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SPANKY'S CLAM SHACK - FOOD
y I Ifi I SPANKY°S CLAM SHACK 138 OCEAN ST. , HYANNIS 32(,g 0cip7 - - - - - �. . £ORM£I,: HARBOR HOUSE {� \�} � \ } r ; } ~� . e : , ! \ � / \ © � �®{ /? <} � \ } �) } . � . \ j < � � } BOARD OF HEALTH Town of Barnstable John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAWNW-ABLE, F.P.(Thomas)Lee v MA&; Daniel Luczkow,M.D. Alt. 69. 1� 200 Main Street, Hyannis, MA 02601 s 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: 254 Issue Date: 01/01/2022 DBA: SPANKY'S CLAM SHACK & SEASIDE SALOON OWNER: SPANKY'S CLAM SHACK LLC Location of Establishment: 138 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 115 OutdoorSeating: 40 Total Seating: 155 FEES - FOODSERVICEESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - MOBILE-FOOD: MOBILE- ICE CREAM: Qn FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: For Office Use Only* Initials: ` .°t"�' 1•� Town of Barnstable - Date !aid AmLP�$_y� : EUURNWAB j, : Inspectional Services Public Health Division Check# Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 J Office: 508-8624644 Fay 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 3 /1 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: Chan,_ A,4/4 E S &aunF sAtDD�v ADDRESS OF FOOD ESTABLISHMENT: /3 S O e 69 N .5 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (,moo$)7L- 2-7 70 V� TOTAL NUMBER OF BATHROOMS: `f WELL WATER:YES NO (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: q/l y/ZzTO /o / 2 7 z i NUMBER OF SEATS: INSIDE: H-S OUTSIDE: �-/4 TOTAL: /SS SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DM AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? YeS IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? 6S TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) k'FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refngeration/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 DM FOR INSPECTION PRIOR TO PEgmrr BEING SUED PLEASE CALL 508-86246" Q:1Application FmmsTOODAPP 2020.doc .S,(q ek G GC OMNER INFORMATION: FULL NAME OF APPLICANT Lr hell0 j /49, 4A i��� ��/�L/A�/►� A', SOLE OWNER: YES/ O OWNER PHONE# ✓S- SD S 972 y l 96 GtJM- `�'7y--q30 gA17/ ADDRESS_3L!�9/Ls�r�Pik Cis SAy►��✓/ua O/Z S3 CORPORATE OWNER: G L C CORPORATE ADDRESS: /,78 0o6,9-h J-,r� /7 9 /✓'I�ZPa f>/ PERSON IN CHARGE OF DAILY OPERATIONS: A 11eD2 t G l21�r List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div.will NOT use past years' records.You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Manners Expiration Date Allergen Awareness Expiration Date 1. 6/�F, ,/17,S,DI/1410 -2 l /S l a 3 1. Sr 3 / 9 S/ 2. G�// 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 openine!! Please call Health Div.at 508-8624644 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 HeaLLth 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.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.31 st each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1sG Q:1Application FoimsTOODAPP REV3-2019.doc 1. 1W IKEI Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARN91rAUM Paul J.Canniff,D.M.D. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate �A 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: 254 Issue Date: 01/01/2021 DBA: SPANKY'S CLAM SHACK & SEASIDE SALOON OWNER: SPANKY'S CLAM SHACK LLC Location of Establishment: 138 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 115 OutdoorSeating: 40 Total Seating: 155 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - --- ---------- — MOBILE-FOOD: MOBILE-ICE CREAM: Qn 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 Offic Initials: �pFINE ipk Town of Barnstable :(/ Amt Pd tARNSfABLE, : Inspectional Services MASS. Check# 1e39. `0 Public Health Division A�fD Mph s Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 3 a?/ o? NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT:_ �vtV�vt S G *p, �V�A-CGt � 1 e ADDRESS OF FOOD ESTABLISHMENT: Mr r d G&9N d--, MA d ZZQ I Y i MAILING ADDRESS(IF DIFFERENT FROM ABOVE): I E-MAIL ADDRESS: 5,oam !'✓l�r c,1&,m eox), TELEPHONE NUMBER OF FOOD ESTABLISHMENT: .S( US ) Uf TOTAL NUMBER OF BATHROOMS: 14f _ WELL WATER: YES NO_je!!!�'... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: ✓ DATES OF OPERATION: At / IS/Zj TO ID /20 /� NUMBER OF SEATS: INSIDE: 1/2�' OUTSIDE: I/'0 TOTAL: I.SS 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? yES IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? y&S TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) —/KO/OD 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 For sTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YES/NO D.O.B_ 20 SZ- OWNER PHONE # ADDRESS,32- / IK.t3{�U1eAJ 61V, �SPtoWiUk a?-S37 ?7'f- .�3$ - gfF_7/ C�jI/yoz63Z CORPORATE OWNER::,4;1 �f C/4YYI9 SA.4Gfr L�� �� pie'£ �(� CORPORATE ADDRESS: �3� (/CE�� �1 yI-41"4/1 PERSON IN CHARGE OF DAILY OPERATIONS: afu £ vf m 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 C�j v 2. . / Z/ SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments, including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.ast). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January I st to Dec.315t each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q:Wpplication FormsTOODAPP REV3-2019.doc ca Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAMSUB1B Paul J.Canniff,D.M.D. 6 200 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: 254 Issue Date: 01/01/2020 DBA: SPANKY'S CLAM SHACK & SEASIDE SALOON OWNER: SPANKY'S CLAM SHACK LLC Location of Establishment: 138 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 115 OutdoorSeating: 40 Total Seating: 155 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: w, Opt►IE tp� For Office Initials: Town of Barnstable !TV BA MASS.LE, Inspectional ServicesMASS.' Public Health Division '°ten Mpr e 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 .3 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: G a f �tfl Et �,e,a�l�E sGjLC7�l� ADDRESS OF FOOD ESTABLISHMENT: /3� ��E9� S� i��`IfJl,{ 2 /# p2-6o/ MAILING ADDRESS(1F DIFFERENT FROM ABOVE): E-MAILADDRESS: c�3i0Ci?!�l E/�i C�elIn COa-'neGu''l—r rJe;r - TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (508) 7�- ,177� TOTAL NUMBER OF BATHROOMS: WELL WATER: VES_ NO !(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: f DATES OF OPERATION: 'f /i6120 TO /0 l 3/ l 20 NUMBER OF SEATS: INSIDE: //S OUTSIDE: y0 TOTAL: S 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:'LApplication FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT 1,212,e�/1 cry IY2 S:S i/JYI,o �/ZAX- m �//904.�� d SOLE OWNER: YES IL<O OWNER PHONE # 509-97X-41/,70 C.�s ADDRESS 2/31 SS -77q- a 32,- 9�f7�Cf-J m 2/�AYSfit/r�iJ �iv Sa. n�.✓;�/ /P7A 02TT-r CORPORATE OWNER: Sprv.��GLSQrv� 4G . GGC_ v r CORPORATE ADDRESS: /3� QC ti ST ��;� ;j '4114 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 ,7 SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments, including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at htti)://www.townofbarnstable.us/healthclivision/apylications.asi). OUTDOOR COOKING: Outdoor cooking, preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q:\Apphcation 1 ormsWOODAPP REV3-2019.doc f v it � r Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. LttlivsTA1SLE John T.Norman MASS, 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: 254 Issue Date: 03/01/2019 DBA: SPANKY'S CLAM SHACK & SEASIDE SALOON OWNER: SPANKY'S CLAM SHACK, LLC Location of Establishment: 138 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 160 OutdoorSeating: 0 Total Seating: 160 FEES -- - - - - FOODSERVICEESTABLISHMENT: $300.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: -- MOBILE- FOOD: MOBILE-ICE CREAM: ` Qpr 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: f 4 G' - _ "o Town of Barnstable i P.ANiIsrnB! t Inspectional Services i6ggr `�� �lfD'MPtA Public Health Division Thomas McKean, Director L� 2.00 Main Su:cet, Flyannis, �ri.A 02601 � 1 Office: 508-862-4644 Fax: 508-790-630,1 A S:1:I:M^ENT A:E'I'L;]:C��`.i.':EON'FOR PERMIT TO OI'[;12�\'C:1±/ FOOD Ii;S'l'.A]3I,I� _ Dr\'J.'I? ��� �' NF,W OWNERSHIP I EN EWAL rlAi\rr,; OVFOOD ESI'ABLISrl:mr<..N`.I:-S �N`r��. 21.... �_ _ � �> E_.•S _ O/ s AD1)USS OF FOOD ESTA B USY MEN'I': � � qNvia IV]A11,1N(Y AD1)RBSS (IF D1,I.FRRLN'1'FROM ABOVh): i 3� Cowl Bass ��� '[WBPHONE NUMBER OF FOOD F.S'I'AI31AS:E.IM:GN't: L'o'fnJ NUMBER.OF 13ATHROO�INIS: -- �;VI;C,1,�ti�cl.'['ISR; YtS _NO_�.. (ANNUAI_,WA.'IERANA]-,YS�1SREQUIRED) NNtIAL; Sl?r1SONA1..,: _-- ----,DATESOI Il NtJNll3l{,I.t M ,SEA'1.',Sr INIS.D E: �,�- OU'l SLl)1,.T�Q— `E'a A1/ I �! S(1;A'INC: MUST O:E3FAEN A COMMON VIC'1:TAl,:E-,l R'S LI('L;NSai� Eil�t)1Y1. l,l(. l,iV,SEti't,-1)1V- j'i �> 0l1 l'SII)I+:;OINIiVa; iti�,itil1N1)I+ R` UU'1'S1U1';I)ININC, MUST J;I':r\1'1'12OV1 1) RY I lII! lfl'rU I'll D14 rV,ll) 7 L( I';�Sl\( , ANll 1i1 F;T Otl'I'S11)I; I)I,\�i� t IS \VAVr TPA1<'F PROVIDED I OR OilrSIDE DI-iNNING? iS ;',N ;1 M CURTAIN I'BOV1 DI'D AT WAPYS'J'AFF SRRVIC;J, (i'XA:SE CURCK AL,7/'I'IiAT APPLY/BELOW) -FAN SKRVLC-k� ,A I(_,FOOD - ONtA!, rc(Iuircd fnr'I'CS fonds (roods 1-oplirin}?, re.lri};craiiu;i/Crccz�:,) & iltli'AI(I�AS'I' ii-0Nl;iti'P.\1, 13RY,A,I(FAS'I' 1�000 INDUSTIN (formerly residcn(ioil Itifclicli) H!;!i'll.\ ]);111.21'r)I ti51:1{`(' iY1ACLiINI?S (NION'1TI,I,Y l;Ali Alit\I..,)';i15 lit;(}tllltl;f)) 1(i;�'�(�R,1llON7t1,(�){I11?1 PAGE 4)il��) 5 0 S 8 g 'IAL'I (UNAPT ENKIPJAIT ON It 1.- UIA,NAME OF APPLICAN e 144A LZ 7— —j� SOLE,OWNFUZ: YES NO D. _ OWNER PaONE 4,11011 �` Ij 1Sy -7 7q q,7 ADDI-ZESS CORPORATE OWN EIZ�ft���e-FEDERAL ID NO. : CORYORATE ADDRESS: now 111i',11SON IN Cf]AUGE OF DAILY OPMATIONS, List: (2) Certified Food .Protection Amagus AND at least (1) Allergen Nwareness Cer-tified StMT , , I I /\.11b'001) ESTABLIS-1-IMENTS must have 1 Cert1h ll ed Food Proteclio Nla1)a9('r I El Sll :F'1'. 1 ATT&CH COPIES OF -'ik1l!'S he -1.-1ealthDiv, WHI pol: use past ymu-s' record, You Most p; vicle .lic)v copics and pOS'J''I']JE CERTIFICATES at ymir Mod establishment. Aivaren�s Cy"Idlind Food Mynapirs Expiration Date Allergm NO A 52, S'l GN A'... DATE OF t)4VTz-,,,t vxp[,�UCA, wASONALFOOD All seasixt tl food emiblishinents, inch(lingnioNe trisk"MM bm"dixHl Ow HmAh OW. Pk,,�iso call Health Div. at.S08-862-461I4 to schedule.Y011r inspection. c,:111 IL Icast(/) Im"i-ozondesserts mot huwswd by Sly to Mod KA PHY 0 qm&ga" VMMNY klwomb-, -esuhs Submitted to the M;1flill Div, to clo!;o will ies,ul.t ill the stlspelnsioll or revocation o[7yw1!- 1",i,w;ll D sclt KmAl until the above Lenris are ind. t IN(, 1101ACT: A i:iyojlC 'A'I 10 (;it lei S Within the'I'oWn of I in usc notify the 1 in ]I by 1'.'1 X or 111 it i pi icl-to HILISt complete a (-idcring notice (build ill LILUa_/LNy tA'j TOBACCO mrABIJSilNIl,,N'TS; Form. IT 1SVOUR RKSMNSIMID Vill NK&M, kt, THE Tp TOWN OF BARNSTABLE .HEALTH INSPECTOR'S Establishment Name: - Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � e59. �•� HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY p s FOOD ESTABLISHMENT INSPECTION REPORT 508-862-4644 Name Dat e of Type of Inspection Routine Address Risk ood Service Re-inspection f Level Retai Previous Inspection Telephone Residential Kitchen Dates, Mobile re-operation Owner HACCP YIN Temporary s ess c Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) 7 � FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities / 0 _ EMPLOYEE HEALTH PROTECTION FROM CHEMICALS {\ J�lyt . ./ ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives /�K ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals �w` l/ FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Food ) , ❑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 LLeta 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 v` 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 ❑❑ 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 9 re ardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 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 P C's Sign Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N �► Id 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* 3-302.1](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.I6(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH - - 33 590.004(F) *_ - Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 02.11(A)(2) Raw Animal Foods Separated from Each 7-]Ol.l1 Identifying Information-Original Containers* * 2 590.003(C)- .Responsibility of the Person-in-Charge.to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 P g Separation-Storage* Applicants* - - 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An _ 3-302.15- - Washing Fruits and Vegetables _ * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance 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) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* •_ .REQUIREMENTS FOR _ 3-306.14(A)(B)Returned Food and Reservice_of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions - - g � ) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g - Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* t 590.004(A-B) Compliance with Food Law* 4-501.111- --Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13__ _ Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.1]A(t)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101,11 Drinking Water from an Approved System* 4-601.11(A) Clean,Utensils an ContactEggs d Food 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* EfftNi 11112001 4-602.11 I Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11- -Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- _ _ _ Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By _ 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* - 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail _ ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g• g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands ( ) * Critical and non-critical violations,which do not relate to the foodborne 3-403.11E RemainingUnsliced 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 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked and Fr from 140°F to Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours d From 70°F to 41°F/45/45°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 2g, Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* _ 8-103.12 1 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. FINE ro TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Dater Page: of OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30A.M. % BARNSTABLE. ' 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified .639.SS. `0m HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name G Dat Zb) Type of Type of Inspection �, O er Routine Address Risk/ pod Service Re-inspection Level Previous Inspection Telephone Residential Kitchen Date: Le Mobile Pre-operation Owner HACCP Y/N Temporary Sus u Caterer neral Complaint Person in Charge(PIC) Time Bed 8 Breakfast HA In: Other I Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Pea c d Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/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 If ❑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 _1 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 5I rat within 90 days as determined by the Board of Health. 1 ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4npn-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 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 anon-critical violations. If 1 critical refrigeration. violation,4 to 8npn-critical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPECTION: Inspector's Signature ^ Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N IC' Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N 1) M IC jy� 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* 13 Cross-contamination 14 Food or Color Additives law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each * 590.004(F) _ 7-]Ol.I 1 Identifying Information-Original Containers 2 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting b Food Employees and Contamination from-the Environment 7-102.11 Common Name-Working Containers* * 9 P g Y3-501.16(A) Roasts Held At or Above I30°F Applicants* * 7-201.11 Separation-Storage* 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"1 l Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-80I.I I(B) Use of Pasteurized Eggs* 3-201.4(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 -20112 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* I 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 DrinkingWater* Concentration and Hardness* 22 3-603.11 Consumer Advisor Posted for Consumption of 3-401.11 A(I)(2) Eggs-155°F 15 sec Y P 5-101.11 Drinking Water from an Approved System* 4-601"1 t(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 590.006(A) Bottled Drinking Water* Equipment* 3-401.11(A)(2) Comminuted Fish,Meats&Game Not Otherwise Processed to Eliminate 4602.11 Cleaning Frequency of Utensils and Food Pathogens* r'X°d-rnrzoa 590.006(B) Water Meets Standards in 310 CMR 22.0* q y Animals-155°F I S sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source Contact Surfaces of Equipment* 3-401.11(B)(I)(2) Pork and Beef Roast-130°F 121 min* 4-702.11 Frequency of Sanitization of Utensils and Food L 1Eggs* 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 * Ratites-165°F 15 sec* ( ) ( ) ( ) (D)in cater- Game s 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 2-301.1 I Clean Condition-Hands and Arms* g ry tY 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 r r Reheating for Hot Holding practices should be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11 A&D PHFs 165°F 15 sec* Requirements. 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 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 3-202.18 Shellstock Identification* 13 Handwashing Facilities 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* _78 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 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 3-402. 5-205.11 Accessibility' P O eration and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 Records,Creation and Retention* Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 27. Physical Facility FC-6 .007 HACCP Plans 6-301.12 Hand Drying Provision 28. Poisonous or Toxic Materials I FC-7 1.008 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback62doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. °p IMF ro TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: S 0 h/1 I`I^ S Cik n JhOJA Date: Page:�_of .. 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 679• `0� HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �A a 508-862 4644 FOOD ESTABLISHMENT INSPECTION REPORT Name I S� Date Tyne of TXpe of Inspection v 0 012gratiol3(s) row tinell Address Risk Co7odc Service Re-Inspection t, l Level Retail Previous Inspection Telephone Residential Kitchen Date: Mill n Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness ` _ O Caterer General Complaint �� Person in Charge(PIC) �� S. , I I Time I,� , Bed&Breakfast HACCP _ In: OtherUV Inspector Out: , S('09 O e U Each violation checke equires 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) ❑ 0 Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. I Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands O U -r- �_ o - ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS Pic ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ✓ ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals r FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ((�����/� ❑ 5.Receiving/Condition ❑ 17.Reheating 6 V�1/�/ V ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HS ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY 6 tAh = pI J 6 ❑ 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) to rva�j Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ Emergency Closure C] Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations g 26.Water,Plumbingand Waste (FC-5)(590.006 if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot ) establishment permit and cessation of food establishment operations. If C=2 critical violations less critical water,sewage 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must ons and than 9 non-critical. I no cr g back-up,infestation of rodents or insects,or lack of violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to a non critical violations=C. Signature Print:i Sna 30.Other PATE OF RE-INSPECTION: Inspector's g (' 31.Dumpster screened from public view 7 L-1n.0 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 �C /' _ 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 7 5 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 Other* Identifying g Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-.Charge-to - -- - 7-102.11 Common Name-Working Containers*7-20111 Separation-Storage* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F _-_ Applicants* � 3 302.11(A) Food Protection* 120 Time as a Public Health Control 590t003(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* _ * :y 7.202.12 Conditions of Use* 590.004 11 - Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) 9 590t003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer - . 3 590t003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria Chemicals* REQUIREME14-TS FOR - 3-306-J4(A)(B)Returnedposits n of and Reated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590�.003(E) Removal of Exclusions and Restrictions g ( ) Disposition of Adulterated or Contaminated -- -- - -- - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11, Incidental Food Contact,Lubricants* Beverages with Waming Labels* 4 Food and Water From Regulated Sources-- " ' "-' 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and * 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 _ Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* - 4-501.112 Mechanical 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* 3-401.11 A(1)(2) Egg's-155°F 15 sec Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Waterfcom an Approved.System* 4-601.t Eggs 1(A) Clean and Food Contact Surfaces of E s-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* Ed i"11112001 4-602.11 _. Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 316 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an.Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan - Contact Surf aces of Equipment* Shellfish* 3-401.11(Aj(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources ' * Proper,Adequate Handwashing Ratites-165°F 15 sec* ing' mobile food,temporaryand residential Game and Wild Mushrooms Approved By - 10 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* j 165°F* foodbome illness interventions and risk factors. 2-301.14 When to as * Other 590.009 violations relating to good retail -590.004(C) Wild Mushrooms_* Wash*_ •_ _ - _ .� 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices_ 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial) Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.1](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* S 18 . Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible ; Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* t 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 I 6-301.4Q1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.1 I Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 1 Conformance with Approved Procedures* ,i S:590Formback6-2doc *Denotes critical item in the federal 1999-Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: A _Date: Wage: of 1.� OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. RARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item D CRIPTION OF VIOLATION/PLAN Off CORRECTION Date Verified 1639, `0ASS. � HYANNIS,MA 02601MON -FRI. 08-8 508-862-0644 No Reference R-Red Item PLEASE PRINT CLEARLY '�rfD MP�p FOOD ESTABLISHMENT INSPECTION REPORT - In CZ It/ Name Date ' Type of Type of Inspection O er Routine Address Risk rod Service Re-inspection Level Previous Inspection Telephone Residential Kitchen Date: ` aJYVA ✓ Mobile operation Owner HACCP Y/N Temporary Suspec Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: got Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ i' Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS /p^ VNoAd ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives VV�� ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) f A � ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures v ❑ 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 �Q�) ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations a Critical(C)violations marked must be corrected immediately. (blue&red items) E�� Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating (3 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 inspect on today,the items ❑ Embargo ❑ Emergency Closure Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4npn-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 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 non-critical. . f 1 critical refrigeration. critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to a non-critical 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address tical violations. If 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to Snon-critical violations=C. 30.Other DATE OF REASPECT O Inspector's Signature Print: ov31.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 ignature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N % ,G` Dumpster Screen? Y N J Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions y° Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 1 q Food or Color Additives Law Cooled to 41'F/45'F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 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*7-102.11 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 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served y Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 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 * Equipment 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 Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective utnooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155'F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in-cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing g' P Game and KIId 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. * 2-301.14 When to Wash* 3�01.11 A 1 All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )ro) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements.practices oshould be debited under#29-Special $ Receiving/Condition 2 401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2 401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) .Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140'F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* � ( ) g illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 13 Handwashing Facilities 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* 3-501.14(A) Cooling Cooked PHFs from 140°F to 70'F P 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 Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* 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* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. OF 114E ro TOWN OF BARNSTABLE ..HEALTH INSPECTORS Establishment Name: Date: V-vi-opage: of OFF IC E HOUS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSfABIE. ` 200 MAIN STREET 3:30-4:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 30-4-FR.. No Reference R-Red Item PLEASE PRINT CLEARLY `rEo MPS 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Dat Tyne of Type of Inspection p Routine Address Risk od Service Re-inspection Level Previous Inspection94 Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast H In: ther Inspector 1 Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 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 Co.isumer Advisories L Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations l` Critical(C)violations marked must be corrected immediately. (blue&red items) n Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or 1 within 90 days as determined b the Board of Health. Overall Rating 1111 y y ❑ Voluntary Compliance ❑ Employee Restrictiori/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 6=One critical violation and less than 4npn-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 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 8npn-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 Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N j Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 0 Cross-contamination 1 q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3- .15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH,,, 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140'F 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 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 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for 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 Wanting 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 * * Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 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* 3-401.1 I(A)(2) Comminuted Fish,Meats&Game Pathogens* Ege,ri-im2oo1 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 P 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 Surfaces aces of Equipment*Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 4-703.11 Methods of Sanitization-Hot Water and Shellfish* 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 Chemical ( )-( ) 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 Game and Wild Mushrooms Approved B 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority y 2-301.11 Clean Condition-Hands and Arens* 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 I I 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) 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 34 Critical and non-critical violations,which do not relate to the foodborne 03.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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 E29.. Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* Management and Personnel FC-2 .003 : 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 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:590Fonnback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. THE r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of OFFICE HOURS t BARN E. PUBL 0HEAST RET 0 ALTH SION ' - - - 8:0 -9:30A.M. 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified Mph, y, MON.-FRI. �A t639,n e HYANNIS,MA 02601 506-662-4644 No Reference R-Red Item PLEASE PRINT CLEARLY 'EO"" FOOD ESTABLISHMENT INSPECTION REPORT r �. /� / P NameIA Date Type of Tvoe of Inspection �, r / p Routine Address' Risk F_od Se Re-inspection i Level Real Previous Inspection Telephone Residential Kitchen Date Mobile ope iti on Owner HACCP YIN Temporary SMpec Hess Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Znw 1 In: Other Inspector Out: t� 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 41411- EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding . PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control a ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP G �, d❑ 11-142- 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories yb 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 Nan-critical(N)violatiuns must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations ' regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4Hon-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 - 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;Tto anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8Hon-critical violations=C. 2 w y 9.Special Requirements (590.009) p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature fin/ Print: Self Service K Wait Service Provided Grease Trap Size Variance Letter Posted Y. N /� /y) i '^' �� Dumpster Screen? Y N f(J 4A� 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 L 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* 1 r 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* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* P g Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-M2.11(A) Food Protection* 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 3-304.11 Food Contact with Equipment and Utensils* * 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* 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 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 183-401.11A(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* Effective utrzooi 4-602.11 Cleaning Frequency of Utensils and Food_ Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CN 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish.From an Approved Source: _ . 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 ' Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g tr 590.009(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* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* -2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A). Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004 Labeling of Ingredients* Supplied with Soap and hand Drying Devices (J) 9 9 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Spec al Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502h Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S.590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF.H r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: ��' Date: )(IPage: of �4 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. i BARNSTABLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � byq: �• HYANNIS,MA 02601 508-86264 MON.--0644 No Reference R-Red Item PLEASE PRINT CLEARLY prFn MPS a - FOOD E TABLISHMENT INSPECTION REPORT J� o Name � Dat Type of Type of ection on RoutineI OL Address Risk ood Se a Re-inspection A Previous Inspection t Level Retail P Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint ' Person in Charge(PIC) Time Bed&Breakfast HACCP t In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors Red Items)) Anti-Choking 590.009(E) ❑ CAI 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 'C- 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) 1714.Food and Water from Approved Source ❑ 16.Cooking Temperatures [35.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 b I ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations VVV 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. 5.Equipment and Utensils FC-4 590.005 6=One critical violation and less than 4non-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i cal violations. . f critical water,sewage bade-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspect Sin re nt: 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 Signatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) [Demonstration signment of Responsibility* 8 Cross-contamination 1 q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) 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* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage*Applicants* 3-302.11(A) Food Protection* P 8 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance 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 Reared or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 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 ca[er- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved B 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under y Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.l l(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. g Receiving/Condition 2-401.11 Eating.Drinking or UsingTobacco* 3-403.11(A)&(D) PHFs 165°F IS sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 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 Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008. HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. "Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. °p TMF► TOWN OF BARNSTABLE _ HEALTH INSPECTOR's Establishment Name: Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS, MA 02601 M-8 -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY 'FO MPS FOOD ESTABLISHMENT INSPECTION REPORT 508-8 Name Date Tyne of T I s ectio O s outine d, Address Risk od Service. � lion J Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness G Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector cL Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling t ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time Asa Public Health Control AM - ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) r 5,6 ❑ 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 c �( Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) ✓ Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Y y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations 9 )( ) cited in this report may result suspension or revocation of the food 4 to 6nnn-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed, 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 anon-critical violations. If 1 critical refrigeration. violation,4 to 8non-critical violations C. 29.Special Requirements_ (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N IC's Si nat r Prin Self Service Wait Service Provided Grease TrapSize Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violation Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 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* 7-102.11 Common Name-Working Containers* 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F * 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of 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,Meals&Game Pathogens* eg cave urnoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* 1 p Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3AOl.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* A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-401.11( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the 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* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F * Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained 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 () 9 9 27. 1 Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand�Yin Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. A°F�HE roe," TOWN OF BARNSTABLE � /� EALTH INSPECTOR'S Establishment Name: � � 5 ( ^ (!I,' %'.1 e Page: of 4 /h✓ OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:3oA.M. BARNSTABLE. • 200 MAIN STREET /� 3:30-a:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified mAss. 0g HYANNIS, MA 02601 (/) M-8 -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �prFD MPS p, .� T" 508-862-4644 FOO ESTABLISHME T INS CIO REPORT Name Date Tvoe of Tyne of Inspection Routine Address FIV Risk ^od Se Re-inspection Level Previous Inspection Telephone Residential Kitchen Date y Mobile re-o Owner HACCP Y/N Temporary uspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Other - Inspector 9 �- Each violation checked requires an explanation on the narrative ages)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ f 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� ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities i EMPLOYEE HEALTH PROTECTION FROM CHEMICALS le ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives r ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals CN FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) O ❑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 HSP11,1011 ❑ 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 n Critical(C)violations marked must be corrected immediately. (blue&red items) (Q 4 [�1 Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating 111 within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically lack of no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 nog-critical. if no critical water,sewage back-up,infestation of rodents or insects,or la be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 n -critic violations. If 1 critical refrigeration. 28.Poisonous'or Toxic Materials (FC-7)(590.008) g violation,4 to 8rion-critic lati =C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: In cto's Sig at r 'Prin 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N C� #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y. N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 1q Food or Color Additives -- - Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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 t 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 1 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F*Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130°F* - _ 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 -590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils ( ) 9 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* —REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and AdulteReserrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g ( ) Disposition 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* q Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501-.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container_* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg g PP y Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ep we 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell . . Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 'Frequency of Sanitization of Utensils and Food 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3-401.11(A)(2) Ratites,Injected Meats-I55°F 15 sec Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009 A Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-�) 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 2-401.11 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* 3403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate to 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* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140'F to 70°F * Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained 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 1 Hand Drying Provision r 29. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Fonnback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ~ ' Civil&Environmental Consulaanm Inc. August 15, 2017 P� Ann Quirk , Barnstable Town Clerk's Offi Town Hall ZA 367 Main Street Hyannis, MA 02601 Subject: Informational Notice to Property Owners and Notice of Property within Disposal Site of Permanent Solution Statement RTN 4-26776 Behind Spanky's Clam Shack 138 Ocean Street Hyannis,Barnstable, Massachusetts 02601 CEC Project#173-323 To the Barnstable Town Clerk: Civil & Environmental Consultants, Inc. (CEC) is writing to you, in accordance with 310 CMR 40.1406 of the Massachusetts Contingency Plan (MCP), that approximately 30 to 40 gallons of diesel fuel was released from the Fishing Vessel Sea Swan to Inner Hyannis Harbor following an over fueling of the vessel while it was docked behind Spanky's Clam Shack at 138 Ocean Street, Hyannis, Barnstable, MA. The harbor is considered to be under the Town of Barnstable's jurisdiction. The Release was discovered at 138 Ocean Street on July 23, 2017 at approximately 7:30 AM, by personnel from Hy-Line Cruises,who own and operate the Sea Swan. The Release was reported to the Massachusetts Department of Environmental Protection (MassDEP) at 8:00 AM on July 23,2017,within two hours of the discovery of the Release;Release Tracking Number (RT )4-26776 was assigned to the Release. In accordance with the requirements of the Massachusetts Contingency Plan (MCP) [310 CNVIR 40.0000], CEC is also notifying you that a Release Notification &Notification Retraction Form (BWSC 103) has been submitted to the Massachusetts Department of Environmental Protection (MassDEP) for the above-referenced Site. A copy of the BWSC 103 form is attached. CEC is also notifying you that a Release Notification & Permanent Solution Statement with No Conditions, in accordance with 310 CMR 40.0300&40.1000,has been completed for the above- referenced Site. The level of oil and hazardous material in the environment has been reduced to background type levels and a Permanent Solution have been achieved for the Release without the implementation of any institutional controls or property restrictions. A Permanent Solution Statement with No 31 Bellows road I Rxynham, MA fl2767 774-501.2176 f:774.501-2469 1 www.cecinc.com Informational Notice and Notice of Permanent Solution Statement CEC Project# 173-323 Page 2 August 15,2017 Conditions, as described in 310 CMR 40.1041(1)(c)(2) has been achieved for the Site located in Inner Hyannis Harbor proximal to 138 Ocean Street,Hyannis. No operations,maintenance,and/or monitoring is required to confirm and/or maintain the conditions at the disposal site upon which the Permanent Solution Statement with No Conditions is based. Details regarding the assessment and remediation activities can be found in the August 2017 Release Notification and Permanent Solution Statement with No Conditions. This report is available for public review online at the MassDEP Waste Site/Reportable Release File Viewer found at hgR://Rublic.deR.state.ma.us/SearchableSites/Search.asR. A site plan showing the disposal site boundaries, as well as an Informational Notice to Property Owners(BWSC 122), are attached. Public involvement opportunities are available under 310 CMR 40.1403(9). If this property is no longer under your ownership or if you have any questions regarding this matter, please contact me, William Hoyerman-Licensed Site Professional (LSP), at(774) 501-2176. Sincerely, CIVIL &ENVIRONMENTAL CONSULTANTS, INC. MaryJtgworthy William R. oyerma�n, , Staff Scientist Senior Project Manager, LSP-of-Record Attachments: BWSC form 122 Site Plan with Disposal Site Boundaries cc: Paul Canniff,D.M.D. Board of Health Chairman Town Hall 367 Main Street Hyannis,MA 02601 Ovil & EnArcnmencal Consultants,Inc. Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC122 This notice is related to: L71 Release Tracking Number INFORMATIONAL NOTICE TO PROPERTY OWNERS 4❑ - 26776 As Required by 310 CMR 40.1406 of the Massachusetts Contingency Plan(MCP) A. DISPOSAL SITE ADDRESS:(associated with Release Tracking Number provided above) 1. Street Address: 138 Ocean Street 2. City/Town: Hyannis, Barnstable 3. ZIP Code: 02601-0000 4.Assessor's Parcel ID: B. THIS NOTICE IS BEING PROVIDED TO THE FOLLOWING PROPERTY OWNER: 1. Name of Property Owner. Barnstable Town Clerks Office 2.Address of Property For Which This Notice is Being Provided: (property owned by person named in 61) a. Street Address: 367 Main Street b. City/Town: Hyannis c. ZIP Code: 02601-0000 3.Assessor's Parcel ID: C. THIS NOTICE IS BEING GIVEN : (check one) ❑ 1. Upon Completion of a Phase PI Comprehensive Site Assessment. �] 2. Upon Submittal of a Permanent or Temporary Solution Statement(i.e., Site Closure Report). ❑ 3. Upon Completion of Additiona0 Investigation showing that Oil or Hazardous Material is not Present at the Property. D. DESCRIPTION OF OIL AND/OR HAZARDOUS MATERIAL PRESENT OR LIKELY TO BE PRESENT AT THE PROPERTY: (check all that apply) AFFECTED ENVIRONMENTAL MEDIA PRINCIPAL CHEMICAL(S)PRESENT ❑ I. Soil ❑ 2. Groundwater © 3. Surface Water DIESEL FUEL ❑ 4. Sediment ❑ 5. Indoor Air ❑ 6. Soil Gas ❑ 7.Other. (specify) E. ATTACHMENTS PROVIDED WITH THIS NOTICE,AS REQUIRED BY 310 CMR 40.1406: 1.A Copy of the Map Showing or a Description Describing the Area where the Oil and/or Hazardous Material is or is likely to be Present. ❑ 2.A Copy of the Phase 11 Comprehensive Site Assessment or Permanent or Temporary Solution Statement Conclusions. © 3. Specify the category of Solution that applies to the Disposal Site. 0 1. Permanent Solution with No Conditions. ❑ 2. Permanent Solution with Conditions. ❑ i.An Activity and Use Limitation has been implemented. ❑ ii.An Activity and,Use Limitation has not been implemented. ❑ 3.Temporary Solution. Revised: 5/30/2014 Page 1 of 2 , 1 Massachusetts Department of Environmental Protection Bureau of Waste Site Cleanup BWSC122 This notice is related to: INFORMATIONAL NOTICE TO PROPERTY OWNERS Release Tracking Number 40 - 26776 As Required by 310 CMR 40.1406 of the Massachusetts Contingency Plan(MCP) 17 Ll F. CONTACT INFORMATION RELATING TO THE PARTY PROVIDING THIS NOTICE: 1. Name of Organization: Civil & Environmental Consultants, Inc. 2. Contact First Name: William 3. Last Name: Hoyerman 4. Street.. 31 Bellows Road 5. Title: LSP-of-Record 6. City/Town: Raynham 7. State: MA 8. ZIP Code: 02767-0000 s. Telephone: (774) 501-2176 10. Email: bhoyerman@cecinc.com MASSACHUSETTS REGULATIONS THAT REQUIRE THIS NOTICE This notice is being provided pursuant to the Massachusetts Contingency Plan and the notification requirement at 310 CMR 40.1406. The Massachusetts Contingency Plan is a state regulation that specifies requirements for parties who are taking actions to address releases of chemicals(oil or hazardous material) to the environment. THE PERSON(S) PROVIDING THIS NOTICE This notice has been sent to you by the party(ies)who is/are addressing a release of oil or hazardous material to the environment at the location listed in Section A on the reverse side of this form. PURPOSE OF THIS NOTICE Parties who are taking actions to respond to releases of oil or hazardous material to the environment are required by state regulations(referred to above)to notify the owners of property where the oil or hazardous material is or is likely to be present. These same parties are also required to notify property owners upon completion of actions to address the oil or hazardous material, or if additional investigations show that the oil or hazardous material is not present at a property. Section C on the reverse side of this form indicates the circumstance under which you are receiving this notice at this time. INFORMATION RELATED TO YOUR PROPERTY Section 0 on the reverse side of this form indicates the type(s)of oil or hazardous material that is or is likely to be present at your property,and the environmental medium(e.g., soil or groundwater)where it is or is likely to be present. Please note that when an investigation indicates that the oil or hazardous material is or is likely to be present at your property,this does not mean that the oil or hazardous material is posing a health risk to you. Parties who are taking actions to address oil and hazardous material releases are required by state regulations to adequately investigate these releases and take necessary actions to ensure that affected properties meet standards that are protective of human health and the environment. ATTACHED MAP OR DESCRIPTION AND REPORT CONCLUSIONS The party providing this notice to you is required to attach a map or description that indicates the boundaries of the area where the oil or hazardous material is or is likely to be present, and the conclusions of the site investigation or closure report(Section E). These attachments should give you additional information about the nature and location of the oil or hazardous material with respect to your property. FOR MORE INFORMATION Information about the general process for addressing releases of oil or hazardous material under the Massachusetts Contingency Plan and related public involvement opportunities may be found at hftp://www.mass.gov/eea/agencies/massdep/cleanup. For more information regarding this notice, you may contact the party listed in Section F of this form. Information about the disposal site identified in Section A is also available in files at the Massachusetts Department of Environmental Protection. See http://public.dep.state.ma.us/SearchableSites2/Search.aspx to view site-specific files on-line or http://mass.gov/eea/agencies/massdep/about/contacts/conduct-a-file-review.html if you would like to make an appointment to see these files in person. Please reference the Release Tracking Number listed in the upper right hand corner on the reverse side of this form when making file review appointments. Revised: 5/30/2014 Page 2 of 2 I t NORTH41 J i p +rt } h APPROXIMATE DISPOSAL SITE BOUNDARY/AREA OF PERMANENT SOLUTION _ tn.2. e 1 W� o i n �i J h O b O C e _ W SCALE IN FEET a _ N t 0 300 600 * HAND SIGNATURE ON FILE o All DIESEL DIRECT, INC. o 11AW,=,V RTN 4-26776 Civil & Environmental Consultants Inc. 22 CHANNEL POINT ROAD HYANNIS, MASSACHUSETTS 31 Bellows Road - Raynham,MA 02767 Ph:774.501.2176-866.312.2024•Fax:774.501.2669 AERIAL SITE PLAN n www.cecinc.com n N DRAWN BY: RJF CHECKED BY: NPB APPROVED BY: *WRH FIGURE NO.: DATE: DULY 20171 DWG SCALE: 1"= 300' PROJECT NO: 173-323 2 Town of Barn stable Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. July 29, 2004 Mr. Jeffrey Spilman Spanky's Cam Shack 138 Ocean Street Hyannis, MA 02601 RE: Extensions to Install Air Curtains and Grease Trap/ 138 Ocean Street Dear Mr. Spilman, You are granted an extension of time to install air curtains and a grease recover device for the operation of a food establishment at 138 Ocean Street, Hyannis. The extensions granted are as follows: PART II, SECTION 1.00 Regulation #14 Outside Dining Toilet Facilities: To install an air curtain over the southern doorway on or before April 1, 2005, while continuing to operate in the meantime, providing waitress/waiter service to the outside dining area utilizing this particular doorway. PART II, SECTION 1.00, Regulation #14 Outside Dining Toilet Facilities: To install air curtains over the two remaining doorways within 60 days, while continuing to operate in the meantime, providing waitress/waiter service to the outside dining area utilizing these doorways. PART ll, SECTION 1.00, Regulation #10 Plumbing: To install a grease recovery device within 45 days, while continuing to operate a food establishment in the meantime, with a deficiently sized existing inground grease trap. The extensions are granted with the following conditions: (1) The screen doors shall be kept closed at all doorways, except while immediately in use for passage by persons. SpankysExtensions (2) The grease recovery device shall be installed in accordance with the State Plumbing Code. (3) This extension letter shall be posted on the wall adjacent to the food permit in an area which is easily accessible to be read by a health . inspector anytime routine inspections are conducted during the next nine months. After April 1, 2005, this letter may be removed from the wall. Sin erely yo , yn Miller, M.D. Chair an Board of Health Town of Barnstable SpankysExtensions VMS Town of Barnstable o� grns� Regulatory Services Department BARN1639. MASS, 200 Main Street,Hyannis MA 02601 n r -) APPLICATION FOR OUTSIDE DINING/SIDEWAL CAFE a LOCATION � > Property Address:/ 0 �619 A) �� � . � A I s �`�-��l o i / _ cn Name of Establishment: �/1�1� CIA-", s q - " ,J c-4S/DtX -7 APPLICANTS NAME:S A �1.1 CLA-M SAA-C t/ L C- Phone# 5 / ZT70 SEATING FACILITIES/EQUIPMENT 3 Total#of Seats Existing /AS/1.el #of Restrooms Provided �� TS/�� Size of Grease Trap e.�to® �4tl Total#of Seats Proposed Air Curtains(Yes or No) Ale) (Total means overall numb of se is indoors and outdoors) Hose Bib (Yes or No) Screens (Yes or No) Brief Description of SeatingArrangement,Type of Furniture Proposed,Hours of Operation,Projected Openmi and Closing Dates L iM CW,-/ /n/a C-4 S d^V cin a" J ,4 &JLC L"k _7v /+M -ro S,+-rvro r.,-.A)- 6,0E'rl/-►f &IoS tro?/f 1 6- %Z-/q '714,6Ld-f G r/YY1 JLl� F'y►/� <J►/L` All n& /,n �9Lf (16dz)-SSr1/6Y Uwe the undersigned certify that the above information which Uwe provided is correct. Uwe have read and fully understand the procedures as established by the Town of Barnstable in accordance with Chapter II, Article 8,Section 2 of the General Bylaws and the Board of Health Regulation#14,and further understand that failure to comply with said procedures may result in the immediate revocation of this permit. Signature of A licant s : ` ' t • z'11,6 Ay 7M,9491? -tit 116 Date: IMPORTANT-PLEASE REMEMBER TO INCLUDE: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation Distances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedestrian Walkway 3 Copies of Pictures of the Proposed Outside Dining Location(Front and Side Views) 1 Copy of the Menu THIS SECTION BELOW IS FOR OFFICIAL USE ONLY Town Manager Approval: Public Health Division: �+ Licensing Board Approval: Certificate of Insurance: License Agreement: Comments: n� c,CA a- k 8 �.. oY BOARD OF HEALTH REGULATION,PART II,SECTION 1.00,#14,Requirements a through n (a) The applicant shall file a written request for outside dining or for an outside cafe on a form prescribed by the Town and shall submit plans of the proposed dining area. The seating capacity shall be determined by the Board of Health after a determination is made whether requirements"b"through"n" below will be met and after a visual inspection is conducted by an agent of the Board of Health. A replacement food establishment permit shall be issued by the Board of Health indicating"outside dining"is permitted and listing the overall seating capacity,only after it is determined by an agent of the Board of Health that all of the requirements"a"through"n"of this Regulation#14 are met. (b) A menu shall be submitted to the Board at the time of application. (c) . The dining area must be appurtenant and contiguous to the restaurant property. The dining area must be mentioned on the described premises as in the case of a Common Victualler's License. (d) Sufficient restrooms,both for customers and employees,must be furnished counting the additional outside seating as required by the State Plumbing Code and Town of Barnstable Health regulations. (e) A grease trap shall be of sufficient capacity,based upon 15 gallons per seat,as required by the State Environmental Code,Title V,and Town of Barnstable Health Regulations. A grease recovery device may be installed to supplement an existing inground grease trap,after receiving the approval of the Board of Health. (f) All entrance and exit doors used by food service personnel and customers must be screened and provided with air curtains meeting National Sanitation Foundation standards. All windows or openings used for the transfer of food will be screened and provided with air curtains. Food cannot be stored or kept outside. All food must be prepared inside the facility's kitchen and kept inside until served. (g) A drainage system designed to eliminate odors will be required for all outdoor dining areas. Hose bibs with vacuum breakers must be available for washing down the dining area. ;/ (h) Trash dumpsters shall be situated no closer than 50 feet from an outdoor dining area. If such a dump ster is in the line of sight from the dining area,it must be hidden from view. The area around the dumpster and stockade must be kept clean and free of litter. Dumpsters must be closed with adequate covers designed to prevent entrance of rodents and birds and sealed to control odors. i/ (i) The patio or other ground surface must be of constructed of material readily cleanable and not susceptible to dust,mud,or debris. (Brick,tile,and concrete are examples of acceptable materials). ✓ (j) Table tops must be smooth,non-porous,easily cleanable and durable;and readily maintained in a clean and sanitary condition. f (k) Food service personnel must constantly police the dining area for waste paper,garbage and other trash. Placement clips,cup holders and other such devices must be utilized to prevent blowing paper. Covered trash receptacles must be provided in close proximity to the dining area and must be emptied as needed to prevent overflowing. (1) Strict clean-up practices must be adhered to. Waitstaff and buspersons must clean up after each F patron as in indoor dining. Each establishment must abide by all regulations contained in Article X, Minimum Sanitation Standards for Food Service Establishments,of the Commonwealth of Massachusetts, Department of Health Sanitary Code. ,/ (m) Outside food handlers must have easy access to handwash sinks and cleaning cloths. Facilities preparation and disposal of sanitizing solutions must be accessible. (n) Hair nets or other effective hair restraints,such as hats covering exposed hair,shall be wom by all outside food or drink handlers. Beards and mustaches must be neatly trimmed. ✓ O .. o 0 0 ol . --0 i yi cli C s Lf I c,0 41 E. r �f yti �9 f -ccPia� q, µf�� Cape Cod ` - '��.'�+ '+�,n�'..'•.��Fw�.4- ���i�,r°�� �.+'•t�'�� - ...� .:' "" _-,fi ��� _ � � •r_ �i^tom�" _;1„ ,} G� 71 pnyg E' er-42 a } • is r YS��` fs xs APPETIZERS 4 SP KIN RAW BAR Oysters on the Half Shell six native oysters served on the half-shell with lemon and the Cape's best cocktail sauce 7.95 Cherrystones on the Half Shell six native clams served on the half-shell with Cape's best cocktail sauce 6.95 Chilled Shrimp Cocktail five jumbo shrimp with the Cape's Best Cocktail Sauce 8.95 Chilled Seaside Sampler an assortment of chilled local seafood including oysters, cherrystones, shrimp 7.95 Steamers served with broth and sweet drawn butter one lb. 9.95 two lb. in a bucket 15.95 !d (!e Steamed Mussels Ot C(aS steamed in a sweet white wine and garlic broth 7.95 $` d S4 7 15 Clams Casino five cherrystone clams baked and stuffed with seasonings, bacon and crumbs 7.95 Oysters Rockefeller five oysters baked and topped with spinach, herbs and parmesan 8.95 Scallops and Bacon 7.95 Baked Seaside Sampler an assortment of baked seafood including oysters rockefeller, clams casino and scallops and bacon 8.95 Stuffed Quahog a Cape Cod favorite, native quahog stuffed and served with lemon 3.25 or two for 5.95 Maryland Crab Cakes house made and drizzled with lobster sauce 8.95 Fried Calamari lightly fried and served with marinara sauce 7.95 Chicken Tenders s served with honey mustard dipping sauce 6.95 Buffalo Chicken TendersF served with blue cheese dressing 7.95 Side of Fried WholeBelly Clams 11.95 Part Side of Clam Strips 9.95 . , r Fried Onion Rings 4.95 Pile O' Fries 3.50 = SPAM Y'S DOCKSIDE C f OW S Cape Cod Clam Chowdah house made, New England style cup 3.95 bowl 4.95 Wicked Good Lobster Chowdah a bowl of our very own, sweet and creamy with fresh lobster cup 4.95 bowl 6.95 a, SPAYS GOLW FRIW DINNERS with french fries and cote slaw Whole Belly Fried Clams 15.95 Large Fried Shrimp 13.95 r Clam Strips 12.95 Cape Cod Fish and Chips 10.95 Fried Native Scallops 13.95 Southern Fried Chicken 10.95 Spanky's Fried Seafood Combo an assortment of Spanky's delicious fried clams, scallops, shrimp and fish 17.95 A. u $ SPI 'S ON `T>yf GRUN Large Green Salad Hail Caesar! fresh blend of greens and fresh peppers, onions fresh romaine lettuce with our house made tomatoes and cucumbers 4.75 caesar dressing and parmesan cheese 6.95 with Grilled Chicken 7:95 with Grilled Chicken 8.95 with Albacore Tuna Salad 7.95 with AlbacoreTuna Salad 8.95 with Grilled Shrimp 9.95 with Grilled Shrimp 10.95 salad dressings: balsamic vinagerette, to-cal raspberry vinagerette, Italian, ranch, blue cheese, thousand island, and honey mustard FRESH LOBSTER SALAD Tender chuncks of lobster meat dressed ligthly and served high atop a bed of a Garden Salad 14.95 or Caesar 15.95 D ROLLS -with french fries and cote staw Whole Belly Fried Clam Roll Spanky's best native fried clams served on a fresh roll 13.95 Fried Clam Strips Roll Spanky's best without the bellies on a fresh roll 10.95 Lobster Roll thick pieces of lobster lightly coated in our specialty sauce 14.95 Fried Scallop Roll r `` lightly fried native sea scallops 11.95 Fried Shrimp Roll sweet shrimp seasoned and hand battered 11.95 Fried Fish Sandwich local cod lightly battered and fried served with lettuce, tomato 8.95 Tuna Salad Roll white albacore tuna seasoned and tossed, served with lettuce and tomato 6.95 Grilled Chicken Sandwich grilled chicken breast lightly seasoned and served with lettuce and tomato 7.95 Spanky's Low-Carb Wrap choice of sliced turkey, ham or tuna salad with bacon, lettuce and tomato 7.95 Sirloin Burger black angus sirloin burger grilled to your liking with or without cheese 6.95 All meats are cooked to order The above prices do not include gratuity or 5%Mass meals taxl8%gratuity added to parties of 6 or more The consumption of raw or rare meats,poultry,seafood or shellfish may increase the risk of foodbome illness Seaside Winner live local lobster steamed to perfection 19.95 Lazy Mans Lo We r Dinner sweet lobster meat prepared with sherry, our ' seafood stuffing and seasoned crumbs, all the taste, without the work! 2.0.95 Baked Stuffed Lobster with our seafood stuffing and topped with scallops 2.1.95 Sd a n ky's C(a M6 a ke live local lobster steamed and served atop a mound of piping hot steamers. 2.4.95 all of the above served with native corn on the cob, potato and drawn butter ®OD WRUS with choice of rice or potato and vegetables Broiled Cod fresh native cod topped with lemon and buttered crumbs 13.95 Broiled Scallops native scallops topped with lemon and buttered crumbs 14.95 Broiled Seafood Combo scallops, shrimp and cod with bread crumbs and lemon 16.95 Baked Stuffed Sole sole filled with our seafood stuffing topped with Spanky's own lobster sauce 14.95 Baked Stuffed Jumbo Shrimp five shrimp filled with our own seafood stuffing and drizzled with lemon and butter 15.95 Roasted Atlantic Salmon fillet of salmon broiled and drizzled with a creamy dill sauce 14.95 Grilled or Blackened Swordfish centercut swordfish grilled or blackened to perfection 16.95 �.,., _ Shrimp Scampi over Linguini _ive large shrimp sauteed with garlic and white wine served over linguini 15.95 Steamed Clams over Linguini cherrystones sauteed with garlic and white wine and baby clams served over linguini 14.95 Spanky's Classic-Bouillabaisse lobster, clams, shrimp,-mussels, fish and scallops sauteed and served in a"traditional. broth and topped. with a grilled crostini.14.95. Frutta di Mare over Linguini shrunp; clams,"scallops and lobster sauteed in a light herbed tomato sauce 17.95 WDLOBBER FAVORITES with choice of rice or potato and vegetables Sirloin Steak Tips seasoned sirloin tips, hand-cut and served to your liking 13.95 Spank 's Surf& Turf a tasty combination of grilled sirloin tips and a perfectly steamed WHOLE lobster ta>_l 23.95 New York Strip Steak 12oz. of the finest strip steak cut in house 17.95 Char-grilled Chicken Breasts marinated in shallots, lemon and garlic then grilled to perfection 11.95 Chicken and Broccoli Pasta Saut6 chicken and fresh steamed broccoli tossed in a light white wine and garlic sauce 11.95 ADD 2.25 FOR A DINNER SALAD AND 3.25 FOR A CAESAR WITH ENTREE SKID'S STUFF with french feies f' Grilled Cheese 3.95 y `, Hot Dog 4.95 Cheeseburger 5.95 \7 Spaghetti in butter or with tomato sauce 4.95 r: Fish & Chips 5.95 Chicken Tenders 5.95 SPA17 i+d r 0® gS ,`� pretty fancy for a c(aM. shack,, eh'? � -Nit i t Key Lime Pie 3.95 Wicked Good Chocolate Cake 3.95 Cheesecake with Strawberries 4.50 Double Scoop Ice Cream 2.95 Ice Cream Sandwiches & Bars 2.25 BEVERAGES Coke, Diet Coke, Sprite, Ginger Ale, Iced Tea, Pink Lemonade Coffee, Tea Sparkling Water SPANKY GEAR AT Tfff BW SHOP Ask your served about Spanky's gear! Pick up some Spanky's logo attire to remember your Cape Cod vacation and the fine time you had here at Spanky's Clam Shack. Spanky's logo 1 Live Entertainment! T-shirts _ 16.00 IThe 'hack Spanky's Denim Shirts eve Saturday I '� I ; . � i 32.00 night all summer .q� � � i long. Swing into Spanky's Sank 's for the Sweatshirts �I :. Capes best bands. 25.00 l S 'eas *14e Satoon WHITE WINE RED WINE GLASS BOTTLE GLASS BOTTLE Bel Arbor Chardonnay 5.00 Bel Arbor Cabernet Sauvignon 5.00 Bel Arbor White Zinfandel 4.75 Bel Arbor Merlot 5.00 Fontana Pinot Grigio 5.75 20.00 Beringer Stone Cellars Beringer Stone Cellars Cabernet Sauvignon 5.75 20.00 Chardonnay 5.75 20.00 Robert Mondavi Beringer Stone Cellars Merlot 5.75 20.00 White Zinfandel 5.25 19.00 McPherson Shiraz 5.75 20.00 Seaside Saloon ' s Signature Boat Drinks OCEAN STREET DOCK RUNNER FROZEN HARBOR rum, banana and blackberry liquor, orange juice, sour mix vodka, peachtree; blue Curacao, cranberry and pineapple and grenadine served tall with a Meyer's float6.50 juice blended with pina colada 7.00 SPANKY'S SPRITZER SEASIDE MUD SLIDE Stoli Raspberry, Absolut Citron, sprite, time juice 6.00 1 Kahlua, Stoli Vanil, Bailey's blended with ice 7.00 LOVE ON THE DOCKS FROZEN BOAT WHACKER Stoli, peachtree, cranberry, pineapple 5.25 Kahlua, rum, dark cacao, and coconut blended with ice JAMAICAN ME CRAZY and topped with whipped cream 7.00 Tequilla, Malibu Rum, banana liquor, pineapple FROZEN VOLCANO COLADA and cranberry 6.50 Midori, rum and coconut blended with ice & grenadine 7.00 MARY MCMAHON'S DAY AFTER Cape Cod bloody mary served with a cocktail shrimp and hot pepper 6.75 SLAB MY CLAMSHELL AND CALL ME Sb a n ky o we could tell you what's in it; but then we'd have to throw you in the hah-bah! 8.00 (2 slap limit) W cked Good Seaside Marsarifia ' s ROCKIN RITA'S PLATINUM FROZEN RITA'S GOLD MARGARITA MARGARITA FROZEN GOLDEN Cuervo Gold, Triple Sec, lemon and lime 6.00 A fine blend of Cuervo Gold, Triple Sec, lemon and lime 6.75 Hornitos Tequila, GRANDE GOLD MARGARITA Cointreau, lemon FROZEN GRANDE Cuervo 1800, Grand Marnier, and lime Cuervo 1800, Grand Marnier, lemon and lime 7.00 Rocks 7.75 lemon and lime 7.75 Frozen 8.875 Do c ks1 Y e Ma rtI n Is THE WEATHER IS HERE WISH YOU WERE BEAUTIFUL Stoli O, Stoli Raz, Absolut Citron, grapefruit, cranberry, lemon and ^_ lime 7.00 SPANKY TINI KEY LIME PIE Grey Goose L' O range with a splash of cranberry 7.so Absolut Vanilia, Licor 43, half & half and lemon 7.00 SOUR JOHNNY APPLESEED BLUE BIKINI Smirnoff Apple twist, Sour Apple Liqueur 6.50 Absolut Citron, Blue Curacao, lemon and lime 6.00 BOTTLE Ice Coto BruschIs Bass Ale, Heineken, Amstel Light, DRAFT Sam Adams Seasonal, Sam Adams, Sam Adams Light, , Buzzards BayAle, Corona, Bud, Harpoon IPA, Bud, Bud Light, t Bud Light Miller Light, Coors t 0' Buzzards Bay Lager Light, Coors NA, Smirnoff Icensc�a, aat ':. .a 1 TOWN OF BAFiNSTABLE DATE ' OFFICE of FEE DAN �1 3 ���� ® BOARD or- HEALTH RFcF.IVFn 711, 367 MAIN S7nEET J UN 9 1995 11YANNIS,MASS.02601 HEALTH DEPT. TOWN OF BARNSTABLE VARIANCE REQUEST FORK /NAME T, VARTANCP,S MUST IIF, SUIIMITTFD FIFTEEN 15 DAYS PRIOR TO 110AIii) OF rrlr;�AL'rn MEE'�ING.-Ricka/rId A)•Craf9 KassOc"T"c OF APPLICANT Jba l�f4Y bDV Aws-- //?��cery EL. NO.,54y-77/-0777� ADDRESS OF APPLICANT /3� DCeah �oek. : N r hy,sy l�llg oaf p/ NAME OF OWNER OF PROPERTY W,-cAard SSc drier- ?" SUBDIVISION NAME DATE APPROVED ASSESSORS MAP AND PARCEL NUMBER .3,6 -o67 LOCATION OF REQUESTJ3, ncea H -Sl 6oel% SIZE OF LOT_ Z ,030 SQ.FT WETLANDS WITHIN 200 FT.YESX NO VARIANCE FROM REGULATION(List Regulation)_W,Gu (aTi ., /y — REASON FOR VARIANCE(May attach if more space is needed) �iS�( �a ItT%1 i Z 2 0GlTS1`cY e �ec�< to 0urc/0,0 �i vii'ytr VIAN - FOUR COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED ' NOT APPROVED REASON FOR DISAPPROVAL BRIAN R. GRADY, R.S. , CHAIRMAN SUSAN G. RASRt R.S. ..JOSEPH C. SNOWr M.D. BOARD OF HEALTH TOWN OF BARNSTA13LE Jane 26,. 1975 Ur Henry Lyons Harbor House Restaurant Ocean street Docks Hyannis, Mas-sachusetts r Mr* Lyons Your request to screen and englose the Porch area of your estaurant. as shown on your sketimh -is.approved. This enclosure mot be constructed t+a effootivelk protect gyappin�sit the entrance into, the premises of flies and other Yours very truly, Fobext E, Chl3lds, Chairman :Ann Bs. gh =Gerald W zard, We D BOARD OF HEALTH mm L� _ Aj No OWN a�wl 1 y 0 , y , �,.� _y__ �'��,,,�. ►,!'� ass� � , c;� .. F\, .. • .r• •_......•_r_.. •rr.�pn.....•r._r_•w•✓.• ....•..rrr.._._�_ .r.rr._n•. r. ti 0� 0: 7aTi57G ol,C'I rq - /�j D30 S•F. N n q 0 4 0 EXi,�TiNv �1fs'h�� •\ �� flssES5G�.E'� Mr7.p 3za 1' ,eC. 97 C 5er.. "-".9 L.G. f'[.�i✓ /S¢9�-i4 A1SESsv.'u' �►r�/P - r� 14ovec1 'IrG C£ T 3S7576 L.C.�[•4iv 28�s9 A T HE�2EQY c'EI�TiF/ 7zi/�9 l' OVe 6VIZ.OIA4G• A4501d TE6 O Jl/ P�4CEGS Gro ��✓O 67 i9d'OVE CGY1/Fip,('NIS 7Z-) !t/E J E7&oj-. K �PE�y1U/�EMEN7_5 OF TfV,!F Z_>VIVG ,BYL V kV 6lF TiyGc 'TVW-lv of B�1�iu�'TA�cE' • . X HER6,6Y CFeT/F'/ 7hi!r T!/F' By/GD//VG .04EPiCTE.D ®N PigiFiCfLS � fINO �7 /S GOrATEU /N FGODD f/�92i9i2A ZoivE A9 w1 rH 8I-lo E 1,r_z4)04 EzEv4r1k YV /o.D sus l�Ec�NF.,/1 TEO D/�/ "F/f�J"Mr9.o �Vo• 2,5�G� q�06 G DATFO 10,941aasT /9) /,91951. CER!if/Eo iCOT � f3�Ef�i9.eE0 FOR Hy�/�/✓is��� Tou,�s, I�vc. . • AT , No. /346 G10E/9i1/ 46 J-C%94E= M.9rfC4AI JOHN `yam G I ,r P. � QOYLE,111 H 6RAPN/C sc•,i`E �N �T �` No.33889 '� _ -.j- 9Z moo.B� 5�s y✓.Frl<M�T1S/ ozs�