I111 I', TASTE OF TWO CHEFS INC S OCEAN STREET MARKET o— °°_ 50 OCEAN ST HYANNIS MA 02601-4006 Attached below is your Retailer License for Sale of Electronic Nicotine Delivery Systems. Cut along the dotted line and display at your business location. At any time, you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800)392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ----------------------------------------------------------------------------------------------------------------------------------------------- MASSACHUSETTS-DEPARTMENT OF REVENUE ° Retailer License for Sale of Electronic Nicotine Delivery Systems b , � This license must be posted and visible at all times. The sale of 0 tobacco products to anyone under 21 ears of age is prohibited. P Y Y g TASTE OF TWO CHEFS INC Account 1D: EDL-18593675-014 OCEAN STREET MARKET License Number: 1564518400 50 OCEAN ST HYANNIS MA 02601-4006 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell electronic nicotine delivery systems at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:July 28, 2020 Expiration Date: September 30, 2022 Return this part with any correspondence so we may identify your account. Please CP 575 A correct any errors in your name or address. 0509907295 Your�Tjelephone Number Best Time to Call DATE OF THIS NOTICE: 08-02-2017 C I�� 55 � i� FORM: SSI4ENTIFICATION NNOBOD 82-2313521 TASTE OF TWO CHEFS INC TASTE OF 2 CHEFS INTERNAL REVENUE SERVICE 105 ROUTE 149 PHILADELPHIA PA 19255-0023 MARSTONS MLS MA 02648 li���llf��huhhi»I�lihuui�ulihniulihli�f�f����ln��h SUst, Commonwealth of Massachusetts Letter ID:L1729685824 s Department of Revenue Notice Date:December 15,2020 ' • °p `U Geoffrey E.Snyder,Commissioner Account ID:CRL-18593675-016 A V�rcr�. mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARS AND SMOKING TOBACCO TASTE OF TWO CHEFS INC o= OCEAN STREET MARKET o- 50 OCEAN ST HYANNIS MA 02601-4006 Attached below is your Retailer License for Sale of Cigars and Smoking Tobacco (Form CT-3T). Cut along the dotted line and display at your business location. At any time,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800) 392-6089, Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE •----------------------------------------------------------------------------------------------------------------------------------------------- �55P Sf MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T A i y Retailer License for Sale of Cigars and Smoking Tobacco b y 4 '0*4w'W This license must be posted and visible at all times.The sale of tobacco products to anyone under 21 years of age is prohibited. TASTE OF TWO CHEFS INC Account ID: CRL-18593675-016 OCEAN STREET MARKET License Number: 2056169472 50 OCEAN ST HYANNIS MA 02601-4006 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:December 15, 2020 Expiration Date:September 30,2022 Town of Barnstable BOARD OF HEALTH * John T.Norman Board of Health Donald A.Gaudagnoli,M.D. RARNSrABL& Paul J.Canniff,D.M.D. o 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: 642 Issue Date: 12/10/2019 DBA: OCEAN STREET MARKET OWNER: TASTE OF TWO CHEFS JNC Location of Establishment: 50 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: CQ� FROZEN DESSERT: _ Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: ` �VJ t ' TNET Town of BarnstableFor Office Use Initials: OF rmDatePaid gAmt Pd$ BMWgrABLE, Inspectional Services l Jb3 =C2�4_E 9� t63q. MA99. ArFo ,A Public Health Division Check# Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 TOBACCO ESTABLISHMENT PERMIT APPLICATION (Non-Flavored) DATE jj�C)q L 1 NEW BUSINESS OWNERSHIP RENEWAL NAME OF TOBACCO ESTABLISHMENT: Q UeAky St May ay k.Q;E ADDRESS OF TOBACCO ESTABLISHMENT: r -e) ce4k4a ASS MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: u � � J 1 Y\ %raw—,� + C-"W-) TELEPHONE NUMBER OF TOBACCO ESTABLISHMENT: /- "/ / 3C4 S7 4� OWNER'S ADDRESS: tv 01/ JfA-YVVM'�J M P-1 00 � 9 - L �Mayjh +d in#' fa ' CORPORATE ADDRESS: I (�OLI�►4t 7 �),m0, D2.f 4� CORPORATE ANNUAL:) SEASONAL: DATES OF OPERATION: / / TO DAYS CLOSED EXCLUDING HOLIDAYS(EX.MONDAYS) TOWN OF BARNSTABLE CODE/MA GENERAL LAW INTERNET LINKS: TOWN OF BARNSTABLE TOBACCO CODE LINK FOR CHAPTER 371-9: https://www.ecode360.com/33996392 MA GENERAL LAW CHAPTER 270/SECTION 6: htt-os://malegislature.gov/Laws/GeneralLaws/PartIV/Iitlel/Chgpter270/Section6 ***NEW BUSINESSES AND NEW OWNERS ONLY*** REQUIRED TO CALL HEALTH DIVISION AGENT FOR AN INSPECTION PRIOR TO PERMIT BEING ISSUED. PLEASE CALL 508-375-6621 ALL APPLICANTS ARE REQUIRED TO SUBMIT THE FOLLOWING REQUIRED DOCUMENTS: 1) MA State License to Sell Cigarettes 3) IRS Federal Tax ID#Document 2) MA State License to Sell Cigars and Smoking Tobacco 4) Payment of Fee(s) -see page 4 SIGNATURE: PRINTED NAME: � ''i 1 03 DATE:I2 / 0 / it 9 Q:\Application Forms\TOBACCO APP-NonFavor 11-21-19.doc • 1 ` Akraf ESTABLISHMENT'S NAME TOBACCO SALES Employee Signature Form This form is for official use to indicate that the employee(s)of this establishment received and understood Chapter 371 of the Town of Barnstable Code and Chapter 270 Section 6 of the Massachusetts General Laws which describes the penalties for selling and/or giving =.obacco products to any person under the age of twenty-one (21). Below is Section 371-9. of the Town of Barnstable Board of Health Regulation: Sales to Minors—&371-9. Sale and Distribution of Tobacco Products. 1. No person shall sell or provide a tobacco product, as defined herein,to a person under The minimum legal sales age. The minimum legal sales age in the Town of Barnstable is 21 years of age. 2. Identification: Each person selling or distributing tobacco products, as defined herein, shall verify the age of the purchaser by means of a valid government-issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person under the age of 27. The employee(s)below received and understood Section 371-9 of the Town of Barnstable Board of Health Prohibition of Smoking Regulation and Chapter 270 Section 6 of the Massachusetts General Laws: Si re Printed Name Date 5 ,C�,\ r sq C\r\\ 12 1 Signature Printed Name Date se i/i,i Sig a Printed Name Date H RNA Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Q:\Application Forms\TOBACCO APP-NonFavor 11?1-19.doc 607)� Commonwealth of Massachusetts Letter ID:L1621432704 �� Department of Revenue Notice Date:January 30,2019 Christopher C.Harding,Commissioner Account ID:CGL-18593675-007 CA .massigov/dor i'• RETAILED LICENSE FOR SALE.*OF:CIGARETTES TASTE OF TWO CHEFS INC OCEAN STREET MARKET N 420 E FALMOUTH HWY ® EAST FALMOUTH MA 02540 Attached below is your Retailer License for Sale of Cigarettes(Form CT-3T). Cut along the dotted line and display at your business location.At anytime,you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy ofthis license: If you have any questions about your license,callus at(617)887-6367 or toil4ree in Massachusetts at (800)392-6089,Monday through Friday,8:30 a.m.to 4:30 p:m. DETACH HERE MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T Retailer License for Sale of Cigarettes S This license must be posted and visible at all times.The sale of tobacco products to anyone under 18 years of age is prohibited. TASTE OF TWO CHEFS INC Account ID: CGL-18593675-007 OCEAN STREET MARKET License Number: 916219904 50 OCEAN ST HYANNIS MA 026014006 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above.This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: January 30,2019 Expiration Date: September 30,.2020 Return this part with any correspondence Aso we may identify your account. Please CP 575 A correct any errors in your name or address. 0509907295 Your Telephone Number Best Time to Call DATE OF THIS NOTICE: 08-02-2017 TM;) r-7 �pli EMPLOYER IDENTIFICATION NUMBER: 82-2313521 FORM: SS-4 NOBOD TASTE OF TWO CHEFS INC TASTE OF 2 CHEFS INTERNAL REVENUE SERVICE 105 ROUTE 149 PHILADELPHIA PA 19255-0023 MARSTONS MLS MA 02648 Ii���III��ImI�hI��Uliluuu�ulih?h��lihli�l�l����lu��h �I 1 ' j v For Office Initials: Town of Barnstable �Q" Date Paid Amt Pd$ ` BABNWABLE,: Inspectional Services MASS. i6 A J9. Public Health Division RFD MPS ;r Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 tom` Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE QZl 0q 120,q NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: S-d O CQ�-, cg` _H,' ;e h I'u� 'a MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: VLkti 6e i; Le Q %^of l (� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: U ",7-7 -1—t 9 21- TOTAL NUMBER OF BATHROOMS: Z— 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? NO IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? N 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*** REOUIRED 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 avy Gi 1�1 SOLE OWNER: YES./NO OWNER PHONE# j�� �j k1 9 ADDRESS a A/O Y kb 31— f l`J'-4.t� .� nt,,+-O : 0 7 CORPORATE OWNER: "-O CORPORATE ADDRESS: i o 02 PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. "ATTACH COPIES OF CERTIFICATES" The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. (..� I;c�,,►..d' 0-7 l 301 z:s ,i f z-7 f 2�0 Z z 2. Ca r Y o9 / f ql SIG URE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. QAApplication FormsTOODAPP REV3-2019.doe 5 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Guadagnoli,M.D. u aNSTAD , = Paul J.Canniff,D,M.D. MAW 4 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems Permit to Sell Tobacco In accordance with regulations promulgated under authority granted by Sections 5,31 and 127A of the General Laws of the Commonwealth of Massachusetts and Chapter 371 of the Town of Barnstable Code, a permit is hereby granted to: Permit No: 642 Issue Date: 1/1/2020 DBA: OCEAN STREET MARKET OWNER: TASTE OF TWO CHEFS INC Location of Establishment: 50 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: Non-Flavored Annual Seasonal FEES TOBACCO SALES: $85.00 YEAR. 2020 Permit Expires: 12/31/2020 a Thomas A. McKean, IRS, CHO, Health Agent Restrictions: PLEASE POST CONSPICUOUSLY Town of Barnstable BOARD OF HEALTH °� !o Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. r�.§�iN3T.A1S€,£. 4 John T. Norman MASS" 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to. Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 642 Issue Date: 05/21/2019 DBA: OCEAN STREET MARKET OWNER: TASTE OF TWO CHEFS INC Location of Establishment: 50 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: MOBILE-ICE CREAM: Cn FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: $85.00 FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: RETAIL FOOD ONLY 1 PIKE ti For Office Use Only: Initials: Town of Barnstable Date Paid • Amt Pd$ 9 „& Inspectional Services 16,9. CK 611-0 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�1 3�'©I NEW OWNERSHIP " RENEWAL NAME OF FOOD ESTABLISHMENT: C-eq �► " j`t� ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( - (,�L� TOTAL NUMBER OF BATHROOMS: 91 WELL WATER: YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / S/ 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)?�I TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) St U V 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 - -- ------ s J PLEASE CALL 508-862-4644 OWNER INFORMATION: (��'�p FULL NAME OF APPLICANTQ ��q� t�� Q 1 / 'r I�� � SOLE OWNER: YES NO OWNER PHONE# o�� ADDRESS_ h Q ,-�� �� AM h� , Al VaB10 I ' CORPORATE OWNER: g"I FEDERAL ID NO. : CORPORATE ADDRESS: fl� � '_l q 01 1!VoWh 17) M�/ PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least(1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1 2. �( 3 /Cp SIGNA F APPLI CANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments, including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/api)lications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec.315`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q:\Applicarion FormsTOODAPPREV2018.doc g I"Er° Town of Barnstable For Office Use On • Initials- Inspectional Paid Amt Pd$ y � Inspectional Services Check# � snxNBTABLE. 9�, �; � Public Health Division a 200 Main Street, Hyannis MA 02601 Office: 508-790-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health Fee: $85.00 MAIL TO: TOWN OF BARNSTABLE PUBLIC HEALTH DIVISION 200 Main Street HYANNIS,MA 02601 FAX 508 790-6304 PLEASE INCLUDE THE REQUIRED FEE OF$85.00 APPLICATION FOR A TOBACCO SALES PERMIT ESTABLISHMENT NAME (DB/A) o �.--- , �y�����s, HA/ OW I ADDRESS OF BUSINESS MAILING ADDRESS (IF DIFFERENT FROM ABOVE) Kaq t1jW I el EMAIL PHONE# . # Do you currently possess a state license to sell tobacco products? Yes No Each employee who sells tobacco products must receive and understand Chapter 371 of the Town of Barnstable Code (copy provided herein) and the Massachusetts General Law Chapter 270, Section 6.00 (a copy is provided on the next page). Each employee who sells tobacco products must sign the Employee Signature Form:(provided --herein). ---- ------------ Signature Date D Q:\Application Forms\TOBACCO APP2019 dob.docx Y L ESTABLISHN ENT'S NAME TOBACCO SALES Employee Signature Form This form is for official use to indicate that the employee(s) of this establishment received and understood Chapter 371 of the Town of Barnstable Code and Chapter 270 Section 6 of the Massachusetts General Laws which describes the penalties for selling and/or giving tobacco products to any person under the age of twenty-one (21). Below is Section 371-9. of the Town of Barnstable Board of Health Regulation: Sales to Minors—& 371-9. Sale and Distribution of Tobacco Products. 1. No person shall sell or provide a tobacco product, as defined herein,to a person under The minimum legal sales age. The minimum legal sales age in the Town of Barnstable is 21 years of age. 2. Identification: Each person selling or distributing tobacco products, as defined herein, shall verify the age of the purchaser by means of a valid government-issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person under the age of 27. The following employee(s) received and understood Section 371-9 of the Town of Barnstable Board of Health Prohibition of Smoking Regulation and Chapter 270 Section 6 of the Massachusetts General Laws: 4 6"k - Signa Printed Name Date ignature Printed ame Date Q Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Q:\Application Forms\TOBACCO APP2019 dob.docx 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 3:3o-a:3o P.M. - Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p M ASS 67 a�0� HYANNIS,,MA 02601 - M-8 -FRL62 464a No Reference R-Red Item PLEASE PRINT CLEARLY 508-8 EEOMP� FOOD ESTABLISHMENT INSPECTION REPORT Name Dat ,t T e o T section u 6 p utine Address Risk Le, 15� Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness ell- Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector 'M (�^ 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 tz, Of ❑ 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 Y Y/ i ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling Vf V ZO ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding wv PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories_ Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations I Critical(C)violations marked must be corrected immediately. (blue&red items) 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, a it�rls 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 9 ardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations re 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 C=2 critical violations and less than 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 violations observed,7 to anon-crit iical violations. If 1 critical refrigeration. non-critical. If no critical water,sewage back-up, 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. • - 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster creened from public view Permit Posted? N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N Pf 's gnature Print: Self Service Wait.Service Provided Grease Trap Size Variance Letter Posted Y N I i "`�� ks�,44wl Dumpster Screen? Y N A264/ 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 EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits 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(0) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003 D Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* ( ) REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP S90.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* effe cri�uuzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* faces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009 A D Violations of Section 590.009 A 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-( ) ( )-(D)in cater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* 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 see* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome * 12 Prevention of Contamination from Hands 3 403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated (E) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 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. pp THE rq TOWN OF BARNSTABLE HEALTH..INSPECTOR,s Establishment Name: Date:J[ w Page: < Of. 1 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 "'A19 HYANNIS,MA 02601 M-8 -FRI aw• . No Reference R-Red Item PLEASE PRINT CLEARLY + n` 'FDN1�` FOOD ESTA LISHMENT INSPECTION REPORT 508-862�t644 Name. ate Type of T ection Oper outine Address C_kjRisk F Service spection Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness -� Caterer General Complaint Ilk I Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: IL 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) ❑ Leff 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 ❑ de 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 Asa Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 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: I ❑ 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 toda , e items Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Emergency Closure Voluntary Disposal Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27;Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration, 29:Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Insppeccttorr'/s�Signature Print: 31.Dumpster screened from public view •-V 1 v Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats IC's Signature Print: Observed Frozen Dessert Machines: Outside Dining Y N Self Service Wait Service Provided Grease Trap Size Variance Letter-Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According toy' 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-Chazge Duties 3-302.14 Protection from Unapproved Additives ' Contamination from Raw Ingredients F15 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 Common Name-Working Containers* ge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* ' Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se azation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) 9 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water I Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1 g IProper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effe 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) Park 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 1p Proper,Adequate Handwashing 3-401.11(C)(3) Whale-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiRequices should be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165*F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodbome Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* 12 (E) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140*F to 70'F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 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 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:59oFormback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. T WN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: Page: of OFFICE HOURS UBLIC HEALTH DIVISION 8:00-9:30 A.M. 3:30-4:30 P.M. eAaNsrAaLe. 200 MAIN STREET MON.-FRI. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. 'gp t639•a�0� � � HYANNIS,MA 02601 e08-862-464a No Reference R--Red Item . - PLEASE PRINT CLEARLY FOOD E TA LISHMENT INSPECTION REPORT Name Date°, /-�hjTyRe o Tyga,"s ection Ogeration(s) utine Address Risk Food Se wice e-inspection Level ai Previous Inspection Telephone ential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked rjKlres an explanatio 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 4��i ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives l ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals C-46 QC CA C 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 V11 ❑ 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, a Items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.-9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 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 4non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.005) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 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. ithin 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. . 29.Special R quirements (59 w y 0.009) p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumps r screened from public view. Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N I RIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y, N y y� `-�/ �" /.�►Z1 Dumpster Screen? Y N 9 I 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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 _ PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 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* 7-203.11 Toxic Containers-Prohibitions* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge Contamination from the Consumer 3 590.003 D Exclusions and Restrictiotis* 7-204.11 Sanitizers,Criteria-Chemicals* ( ) 3-306.14(A)(B)Returned Food and Reservice of Food* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 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* Eggs 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* Eg°"-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* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11 C Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* ( )(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g. g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F * 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the Foodborne 3-101.11 Food Safe and Unadulterated*6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item I Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.006. BN B`LE L HEATH INSPECTOR'S Establishment Name: Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. ennNsrneLe. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. 0g HYANNIS,MA 02601 MOP.-FRI. 'cbA .e SS.n 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY 'EOM FOOD ESTABLISHMENT INSPECTION REPORT ' Name Date J/ Tvoe of Type oLlpspection �es Ine Address Risk R p24ionLevel RPrevious Inspection r1. Telephone / Residential Kitchen Date: Tele p �- "' J Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) y T, imeT Bed&Breakfast HACCP - /l�( 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) ❑ % T 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 Foo s)q�� , ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures f ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling wo, Cj� V ❑7.Conformance with Approved Procedures/HACCP Plans ❑19.Hot and Cold Holding C PROTECTION FROM CONTAMINATION ❑ 20.Time Asa Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ; f ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP L - ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY 1 ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories �F _/-, N,0111 Violations Related to Good Retail Practices(Blue Itemsl Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) ' Non-critical(N)violations must be corrected immediately or Corrective Action Required: No ❑ Yes within 90 days as determined by the Board of Health. Overall Rating ��� jl ❑ Voluntary Compliance ❑ Emplo a Restriction/Exclusio ❑ e-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 24.Food and Food Preparation (FC-3)(590.004-) constitutes an order of the Board of Health. Failure to correct violations A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations. If no critical violations observed, 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations 9 or more non-critical violations=F. 2G.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 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 9 P, 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 C=2 critical violations and less than 4 non-critical. If no critical refrigeration. be in writing and submitted to the Board of Health at the above address 9 29.Special Requirements (590.009) within 10 days of receipt of this order. violations observed,7 to 8non-critical violations=C. 30.Other q DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster, Greened from public view QA 1/1 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' Signature Pint: , Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) w t FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 7501.14(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 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 1 g PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* r 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 3-304.11 Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water I Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 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-1 ook 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145'F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E17 ctwe//112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22. Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* * 3-401.11 A 3 Poultry,Wild Game Stuffed PHFs Shellfish - 4-703.11 Methods of Sanitization-Hot Water and ( )O ry, SPECIAL REQUIREMENTS k 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009 ( )-(D)in cater- Chemical (A)-(D) Violations of Section 590.009 A Sources* Ratites-165°F 15 sec* in mobile food,temporary and residential 10 Proper,Adequate Handwashing g� P �' Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 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 1 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 Game Animals g g Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the 3-101.11 Food Safe and Unadulterated* Ile Prevention of Contamination from Hands 3-403.11(E me );, Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found inn the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 1.006 6-301.11 Handwashin Cleanser,Availability 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ g y 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590FormbackE2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. `Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. i pFu;E Tp� TOWN OF BARNSTABLE - HEALTH INSPECTOR'S Establishment Name:�Cl�� ;S / � ate: Page: of v` tip 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/P AN OF CORRECTION Date Verified MON,639. �0� HYANNIS,MA 02601 -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY p'EDN10'a FOOD ESTA LISHMENT INSPECTION REPORT s08-8s-as24saa Name Date 17 Tvne o ImKionspection Operation(s) u Address Risk/ foo rvice spection Level eta' Previous Inspection Telephone esidential 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: l �i�•�U 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 L ❑ 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 Embar o checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations 9 )( ) cited in this report may result in suspension or revocation er the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up, infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) PY within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signatu a Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N 1,WA _ 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-Chazge Duties 3-302.14 Protection from Unapproved Additives ' Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 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 * 7-201.11 Separation-Storage Applicants* 3-302.11(A) Food Protection* * 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) 1 Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and AdulteReserrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashin 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 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- mme is sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg°"°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* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source Contact Surfaces of Equipment* 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 temporary and - ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F IS sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms practices should be debited under#29-Special 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding 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 PHFs Received at Proper Temperatures* 2�01.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5204.1 I 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. 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 Foud Code or 105 CMR 590.000. oFIKE row TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page:. . of ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00=9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. MON.-FRI. HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEAS, PRINT CLEARLY 'fDN1P' FOOD EST BLISHME T INSP C ION REPORT _ Name r Date e o Type of Inspection �Fj RoutineAddress Ris od-Servi a-insp" e'r coonLevel ai revio s nspection Telephone ential Kitchen Date: �6 1 Mobile Pre-operation Th- Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: !fljZS_yZ/_/� Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. pop 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) ❑ IN 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 TIMEfrEMPERATURE CONTROLS(Potentially Hazardous Foods) ` ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures . ❑ 5.Receiving/Condition ❑ 17.Reheating L ❑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 (A� Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations r Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective�^ Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating. d( within-90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C 'N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more.critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6;non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8 non-critical violations C. 29.SpeciaLRequirements (590.009) y p , 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view ` _l Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's S g e P t: Self Service Wait Service Provided Grease Trap Size Variance.Letter Posted Y . N Dumpster Screen? Y N ___.1 Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red.items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 19_ PHF Hot and Cold Holding 3-302.14 Protection from Unapproved Additives.* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) * r 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 Applicants* P g 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Time as a Public Health Control 3-302.15 Washing Fruits and Vegetables* 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*Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* * 590.004(11) Variance Requirements 3-304.11 Food Contact with Equipment and Utensils* 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* .REQUIREMENTS FOR- 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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* I Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. CONSUMER ADVISORY gg 16 Proper Cooking Temperatures for PHFs 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145*F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E�crfve mrzoo1 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3 401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 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- 10 Sources* Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By Ratites-165°F 15 sec** 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 1 7 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 Tune* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand�'in Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:59oFomrback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF,NE roN TOWN OF BARNSTABLE, HEALTH INSPECTOR,s Establishment Name: Date: 3 aClagel of 4, OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ' 200 MAIN STREET 3:30-4:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS, o. MON.-FRI. .a3v p.0 HYANNIS,MA 02601 508-862-464a No Reference R-Red Item - PLEASE PRINT CLEARLY rF°M� FOOD ESTABLISkIMENT INSPECTION REPORT • Name Date/• T e o sec ion outine Addres ' Risk Se ct+on �I nr (� - ' Level etail Previous Inspection Telephone � n ial Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP14 In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. r Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ 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 ti C ❑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 i PROTECTION FROM CONTAMINATION ❑20.Time Asa Public Health Control r - lr ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) �. ;•r ( -� ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY i ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories 5 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations i (�', � Critical(C)violations marked must be corrected immediately. (blue&red items) 1 �`^^`� ti Corrective Action Required: _ 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 4non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9"non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 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 Sianature Print: 31.Dum ster screened public view p eened from Permit Posted? Y Grease Trap Previous Pumping Date Grease Rendered Y N N P P 9 PIC's Si nat r Print: #Seats Y N Observed Frozen Dessert Machines: Outside Dining 9 Self Service Wait Service Provided Grease Trap Size Variance Letter Posted, Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) r 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 8r3-302.11(A)(2) Cross-contamination 1 q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* *- - 19 PHF Hot and Cold Holding 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 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* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control P i i 11 Re striction estrcton-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7- 3-501.19 Time as a Public Health Control* * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003 D Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* ( ) REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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 Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Eggs Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Utensils and Food 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cep"1i1n001 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* Animals-155°F 15 sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in eater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165"F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 11 Good Hygienic Practices practices should be debited under 929-Special 3-201.17 Game Animals* 17 Reheating for Hot Holding 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* i 3-301.12 Preventing Contamination When Tasting* 3�03.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) * 12 Prevention of Contamination from Hands 3403.11E Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate to the foodborne 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 HandwashingFacilities 3-202.18 Shellstock Identification* �. 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F. Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand�yin Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 1 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 1099 Food Code or 105 CMR 590.000. P`pp IKE r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: age:�� 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 HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE RINT CLEARLY �prFD MPS°' 508-862-0644 FOOD ESTABLISHMENT INSPECTION REPORT Name (1 Date"13) I Tvoe of T - i outine Address Risk o Servic 'Re-inspection Level etail Previous Inspection Telephone - 'deal Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illnessz7LIV, Caterer General Complaint 01 Person in Charge(PIC) Time, Bed&Breakfast HACCP G� i In:0 - o f/ 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 j ❑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 L ❑ 5.Receiving/Condition ❑ 17.Reheating ry 1 ❑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 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 p, r, 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: N 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 ❑ Emergenaysuspensiq C N Official Order for Correction:Based on an inspection today,t e items Embargo Emergency Closure voluntary Disposal checked indicate violations of 105 CMR 590.000/Federal Food Code. ® g ❑ g y ❑ ry P ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to Gaon-critical violations=B. t� 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of (� 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements- (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view �JA�l 1��� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N1, -� #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N i Dumpster Screen? Y N '� -• �. Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 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 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F 590.004(F) EMPLOYEE HEALTH_ 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140'F 2 590.003(C) Responsibility of the Per in-Charge to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F Storage*- Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Reared or of Food 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-801.11(1)) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 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 Eggs 5-101.11 Drinking Water from an Approved System* 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* Ef dive 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155`F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 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* (A) Stuffing Containing Fish,Meat,Poultry or 590.009 -(D) Violationsof Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential HEProper,Adequate Handwashing Ratites-165`F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition g, 8 g 3-403.11(A)&(D) PHFs 165`F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140'F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the 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 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70'F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70'F to 41'F/45°F Item I Good Retail Practices FC 1590.000 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/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6 2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. t �p IMF T 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 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �A MS39,a m� HYANNIS,MA 02601 _ M- -FRI 5088 62-4644. No Reference, R-Red Item PLEASE PRINT CLEARLY . 'EDN1P� FOOD ESTABLISHMENT INSP C ION REPORT r Name Da a Tyne of Type of Inspection pRR Routine L Address Ris od Service Re-inspection Leyel Re aI Previous Inspection Telephone Residential Kitchen. Date: ` Mobile Pre-operation Owner HACCP Y/N Temporary ff0thert Caterer Person in Charge(PIC) Time Bed&Breakfast In:l - Inspector - Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities ' EMPLOYEE HEALTH PROTECTION FROM CHEMICALS v ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives .--� ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially,Hazardous Foods) 06 !� =t ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating rl t ❑ 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 H P ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY p "b� Ld h 11.Good Hygienic Practices , 22.Posting of Consumer Advisories �1 a❑ ❑ 1 I 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 IN)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: i 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 I (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. )(590.008 28.Poisonous or Toxic Materials (FC-7 be in writing and submitted to the Board of Health at the above address) violation,4 to 8pon-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Insspe�ctor's Si nature P t: 31.Dumpster screened from public view /� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Si nature Print: �', ` /_ > 9� Self Service Waft Service Provided Grease Trap Size Variance.Letter Posted Y N 1 !��/ Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*7-]02.11 Common Name-Working Containers 590.004(F) * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140'F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se aration-Stora e* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) Variance Requirements 590.003(G) Reporting by Person in Charge .. Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR. 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for 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* 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 3-262.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155'F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145'F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ep ctive 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155`17 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 rf cesSanitizationEquipment* of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155`F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' S90.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165`F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(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-165'17 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 140'17 to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45'F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F. 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 27. Physical Facility FC'-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods*. 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Folmback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF� r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date:--7)) , Page: of_� OFFICE HOURS Aa'N"s,�Eo PUBLIC 2 0 MAIN LSH STREET 3:30-4:30 P.M. DIVISION : 0- :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified .6 HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item. PLEASE P INT CLEARLY �'°rao MPS°`0 508-862-4644 FOOD ESTABLIS MENT INSPECTION REPORT Name Date_t� T e o e o s c ion Routine Address Risk od 'pe on Level a Previous Inspection Telephone ! Residential Kitchen Date: Mobile Pre-operation Owner �O j HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PI 6) Time Bed&Breakfast HACCP Other In: 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) o I Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands AmQl ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS /)(/(® W ❑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 TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) 4 (( /j ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures 6 /TV ❑ 5.Receiving/Condition ❑ 17.Reheating Ida ❑ 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 Itemsj Total Number of Critical Violations ( Critical(C)violations marked must be corrected immediately. (blue&red items) I Ic Corrective Action Required: ❑ No El-Yes Overall Rating Non-critical(N)violations must be corrected immediately or 011 Rati within 90 days as determined by the Board of Health. ® ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than 4 non-critical violations 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 violations observed 7 to 8nnn-crit cal violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address , i 29.Special quirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=-C. 30.Other GATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dump er screened from public view �l/✓ ar 1 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y NSignature Print: Self Service Wait Service Provided Grease Trap Size. Variance Letter Posted Y N Dumpster Screen Y N -' Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 411/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130*F Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 7-202.11 Restriction-Presence and Use*Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rered or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual-Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501,114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Eggs Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef cri-I112001 4-602.11 - ]Frequency 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 of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A (D) Violations of Section 590.009 A m cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ) ( )-(D) Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 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 practices should be debited under#29-Special for Hot Holding Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F 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 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 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 ro TOWN OF BARN.STABLE HEALTH INSPECTORS Establishment Name.O Date: b � �1 Page: of p. o OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSfABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p MASS.9.a. HYANNIS,MA 02601 M 5088- -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY . 'fDM FOOD ESTABLISHMENT INSPECTION REPORT Name Date `�/ Tvoe of ec ionLj Address - Risk gn Rein pectionLevel Previous Inspection Telephone al Kitchen Date: Mobile Pre-opemtio Owner HACCP Y/N Temporary u-spe­cfTnness Caterer General Complaint Person in harge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: U 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) ❑ IT- 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 S , ❑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 Z: yal Critical(C)violations marked must be corrected immediately. (blue&red items) orrective Action Required: ❑ No Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. o tary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection toda a items checked indicate violations of 105 CMR 590.000/Feder ood 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 her or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4 non-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and,less than 9 non-critical. If no critical water,sewage back-up, infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) PY within 10 days of receipt of this order. olation to 8 non-critical violations=C. 'o i ure P' 1 30.Other - - PATE OF RE-INSPECTION: Inspe - 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen 7 Y N L 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 3-201AZ-4_ Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 7-102.11 Common Name-Working Containers* _ Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145F 15 sec*' Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) .Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg°"°e tarzooi 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 * Stuffing Containing Fish,Meat,Poultry or 590.009 A - D Violations of Section 590.009 A Chemical ( ) O ( )-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-0Ol.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 foodbome 3-101.11 Food Safe and Unadulterated 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the. 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 1 g3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibili Operation and Maintenance Temperature Ingredients to 41 F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention ty• Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 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. piME►o�," TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: � �-n��/U' fir ` Date: J� /��L � Page: of .° W OFFICE HOURS i AaNsrAaLe.° PUB2 0 MAN SH DIVISION3::30-0-4:30 P.M.:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ON e�.p�e� HYANNIS, MA 02601 M 508-8 -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY 'FON1P' FOOD ESTABLISHMENT INSPECTION REPORT Name Date��� Type of T ec io Oaeration(sl _ Address 6 Risk Fo ervice 5 Re'-inspe6ion Level 41a Previous Inspection ` Telephone Residential Kitchen Date- Mobile re-operatio Owner HACCP Y/N Temporary Hess ►�� -�'' Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspect o 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 AdvisoriesL��f:T/� ) Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �J Critical(C)violations marked must be corrected immediately. (blue&red items) at jl� o rective Action Required: No ❑ Yes Non-critical(N)violations must be corrected immediately or ` within 90 days as determined by the Board of Health. Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection tod ,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 )(590.005 B=One critical violation and less than 4 non-critical violations 9 (FC-4 ) 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. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspe s a re P' 31.Dumpster screened from public view _ Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N ddd #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature 4 Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N 14 Vo of Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodbome 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.*2-103.11 Person-in-Chazge Duties 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage** 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* P 8 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* I Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served y Pe 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 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY * Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water 3-401.11A(1)(2) Eggs-155°F IS sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effecriw 1/112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* 1p Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under 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) Ali Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Lu Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140'F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 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.590Fomtback6-2doc *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. Ocean Street Market 774-552-3912 XV : t I 50-ti0'AJ] CHOOSE YOUR MEAT VEGGIES FRESH PICO DE GAL_ LO GRILLED STEAK AUTHENTIC MEXICAN GUACAMOLE GRILLED CHICKEN ONIONS LAMB BARBACOA CUISINE OLIVES GROUND BEEF 50 Ocean Street CILANTRO FISH&CHIPS Hyannis HOMEMADE JALEPENOS AND MORE LETTUCE ' •• QUESO FRESCO ' SIDES CHIPS $2.00 Ai OPEN CHIPS +SALSA $3.50f CHIPS+GUAC $5.50 RICE $3.00A V BEANS $3.00 I BUILD YOUR OWN ' TASTY HOMEMADE HOT { QUESADILLAS BURRITO SAUCES MOCAJETE (MILD) 7� ROASTED TOMATO, ONION, GARLIC,JALEPENO AND CILANTRO - ' CHILE VERDE(MEDIUM) ` ONION GARLIC AND JALEPENO, , s CILANTRO MEAT. EXTRA MEAT $8.47 $2 CHILE DE ARBOL (HOT) _, �c f' ;• .. A._MIX OF HABANERO,CHILE DE VEGGIE EXTRA GUAC ARBOL,WALNUT,GARLIC,AND $7.50 $1.50 :ONION MEAT $8.47 VEGGIE $7.99 NACHOS m_. w SOFT SHELL TACOS y TRADITIONAL MEXICAIV SODAS WA SMALL MEAT$8.47 VEGGIE $7.75 LARGE --. MEAT $3.72 (each) MEAT$13.25 VEGGIE$11.25 arm, r VEGGIE$2.50(each) dll.r��, MDr Jy � — EIECTR IG - * Gnt�o uNo�a poo4 yl 1 + _ n .h MDi 31 �La lie, .+. tle � I 1 s-m0.At£ Q � I +I i I ��---- -----------------=-------...----------------'--------.__.—�t�.:_Dom-=----------------------- ---- I //1 _ W ' a , haoR. i 6 ° A o E-1sTi 1 G, 19E F 9 1 rl 2r _ '� S MdP +� cASE � S SArJDvJic}F + '------.._.._.._._ ...._ .. .. ,..,.___..__. _1� MAC+-t . � P � i• VN IT � x wn-L- GnT� Ll f 4r��ri Bi EacA E� GarT-I. GASH CorFGE 57h T l t STt�Tt o�J Li � H Dora K{tJ o N Q'7 lON T Gov Jtt_(L T'��DfT VH r2oN i Dao2 S W 0 � a e 3 T `I A 54 • s LD J, N o EKtS'it�.3G, '�Z'c�t=sc:,E�L�1"7`EBF�} 3 � � '� S ? `I� �ar.tv-r GASP✓ � 5 � SArIDvJf(.}{ � y' v,r�aiL ^� O J U i (f �L 8 Sr i IC T,I. GASi� �Ot=FGE 5'fA s i td f STltTI C> CTI E- PAriFI.. j Cn 9 � S co f Q LO 6 Ln f`HRIS T II S SQ .oc.FArJ U MA . 9 - i s 01_— T ti_SUN K 1 t�f �o N�fT Gov.,Is'�.ft•. T�DD TtO� - E f-2otf'i DaaK.S 3107—Blo'7D "��•,., Fbwe�rs s, Your Grease Trap. Pitd.' -.,10 SERV. I.CESI INC* Drain Specialist P.O.: Box:294 ' Bridgewater, ,MAI.02k4 LIKEKI 508 697-9565 1 (800) 449r4480 (508) 759-0979 us ON www.PatdotServ'kesMa xom Date of Service q t Irivoce # Customer Name '.A jn , r3 Phone # Address j Job Address.(if different than customer)' x Apt, J Di9scl IPTIO_N`O/^F WORK77 c CIO ol e ;. 3r. I hereby authorize you to perform the above described services and I agree to pay the amounts indicated to' the right.I certify that 1 an duly authorized to order acid approve the work requested.. r PARTS ' Signature ).lbw f l s LABOR OTHER Terms: PO # Bill Out TAX, TOTAL This is to acknowledge com letion of the above descnbed work DISCOUNT - : which has[been done to mypcomplete-sa�tisfacnon x" TOTAL.DUE - - A',PATR T-/ Signature. 7e ,.t: ✓ ., - Date Customer Name Customer E-Mail Address BLACK* DIAMOND Black Diamond's.Standard Series radiant gas countertep charbroilers are designed for use with either natural or LP gas. Constr.ucted of stainless steel front and sides that are fully welded, these units are able to stand the toughest of kitchen environments. Each unit includes tips for field conversion to LPG. P� .Standard Features o Fully welded stainless steel front bullnose design with galvanized sides ® Fuly welded stainless steel backsplash for extra durability ® 30,000 BTU per burner • One stainless steel burner every 12" grate width • Cast iron grill grates are reversible and height adjustable ® 4"-5" adjustable legs o Separate gas valves for each burner with standing .pilot ignition system a Removable stainless steel drip tray for easy cleaning o 3/4" rear NPT gas inlet ETL. Listed and ETL Sanitation Black Diamond warrants this product to be free of defects in materials and workmanship for period of 1 year from the date of original installation. e BDECTC-1.6/NG 16" 1 30,000 95 121 BDECTC-24/NG:. -24" 260,.000 119 15 BDBCTC-36/NG 36" 3 901000 163 218 ° BGECTCm48/NG 48" 4 120,000 ?44 359 z m � .. ..:.,.:. 3a:.'.....n77 L Plan Vier 25 a ti f I 22.75 . <6 r Unit Dimensions (inches) ti 1BDECTC-16/NG 16" Charbroiler 16 26 15.75 BDECf C-24/NG 24" Char'broiler 2q ,, 26;': 15.75` EDECTC-36/NG 36"Charbroile448 36 26 15.75 BDECTC-48iNG 48"Charbroile 26 15.75 Drip Tray (inches) F A. BDECTC-16/NG 11.5 21 1 1 BDECTC-24/NG 20.75 20.75 1 1 BDECTC-36/NG 31.5 20,75 1 1 BDECTC-48/NG 20 20.75 1.25 2 ....«.,5.w.• ,::. ,u.✓Ysi .a,.wi.G° P+.t:b=-. `.�,V r%A.a6, ..,,.,sxasder,,,., MB, LAC, K+DIAM0N [Y "Na Black Diamond's:heavy duty thermostatic griddles are resigned to maintain precise cooking temperatures during your busiest hours. Each "U"shaped stainless steel burner puts out 30,000 BT.U/hr and are spaced out evenly throughout the entire griddle plate giving you a more uniform heated surface. The thermostatic controls allow for precise cooking temperatures along the cooking surface. Each burner has its own individual standing pilot light and control which allows you to set up different cooking zones along the griddle plate. The 1"thick polished steel griddle plate is made to handle cooking at high heats for an extended period of time. The 0"cooking depth provides maximum cooking surface area. Comes standard with adjustable heavy duty Legs,.drip tray arid has a 3/4" rear NP'T gas connection. Field convertible to LAG. ETL Listed.and ETL sanitation. � 3 P7t7¢ } . Standard to r s o Stainless steel front, sides and splash guards that are fully welded for extra durability Griddle plate is made up of t"thick polished steel ® One "U shaped stainless steel burner for every 12"' griddle width 30,0.00 BTU/hr per burner o� Separate gas valves for each burner with standing pilot ignition system * Adjustable thermos-3tat from 200°- 450 IF for, precise control while cooking o 3" wide grease trough for easy cleaning * 4"-5" adjustable heavy duty steel :legs 0 Removable steel drip tray for easy cleaning ® 3/4" rear NPT gas islet �o Field convertible to LPG - L.P. orifices included ETL Listed and ETL Sanitation Bl CTG-24T- 2 60,000 140. 200 BDCTG-481- 4 120,000 300 360 : t LBDCTG-60T 5 150,000 463 529 ` h}trielC Ind�rtck i ACK* IA Plan View i 31 n --`30 ........ f - ea f a. 2T _ 1 24'% 36", 48" 60"Widths Available ua aoa a aaa a o 0 o a o o as Specifications BDCTG-24T 24"W x 32"C7 x i6"H 1" 2000-450°F 23,75"W x 22"D BD:CTG-36T x hi y, 1" 200°-450°F 35:75"W x 22"D BDCTG-48T 48"W x 32"D x 161/H 1" 2000-4500F 47:75"W x 22"D BDCTG-601- 60"W x:32"D x 16"H 20.011-450OF 59:75"W x 22"D Black Diamond warrants this product to be free of defects in materials and worknrianship for period of 1 year from the date of original installation. Quantity: CD w"eAHGE Of CALIFORNIA me Prt3fGCt. Energy Efficient Deep Fat Fryer MlOdels� D REEF-35 pool Gas Type: (Natural LP 3 Elevation (if above 2000 ft.) CD : Options and Accessories 0 Stainless'steel tank cover 0 Stainless steel side splash guard U Stainless steel joiner strip G148" quick disconnect and restraining cable U 5" swivel casters (set of four 2 locking) •. IANy J P 4 .. � Standard Features • All stainless steel front and sides • 35 lb capacity stainless steel tank assembly ® Frying Area: 13 518" x 14" • Cast iron burners rated at 24,000 STUIhr each ® Millivolt control system with 100%safety shut off i Thermostatic control with 2002-4002 F range * Twin fry baskets with plastic coated handles for ease of handling * 11/a"full port drain valve: 6." high adjustable heavy duty legs * Five year limited (prorated)warranty on S/S tank * One year limited warranty, parts and labor C ldS Intel"tek Intert k MADE IN u«xa- Royal Range of California, Inc. 3245 Corridor Cr. Eastvale, CA 91752 n (300) 769-2414 (951) 360-1600 U, .S, A, Fax: (951) 360-7500 • www.royalranges.com • sales@royalranges.com -. .. .,..... ,Se.,.._. h %vN c._'s', .,.. .,•$' S�x^«e,. Y......�bc__^,%+WPyl.A.,e',@tS-es; �ce'�,u�T. :�£.k:k?,h��.�:4X , ...:<--_ ... �.£R".a.P"�; LL 314 N PT LL GAS INLET �Ft„ 1 7„ — 31" S 454" OEM 33` I l LU fi r 6„ 61„ i Model Number Cooking area Number of Total BTU Ship Weight Burners REEF-35 13 5/8" x 14" 3 72,000 210 lbs. Notes: Gas Pressure:. to Burner rated at 24,000 BTU/hr each 41>MC. Natural Gas 11" W.C. Propane Gas Connection: 3/4" NPT on the left hared rear of the appliance. Clearance: No external pressure regulator required. Combustible Non-Combustible Rear 6 0„ Sides 6" 0" Specify type of gas and altltude; if over 2,000 feet, when ordering. Due to continuing product deveiopment to ensure best possible performance,these specifications are subject to change without prior notification, Royal Range of California, Inc. 3245 Corridor Dr. - Fastvale, Cal 91752 (600) 769-2414 ® (951) 360-1600 3/17 Fax: (951) 360-7500 A www.royalranges.com - sales@royalranges.com yJ yygg N � A BLACK* DIAMOND Black Diamond's gas ranges are constructed of a stainless steel front, backriser, sh lf:and feet. Each 30,000 BTU burner has its own 12N1.2" removable cast iron grate:with standing pilot light and individual control knob for quick, instant lighting. The oven has a total BTU output of 30,000 BTU/hr. The interior of the oven is constructed of all steel with a porcelain oven liner. The oven thermostat adjusts from 150OF-SSOOF and is equipped with a dame failure b safety device. 6"stainless steel legs and 24.7 "high backriser. 3/4" rear NPT gas connection. o�. WConstruction A Stainless steel front, backriser and shelf m o 30,000 BTU/hr top burners with lift-off heads 12" x 12" cast iron removable top grates ' Individual pilot light for each burner 4 Spring loaded door with cool to touch s/s handle ' �¢ . qr ® Removable crumb tray for easy cleaning { r' 4, 6" stainless steel adjustable iegs !: 3/4" rear NPT gas connection Oven Features 30,000 BTU/hr total output ® Flarne failure safety device ai • Adjustable thermostat from 150°F-.550°F � • Steel liner on door and sides with a porcelain oven liner • Includes 2 removable and adjustable oven racks ' • Cool to touch stainless steel oven door handle BDGR-3� , Top Burners ® Cast iron burners each giving off 30,000 ESTU/hr it /! ® 12 x 1 cast iron top grates are removable for easy Cleaning and maintenance s Each burner has an individual standing pilot light and control knob 1 Black Diamond warrants this product to be free of defects in materials and workmanship for period of I year from the date of or•irginal.installation. 11 LAC; 1.) 1AM %1 k Plan View BDGR-24/NG BDGR-36/NG " s . y Al l F C"f a: .: BDGR-60JNG so- , I ` w � «. p . Specifications tE !NG- 73Gas BDR-2e tiv/4 Burners NG 150,000 ; 3'65 !bs 291 lbs BDGR-36/NG v/6urr7ers N 210;OOQ56 Ibs 300 Ibs 13DGR-60/N1.:I 60" Gas Range w/10 Burners NG 360,000 785 Ibs 617 Ibs� BDGR-24/NG 24"W x 32.5„D x 60"H 2O.5"W x 26`'D x 14"H 1 No BDGR-36/NG 36"W x 32,5"D x 60",H 26.75"W x 26"D x 1411 1 Yes BDGR-60/NG 60"W x 32,5"D x 60"H 26:75"W x 26"D x 14"H (2 ovens) 2 Yes II STAINLESS STEEL GAS HOT FOOD TABLES ADVANCE T' _ nc: Af,,F WITH UNDERSHELF 1i-5 .,.it�`tT1 ...:.. lj�'., ... .. Fur (.)se ivith Optional i Spillage,Pan's y z Model �# w Project Fe trrrrrrrd a-V Standard: cs'Fs w- e Rail ��a ir�,3 ti . y R'MR� v v �.,' Adjustable Undershelf with Die Cast Leg Clamp , ,"a :r HF-3G-NAT Shown �u. FEATURES. T I L : GAS, .,i t TOP 01 o ti.f, #`—j,l„' u.e.:; 0.,, h o, p"✓ilial,lu t r sat:;' I it al�.i ` BODY ���� t �r=a Q s'1i!11� �a .:.(i fit`` i LECG a Cif i nt t r t €L)t'' ��vcal,lL,nf .fool 7�1)[tCa il.,i.l?11(. c":,n-rol kno":j:; Note: E-XGe :A .E,i.,l),7re�v�„slu.i:.Fjl3)S,•:.t 3/ IhIck,5E5{icut'irg b" E:3!'r..i Ships K,D, 7, r �i � s,�, is e ule(I 4' VVC, l".,':'�..WC3fl.. t.It�113�� I�EI.:�: (::rll,,.i i!>JC,SiUf'.I � I air)1 x s el t)o dy pno;top LINERS 6 deep;22 gauge galvanized. i:oi Natural Gas an.(", F,0` e u tl€.,rshelf&leas vvl_,; s'Aa�rt Met fi�eF Utal {ra�� �`i .l pgrc3d.. i.l,?# U- 2C�: �riFirf is 1.F� tlE:.E. ,.it;t: �•'.( 1.;:,(;i,lu(Tira'J:1laiii ,.;4t C i ir.5v�cttt7 ..•.t.31 CUTTING BOARD:��is.tt�.i�tlUl"r1"IilrJlc-iS'.1r„ Ir , << c ;ii rfa. 1'ht uE:i' raYc r i uii 1 for oliy CUTTING BOARD BRACKETS: 16 lance, (,.E rat �I I T o Z q)faod rriolst add a s 1`i.��{?f)� �;I`2`s°ra,�,lf. �,eaI F Vol HF 2G NA'� JA 'Ii�AL AS E A 13 1(r :0` K 2 92 lbs d8 HF 4G NAT j �INATURA!GAS hiF 8G NAT rNA1UAX•0, `D 7r 3 ,';• 3v wb a 1,7Q tbs.I` � HF lG LR B 017 LZE U(.A A 31 1 a 30-5 8 2 I 92 tbs. 28 .. _ 1 Ib9 4f, ; _ �I Hf'tG-LP 801 fl i'Mj G t� C -G, 71'6" 3l,u t, A 165 tbs. 5 E. IiFSr..tJF E3C17'LtliGA I'� 77 t4"` "'En" lcr;idth Inclu,, es, (V'Cuttirs �.Board .. _ NOTE:Units are not designed,to cook or heist frozen or refrigerated foods.Food placed in tables should already be hot, and the cable will maintain the proper temperatures Stainless Steel Legs&Undershelf Upgrade :2 then'Tqbie 'Well Tay Ic 4 vd�TadloWeU Tabl6SUU-230 a Customer Service Available To Assist You 1-800- 5- 15 8:30 a . 8.00 pm E.S.T. 2 For Orders&Customer Service: For Smart Fabrication"QLiotes. ADVANCE T C04 Email:_ctisturnrr@adva.n(etal),,o,cowior'Fax:5;31-242-F900 Frail:slnartf�k� ,�advancGtahto.cr�mor'F<ix;631-`386t 2933 DIMENSIONS and SPECIFICATIONS TOL�, .125' ALL DIMENSIONS ARE TYPICAL D ........... B DETAIL OF BURNER SET-UP BURNER JET PILOT LIGHT F Ll i K l�� 'k .....................__­­................­­­...... ­______­_____._._.................................. ........... )4 ............. .............. ........... .......... l"OLY CUTTINO BOARID SHELF CONTROL KNOB D ................................... ............ ............ .................. V: "v a. ............................................. T 14 34' GONTROL KNOBS ........................ .......... ........................ ------------- GALVANIZE'D A0j:USTA.1MJ-' 0ALVANIZED LEGS W/ PLASTIC BULLET FEET UNDEWSHELF All dimensions are the same for the stainless steel wells option, Food Table Shelving Mv.................... Am 0 V, A 0 A 10"Wide Buffet Shelf 10"Wide Serving Shelf Acryll''Slde 'F*cf,iy 1! 51 " VAth Built-in Food Shield with Built-In Food Shieldce for Buffet Shelfor Apprw Cu, Appfox Cu. k1odel Length Wt. Ft. SF fulodel Length Wt, Ft. 4dufltjoiial ,I TB5-2 31-13116; 34 IbS. 9 - TSS-2 31-13i;6" 18 Ibs, T5P"'�-O neSrde TBS-3 47-1"V 4gibs, 3 +2 05 TSS.3 47-1;,8 2,3 lls 3 TSP�2 7waSixt 1`BS.4 62-h'16' 47 lbs, 4 leld Jleld 1,gidailori ',ijzibu F1 TSS-4 b 30 lbs, 4 �Ava 5: TBS.5 77-3f4' ;)5 ll)s, 4 TSS-5 77'31' 35 flb,.s, Food Table Accessories Visit our wabsito for additional Food Table Accessories %* A' p. SU.-258 Add Castei ( -s,1 Food Units will, Jned-,isnelf 4, SU41P-1,05 Jet Burner for Natural Gas Unit NAT 5116;661) i, Swivof Casf&3,2 wi6rakrs&Lf.xp Thai 1vial'ohain Haijht) v `74)SU-P-1 06 Jet Burl r for Natural Gas Unit(NAT 5/1166 l, SU-25 Add Castefs to Food Units Undeisnelf `�Or Units Bvilt Before Oct. V Swivel Casiers,2iVRaji0S.j SP-A AlUlnirl.1111 Spillage Pan SP A Pan, SU.P.101 Gas Valve SP-S Stainless Steel Spillage Pan '66 ADVANCE TASCO is constantly engaged in a program of ADVANCE TAB= improving our products,Therefore,we reserve the right to change specifications Without prior notice. 100 He'airtlaj ld Bouevaro, E"Rqowc')Q�.j 'Nly 1:1717­838"', CD ADVANCE TABCO,JIMY 2017' sl�ds r ..._,.. .._...._.. .._....._. 2J._..._....._.._. .................._....................................................._...._....................................22. Char Grill 11— xw. Existing Had Smk ftii Gill nvaas •, Frcac Si nk ink .r• .... Hvnd Slnk and-P nls1am1)0' ............................... 0 Feud 1\epara�iun Are. i _ �andw..hCa.� 0000 • - .6 Fri%-It,Uall lY\1'i.IX Glass Guard Ocean Street Market 5J' 50 Ocean Street,Hyannix,MA,02601 d, H dS'k Srala ® I 4' li• Wid*0.d51Hoeht 0.24 cm-I fm _ II' S.5'lix3.21i.e 2\t"r a i a 6'• E J' fi'• a 6' d. Gondola, J' d' 125' d' 26.5 -1 _ -� .....1 .....1 .....1 •....1 ...... E,imia2 W,,IWn@ Cunler 2J.. ............ .... ._.._...._..............._: ............ . .._....___. ...._......... _...__....... .__ ... ..._...... _.....__....... ......_46. ...___........ ...... .................. ........ ........ .22. ....... _....... ._....... Char Gnll FrSvlatm ................_..; Flat Grill ^�^•, ewwa w an W rYnnt Sink NPnU Vn4 end PnPnulancr 20' _ 1 u tell cW Y.m Twr ]e5 ............... 6 Sandw eh Caxe / O L _ iab FrcSlandinp x'all 12'With IS'Glen Guard Ocean Strecl MarketsJ• 50 Oman Street,HSanais,MA,02601 7.Hand Sink J &alc ® ! ....d�............... la Width 0.45IHciphl 0.24—•11.0 , R I l' 5.51I a 5.21k 2W w Cou _ k 6.. V $ 6• J J I 6' d' d' 1 J• Izs• J' 26.5 Esiwtiny Walldn l Caolcr CDG Series KarjPtak, Liquid Dispensers CDG-211 CDG-311 � r r 7 ✓err, , r Wsy 6 �. a z i t 3• a.` ,� "s ',a �.n"2 ,a� en ralrw � .-"7 " i °,TH A aas� -4 %fed/ �� � � ' a4 rf l .y. £ #1 Yss E 34 Pits 971 I'y� 343 A s v"YN' '� n ry x '�„�„�,�,�� 9.�'rh �`� r�_ � ' � .. _ _„�-., ',•Ifs" WR 4 KanPak LLC, 425 Main Street North, Southbury, CT 06488 Phone: 800.569.0826 or 203.264.7203 • Fax: 203.264.7292 • Email: kpservice@kanpak.us www.kanpak.us 8-0500-0003 - 20121212 K U arLPa,kkD., INTRODUCTION.................................................. 1 INSPECTION FOR DAMAGE....................... 1 SAFETY........................................................ 1 CDG Series SPECIFICATIONS.................................................. 2 UNPACKING THE DISPENSER............................. 3 Liquid Dispensers RESHIPMENT........................................................ 3 REQUIREMENTS AND SERVICING ELECTRICAL REQUIREMENTS................... 3 ELECTRICAL SERVICING............................. 3 REFRIGERATION SERVICING..................... 3 CORRECT DISPOSAL............................................. 3 INSTALLATION AND LOCATION.......................... 4 INSTALL STARTUP................................................ 4 KanPak Equipment Service LOADING PRODUCT............................................. 5 PRODUCT LOADING INSTRUCTIONS........ 5 Phone: 800.569.0826 OPERATION.......................................................... 6 Fax: 203.264.7292 MAINTENANCE..................................................... 6 Email: kpservice@kanpa.k.us PREVENTATIVE MAINTENANCE SCHEDULE............................................... 6 DEFROST..................................................... 6 RESET.......................................................... 6 DISPLAY................................................................ 7 LCD.............................................................. 7 LED INDICATOR.......................................... 7 TROUBLE SHOOTING GUIDE............................... 8 KanPak LLC DRAWINGS 425 Main Street North CDG-211 H DIMENSIONS.......................... 9 Southbury, CT 0648E Phone:800.569.0826 or 203.264.7203 CDG-211 HT DIMENSIONS........................ n/a Fax:203.264.7292 CDG-211 V DIMENSIONS.......................... 11 Email:kpservice@kanpak.us CDG-311 H DIMENSIONS.......................... 12 www.kanpak.us CDG-311 HT DIMENSIONS........................ 13 CDG-311 V DIMENSIONS......................... 14 GENERAL PARTS LIST................................ 15 WARRANTY.......................................................... 17 CDG SERIES LIQUID DISPENSERS OPERATORS MANUAL Please Read this Manual Now, And Retain it for Future Reference KanPak CDG Series Liquid Dispensers provides a temperature controlled environment to sustain liquid product, such as cream, milk, and other liquids. The product selections are made by depressing a lever to dispense product.The product is stored in the sanitary interior compartment within the dispenser. The product (cream, milk, etc.) is prepackaged in a Bag-in-Box. Operating the dispenser is a simple two-step process: 1. Place a cup under the product tube. 2. Push lever down for the desired quantity and product. 8' When you receive the dispenser, inspect the exterior of the shipping container for damage. Note any damage in detail. Unpack the dispenser at once (follow the instruction sheet inside the top of the box, or see instructions in this manual). Examine the dispenser for damage. Report any damage to the transportation company immediately. File a claim for damages promptly. Your immediate inspection protects you against loss since KanPak is not responsible for damages incurred during shipment. ti. KanPak, LLC strives to design robust equipment where safety,simplicity and efficiency are paramount. To this effect,the CDG Series has been designed to be low maintenance with a single outside connection (electricity). These features are aimed at protecting both operators and technicians. ,RI SAFETY\PRECAUT.IQNS: \` MR, �\�\\\\ \�Q\�O`�\\��\Q b\\�\ •/j//A� , �\ ,ays plug the dispenser into an approved electrical outlet \ \\ j/jDo not touch,fihe"dis ensr w�thwet; \' \\\ \ hands , , ` \� \\\ /�Urtplug`the`drspenser frog its elec r�,cafzS\ \source before.servrc�ng\�` �• � Do,,rt, t immerse\the dispenserin water l U �\�\,�\ \` \\.\;, \.."\�\���,�� • �b>ser a alhsafey:precautions;wrth this dspenser`that ou would\ o \ \ \\ \ y \\ \\ \\ \ v \O\\\\\\\\\\\\\�\\� ,,\ \\ \\\ electrical`appltanc�` \ \ \ „\\\o\\\\\\ \ ` \\ Ch'Idren,'shoud,b� spprv�s�.d to ensure\ h:at the `dono pla \r �: , MIN \\\\\ \ \ ��:. This appliance is not to be used by persons (including children)with reduced physical, sensory or mental capabilities, or lack of experience and knowledge, unless they have been given supervision or instruction concerning use of the appliance by a person responsible for their safety. Page 1 x t' a'Sa . n�a to m p xx CDG211 H 2 x 2 Y:Gallon Manual Lever Operated Dispenser 77 Ibs 22"x 12"x 25%:" CDG211 v 2 x 2%:Gallon Manual Lever Operated Dispenser 77 Ibs 18%:"x 12"x 32" CDG311 H 3 x 2 Y:Gallon Manual Lever Operated Dispenser 88 Ibs 22"x 16"x 25%:" CDG311 HT 3 x 2%Gallon Manual Lever Operated Dispenser 92 Ibs 24"x 16"x 32" CDG311 v 3 x 2%Gallon Manual Lever Operated Dispenser 88 Ibs 18%:"x 16"x 32" Power Supply Requirements 120 VAC, 60 Hz, 1 Phase, 4 Amp c us Refrigeration Cold Wall Evaporation 1/6 HP Compressor Intertek Intertek 134a Refrigerant, 165 Grams Certifications NSF/ANSI Standard 20 UL Standard 471 CSA C22.2 No.120 KanPak LLC, 425 Main Street North, Southbury, CT 06488 Phone: 800.569.0826 or 203.264.7203 • Fax: 203.264.7292 • Email: .kpservice@kanpak.us www.kanpak.us Page 2 WARNING: Do not attempt to lift the dispenser from the box. Improper lifting may damage the dispenser. • Inspect the box for any shipping damage. • Remove the protective material from the top and sides of the dispenser. • Remove the corrugated tube from the base. • Remove the dispenser, and other material from the box and inside the dispenser; Lift the dispenser from the bottom of the equipment. • Remove the plastic protective covering from the stainless steel exterior, if applicable. • Place the dispenser in its final location. • Retain all of the packaging for future reshipment. CAUTION:Wait 3 hours before plugging in the dispenser to allow the compressor oil to settle. Packaging for reshipment is done in the reverse order of unpacking. If packaging is not available, it can be purchased locally, or from KanPak by request. Any damage occurring in transit of the returned goods caused by improper packaging is not considered a defect covered by warranty. • Be sure the current at the power source receptacle is: 120 VAC, 60 Hz, single phase,4 Amp. • The dispenser is furnished with a UL-approved Tpower cord.The power cord comes with a 3- prong(NEMA 5-15) plug, designed to fit a receptacle with provisions for a grounding stud. The dispenser includes a microprocessor and must be operated on grounded electrical wiring at all times. Failure to do so will void the Warranty. • To avoid an electrical hazard, if the supplied power cord is damaged, it must be replaced by the manufacturer, its Authorized Service Agency or by a qualified technician. Electrical servicing must be carried out by a qualified technician. The Warranty will be null and void if the dispenser is serviced by unqualified personnel. Any servicing of the refrigeration system must be carried out by a qualified technician. The Warranty will be null and void if the refrigeration system is serviced by unqualified personnel. This marking indicates that this product should not be disposed with other household wastes at the end of its working life.To prevent possible harm to the environment or • human health from uncontrolled waste disposal, please recycle it responsibly to promote the sustainable reuse of material resources. To return your used device, please contact the manufacturer,the distributor where the product was purchased, or the local collection system,for details of where and how they can take this product for environmentally safe recycling. Page 3 When locating your CDG Series dispenser, convenience and accessibility to best serve your operation are important considerations, but the following factors must be observed: • Counters, platforms, or shelves should be strong enough to support the dispenser and full containers of product. Refer to the minimum weight specification of your particular model of dispenser. This is the weight of the empty dispenser. • The dispenser requires 3" (75mm)of clearance on either side, as well as a 6" (150mm) clearance on the top. Do not place items on top of the dispenser. Inadequate clearance or covering the top vents will significantly reduce system efficiency and cause damage to the compressor. There are no space requirements for the rear of the CDG Series dispenser. • The dispenser must be placed onto a level surface. • Avoid placing the dispenser too close to a heat source, such as a coffee maker. This would affect the performance of the unit. • Place the dispenser at the appropriate serving height so that staff drawing product from the dispenser can operate the unit properly. • Do not remove the legs from the dispenser or allow the dispenser to sit flat on the counter. Airflow and circulation under the machine are essential for the proper operation of the refrigeration system. Make sure the legs at the four corners of the bottom of the dispenser are in place. If one has loosened during shipping, re-tighten it. Removal of the legs automatically voids the Warranty. + 111 W. Before starting the dispenser, make certain that all Installation instructions have been followed and that the dispenser has been sitting upright for a minimum of 3 hours, to allow the compressor oil to settle. • Connect the power cord into an approved electrical outlet. • Activate the control system and refrigeration by switching ON the power control switch. Power can be confirmed by the following (as applicable): o LCD will indicate "Always Fresh"; o Power LED will illuminate green; o Backlit door display will illuminate. • The temperature control has been pre-set at the factory. Allow the dispenser to run empty for one hour before loading pre-chilled product. Compartment temperature is confirmed by the following (as applicable): o LCD will indicate compartment temperature of 320F to 40OF (0°C to 5'C); o Ready LED will illuminate green; o Interior compartment thermometer will indicate 320F to 40OF (0°C to 50C). • Locate the Drip Tray and install the Bag-In-Box Shelf(or optional accessory). • Load pre-chilled KanPak product of your choice, as instructed. • Close the dispenser door and secure latch. Page 4 ty+..F^ �Z GAD D , Go KanPak CDG Series dispensers are manufactured to be used in with prepackaged Bag-In-Box products. TO LOAD PRODUCT IN THE CDG SERIFS DISPENSERS PARR CARGAR EL PRODUCTO EN LOS DISPENSADORES DE LA SERiE CDG • Wipe down the inside of the unit to avoid fmr t buildup 1 Lupin$el interior ire la uni dad Para evitar la acuniulaci6n de escarclia, r�iways ipaci �ectitteti l�rotluct f Sit=mpse cargos el prilclucto}+a refra �ri�, IN Sys • Open the main refrigerated Abra la puerta del.compartimiento compartment door of the dispenses refrigerado.principai,del dispensador. Turn the black thumbscrew on the white Votteeof tomiiio negro de la Alvula A.o- valve counterclockwise to open valve, bianca hacia la lzquierda,para abrir la y • Wipe down the inside of the unit to vaivula. -x•; avoid frost buildup. + Limpie of interior de la unidad para evitar la acumulacibn de escarcha. • load the prechilled"Bag in Box"dairy • Cargue et producto lacteo ya retrigerado product into tie dispenser on the "Balsa en raja"en el dispensador,sobre r product platform provided, la plataforma provista. N • Ensure the dispensing tube is centered in • Compruebe give el tubo de suministio „< the dispensing valve and on the platform. esit centrado en la vaivula dispensadora + The tube must not be pinched or bent. yen is pla4nfarma. • El tuba(to debe estar pisado m tlnblatlo. r' :r. .. e : a ` • With the dispensing hrbe centered in Cuando el hrbo dispensador este centrado tie vatae,.close the valve door and turn en la v3lvula,cierre la puerta de la vaivula Die black thumbscrew on the valve door y gire el tomillo negro de la vaivula hacta clockwise to secure. la derectia,para cerrar. Ensure that the valve door is completely Compruebe que la puerta de la vaivula closed and the dispensing tube is not quede completamente cerrada y que el pinched in the valve door when the tubo dispensador no estd pisado en la thumbscrew is lightened. puerta de la vdivula,al apretar el tormllo. • To avoid valve breakage,do not over- No apriete demaslado of torniilo,para tighten the thumbscrew, evitar que la vatvuia se parts • Obtain sanitized scissors. • Consiga tijeras desinfectadas. .F. • Cut the dispensing tube diagonally Corte el tubo dispensador diagonalmente, approximately 1/4"below the bottom aproximadamente 114"per deba_jo de la of the valve. parte inferior de la vdtvuia. Discard the cut portion of the dispensing • Deseche la parte cortada del tutor tube; dispensador. Close the main refrigerated compartment • Cierre la puerta del comparlimiento door and latch of the dispenses refrigeraeo principal del dispensador. •The machine is now ready to dispense! • ilamaquina ya esfa lista para dispensal • Each time product is loaded,wipe douvi'i rite inside of the snit to avoid frost buildup f t;Aa vez clue r;`etgue el producto.huiplie el interim ire la unid d para evitar la aouniulac&de escarchn. • Always load prechitled product J aiernpre cargue el prr"ducto ya refri era€io. • Ensure the dispenser has achieved proper operating temperature by running empty for one hour before loading pre-chilled product to be dispensed. • Product must be pre-chilled prior to loading it into the dispenser. Product temperature range must be between 32•F to 40OF (0•C to 50C). Page 5 When the initial startup is complete, operating your CDG Series dispenser is simple. • Place cup under the product tube. • Push lever down for the desired quantity and product. • Load product as needed. • Perform preventative maintenance as outlined. Though the preventative maintenance of your CDG Series dispenser is minimal, these few steps are important for continued operation to maximize the life of this appliance. RECOMMENDED PREVENTATIVE MAINTENANCE SCHEDULE Drip Tray Daily Wash using warm, soapy water or in dishwasher. Exterior Cabinet Daily Using a soft cloth, wash using warm, soapy Surfaces water. DO NOT use abrasive cleaners. Refrigerated Interior Each time product is Using a soft cloth, wipe down and thoroughly Compartment loaded. dry to remove any condensation. Monthly, or as needed. Manually defrost when there is ice build-up. Valve Assembly and Monthly, or as needed. Wash using warm, soapy water or in Area dishwasher. Condenser Every six (6) months. Clean using vacuum. DEFROST The CDG Series dispensers are equipped with an automatic defrost cycle to minimize frost build-up. The defrost cycle reduces but does not eliminate the need for a manual defrost. Frost or ice will reduce the system efficiency. When frost or ice is build-up is excessive: • Remove product from the dispenser. • Turn the power control switch OFF. • With the compartment door open, wait 15 minutes for ice to melt. • Remove ice gently, and wash using warm, soapy water. • Thoroughly dry with a soft cloth, and close the compartment door. • Turn the power control switch ON. • When proper operating temperature is achieved, load pre-chilled product. RESET Occasionally, it may be necessary to reset the control system. To accomplished this, simply: • Turn the power control switch OFF. • Wait 5 seconds to reset the microprocessor. • Turn the power control switch ON. Page 6 P . ' SEEM The CDG Series dispensers have multiple display options available. Reference the applicable display option(s) for your dispenser. LCD CONFIRMS POWER ALWAYS FRESH • LCD turns ON by switching the power control switch ON. o "ALWAYS FRESH" = Power is ON. o No display= Power is OFF. INFORMATION DISPLAYED ALWAYS FRESH 35 F • LCD indicates the compartment temperature. o "ALWAYS FRESH" +flash compartment temperature. • LCD indicates the compressor cycle. ---------- o Asterisk"*' identifies compressor cycle in progress. ALWAYS FR!�� o "ALWAYS FRESH"+alternately flashing asterisk and ALWAYS FRESH compartment temperature. • LCD indicates the automatic defrost cycle or service. o "ALWAYS FRESH DEF" =Automatic defrost in progress. r o "ALWAYS FRESH ERR" =Service is required. ALWAYS FRESH DEF': Contact KonPak Equipment Service when unit requires servicing. LED INDICATOR CONFIRMS POWER _ —...—� ;........_................. • POWER LED turns ON by switching the power control switch ON. .................. - o Solid Green = Power is ON. o No light = Power is OFF. INFORMATION DISPLAYED • READY LED indicates the compartment temperature. o Solid Green =Temperature is 32°F to 41°F (0°C to 5°C). `I o Flashing Green =Temperature is 427 to 46°F(5.6°C to 7.8°C). o No Light=Temperature is not 32°F to 46'F (0°C to 7.8°C),or automatic defrost cycle in progress. • DEFROST LED indicates the automatic defrost cycle or service. o Solid Yellow=Automatic defrost in progress. o Flashing Yellow=Service is required. o No Light= Defrost is not in progress. Contact KanPak Equipment Service when unit requires servicing. Always allow the dispenser to run empty for one hour to achieve proper operating temperature. Compartment temperature during normal operation should be 32OF to 41 OF(0°C to 5°C). Page 7 � ffi No power, display, or Power switch is not turned ON. Reset the power control switch lights (as applicable). located on the lower left side of the unit. Turn the switch OFF, wait 5 seconds, then turn the switch ON. Circuit breaker on the dispenser is tripped, indicated Reset the circuit breaker located on by a white strip on top of the the lower left side of the unit (below breaker button when popped the power control switch). Depress out. the breaker button to reset. Power cord is not plugged in. Ensure the dispenser power cord is plugged into a functioning outlet. Depress the reset button of a GFI outlet if equipped. No power at the outlet. Have a qualified person check the in-store circuit-breaker to restore power to the circuit. Dispenser will not Product tube is not inserted Verify the product tube is installed dispense product. properly. correctly, and is not pinched, twisted or bent. Dispenser is leaking Valve door not fully closed. Confirm the valve door is fully product. closed and the thumbscrew is tightened securely. Product tube is not centered. Ensure the product tube is centered properly in the dispensing valve assembly. Product accumulation within Clean the valve assembly and valve assembly. surrounding area. Display/compartment Vents are covered. Remove obstructions blocking the temperature is too vents located on the top rear of the warm or too cold. unit. Defrost cycle just completed. Check the temperature again after 15 minutes have elapsed. Compartment has ice and/or Perform the standard preventative frost build-up. maintenance (PM) as outlined. The temperature control Contact KanPak Equipment Service. requires adjustment. ERR on Display, or The unit requires servicing. Contact KanPak Equipment Service. Flashing Yellow LED Page 8 12.0; 305 I C 20.71 22 526 560 yy C 13.7' 348 1 25.8 1 656 �.. . � t I 9.2. 2.8 a a � 233 70 I ' KanPak MODEL CDG-211 H Page 9 E This page is intentionally left blank. i Page 10 � P 12.0' 3 305 [14.8E 18A l 376 458 j t .........................._..........................,.......................... 4 { 133 I 348 I I � �....... i 1 i i3t 810 ; �J 9:2 1.OE 25 233 L..............—' Y. y......................-....._: KanPak MODEL. CDG-211 V I t I Page 11 Y 16.01 j i 20.71 22 SZ6 560 k� i I I I ! i j .............. ` f 17.71 450 i I 1 I ........................ a_ [25.8li 656, 9.2 i ( 2.8.1 233 a a _.._.. _ 70 i C - ,... .. I .KanPak MODEL CDG-311 H Page 12 16.0 ............................ 407 20.7 526 24.1) 613 r 17.7' 450 --- t � I 32; 810 i { i 9.31 2.8 • � e 235 _ �... 70 ...r. r.:........._......_ KanPak MODEL CDG-311 HT Page 13 f Ing OUR, . r z r s 1as �. a ........._......_ 16.0 407 j i i 14.8] 376 18.2' 463 I I �1 'I .............................................................................................. ........ 1 f [17.7] 450 ......._....... i l , 1 32 810 Ll i 1.0 234 25 I KanPak MODEL CDG-311 V Page 14 rrum 6E5[g11niON 1 ILeg Assembly ................................................_....._......__..........__................_.......... , la (Lower Adjustable Leg Foot t__........_L._...._...._.....__........__.____....,.._.__..._.._...._..__......._... l 2 !Bagdn-Box Tray _ — ..... 3a dCompressor Starting Relay 3b ConprtssorTf trial Uvcdcad Pwtectw \o/ \ `,`� ......Q.. Condenser AzsembN ................................ 5 'Filtef Dryer �`\ .......:........._.._._....._..........._........_.._......._.. \\ l 6 ICabinet Door Assembly 7 !Door Latch Hook Bracket �� \ i Assembly, ................. 9 'Door Gasket 1 } .... ... ..... .to 17 LCD Assembly ., i•; ! t 1 �� ....12,,,.., �,..,13 Eear cal line Filter ..._ u Sth Assembly c ... 1c Pow _...._. .. _._. ...... 15 lRear Access Cover Panel i r 16 imain Relay 17 'Front Lower Access Cover Panel 1 98 ;... itgreaker 19 (PCB-Control Board _._..._.,.._._...___._.. ....�_..,,.. ........._._._.., 20 'Valve Lever Assemby _.......................................................................................................... : %�-/ ..._21...aVatve:5pring......................................................................... ; 22 jVai a Plunger _.�.23 H nge Assembly ... .. ......_ t .... 24 Door latch Assembly ` \ \t 25 �Vaive Doar Sub-Assembly mm t \ ~`"�•.. 2.6 JRea VaWe Door Block I•� •\ \ T��la� 27 ITemperature Sensor(not shown( ....... .............. .... 28 !Thermometer Assembly(not shown) t \� 29 W—e,Co,d(nntshown) \B) �IJI :�19f c12, 113� �16 .......t............................:............................_._........__........__......... .. _. 30 iNckaglng Kit(not shownj Page 15 GENERAL.PARTS LIST Item No.IternDescription 1 Leg Assembly 1A Bolt-Leg 18 14 21 22 20B.. 23 27 10 4 15 2 Sao-in-BoxTray 3 Compressor 9 3A Compressor Starting Rely 313 Com r.Thermal O.L-Protector 4 Condenser Assembly 25A 5 lFilter Dryer 6 Cabinet Door Assembly 25 7 Door Latch Hook Bracket 8 Drip Tray Assembly. SA Top brip.Tray Insert. 8B Bottom Drip Tray Support b , 9 Door Gasket 10 Fan r LCDAssemblTransformer 7 Electrical One Filter Power Switch Assembly Rear Access Cover Panel Main Relay - 3 17 Front Lower Access Cover Assy 18 Circuit Breaker 19 PCBAssembly ZOA 5 20 Valve Lever Assembl 20A Valve Lever Handle 0' 20B Valve Lever Bracket 24 21 Valve Spring 22- Valve Plunger \ 26 .23 Hinge Assembly 24 Door Latch Assembly 25 Valve Door Sub-Assembly 16 25A.Rear Valve Door Block -26 IValve Door Sub-Assembly 26A Rear ValveDoorBlock 13 27 PCB Support_Panel 28 LED Assembly 29 Power Cord not shown). 2 8 17 - 19 11 28 1. 12 Page 16 All dispensing equipment manufactured by KanPak is warranted against defects in materials and workmanship for a period of one(1)year from the date of purchase. This Warranty does not apply to installation or problems because of installation. This Warranty does not apply to normal preventative maintenance,maintenance or adjustment. This warranty is subject to the following conditions: • This Warranty applies to the original owner only and is not assignable. • Should any equipment fail to function in its intended manner under normal use within the limits defined in this Warranty,at the option of KanPak such equipment will be repaired or replaced by KanPak or its Authorized Service Agency. KanPak will be responsible only for charges incurred or service performed by its Authorized Service Agencies. The use of other than KanPak Authorized Service Agencies will void this Warranty and KanPak will not be responsible for such work or any charges associated with such work. The closest KanPak Authorized Service Agency must be used. TIME PERIOD One Year on parts and/or labor,effective from the date of shipment unless otherwise specified. KanPak reserves the right to replace a unit in warranty in lieu of a service call. The Authorized Service Agency may,at its option,require proof of purchase. Parts replaced under this Warranty are warranted for the unexpired portion of the original equipment warranty only. A service consultant is available to assist you during our normal business hours. All service-related issues will be addressed by a return telephone call the next business day. WARRANTY PROCEDURE 1. Secure the model and serial number from the data label on the lower left side of the dispenser. 2. Call the phone number(1.800.569.0826 or 203.264.7203)provided on the service label on the dispenser. 3. The service agency will discuss the issue with the operator and determine if parts or servicing/replacing the dispenser will resolve the issue. 4. If parts are needed,the appropriate parts will be sent to your location. 5. If a dispenser needs to be serviced/replaced by the KanPak service department(at the discretion of the KanPak service representative),KanPak will provide the operator with a Return Material Authorization(RMA). 6. The operator will arrange for the out-of-service dispenser to be shipped to KanPak in Southbury,CT. 7. Once the out of service dispenser is received by the KanPak service center and it has met the conditions of the warranty,KanPak will cover the shipping costs to ship a dispenser back to the customer's original shipping location. WARRANTY EXCLUSIONS The following conditions are not covered by this Warranty: • Equipment failure related to improper installation,improper utility connection or supply,and problems due to ventilation. • Equipment that has not been properly maintained,calibration of controls,adjustments,damage from improper cleaning,and water damage to controls. • Equipment that has not been used in an appropriate manner,or has been subject to misuse or misapplication, neglect,abuse,accident,alteration,negligence,damage during transit,delivery or installation,fire,flood,riot,or act of God. • Equipment on which the model number or serial number has been removed or altered. If the equipment has been changed,altered,modified or repaired by other than a qualified service technician during or after the warranty period,then the manufacturer shall not be liable for any damages to any person or to any property,which may result from the use of the equipment thereafter. This Warranty does not cover services performed at overtime or premium labor rates. Should service be required at times which normally involve overtime or premium labor rates,the owner shall be charged for the difference between normal service rates and such premium rates. KanPak does not assume any liability for extended delays in replacing or repairing any items beyond its control. In all cases,the use of other than KanPak authorized OEM replacement parts will void this Warranty. This equipment is intended for commercial use only. Warranty is void if equipment is installed in other than commercial applications THE FOREGOING WARRANTY IS IN LIEU OF ANY AND ALL OTHER WARRANTIES EXPRESSED OR IMPLIED,INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS AND CONSTITUTES THE ENTIRE LIABILITY OF KANPAK IN NO EVENT DOES THE LIMITED WARRANTY EXTEND BEYOND THE TERMS STATED HEREIN. Page 17 KanPak LLC 425 Main Street North Southbury, CT 06488 Phone:800.569.0826 or 203.264.7203 Fax:203.264.7292 Email:kpservice@kanpak.us www.kanpak.us BACK MOUNT MEGA-TOP SANDWICH PREP. TABLES Back Mounted Condensing Unit U E R E S T www.EVERESTref.com mw 11 z 3 .O NO or, n n ... Oft A EPBR1 A EPBSR2 A EPBR2 ha. t � �Kll s ak / s . A EPBWR2 s EPBR3 Cabinet Construction ors _ ......... Heavy duty stainless steel interior/exterior with rounded corners for a hazard- Heavy duty stainless steel interior/exterior. free workspace. 2.5"thick high density polyurethane insulation. 16 gauge,high quality stainless steel worktop,lid and hood. Frame heaters prevent exterior moisture build up. Galvanized steel bottom and rear. Self-closing with adjustable torsion system for a positive seal. 2.5"thick high density polyurethane insulation. Snap-in magnetic door gasket make cleaning and replacement an easy process. Four 5"swivel casters with locks on front set. High strength,recessed door handles. I Refrigeration System Preparation Area _-M.........._ .. ......... Mega top fits three rows of NSF certified polycarbonate 6"deep pans(see table Back mounted,self-contained and fully detachable Blizzard R290 condensing unit uses environmentally friendly,EPA-compliant R290 refrigerant with zero(0) for size and quantity). Ozone Depletion Potential(ODP)and three(3)Global Warming Potential(GWP). /z"thick,foam insulated lid keeps top pan area cold and prevents moisture build-up. Blizzard R290 is easily replaceable and requires no on-site brazing. 91/8"deep cutting board is removable for ease of cleaning. Front air breathing for flexibility in installation. Electronically commutated(ECM)fan motors achieve rapid cooling with less Shelving energy consumption. One epoxy coated,steel wire shelf per section. Full-length air duct system ensures optimal circulation of cold air. Height adjustable stainless steel clips. Time-initiated and temperature-terminated auto defrost cycle for seamless operation. m Large capacity,corrosion-resistant condenser and evaporator coils. Temperature Control Self-maintaining,energy-efficient condensate drain pan requires no external Multi-function digital controller with easy to read LED display. drains or electric heaters. Factory preset temperature,35°F.Temperature setting range from 33°F to 54°F High performance,auto-reverse condenser fan motor supports compressor Audible overheat protection alarm for compressor and condenser coil. ventilation and condenser coil cleaning,Refer to owner's manual for full maintenance instructions. — � Pressure relief devices allow smooth access to cabinet interior when re-opening 1 Options doors. NSF certified stainless steel double overshelf. Pre-wired and ready to plug,11 5V/60Hz/1 Ph,NEMA 5-15P. Additional shelving. 3"swivel casters with locks. 3.5"—6"height-adjustable and interchangeable legs. Left hinged door(applies to EPBR1). /,w� !!iifl��lalll�',9'y�r�'r�;j!''�'• �' 201 W.Artesia Blvd.,Compton,CA 90220 T.(310)323-6586 F.(310.)323-7524,(310)761-1127 �Dimensions v Side View 23 31 1/2" i��i/ �� 716 OOO i 116 OOO L f 0000 0000 0 9r-1/8 A i iA i W A N I —n 27 3/4" 35 5/8" t_ 1O _ 41 _ 00 17 1/8"ou ! CD00 w � CD CO W 'i 26 1/2" 17" 17" 26 3/4"` A N N AN N Equipped with 9 ft long NEMA 5-15P plug. - J ,,Mounting.spa overshelf s EPBR1 EPBSR2 43 1/4" 55 1/8" 66 7/8" 9OOOOO. 1/6 116 OOOOO OOOO 000000 0coo OOOO OOOOOO OOOO OOOOOO I NOA 0000 OOOO 00 000 0000 � I N W ___.... ....---- W .... ....... _ ...._... __... W .___._ A ___ ______ -_-___ 471/2" ---- 591/8" 711/8" 1 v2'��J J:j�11/2° 1 tl2'�`J J�j� J J�i1 22 3/�4 3/4' $ o N N I 28 3/4 C) C N 22 3/4 i_ 22 3/4 ;3 �22 3/4" $ C I N N A V. : I FTTR[I CL@L CinYR EPBR2 s EPBWR2 EPBR3 ExtenorDimension Ref! :r Crated #of capacity #of #of Power (Inches) Model Frz/ Doors (Cu.Ft.), HP Refrigerant Shelves Pans (V Mz Ph) Amps Weight Dual (LBS) L Db H* -, .., _ -. ... �>-C...�°`.k.,,.� .Ta. „m Tw._-,_ fir•-... _ .:..�,X�w� .'r. .. ,.,..,ia.,��.%a�".,,z.-. ,��'� .....: .... .. ... _......a.,.,-r,..,,A... ,. ..�: ,n.. ___ ._a. .< EPBR1 Ref 1 8 1/5 R290 1 1/6 x 12 115-60-1 2.50 230 27 3/4 351/4 381/2 EPBSR2 Ref 2 10 1/5 R290 2 1/6 x 12 115 60-1� MO, 272 35 5/8 � 351/4� 381/2 EPBR2 Ref 2 13 1/4+ R290 2 1/6 x 18 115-60-1 3.50 339 471/2 351/4 38 1/2 EPBWR2 Ref 2 16 1/3, R290 2 1/6 x 24 115 60.1 2.50 393 . 59 1/8 351f4 38 1%2 EPBR3 Bet 3 19 1/3 R290 3 1/6x30 115-60-1 2.50 455 711/8 351/4 381/2 _. ._ _...... _ *:Height does not include 5"for casters. Bet=Refrigerator b:Depth includes 91/8"cutting board. Da,Db:Interior Depth Ha,Hb:Interior Height r[LTI_ LTI. Specifications subject to change without notice. ` `CI0- \I Y Us Product dimensions are for general purposes and not absolute value.Product capacity is calculated based on standard Please visit our website for updated industry figures.Slight variations may exist.If dimensions and capacity are critical,please contact Everest Refrigeration. Energy Efficiency information. APO"9099SUR COMMERCIAL-GRADE daff"a"Oc""o RESIDENTIAL ELECTRIC WATER HEATERS PROLINED COMMERCIAL-GRADE RESIDENTIAL ENHANCED HEATING 9 Designed for easy operation, ELEMENTS this valve includes an integral •Dual 4500 watt elements for faster screwdriver slot that features a 1/4 recovery and reliable operation.* turn (open/close) radius, which not •Incoloy stainless steel lower only permits full straight-through element lasts longer than a water flow but also a quick and � standard copper elemon � positive`''-^ ~^. CODE COMPLIANCE SELF-CLEANING DIP TUBE °Meets UBC' and |CCNational *Helps reduce lime and sediment buildup and maximizes hot water Code and listed with CEC. output. Made from long-lasting *Complies with the Federal Energy PEX cross-linked polymer(se|f- Conservation Standards effective cleaning design ia not used on April 16. 2015. in accordance lowboy models). with the Energy Policy and HIGHER EFFICIENCY Conservation Act(EpCA). au amended. *Eoo'friend|ynon'0F{)foam insulation, heat traps and other APPROVED FOR features combine toyield a higher MANUFACTURED HOUSING Uniform Energy Factor that *A|| residential electric vvotor maximizes savings;onoperating heaters are compliant with HUD costs. standards for mobile homes/ � manufactured housing. ����RE��ARD ANODE ROD CERTIFIED TOUL174FOR °Our anode rods have ustainless HOUSEHOLD ELECTRIC WATER steel core that extends the life of HEATERS the anode rod allowing superior tank protection far longer than CSACGRT|F|ED ANDASK8E standard anode rods. RATED T@9 RELIEF VALVE � BLUE D|AyNON0wGLASS DESIGN-LISTED BY COATING UNDERWRITERS *Provides superior corrosion LABORATORIES resistance compared to industry' ~Certified at 308 psi test pnanauna � standard glass lining. and 150 psi working pnaaouna � � � ENHANCED-FLOW BRASS DRAIN VALVE *Unt*d according 0oUL174 standards governing storage ^Our residential water heaters have tank-type electric water heaters. 000|id bmna. tamper resistant, G��E�RL|KH|TEOTANPCLlK8|TED enhanced-flow, ball type, drain valve. PARTS WARRANTY � � °Uses a standard female hose °For complete information, consult fitting that aU w��anwmna�yorQotonwafortsotand easy amerioanvvutorheatecoom . dn�ningduhngm�n1enunoe. � - --- -- --- - *Model em20L has a single element. / Page 1mu � www.americanwaterheater.comm call(800099*oo|Copyright C January xo1oovAmericuno Water Heaters All rights reserved. wns000mn -� COMMERCIAL-GRADE RESIDENTIAL ELECTRIC WATER HEATERS W A T E R H E A T E R S ;.g Recovery. a1� 5a Nominal Rated First Hour " c Element Wattage 2401/ D:mensrons m Inches „ Approxt r Model Number Storage Rating tJEF 80 F Rise + Shipping r Capacity Ga11on Peat .,' �" volume (Gallpns) �xHour Strtdard Mini,`mumMax:mum .. . A B 01 � Wei9ht,(Ibs); 7a)1 Models:: 7-77-7,77777 tE6N-30H 30 27 48 0.89 21 4500 1000 6000 46-1/2 39-1/2 19 95 tE6N-40H 40 36 53 0.92 21 4500 3500 6000 61-1/4 53-1/4 18 118 tE6N-50H 50 46 62 0.92 21 4500 03000 6000 60-1/2 51-1/4 20-1/2 125 tE6N-50HW 50 46 45 0.88 11 - 1000 2500 60-1/2 51-1/4 20-1/2 125 tE6N-55H 55 55 72 0.93 21 4500 2500 6000 56-1/2 48-1/2 24 145 Short Models � �3.. 3,ix xlk +, ��fet. E6N-30RB* 30 27 50 0.90 21 4500 1000 6000 39 30-1/2 20 95 tE6N-30R 30 27 1 47 0.89 21 4500 1000 6000 39-3/4 30-1/2 22 94 tE6N-40R 40 37 55 0.92 21 4500 4500 6000 49-3/4 40-3/4 20-1/2 109 tE6N-40RW 40 37 41 0.88 18 - 1000 4000 49-3/4 40-3/4 20-1/2 109 tE6N-50R 50 46 57 0.92 21 4500 2500 6000 49-1/4 40-3/8 23 161 Lowboy Top Connect Model's „ .__. E6N-20L 19.9 19 N/A N/A 1 21 4500 1 1000 6000 30 21-1/4 20 65 tE6N-30LB* 28 - 26 43 0.89 121 4500 1000 6000 30 21-3/4 20 90 tE6N-30L 28 26 44 0.90 21 4500 1000 6000 311/4 21-3/4 24 115 tE6N-36L 36 33 51 0.92 21 4500 @ 4500 6000 32 24 24 118 tE6N-36LW 36 33 37 0.89 18 - 1000 4000 32 24 24 118 tE6N-40L 38 35 50 0.89 21 4500 1000 6000 331/2 24 26 118 tE6N-40LB* 38 35 51 0.92 21, 4500 @ 4500 6000 32 24 23 118 tE6N-40LBW* 38 35 38 0.90 18 - 1000 4000 32 24 23 118 tE6N-50LB* 48 44 60 0.93 21 4500 @ 4000 6000 34 25 26-1/2 172 tE6N-50LBW* 48 44 40 0.91 16 1000 3500 34 25 26-1/2 172 tE6N-50L 1 51 48 54 0.92 21 4500 4000 6000 1 36 1 25 1 26-1/2 172 Male 3/4"water connections on 8"center. 'Models ship with supplied insulation blanket. tFor 10-year tank and 10-year parts limited warranty,change"6"to"10"in the model number(example:E10N-401-1). E6N-20L is a single element configuration only Models requiring a lower wattage than what is listed in the minimum wattage column and showing the @ symbol,will change to a"W"suffix model number. "W"suffix models are available down to 1kW.(example:E6N-40R using 4,000 watt elements or less will become"E6N-40RW"). Top T&P is not available on the 10 year lowboy models. Dimensions and specifications subject to change without notice in accordance with our policy of continuous product improvement. ANODE OR OPTIONAL TOP T&P T&P VALVE LOCATION FOR E6N-20L ACCESS SECOND ANODE ROD FOR LOWBOYS PANEL OR OPTIONAL TOPT&P (All Other Models) I 0 O C B A C O O JUNCTION BOX ACCESS 1 O T&P VALVE PANEL DRAIN VALVE For technical information call(800)999-9515.American Water Heaters reserves the right to make product changes or improvements without prior notice. American Water Heaters 15500 Princeton Road(FEDEX,UPS),Johnson City,TN 37601-2030 Page 2 of 2 P.O.Box 1597(Mailing),Johnson City,TN 37605-1597 NRESS00117 ��/r` ,�' �'/ rfr!�y� f? ��,G•�� �/i��,r�� - %ii'"rho �S t � o < y, y�. CHEF BASES � 61 INO 3 Features •CFC free refrigerant and foam insulation •Electronic thermostat and digital LED temperature display for accurate control and easy reading f •Easy to mount 4" casters (two lockable in front) are standard with all units •Magnetic gasket can be replaced without any tools „.s •Stainless steel framework construction "9 •Auto defrosting and auto evaporation of condensation water •4" PC pans not included. Note:this unit cannot accommodate 6" PC pans. '. 4 •Raised marine edge contains spills •Exterior: 430 stainless steel top, front &sides. Aluminum back panel. F a •Interior: Aluminum with a 304 stainless steel floor •Temperature: 33 to 41°F/ 0.5 to 5°C •Electrical: 1 15/60/1 with NEMA 5-15P plug Specifications ' MODEL DRAWERS EXT DIMENSIONS AMPS H.P. SHIP 'Q U W x D x H WEIGHT ' rx KCBR-48 2 50 x 31.9 x 26 5.8 1/3 162 Ibs KCBR-60 2 62 x 31.9 x 26 5.8 1/3 200 Ibs KCBR-72 4 74 x 31.9 x 26 5.8 1/3 232 Ibs Options k See page 34 for pan configurations for units. CERTIFIED TO ANSI NSF-7 STANDARDS � !� C US Intertek Intertek 5659 Royalmount Ave. 12000 Biscayne Blvd.,Suite#108 '; Montreal,OC,Canada 1-14P 2P9 Miami,FL,United States 33181 " Telephone:514.737.9701/Toll Free:888.275.4538 Telephone:786.600.4687/Toll Free:844.218.8477 Fax:514.342.3854/Toll Free:877.453.8832 Fax:786.661.4100 n { G R O U P sales@mvpgroupcorp.com/mvpgroupcorp.com b«,, rr �;y / ��/y�,�+J, r��$r3�an// ��'�rr f�... r yfi[�.. '7,�a`��`^."� .�a ✓ a :.•, � ^�.,. nl CHEF BASES ' f f- A �. r 36.2(919) 50(1270) £ 32.2(61 48 1219 a � 31.9(810) v7- > 31.4(798) 13(330) 29.9(759.2) y � o❑ I I :t v _ o g ti ;s a;s 9 48.2(1225) 62(1576) 44.3(1125) 600525) 31.9(810) 43.50104) 13(330) T. gg o❑ I I / - 3 r� z - 60.2(1529) 74(1880) 56.3(1429) 72(1829) 31.9(810) 25.6 650 25.6 650 13(330) 29.9(759.2) / I I � i.a Dimensions in inches (mm) E1� 0�i� usCERTIFIED TO ANSI/NSF-7 STANDARDS M. � C Intertek Intertek 5659 Floyalmount Ave. 12000 Biscayne Blvd.,Suite#108 Montreal,QC,Canada 1-14P 2P9 Miami,FL,United States 33181 Telephone:514.737.9701/Toll Free:888.275.4538 Telephone:786.600.4687/Toll Free:844.218.8477 Fax:514.342.3854/Toll Free:877.453.8832 Fax:786.661,4100 GROUP sales@mvpgroupcorp.com/mvpgroupcorp.com i< BUNN® ITEM# UltraTm High Performance PROJECT Frozen Beverage System with 2 Hoppers DATE Ultra Gourmet ice® System • Reversing auger design quickens freeze time and reduces air mixing. Very simple to program and run with touch ad display,which also guides cleaning Y P P 9 P 9 9 and preventive maintenance. • Refrigeration system internally monitored to ensure long lasting performance. k • Large 3 gallon (11.4 litre) hoppers for optimum cooling and serving capacity. c • Full 2-year parts and 1-year labor warranty.5-year parts and 1-year labor warranty F, on compressor and 3-year parts and labor warranty on electronics. See the product manual for additional details. :j Sanitation listed by NSF to Standard 6 and 18(including dairy&alcohol) and safety listed by ETL to UL Standard (UL 471)and CSA Standard (C22.2 No. 120). White/Stainless, Black,Stainless and all Black finishes available. a � High Performance versus standard model comparison: Ambient Room Temp. Ultra-2 HP is: 70OF 17% Faster freeze down time 80OF 21% Faster freeze down time gpz 90OF 32% Faster freeze down time y1 %' Note:The higher the ambient temperature,the greater the improvement. Ultra-2, HP Dimensions: 31.9"H x 16"W x 24.5"D (81 cm H x 40.6 cm W x 62.2 cm D) For current specification sheets and other information,go to www.bunn.com. AFPO-2 SL Autofill Liquid Autofill Kits(LAF) CDS-2 Hopper Kit(black) System(Post-Mix) For use with external brix pumps. Product No.:28485.0043 Product No.:28400.0007 Product No.:37960.0000(4 water lines) Dimensions:7.8"H x 17.5"W x 12.7"D Product No.:37960.0001 (2 water lines) CDS-2 Hopper Kit(no lid) 19.81 cm H x 44.45 cm W x 32.26 cm D Product No.:28485.0044 Conversion Kits Kits convert hoppers on CDS-2 machine to pp CDS-2 Hopper Kit(flat lid) � new ULTRA-2 style hopper/faucet. Product No.:28485.0045 CDS-2 Hopper Kit(white) Product No.:28485.0042 Kit for Ultra-2 Lid Lock Kit for Ultra-2 Lid Lock Kit Part Number: 34996.0000(white) Part Number: 34996.0001 (black) Kit for Ultra-2 Lid Lock and Handles Kit for Ultra-2 Lid Lock and Handles Part Number: 34996.0002(white) Part Number: 34996.0003(black) CW Kit for Ultra-2 Handle Lock Part Number: 34996.0004(white&black) Model Agency Listing ULTRA-2, HP � a Central Restaurant Products Dimensions & Spech icat►ons Model Product# Volts Amps Capacity Cubic Shipping Cord Measure Weight Attached ULTRA-2,:HP(Stainless/White); 34000.00.79, 120 12 2 Hoppers@3.0 gal 14.9 W, 137 lbs. , Yes* ULTRA-2, HP (Stainless/Black) 34000.0081 120 12 2 Hoppers@3.0 gal 14.9 ft3 137 lbs. Yes* ULTRA-2, HP(Alt Black) 34000.0080 120 12 -2 Hoppers@`3.0 gal. 14.9,ft3 137 lbs. °Yes 'Power cord(NEMA 5-15P) 15 Amp-120V machine only. Electrical: Models require 2-wires plus ground service rated 120V,single phase, 50/60 Hz. 0 0 II II a II II II II a 24.5 e o ll o II o O O 16.0 a s i I II I I I I 1 1 I I I I I I I I I c O 0 31.9 I I I 10.6 I I I I I 11.5 v REAR LEGS� 8.3 14.0 2.2 12.1 FRONT LEGS Bunn-O-Mati&Corporation-1400 Stevenson Drive Springfield,Illinois 62703.800-637-8606.217-529-6601 •Fax 217-529-6644•www.bunn.com BUNN"practices continuous product research and improvement.We reserve the right to change specifications and product design without notice.Such revisions do not entitle the buyer to corresponding changes,improvements,additions or replacements for previously purchased equipment. All dimensions shown in inches. 711008unn-o-Madccorpomdon Central Restaurant Products Ocean Street Market 50 Ocean Street, Hyannis, MA, 02601 Equipment Spec Sheet Item Item Description Manufacture company Model NO. Serial NO. No. 1 Walking Cooler 9 Door Tyler Refrigeration Corp. 7400260SPL 9863215DI 27'L x 9'W=243 sq.ft Walking Cooler Division, Olive Branch, MS. 2 Walking Cooler 2 Door CCI Carroll Coolers Inc. 16897 27001 13.5' L x 9.5'W=128.25 Sq,Ft BTU 14780 3 3 Door Freezer True GDM72f 4 Mop Sink KCS Metal Products KCSD316-1818-1 5 Three Bay Sink 56"L x 24"W Advance Food Service Equip. N/A N/A 6 Hand Sink Advanced Tabco 7-PS-60 7 Coffee Brewer Machine Bunn Dual TF DBC- Dual 146314 34600.0007 8 Grease Interceptor Watts WD-25 9 Water Heater Tank American Water Heater E6N-50H 120 1906113648367 10 Chef Base Refrigerator ikon KCBR-60IN 8066283 10 Sandwich Prep Table Everest Refrigeration EPBR2 BPBR218120031 11 Frozen Beverages Dispenser Bunn ULTRA-2 UL TR264276 12 Cream Dispenser KAN-PAK Dispensing Equip. CDG211 2110-6198 13 Sandwich Show Case OMCAN DC120-HC-BK 186750 14 Hand Dryer Fast Dry HK-JA AIA# TRUE FOOD SERVICE Project Name: ® EQUIPMENT, INC. Location: 2001 East Terra Lane•O'Fallon,Missouri 63366-4434•(636)240-2400 Item #: Qty, SIS# Fax(E36)272-2408•Toll Free(800)325-6152•Intl Fax#(001)636-272-7546 Parts Dept.(800)424-TRUE•Parts Dept.Fax#(636)272-9471 •www,truemfg.com Model#: Model: GDM-72F-LD I I � I v '� ' 4• aS .+!fir a. rlTsr+n��A�t { r 1 } it li l &„ fihf.r- ® The world's#1 manufacturer of glass door merchandisers. gw- d�oftlrol 1 Designed using the highest quality, " refrigerant, materials and components to provide ® the user withan attractive,point;of purchase merchandiser that brilliantly ; m � displays frozen food�and ice creaR, 'resultingin high impulse sales � 04ers¢ed,factory balanced refrigeration system holds 10 F"•�. $` 7 (-23 3 C) Ideal for ice cream and.frozen food products .. r" -" �... .. Extenor non peel or chip white ".laminated vinyl;durable and y permanent. 1111� Interior-attractive NSF approved white aluminum interior liner with stainless steel floor. t a"s;"a z ' Self closing door Positive seal totsion type closure system b �r > �` ;� � � �� door assembles with extruded � t � d+ � s aluminum frames "Aar d LED mtenorlightmg provides,more 661ighting'throughoutthe cabinet Safety shielded Entire cabinet structure is foamed in :.-place using�Ecomate.Ahigh density, polyurethane insulation that has zero" - ozone depletion.potential(CDP)`and zero.global warming.potential'(6WP) ` Bottom mounted units,feature.,' 1111 "No stoop'lower shelf„to maximize product visibility I '� ® Storage on top of cabinet Shown with optional black exterior. R c cllean,accessible condenser coil for eaning. Scancode for video RO(JGH=1N DA1"A _� _ .�.,M A. .��..tt��.r: n_..M.�..�n�.,._ . µ,��..�.....a.�.W.�.� �.�..� .. Specifications subject to change without notice. Chart dimensions rounded up to the nearest'/B"(millimeters rounded up to next whole number). Cabinet Dimensions (inches} Cord Crated (min) Length Weight NEMA (total ft.) (lbs.) Model Doors Shelves L Dt H HP Voltage Amps Config. (total m) (kg) GDM-72F-LD 3 12 78'/8 297/8 785/8 11/2 115/208-230/60 12.7 14-20P 9 825 1985 759 1998 11/2 1 230-240/50/1 13.2 ♦ 1 2.74 1 375 t Depth does not include 1 1/8"(29 mm)for door handles. ♦Plug type varies by country. Requires 1 15/208-230/60 Hz,single phase,3 pole,4 wire circuit. � . u -e.. °'' NOTIM C EAPPROVALS: AVAILABLEAT.NSF EAR 10/15 Printed in U.S.A. Model: 6 • • - GDM-72F-L® . a ►® s STANDARD FEATURES DESIGN • Interior-attractive,NSF approved,white MODEL FEATURES • True's glass door freezers are designed with aluminum liner with stainless steel floor. • Evaporator is epoxy coated to eliminate the enduring quality that protects your long term • Insulation-entire cabinet structure is potential of corrosion. investment. foamed-in-place using Ecomate.A high • See our website www.truemfg.com for latest • True's commitment to using the highest density,polyurethane insulation that has zero color and sign offerings. quality materials and oversized refrigeration ozone depletion potential(ODP)and zero • Backguard and floor rack ensure optimum systems provides the user with colder global warming potential(GWP). airflow. product temperatures,and lower utility costs • Welded,heavy duty steel frame rail,black • Listed under NSF-7 for the storage and/or in an attractive merchandiser that brilliantly powder coated for corrosion protection. display of packaged or bottled product. displays frozen food and ice cream. • Frame rail fitted with leg levelers. ELECTRICAL REFRIGERATION SYSTEM • Illuminated exterior sign panel.Variety of Unit completely pre-wired at factory and • Factory engineered,self-contained,capillary sign options available. ready for final connection to a 115/208- tube system using environmentally friendly DOORS 230/60Hz single phase,20 amp dedicated (CFC free)R404A refrigerant. • Triple pane thermal insulated glass door outlet. Cord and plug set included. • Extra large evaporator coil balanced with assemblies with extruded aluminum frame. higher horsepower compressor and large • Each door fitted with 12"(305 mm)long 115/208-230/1 condenser;maintains-10°F(-233 (i:eC). extruded handle. NEMA-14-20R • Sealed,cast iron,self-lubricating evaporator • Self closing doors. Positive seal,torsion type fan motor(s)and larger fan blades give True closure system. OPTIONAL FEATURES/ACCESSORIES merchandisers a more efficient low velocity, • Magnetic door gaskets of one piece Upcharge and lead times may apply. high volume airflow,design.This unique construction,removable without tools for O 230-240V/50 Hz, design ensures colder standard temperatures ease of cleaning. J Black exterior. and faster recovery in high use situations. SHELVING J Stainless exterior. • Bottom mounted condensing unit positioned Twelve(12)adjustable,heavy duty PVC Black aluminum interior liner with black for easy maintenance. "No stoop'lower shelf coated wire shelves 24YR"L x 203/4"D(613 mm shelving. maximizes visibility by raising merchandised x 528 mm). Four(4)chrome plated shelf clips J Stainless interior liner. product to higher level. included per shelf. J 6"(153 mm)standard legs. • Automatic defrost system time-initiated, Shelf support pilasters made of same material J 6"(153 mm)seismic/flanged legs. temperature-terminated. Saves energy as cabinet interior;shelves are adjustable on J 2/2"(64 mm)diameter castors. consumption and provides shortest possible 1 ❑4"(102 mm)diameter castors, P p P /z'(13 mm)increments. defrost cycle. ❑padlocks.LIGHTING J Novelty baskets. CABINET CONSTRUCTION LED interior lighting provides more even J Additional shelves. • Exterior-non-peel or chip white laminated lighting throughout the cabinet.Safety J Pricing strips. vinyl;durable and permanent. shielded. J Available in R290 hydrocarbon refrigerant PLAN VIEW::— 781/a" (19R5 mm) 7615h6" / (1955 mm) 785/e" 2913h6" (1998mm) 3021/32" (758mm) (786 mm) 535/s" 1 (1363 mm) i i 13/3z' � (28 mm) 2313/16" (605 mm) ELEVATION -- 5/16" PLAN VIEW (35 mm) (8 mm) WARRANTY* Three year warranty on all parts METRIC DIMENS"10NS'R0UNDED'0P TO THE andaabor and-an additional 2 year NEAREST WHOLE MILLIMETER Nlodel Elevation Right Plan 3D" ; Back t warranty on°compressor _.>" (U:S:A.Olily)" SPEEIFICATIONS SUBJECTTO CHAN�iE GDM 72F LD TFAY0IE:, FAY TFMY02P�TFAY013 RESIDENTIAL APPUCATIONSITRUE assumes no liab,litv for partsor WITHOUT NOTICE labor coverage for component failure or,other damages resulting `,` W' , from installation in non-commercial or esioential applications TRUE FOOD SERVICE EQUIPMENT 2001 East Terra Lane•O'Fallon,Missouri 63366.4434•(636)240.2400 9 Fax(636)272-2408 9 Toll Free(800)325.6152•Intl,Fax#(001)636.272-7546•www.truemfg.com STAINLESS STEEL FREE STANDING SERVICE SINKS ADVANCE TABCG ........................................................................................................................................................................................ SMART FABRICATION- item #: _ _Qty#: Model#: .............. ................................................................ . Project#: ...........__. FEATURES: Leg mounted design. DEEP DRAWN High back splash. SINK BOWL 3 1/2" Basket Drain Inlcuded 8-OP-16 8-OP-16 includes stainless steel side welded crossrails (front to back). CONSTRUCTION: All TIG welded. Welded areas blended to match adjacent surfaces and to a satin finish. � �. MATERIAL: 6 Legs are 18 gauge type"430"stainless steel FABRICATED with 1"adjustable stainless steel bullet feet. SINK BOWL 4-OP-18-Heavy gauge type"304"series stainless steel. 4-OP-18 8-OP-16-18 gauge type"304"series stainless steel. 8 OP-16 16"x 20"x 8" 25"x 23" 50 lbs. 13 4.OP-14 24"x 21"x 8" 24"x 25" 50 lbs. 10 1 IRVIIE 0140 S 1' C 1 TI TOL± .500" ALL DIMENSIONS ARE TYPICAL 24 3/4"--{ 24". -{ 1 _ ... .. . I K DEEP DRAWN j ,�'� FABRICATED 21 7/8" 16" SINK BOWL /' /�\ 21" 241/2" SINK BOWL 1 \ 8-OP-16 = i (,� �) i � � 4-OP-18 s 8" - 8" ; O.0 O.C.I-- ............................__... f 811 � s 36" gll �� 30" } 35" ......_. _......._......._. ...._..f.. � 31 1/2" 2 8"�+12 1!4" 11 1/2" r 27" 71/2'�i 1 1/2" IPS Customer Service Available To Assist You 1-800-645-3166 8:30 am - 8:00 pm E.S.T. For Orders&Customer Service: For Smart Fabrication'"Quotes: ADVANCE TABC®.S.vtART Email:customer@advancetabco.com or Fax:631-242-6900 Email:smartfab@advancetabco.com or Fax:631-586-2933 FABRICATION'- www.advancetaboo.com ADVANCE TABCO is constantly engaged in a program of improving our products.Therefore,we reserve the right to change specifications without prior notice. ©ADVANCE TABCO,SEPT.2017 REF-E %%NWA ° WD Series PDI Certified Grease To : Interceptor 9 p SPECIFICATION: Watts Drainage WD Series PDI Certified recessed or floor mounted epoxy coated steel grease interceptor with gasketed epoxy coated steel skid-proof cover secured with hex head center bolt(s), removable baffle assembly, deep seal trap with cleanout, external cast iron flow control fitting, and no hub (standard) connections. 5 K Flow Rate(Select.One) , ' ' • 9002 Suf(sz VN Descnphon " „ ce T F ED .,4,. 4 GPM >❑' 7 7 GPM ❑ 10 10 GPM ❑ 15 15 GPM El C UPC 20 20 GPM ❑ Ld.f'M9 'IM 25 25 GPM El® 35 35 GPM ❑ 50 50 GPM ❑ D(Length)x E (Width) —�{ Opfions(select One or More); Suffix Desinphon B Sediment Bucket ❑ -E Extension ❑ C -FC Flange&Clamp Device ❑ HD Heavy Duty IT0,000lb.) ❑ A _ I _ Traffic Cover y O Inlet&Outlet other than ❑ 1 Standard Size Inlet Outlet F -SS Stainless Steel ❑ -THD Threaded Connections ❑ F�ow ElRestrictor B -US Buy American Compliant = w/Vent Connection I L_L] flow A� B C � ' k DEF Interceptor Grease V Catalog Rate Ca�aclty Inlet& Bose to Top to Len th Width Her ht Number GPM, .y Lis. Outlets a Eenter Wig,-t WD-4 4 8 2"(51) 7-3/4"(197) 3-1/4"(83) 16"(406) 10"(254) 11IF(279) WD-7 7 14 2"(51) 8-1/2"(216) 3-1/2"(89) 18"(457) 13"(330) 12"(305) WD-10 10 20 2"(51) 8-1/211(216) 3.1/2"(89) 21-3/4"(552) 14IF(356) 12"(305) WD-15 15 30 2"(51) 10-1/2"(267) 3-1/2"(89) 2211(559) 15"(381) 14"(356) WD-20 20 40 3"(76) 11-1/2"(292) 3-1/211(89) 24"(610) 15-3/4"(400) 15"(381) WD-25 25 50 3"(76) 12"(305) 4-1/2"(114) 26"(660) 16-1/2"(419) 16-1/211(419) WD-35 35 70 3"(76) 14"(356) 5"(127) 30"(762) 18"(457) 1911(483) WD-50 50 100 4"(102) 16"(406) 5-1/2"(140) 32"(813) 22"(559) 21-1/2"(546) Job Name Contractor Job Location Contractor's P.O.No. Engineer Representative WATTS Drainage reserves he right to modify or change product design or construction without prior notice and without incurring any obligation to make similar changes and modifications to products previously or subsequently sold. See your WATTS Drainage representative for any clarification. Dimensions are subject to manufacturing tolerances. `<.. Specification Drainage Products USA: 100 Watts Road,Spindale,NC,28160-2298; TEL: 828-288-2179 TOLL-FREE:1-800-338-2581 www.watts.com ES-WD-WD SERIES USA 1304 WD SERIES TOWN OF BARNSTABLE CFTHET� OFFICE OF i EAMSTAIM BOARD OF HEALTH y MAs B. �p 039. \�0 367 MAIN STREET owaa�� HYANNIS, MASS.02601 July 11,2001 Mr. Thomas Powers P.O. Box 727 West Yarmouth, MA 02673 RE: Dunkin Donuts Dear Mr. Powers; Your are granted variance from the Board of Health"Revised Supplement to Minimum Sanitation Standards for Food Service Establishments" Regulation 10 that requires a minimum of a 1000 gallon grease interceptor at all food establishments. This variance will allow you to continue to operate a food service establishment at 500 :Ocean Street, Hyannis; with the following conditions: No cooking of food will be allowed, only the tasting of bagels and reheating of pre- made egg and cheese sandwiches and micro waving of canned foods are allowed 1..: Only disposable single service paper, plastic, and other disposable dishes and utensils are authorized. 2. This under the sink grease interceptor shall be cleaned monthly. 3. All other regulations contained in 105 CMR 590.000: State Sanitary Code, Chapter X—Minimum Sanitation Standards of Food Establishment and of the Town of Barnstable Board of Health sanitation regulations shall be strictly adhered to. This variance is not transferable, and will be voided if the establishment has a change In use, change of ownership, or leased to a party other than an applicant. Very truly yours, Susan G. P sk, R.S. Chairman Board of Health Town of Barnstable sG/fs �FIME Tp� ,� DATE: -� FEE: "+ +� BARNSTAHLE. MASS. v� 163.9. �� REC. BY Town of Barnstable SCHED. DATE: Board of Health 367 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 . Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: � �00 ()c r�s� S 'V,2,�l;t.-� r Assessor's Map and Parcel N er: Size of Lot: Wetlands Within 300 Ft. Yes Business Name: CG,ri SI'Al ' No Subdivision Name: APPLICANT'S NAME: C s o �ee �o� Phone -S�8) \7 7 ( — O?CD Did the owner of the property authori you to represent hire or her? Yes No PROPERTY 9OWNER'S NAME CONTACT PERSON Name: l�rJf`11�� �'�, I�O�.. Name: Address: t OMiS Address: Phone: Phone: SOB -T7 75, - Z 4(36 V,kPaA NCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) i �CFC7�c7N '�- 0_6 Pf2d;-,g ek JDUX� �N Di1niLt-- toL.,a S al read ,C Z_,_, re-rric�¢ �jt�ca¢_ .� ND oo1C nS ons;r�z/ �f �` Sa � NATURE OF WORK: House Addition House Renovation ❑ R❑ epair of�ailed Septtit'System ❑ Checklist(to be completed by office staff-person.receiving variance request application) _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request _Applicant understands that the abutters most be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) _ Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same ownerPeasee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems [only if no+expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIREQ L 06/0812001 10:51 5082959305 SKJG CO PAGE 01 a • DUNKIN FRANCHISEE Canal Management Co., Inc.. 17 Kendrick Rd. Wareham,MA 02571 (508)295-8967 (508)295-9305 Fax Susie 8, 2001 Lauren Tom Powers Construction. FAX 50&771199W 0;v y Dear Lauren: The following.is the information you require regarding the proposed menu for the Dunkin'Donuts on 50 Ocean St:,Hyannis, MA.02601: Coffee Donuts Coolies Coolatta Breakfast Sandwiches ( fiCxOwave to Warm) Bagels Cream Cheese Ice Tea Lemonade Please call with any questions. Thank you. Sincerely, r Stephen I McCarthy President i IS TOWN OF BARNSTABLE ypi TH E Taw eP �� OFFICE OF Z Desa9TdBL i BOARD OF HEALTH � MA64 0 i639' `eo 367 MAIN STREET .EO mix*- HYANNIS,MASS.02601 �1 - ath P-© C '0263 GLr�K�,, Do n ( You are granted 1 variance from the Board of Health "Revised Supplement to Minimum Sanitation Standards for Food Service Establishmen s" Regulation 10 that requires a minimum of a 1000 gallon grease interceptor at all food establishments 'moo Oce� This v ance will a you to continue to operate a food service establishment at AWWRPh treet; Hyannis, with the following conditions: re'" (1) No cooking of food will be allowed, only the s C14u, and microwaving of canned foods are allowed. �""`Q"''`A" (2) Only disposable single service paper, plastic, and other disposable dishes and utensils, are autho ' �C1 (3) This/grease interceptor shall be cleaned monthly. (4) All other regulations contained in 105 CMR 590.000: State Sanitary Code, Chapter X - Minimum Sanitation Standards for Food Establishment and of Town of Barnstable Board of Health sanitation regulations shall be strictly adhered to. This variance is not transferable, and will be voided if the establishment has a change in use, change of ownership, or leased to a party other than an applicant. Very truly yours, oar T arnstable GF/bs ....___ .. .... ............ .......... ............ .................. _.....,.. ...........,-24' .. .._. ... ..............._....._ _......... ... ..... ............ .._.....__.... 22, — — ---1 CharlGrill Ftwlator R.., ........... ................ .. ..... .. .... ... ... ....... .... ...� .. I. ao Srn ............ .. Flat Gnll � .... .. -. ... .. ._ ....... .ALp1inY e e Freeper 3 Companment Sink HnnJ Sink anJ Prcp Dktanm 211 -------� -�-�• ^I Food Preparation Area C Id FaM T�F � ,' tlm Fad'raM1k Sandwich Gase o 0 0 L o 7.5' ___�.._ 6 U 2s6 Free Standing Wall 12'With IS"Glass Guard Ocean Street Market 54' 50 Ocean Street,Hyannis,MA,02601 ;r Hand Sink Scale ® 4' 13' Width 0.45/Height 0.24 cm=1 feet -._.._ _ .... _............ ..._. „ � I I I' 5.5 >3.2..c 2 W' F 4. _ Show CaseH _ 6 .... U 1 4' ly'L<3'H.r 2.4W' I U 4' 6' 4 O V 4- 6' 4' 4' Gondolas 4' y I I 12.5' 4' 26.5 Existing Walking Cooler r 6T- Town of Barnstable 4947 Department of Public Works Permit Number Sewer Connection Ft Trench Opening Permit Connection Disconnect Mod or Repair X Map ft Parcel# : 327 - 264 water Supplier DPW - Hyannis Water Dept Street : 50 Ocean Street Sewer Account# Money Order Village Hyannis Permit Fee It Check# : $50.00 17 - 846 555 753 1. Residential Bldg Fee-$420.00 ; Commercial/Industrial Bldg Fee-$875.00 Septic Abandonment Permit# N/A 2. Surcharge for Each Additional Bldg on Same Service-$200.00 3. Surcharge for Pump Station-$300.00 4. Minor Repair or Disconnect of Existing Service-$50.00 Project Contact Information Contractor Name : Rodney Fisher Owner Name ; MKPM Hyannis , LLC Contact Name : Mike Leary Mailing Address 1 Burlington Woods Business Address Burlington , Mass 01803 Contact Phone Telephone : 508 - 726 - 5445 Contact Fax Property Use Information Residential Commercial : FX-1 Commercial Use Variety Store Industrial Standard Industrial Code Number of Bldgs 1 Size of Parcel (acres) 3/4 Acres Pipe Dia a Material : 4" SDR35 Pipe Length : 100 ft Before excavating in a Town Way or on Town owned property, the sewer installer must obtain a Road Opening/Trench Permit and comply with the Construction Standards 8t Specifications outlined therein. Applicant must notify DPW 48 hours prior to installation. Failure to comply with the regulations shall be grounds to revoke this permit. The Sewer ft Trench Permit is valid for 180 calendar days from DPW approval and the installation must be completed within that time period. Engineered drawings must be submitted, with this application form, to the DPW for all commercial or industrial installations. The drawings must be approved before a permit will be issued. Contractor Signature B Date : R Fisher 2/21/2019 DPW Approval Signature Et Date : DJ Anderson 2/21/2019 Sewer Permit Expires : Aug , 2019 Sewer Connection Form (Rev; 2010) Page 1 of 4 TOWN OF BARNSTABLE Date: 02/21 /19 DEPARTMENT OF PUBLIC WORKS Permit: 4947 Installer: Rodney Fisher Property Owner: MUM Hyannis , LLC Tie-in Location: 50 Ocean Street Village: Hyannis Map If Parcel : 327 - 264 Pipe Length: 6" SDR35 Pipe Dia&Material: 116 1/2 ft The work has been done in conformance with the Rules and Regulations of the Department of Public Works Signature : DJ Anderson Date: 6-Jun-19 Department of Public Works See Attached for Tie - in Sketch Sewer Connection Form (Rev; 2010) Page 1 of 4 Town of Barnstable, Mass Department of Public Works 1 ,1 1 1 @ �.,. 1 � 1 50 Ocean Street 1 Map Ft Parcel Hyannis o,t 327-264 �° co 1 r , ; n 1 ➢ x b-d at 4 :dc^p 3 f,deep / O / : tied-in 1 April 19 , 19 1 OI C, all CD '1 o I 71 . ..... / South Street OO ,, ..__........._.._.._.._......................................... _._._ i Sewer&G p(Grease Trap Tie-in for 50 Ocean Street, Hyannis i Town of Barnstable �oFIME royti Building Department Services o Brian Florence, CBO * Building Commissioner BARNSTABI,E R"NSMBLE, 9 0 200 Main Street, Hyannis,MA 02601 "AWMP n�R;ILLt%41 WI$'4 VS lb'S9• , i63Q-3010 Arlin Mph a www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 November 26,2018 Mr. Mian Saced 2751 Falmouth Road Osterville,MA 02655 RE: Site Plan Review#078-18 Informal Review— Ocean Street Market 50 Ocean Street,Hyannis Map 327,Parcel 264 Proposal:: Convenience store with a prepared food counter with no seating is proposed. Previous use was a convenience store which included the sale of sandwiches,hot dogs, coffee etc. Dear Mr. Saeed: At the informal site plan review meeting held with staff on November 20,2018,the Site Plan Review Committee found the above proposal to be approvable subject to the following: • A licensed Construction Supervisor is required to apply for a building permit for the proposed tenant fit out. A professionally prepared scaled floor plan indicating all interior features including shelving, counters, cooking areas, refrigeration,bathrooms etc,will need to be submitted with the building permit application. Contact: Building Dept. 508-862-4038, • Prior to the issuance of a building permit,a permit to install a 1,000 gallon minimum exterior grease trap,or confirmation of the location of an existing exterior grease trap,is required. Consultation with Amanda Ruggiero,Assistant Town Engineer,DPW will be required for design of grease trap connected to the town sewer, and/or review of grease trap variance conditions"if applicable. Contact: 508-790-6400. Additionally,the three bay sink will require an under sink grease interceptor. Consultation with the Plumbing Inspector,Robert Duffy,to ensure compliance is recommended. Contact: 508-862-4038. • Prior to the issuance of a building permit, a floor plan depicting location of all utilities,NSF spec sheets,as well as cut sheets and a list of materials will require approval from the Health Department. The distance from the existing hand sink to the proposed prep area will need to be indicated on the plan. The installation of one prep sink in the prep area is required. No seating is to be proposed. 644 r f • Prior to the issuance of a building permit,if one bathroom is proposed, a bathroom variance will need to be obtained from the Board of Health to allow for a single unisex bathroom where two bathrooms would otherwise be required. The bathroom is not to be open to the public. • Subsequent to the issuance of a bathroom variance, if applicable,proper grease trap compliance, and approved floor plans, a food permit from the Board of Health may be applied for. Health Department contact: 508-862-4644. • It was confirmed through Health Department records that the underground gas tanks and gas pumps were removed in June, 2017. It was determined that the canopies may remain in place, however,per Deputy Chief Dean Melanson,the fire suppression system will require removal unless it is activated. • Deputy Chief Dean Melanson advised that at the building permit stage the fire suppression alarm system plan will need to be updated to include a CO detector in a Type I hood. A one valve gas shut off is recommended for both the CO detector and gas cook line. A plan indicating the location of the range, grill, and flying stations with adequate clearances and partitions will need to be reviewed and approved by the Fire Department. Contact: Deputy Chief Dean Melanson, Hyannis Fire Department 508-775-1300. • Any exterior changes, including signage, will require a Certificate of Appropriateness from the Hyannis Main Street Waterfront Historic District for aesthetics. Contact: Planning& Development,Historic 508-862-4064. Applicant must obtain all other applicable permits, licenses and approvals required. Sincerely, Ellen M. Swiniarski Site P1an:Review Coordinator CC: Jeffery Lauzon, Chief Local Building Inspector, SPR Chairman Deputy Chief Dean Melanson,Hyannis FD M David Stanton,Chief Local Health Inspector Amanda Ruggerio,Assistant Town Engineer,DPW Robert Duffy,Plumbing Inspector Paul Wackrow,Principal Planner Town of Barnstable pOHEt Building Department Services °�ti Brian Florence, CBO * BABNSTABLB, : BuiIding Commissioner BARNSTABLE Is MASS' 200 Main Street, Hyannis,MA 02601 `�N MO R'll,'T'Rf"°5 1679. 1 1639-2014 Aj6D MPS a www.town.barnstable.ma.us � Office: 508-862-4038 Fax: 508-790-6230 November 26,2018 Mr. Mian Saeed 2751 Falmouth Road Osterville,MA 02655 RE: Site Plan Review#078-18 Informal Review— Ocean Street Market 50 Ocean Street,Hyannis Map 327,Parcel 264 Proposal: Convenience store with a prepared food counter with no seating is proposed. Previous use was a convenience store which included the sale of sandwiches,hot dogs, coffee etc. Dear Mr. Saeed: At the informal site plan review meeting held with staff on November 20,2018,the Site Plan Review Committee found the above proposal to be approvable subject to the following: • A licensed Construction Supervisor is required to apply for a building permit for the proposed tenant fit out. A professionally prepared scaled floor plan indicating all interior features including shelving, counters, cooking areas,refrigeration,bathrooms etc,will need to be submitted with the building permit application. Contact: Building Dept. 508-862-4038. • Prior to the issuance of a building permit,a permit to install a 1,000 gallon minimum exterior grease trap,or confirmation of the location of an existing exterior grease trap,is required. Consultation with Amanda Ruggiero,Assistant Town Engineer,DPW will be required for design of grease trap connected to the town sewer, and/or review of grease trap variance conditions if applicable. Contact: 508-790-6400. Additionally,the three bay sink will require an under sink grease interceptor. Consultation with the Plumbing Inspector,Robert Duffy,to ensure compliance is recommended. Contact: 508-862-4038. • Prior to the issuance of a building permit, a floor plan depicting location of all utilities,NSF spec sheets,as well as cut sheets and a list of materials will require approval from the Health Department. The distance from the existing hand sink to the proposed prep area will need to be indicated on the plan. The installation of one prep sink in the prep area is required. No seating is to be proposed. r 4V • Prior to the issuance of a building permit,if one bathroom is proposed, a bathroom variance will need to be obtained from the Board of Health to allow for a single unisex bathroom where two bathrooms would otherwise be required. The bathroom is not to be open to the public. • Subsequent to the issuance of a bathroom variance, if applicable,proper grease trap compliance, and approved floor plans, a food permit from the Board of Health may be applied for. Health Department contact; 508-862-4644. • It was confirmed through Health Department records that the underground gas tanks and gas pumps were removed in June, 2017. It was determined that the canopies may remain in place, however,per Deputy Chief Dean Melanson,the fire suppression system will require removal unless it is activated. • Deputy Chief Dean Melanson advised that at the building permit stage the fire suppression alarm system plan will need to be updated to include a CO detector in a Type I hood. A one valve gas shut off is recommended for both the CO detector and gas cook line. A plan indicating the location of the range, grill, and frying stations with adequate clearances and partitions will need to be reviewed and approved by the Fire Department. Contact: Deputy Chief Dean Melanson, Hyannis Fire Department 508-775-1300. • Any exterior changes, including signage, will require a Certificate of Appropriateness from the Hyannis Main Street Waterfront Historic District for aesthetics. Contact: Planning& Development,Historic 508-862-4064. Applicant must obtain all other applicable permits, licenses and approvals required. Sincerely, Ellen M. Swiniarski Site Plan Review Coordinator CC: Jeffery Lauzon, Chief Local Building Inspector,SPR Chairman Deputy Chief Dean Melanson,Hyannis FD M David Stanton, Chief Local Health Inspector Amanda Ruggerio,Assistant Town Engineer,DPW Robert Duffy,Plumbing Inspector Paul Wackrow,Principal Planner SiCAycs 1=X15�11`1G (3At�+�co�vn �— Not eS' i-xi. �JfSjr�- basIx.I - . � h�vie I i .►L�_Rt b!i c. P�r�-�h�-�a.m.�. closet ROY i CG o XiSN� LouNttr-Ql�w S�Nx =� ��.StL-rAG C.00leh \, r ( '4 a — i 3V 4 l -XI 1 StAK01N& Wall 3�" ck.I -x�st,NG Lcoolelrs -. _ 2P (- - - RAN DbRtt nt 3c: ° -e '' - -- �7V. -- -- — i 0 IENt- c e Poo�-.s _ C I q n � vU i s��N� 3 6p�t Sin��S - EXIS�.•tNy C3atH�v�w1 *` i - N�S Xi tl'n« r��l br�slx I beatk Dom_- c-Lose+- _ o� XiS�IN�° CoGNttr-QRy 51NK I , I - 3" j I i 2x �4V, e SLAi^tDIPI& Wgtl 31 , j •. p _-Y.1SttryU CC°O12},5 i _ � 2�,0" I _ , .- -� _ .. . .. ,. ��•i'" _�-'�.p` �- -� — — U o _ ran. CA, I 8 { I r -o• f�- h5 _ I OCX 7.......... LEA 7 2 No soon, >51 map �07 7777....... .............. ............SO .............. ........ ............ ........... ........... . .. . .........:0 ol A& flu :7 7-77-7777 Age am "ma 7: Imam 04 05�1 ant jt! its MIS'. 7 AWT A, wz7nv mad =� ...........list -fill 41: NERO woo, ............ 1. S Of Q Oil............ w i �x,s�i�►� 3 a� ��IKS E-M5 'ltAC- (3athkvoun - � Note t rx» brasIa: 1 >3r�Ei,rvam Oral NOY �� I+ uoset �J I , i ............ -------------'--...-_ cG��ee5tl,Nc f_xISUIa c NttY-Gay5; Y, ��I StL-Nr- cric, e-h _ I , I - t i I 2,x 4,�Pvee Stnr l)(Nc, 1 1911 3q„ '�'9" G11a55 At•�f-7'kIUN 1&" hiot, ran. FlAt Ib ! (fir Ban c�e ocx Poo a5__ aF4 1C4yc t 1 i3r�t{, v o n'm OrJt c>_o s e t - ---- r � cC,�gee n z,-x INS°Co -k Y-dr+r SANK =� _ i I - f 1 Z,x 6�Pvee Stnf- o(mG Wail 311, +I I I I I �(o'`I GLg55 Rr-�f-7tIUN 1S" hiGG, i G n bE ran. 30' I; Y •'' ! L' I� r -a• F� 4- I I W11 1.4 X. I , Ntdr Nce Poops__ 5�} G ]m Rk MR, �j,�6 R, �,v ig -77 T7 PR U-M, ......... A �S4 :t� jg t,- oil . . ....... < - . I . - . . . _ i I I � . .. . •:. . I I . , . - ,. , - - ' ` -' , . , � . � , , . , - � � ` ., , �, . . „ s Y rl ,.. ..'. - . - -,. , �I . I. � ... . I . _ . , .1' -Y i 1 . I - . ., % ti , j - f J rI / B i . - ` t 1. %- r t S ,r - - t. r J _ , ti,,, .A - - . r' . - - ,.--' _ T.B.M. TOP CONC. BOUND I ELEV = 97.96 (ASSUMED) t J I. I . .1 JI.-1 1� ,.�I., :,.I­-­...'_4�,I��.�t­l,.,:­�..�_,-,-"�.�­.,�._�-,1..,'�,-`.-,-�.-�..-,I�,.I-.--.I..1t 4ffi \' - <. i_. i Jf, , - __ _ _ -- _ - cw�a eurbing.._ - - :.. -- _. seta-- --- - -- - - ' - - - . `<: !---- -- +- - -- -- -- - -------- _ --- - ------ _- -- _ - l- `�'3 - r - ' - _ J i ..` " . - . .. olirm_ pole llght or> /S sq. tuna base K&p, - J ,-. ,` • - r ,, c. i ., '*11l ` 1 4,` r i \ \ P P KING AR CO f, . I � 0I .(A3' ------\;-� I-I -I 9-&7 � -I I AVER AR EA p� , _/ S ^' .4 W' X 22 \ 4 f con Tequipmenf Pod 'r x moe ; O t µ \ � x iIl -.I..II..1-.�­I1..,I�...I�.II-�I-�L-�.�:,".I..kI.._��"-..�.-.�<,�..--�-_\._"II�.II'..-k N�..­�.I�I_\-,.-.,��I_-.--I I­-1I,_,­�..:1r_�A I.,l l.\.��.I\,\I_�.-III\\I,�._I­�I1�'I1.N.-%1�,,.1--.\­1-.1 A.,1_I�1'I.-I.,I I-..'"I/�zI.I.. I._,I.I-.._.0.II."..I,�__.�I\.�-I.-:,II1\�."I.I�_-��1,II�-.:_.I�I..�\:.--I.,�",,-.,...I�.�,I_..kI-,../0.I.k�.,I,����-,�II�I....,I�I-.;-1k�.._,-III.I.�I.I IA�..,_-�-'-I1-�...A�I"N I,,.II.-!III..I I�.,I-.�k�..%�...1..�c.�.�I.I_�1_I I la.r-.6.-��-I-��1p..p t 1,._/._a-.�I,I�/p!I..--­.­-1\/.I/-.Ie/p-_II.II I_'-/I_ �I-,./.l�I�lI�-I.\-�.I"II-I.I1r 1.�I-.-�I-I,_-\I"::II_,1./.."I_I I 1_Iy Z;/.////.".�%I 1�1�/X/�I'/���"%.,1 1'/­I N1/\,,�,'"/,...,II N I,,I-I.-.�%.I1,_,.�.\%.-T.","I. t I 1�I--I�.I _IVt�.1rI�..�.A"-1,�99V I_-�,I1I-�I)��I..I�I_1"I-I"�_IIII�1 I,%�.,I I,7 I.��;I,I­�A"I,I.�I­II:,_,�I�I--x�..l I.,I.--_�I�L 1-I I-,II-I/1 rI\�l­II.I,,.,I I,I_,_I/��­-.l I_.II I--I%_,K.�I--_�I�,t.._1 II.1-I-�.Ii i-II.�I�-.;�,-I-I_��4,__-I-_-1I.I:_.,_I�`,,_IV.�N,._"._�I!.I l-I I._1I�� �I-��I\!9 I,I.I�I/�.!­7"/..-3I_,4.I_.�I�I i�.�-IIII 7-II.II-..II I.�0­wII:��i�,-�I-_-�'I I--:I,,-�_�t_.�I I,�z,'I�-Il.,�1:._-I�,_�-,19 1.-I_.II5.I..I.I�I-��..I.I.3.I1 II 8.�I11.I;t��!1_.I--.--'";I�.II�I-./�I- �:I-..,�,I-.._-.!\I-.1,I.I��,0:4...�.,,�Im--II-I.!���I.�.1.,�.1.�..".�..\..I-,�_,,k.�.,l.-..I,I__�II I I,,�,..,.�i.�I I-'�,...�.I��-.Ii,-1��k 1.I1I.'�..II-._.,I��.-_,..I-�I'I.lII-i6�. ��'}}•�� (( FI Ii II .x aA wl?mv 96 0.T f x is ,, •y \ _ .. - r 4 t 104.07 e/ec box *- 15 , _ ° ', j to J I It j I N I2 _ f q M o f1, r t t0t.82 I '`r // , \ i f ­w - -, It II III�III�k III Y 103 50 f. I /l t 6' . ! ' ., t E -_1 / . N J - ,; : - f high frees 4 a a c , ' T02e; = r ':;r is i �- - - --- ----- -r i _,---.,'',�-,,-,,�..,:�"�,..�--�1 I.1..".�­1��II,.�.��.�-.I�I�.1I�I',4.:'-..I.I*.,'­:,,_��I--�1.I.,�.�I.-�­I��.,,,�".r..:.I.I.I�."..�I.lI�1��-...r'I I-I-�;-.�-1,,.��--...��.!�..�..�-I\.:,_.."�I-,o.-.-II,I�%l.�,�....-.��I.,I,;'.X-,�:_1I'.'_.I1.1I_�..I 11,,- ­��­...�,�'..,-_.!:.,.".���,�-.­.�,!�-.,:I�.-I-_,��.I:�.,..�II.-"I..,.�l'..�.I"I;,�%�I-....,--l�..�,:�I.­­..-I..1.,,_��.-I�­,,I_.II'1,..�,..,I�l.-._..\.II�­-.-,t�..�.I I'I--:.'..I...I I i.��.I,I1-....­._-."._.­�,,.I.\,--­,_.,",!..l._�­­II...­�i I-e,�I,",".1I..II 14­.I,�!�--�.1.1,-.'�-..1��I l:��l..":I.1..,......'-.�-\,�,.�.'I.._...,�'...."�,,.VI­.;'.���1..��1,:1I 1��-..,I..�,m,,�.....­�...-I.,�..�I.1,1..�,:,..-1�"-..-1,",,,`",-,.�-l.'.-�.I.,,,,..­1'-\�.-�_.I,..*..­l I.I l�,...I.I��...,�­�,I'..._.1:I��,�I-,..��...�-tI,V�*-.I.I...I,�..�..:,'I�'I,:..�I,.1�'-I,,..�.�...1 I_..*1.,_I'_--z-I--,.II'..:".-..--._."­.I.\1-.­,.-.:,.�7I..I._I.-,.­.-..:L�,..�­"�.I.-.1II.,-­,�.�II:II-�,,*_,,-....�.1.II.�"I­I.­.'..-I�,,(.1-�_-.-,�..�,'1I,.1._T.�._7.,,---.,1�_-,�;,,�.I,,-..�_­�-,,I�I.'I 1:.....I,-,_.�,I...�I�I�,.�.-­..�I-­..-­�_;�"_�,....I\,-�.,...."-,­-.�,-I..-1.I­;I-��.l.II,;�,�:II,.I�__,�'..I-�-I-"-I,I?:.,��_.�,-0�II,�.1.-..,��I....,,­..L.�I"­,II�1 I.�-�..�,�-_.,-.---_.�l I�-����I,.�I,�.,"�:t1"l,-­,.-,.�"_..�1:,,I-.I.:I�'���,....��:--N�I��I,'..�-�I,I:�...�..",�.�­I_-.!1-.��,'�I�1 I--I,,I�,_,_7-�t I._-....�-�I�,..."-L�.-..I"1-;...�*..�I,t,.­��1"II.,,�I�-.-�...­�;.,..���.I.�.I--l-I�.�,�,,.1-f'I.I�;,­..-....I,�....'11�-1�-­.,.Iw1.I.�-,,,,-_.1.,',,�.W.I'--�.-I"..I l.�4­;..-,..:.._�,1.,.I:.1-.1 I--;.�,-.-.....�..­,*­.,�.�.­II 1�"I-1,.I.. I A. sidewalk . \ p� / �!/i%%lii:i ;i : !:. iiii,;i /iii% f: scnG poo �r r / I tI N -. p/oe SSA -a------ / ,0 i ConC { e-Ysti.-ng sln9'e sfcry bui'dng :' I h I - / Pod ./ ,; / _ _ cony curb ' cone sio"e /k i;• f♦f. P'e v = '02.D; /ea I ,` ' / r 9a= I - i r I' r �4 , { bit• coot• curb I-- : , t . i C1.11 , . 1 ; : --_' _. -,_-_ ,, - - -- - - - �� i rod dole cotes- - - j- --_ .- - r"-4 i O' - - 1 . , d n_ _ l--, a 0- I i' . , 4 Liz : roof rhang I- 7` 1' j y, 82.4 E./ , ._...`. 5,58, _ - _�- _. ___ i _ . © vase]6.50' c ) / I " eag@ of S'dCWn.,1'__J. I. .. 1 v' /, 1 Q 8/�#t5TI91£ f • ' '1. 1'{1 Q1.08. -- - / / � C10.C� 0 -f; - '' ) 6 0 kt71W COkt_o- /0,, l� NRPORT / Q� x IN r �L. , n �. l I { I� k X?G437 d" { ��,,_ ! y / erg *eldispensers I ( }- i� , I Conn ad orr�u fuel di erasers t { ' ' t r p I / �\ P SP { � f I Z - Y' � �Jr ; NO R/Cf/T TU!?N �� i t U r-__ - 1 '. rc ,:, },I I �`-I fcv C) - W I'' PROPOSED FUEL DISPENSERS AND CANOPY ^ Q 1 ti� '; v o LOCUS c� 0 1,/ r,?, k \ ----- �I • t ft�' ' sideArak \ $ m F� \ �`` <, -_Jl f , . \ . / 0.� \ �, LEfT LAN£ trf/ST TURN LEFT' �� _ 7Q O' I _ \\ cc. cu.:5 ' Y E e � b!t♦ -- . - _ a . '- ___-_ ve e3 m.Yror can st. posf t. s,'€ \. \ , , ' r / - %_ USGS HYANNIS QUADRANGLE ;- �:}a,, , . - brf tuna curb \ \ ; 2000: ,oclo .�. , J 2000 " Q 1000 � ' - \ \ o sfaroge rlarw corm _ - i ,�'"� J6v ' \t; rsr u.¢ 1- 2000 �r / \ \ t tank flats EGG _* 'k e - - ? y i I �.' CQna Curb ! \ { _ . ~'11 . _ �\ { t M . . ------- _ I J ` - •- _ ors - NO R1GJ�1T TURN" drainage in/et - - _ - ------ -.*` ' , 1 bit. tuna Curb �. �. 9 I / �: _ ,. olae st. post /� t w 2� cones b �;-/ i xs4a } - - u`.f i' ✓l t - _r t�%CojJ t j s ' 1' 1Qt.3+S l t 1 y' 07.4 C- dam, r .i�.� ,- a / �� k 10i.37 `t I � h i ` 1 1 r� \ pole /Y76129 `" .\ \- ) 1 j ,; I \ \ �� 4'd gale pipes I '� - s ; I , %f NOTE: , .-I i \\` \ � I I I EDGE OF PAVEMENT AND BUILDINGS OPPOSITE SITE FROM 1. `y , TOWN OF BARNSTABLE GIS DATA. " SITE DETAIL FROM .� \` I 1` - INSTRUMENT SURVEY BY DOWN CAPE ENGINEERING, INC. f = , �I \� f,, I I I MARCH 24, 1995 z ,I . . , - . ,� \ I ,. l < . .{ \/ j t I $a.ae / I gr I O '- 7EFT LAA'£MUST TURN LEFT' I 1 i . ( - x .� \ \ I end,vcpyd syVewalk :y . .,. _ -- - , : . \ - granite curb ',, , vaos 00 NOT ENT£I?` �' ----- �'r - pomd sldewclk . _ ,,:ii , '.HR/STYS arao. R = 20.00' �' `i ,,; L - 52.10' ' t f 0 ]49'16'OS' { �. I = '' ��J'r- < - I , . I . I lam, , ,. . , .. - 7 s : y (. / - b u : - r _ . e % ,� .- --- --- - - - . L Y i 1 - i .. / - - _ , Sov . . �" _ �f y . . l . - r, - � €' �. . - . . , . - _ - -' '4 . . _ . . f-- __ 20 Q 10 20" 40 I s0 . . - F x �,4',3',; . - e. Lti: _ '- b'S. `( IN FEET } ! ��; K ' _ �{ t :1 > i Ir1 ch = 20 ft. ' Z \ '� . Q h ' y y _ v h Ir .. ,.. - Y , �� _ , a. -' 50.1' 15.4' 0.7' . . : ma's. ws ' "� - ` &- f _r'3, - _ d ". 1 r t f 1 SITE DATA• r ,N.�F +r, l<• 1 L F :, TITLE AND PLAN REFERENCES .,. .may � , d. . h {_.`. BARNSTABLE REGISTRY OF DEEDS BOOK 8526 PG 241-242 k � � :}' �, ,- r . .: _.. : - - - _ _ F J. .- - - p e f �. f. - .: REGISTRY.,PLAN BOOK 268 PAGE 54 ` ': , .-..: . I ; - I ,. ASSESSOR'S MAP 327 PARCEL 264 t : `{ . � x,r �...q,.:�_.-, .�-a.> i.a .:a i.�rs ��c<f atn -_ _',iL YW_;I8zig. r, ' s�sr.Ya a,-� , t ' - �` ;„ e .. _. F x w __ __ - -- . _ _,,- - M HOSE CH STY ., - - - _ - _ _ t- 1./u t,r1:uJ11 J t�lr"i�h.:.t, Ii'�, . . f . , l 22 CHRISTY'S DRIVE . ,. I }'s : s BROCKTON. MA 02401 . L. w . - & �w EXISTING CONVENIENCE FOOD STORE ` ,<` CHRISTYS MARKET INC. _ , :. r , ,, :r1 _ 1 STORY. FLOOR AREA 2,254. SF - r L 22 CHRISTYS DRIVE - ; C� I ' x <p BROCIfTON,.MA 02401 ,`� n , r �, f, .. - r r .. - - r , - ZONING DISTRICT: RE-1 t `` ;f LOT AREA: 43,560SF r { FRONTAGE: 20FT ',:;,.,• }, WIDTH:'>, 100 FT . - , f FRONT YARD 20FT _ r `, .. , , ,., _ . _ _ 10FT , - SIDE EAR YARD. r z _ .. +,. n. S L3,,.'r.° x'<'mii- r8[ +E--aN,:, .i'"i .. :iSA�,y` I,r. s c+ a ':��'y,_ i r t- 4f f'> ' - -. " . ..,. STORIC I I - . _ .. .. . , r-{ - a­. - r- _ .. .. - NO-HISTORICALLY SIGNIFICANT,BUILDINGS EXIST ON THE SITE ' ,.° . - _-_._ _ ___------ --�---= ------- -- -- ------- ; . .. e _,.,' ::. - __ __ - - t: 'i, PUSUC WATER �I,JPL'LY• flI r . ROOF OVERHANG `" -4 . SITE IS NOT IN A ZONE OF CONTRIBUTION TO A PUBLIC WATER ,,' - „. . SUPPLY.- IT IS IN AQUIFER PROTECTION DISTRICT 'AP' - . s FLOOD ZONE. 661' • .- , 7 - _ - , FIRM FLOOD ZONE C - SEE COMMUNITY PANEL 250001 0005 C - - - - . . - - d y, - f REVISED AUGUST 19 1995. _ _ ti Ai �i : < • .,,. - f J , . - f'• ^ - J rtZf? ,:(i . : _ -, - _ - d - tc:. - s I . , - ti . . - I Yk :. �r ' ! 0CT2 � ­ 4M , ,• ', _ �, t . . - _ ye t`hr 1 , k,.1 ys •i' r : : ,-__ - : . ,_ off 508 362 454 t Y _ fax 508'362 9880 . , 1 t F R: REVISIONS- S TE PLAN DRA TE DCT T : i�' �. 3- _. •-�� d e e r�ee n DcY - own ' - cap •� n.gi ri q, in. l 4 � In (J1 ; __ _ _ r,i ;: e . - CHRISTY S MARKE7 - . .,1. -i :., -. ., ::_ -.. _ _ _:;;;? - -der, ., ._t DESIGN. DCT E _ Cl t/lL ENG/NEEf?S .�- ,. . 50 OCEAN.STR BARNSTABLE HYANNIS MASSACHUSET S t. - F C SCALE AS NOTED LAND SURVEYORS 3 - ,. . .. , T o . , . r • n _ T FO CHRISTY S MARKE S INC. .': .__.. r , �. R,. �. 0 T. 10 99fi., C 1 _ _ - - 939 a- ` S e -YARMO T_ _� <, _. _ - . t U N 1�17a SS r _. - MA 0 40i F -22 ChRlSTYS DRl,� BROCKTO 2 _ , _ - y� - - r , , , , x.' K4 f _ _. _. - -.-__. _ -. _ -. -_ -___... .-.__. .____. _._. _ _... -..__. _._.-_---_-_. ___ ._.. __A..-_._.__-_--___ .._.. ,.__--.-'-_ ______-_- -. ....._ -,-._,...,-._-_,._._--,»._....-- -.____-_ _..-___..__- ,-... _..._..-.-__.,-,-_,,.�._.- __... ......_..__.. ..-,.,,.-,a +......-.e,,...•.r ^�^',. _.._ -.. . ____....._-__.__- :-_.--- ,- - r _-__... _. __.._-_.. _- _ _..