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"rk •'.ka=r+ni"�'` rK.n.r .<h 3,✓d>Ei r-. a'^'t,�tn r:ze (' Town of Barnstable BOARD OF HEALTH ti John T.Norman Board of Health Donald A.Gauda noli,M.D. g B1A3dNSTABLL F.P.(Thomas)Lee,. v� 39 Daniel Luczkow M.D. Alt. rby9• ��+ 200 Main Street, Hyannis, MA 02601 ° a Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 141, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 366 Issue Date: 01/01/2022 DBA: BAND B PIZZA OWNER: MACAAB, INC. Location of Establishment: 10 SEABOARD LANE HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 20 OutdoorSeating: 0 Total Seating: 20 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Qp FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: For Office Us • Initials: �n+rrgo Town of Barnstable +aA. ql 1 Date Paid a &4awrABM Inspectional Services 9� Public Health Division cack l — '�Fc�+A Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APfPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 1Z /4 12, NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTA BLISHMENT. Is P�t �7��C _o �NCOA.(4 Y74 0260I MAILING ADDRESS(IF DIFF,rE�RENT FROM ABOVE): l ( E-MAIL ADDRESS: Q of C(,l j, TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (5069-) 434- 0 TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO__y... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: --r�l TO / --F-- NUMBER OF SEATS: INSIDE: OUTSIDE: X TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? 1 IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL, MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application ForrnsTOODAPP 2020.doc ;OWN,ER INFORMATION: ` (� FULL NAME OF APPLICANT C/ p" P-l5kt`C(r\ y�('e SOLE OWNER: NO OWNER PHONE # w ADDRESS 10 S&9,60 GC� C/1 C-rlA CORPORATE OWNER: f t C jor h4OZ63zi CORPORATE ADDRESS: IU S�Gc � �� W C/1 (S (1A 0-266 l PERSON IN CHARGE OF DAILY OPERATIONS: C1 a—,-C,IQV,(—\ 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 i3 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.asy. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1 st. Q:\Application FormsTOODAPP REV3-2019.doc I i rj f Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARNST'iuM Paul J.Canniff,D.M.D. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 366 Issue Date: 01/01/2021 DBA: BAND B PIZZA OWNER: MACAAB, INC. Location of Establishment: 10 SEABOARD LANE HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 20 OutdoorSeating: 0 Total Seating: 20 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: I f . • Initials: Town of Barnstable For Office Date Paid •y�I G► Amt Pd$ : .M,ASS.,E : Inspectional Services � 3�0� t^ v� ," Eo, pEE039. IN Public Health Division Check# Thomas McKean,Director Tj 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE iZI IZo w NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: u 1' ' 4 ADDRESS OF FOOD ESTABLISHMENT: to Sea60'(A dAI'II S a-z"-6aj MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: c�o u+ Sg V . C'G/►� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO_?S ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:j—/4/-2&O NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? I'�8 IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)?—LVZ4 TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED& BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc b ` OWNER INFORMATION: .�.� FULL NAME OF APPLICANT �'�� U u e �- SOLE OWNER: S/NO OWNER PHONE# 5-0 l' ADDRESS_ L.134 /1,ta-iA �`?A 4f-1,( e VIA 0-26 3 2 /� CORPORATE OWNER: I �t T c-AA tS —a4 CORPORATE ADDRESS: to S e,v ba4 ' PERSON IN CHARGE OF DAILY OPERATIONS: 540, 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 M+6- ei 04D 3 - 1 'Z.®22Veir-ROA-1 CeD�IA. LZl 6(,P J2.�, 1. 1. - 2. 12 i 1 i Zo 2C> SIGNATURE WAPPLICANT 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/apylications.ast). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3 I't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q:\Application FonnsTOODAPP REV3-2019.doc I Bellaire, Dianna From: Christian boutiette <cbout58@gmail.com> Sent: Friday, February 26, 2021 3:00 PM To: Bellaire, Dianna; Soto, Kathryn Subject: Re: B AND B PIZZA Hi I.m dropping off the app and check shortly. Sorry for the lack of communication. With us being closed I didn't realize it was necessary. I am aware our serve safes are close to expiring. I will have 4-5 new ones within the month. I am enclosing the specs for the two new pieces of equipment. -----new larger three bay sink ----commercial upright dishwasher All other equipment and layouts are remaining the same. We will have an epoxy floor with built in drains installed as well. The general contractor used this same epoxy at Crisp in Osterville to great success. Epoxy: ---Corotech v440 with a non-slip additive. This product is FDA approved. It is a Benjamin Moore product. We do have electric and plumbing permits in hand. Also, Mr Lauzon from the building department has told us that we DO NOT need a building permit because we are not changing any design/egress features of the building. I have also been in contact with Hyannis Fire Dept they are fine with everything we are doing. The one thing they asked for was to have the hood vent system cleaned before/shortly after we reopen so we are starting fresh on that front as well. I am in the process of scheduling that with the licensed cleaning company. We just need the floors to be complete before that can occur. I will get you a floor diagram of the new sink and dishwasher on Monday. The General Contractor left it on his desk this morning by accident. I do realize we will need a new Health inspection as soon as we are done. I think you will be very happy with the improvements we have made. We are looking to be back open Wednesday March tenth(3/10/21). Hopefully we can get Kathryn in here next Thursday or Friday 3/4/21 or 3/5/21 1 would however like to get through the weekend before committing to the date though to make sure we are ready for you and don't waste your time. Again, my apologies for the interruption in communication. I ended up putting myself in the hospital with multiple heart attacks after the stress and rigors of making it through the original bout of Covid19 virus. Although I now have some new hardware in my chest, recovery is going well. It did really make me stop, slow down, and step away from the business completely for a little longer than I should have allowed. I i I . wilt be more conscientious in the future of making sure you at the Board of Health, and the rest of the Town of Barnstable are in the loop of what is being done at B and B Pizza. Thanks!---- Christian Boutiette---owner bnbpizza (cell 508.776.0611) Please let me know if there are any other questions you would like answered, I promise I'll be more on top of responding :) On Wed, Jan 20, 2021 at 1:23 PM Bellaire, Dianna<Dianna.Bellairegtown.barnstable.ma.us> wrote: (f {I S Mr. Boutiette, We were notified by the Licensing Dept. that you closed your establishment until March of 2021. You didn't contact the health department. You are still required to renew your food permit. You will also need an inspection by your Health Inspector before you can re-open. You are considered late now that you have not responded to my past emails or submitted your application for renewal. I have currently you and Cheryl McCann as the Servsafe Food Managers and you both expire April of 2021. You will need to make sure you get your renewals by that time. Your new Health Inspector is Kathryn Soto. I have copied her on this email to make her aware of your notification. You will need to pay the late fee. The total amount owed is $260.00. I've attached the application and Servsafe companies with allergen training links as well. We will mail written late notices next week. i Thank you. i £ Dianna Bellaire i Permit Technician i Town of Barnstable i Health Division 200 Main Street Hyannis, MA 02601 i P:508-862-4643 Fax:508-790-6304 2 t Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARNsrABM Paul J.Canniff,D.M.D. MAM 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: 366 Issue Date: 12/10/2019 DBA: BAND B PIZZA OWNER: MACAAB, INC. Location of Establishment: 10 SEABOARD LANE HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 20 OutdoorSeating: 0 Total Seating: 20 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q.� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: A- 541ta IKE For Office Use Only: Initials: y�°fti Town of Barnstable 1 rT q` Date Paid�a �`� Amt Pd ply✓ BARNUMBLE, : Inspectional Services �3 MASS. ,0 NoL Check# N:; '�lEp,,tpya Public Health Division ; 1 €,I Thomas McKean, Director ,rill 200 Main Street,Hyannis, MA 02601 j;a Office: 508-862-4644 Fax: 508-790-6304 u.� APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE Z flL NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: p ADDRESS OF FOOD ESTABLISHMENT: V vQ�oa`d W 1 �CI�I�I 1 s, vrA o 2 zo MAILING ADDRESS(IF DIFFERENT FROM ABOVE): 01 E-MAIL ADDRESS: C 'D © L)T 59 (q) Sri, At 14 CUM TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ' 3 3.36 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/_ TO /_/_ At NUMBER OF SEATS: INSIDE: _Zt—) OUTSIDE:__�-,_TOTAL: Z f� SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) - FOOD SERVICE RETAIL FOOD-ONLY required for.TCS foods(foods requiring refrigeration/freezer) BED.&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q\Application FormsTOODAPP 2020.doc I r OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: E /NO OWNER PHONE# J V �� /� ADDRESS 6 5 eg 1 ,Op rJ CAI W� eyA� I l/� 4!<o CORPORATE OWNER: to C AA a K) -e dam CORPORATE ADDRESS: Sqfl- PERSON IN CHARGE OF DAILY OPERATIONS: a List(2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records.You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. a4tr4 L tic Cq a / t- / F( 1. N y( �rc�c��,� - a z v SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http•//www townofbarnstable.us/healthdivision/ai)plications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January l st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Wpplication FormsTOODAPP REV3-2019.doc tpf MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis,MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, you must mail the required fee amount(see box below). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. FEES: Bed &Breakfast Permit= $55; Food Service Permit 0-49 seats= $250; 50 or more seats $300; Continental Breakfast=$30; Retail Food (only TCS Foods) = $20;Retail Food Store—Less than 8,000 S.F. _ $100, more than 8,000 S.F. = $285; less than 1,000 S.F.; Retail Food Combo/Limited Prep. - $200.00; Cottage Food Industry= $75; Mobile Truck=$50; Mobile Ice Cream Truck= $35; Frozen Dessert License=$30; Additional non-refundable Fee for New Establishment or New Ownership= $100-$500(see staff),Late Fee= $10 Q:\Application FormsTOODAPP REV3-2019.doc nFTHE Tpk, TOWN OF BARNSTABLE, ,.HEALTH.INSPECTOR's Establishment Name: - Date: _ _ Page:_�of Z- ti 'OFFICE HOURS PUBLIC HEALTH DIVISION, a:oo-9;30A.M. BARN57'ABI.E. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified A a3y. `0� HYANNIS, MA 02601 soa-8s2-4s4a No Reference .R-Red Item , lEn Mn+a PLEASE PRINT CLEARLY - FOOD ESTABLISHMENT INSPECTION REPORT J k &JkD Name77 Date 3 3c. Type of Type.of Inspection .wine Address /� Risk Food S Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Bed&Breakfast HACCP ' !�f �/� Other Inspector Out: To / L j o WV r^�l in V, Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ �G7 Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands 1. 2./ ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS L w;ril �ry �l [�Uvc✓ n ❑ 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) V❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures bwc V0- co1 L_ ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control I ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) {/ ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ,/ ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories 1 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel . (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8 n critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's ignath Prirp)t: 31.Dumpst screened from public view l Permit Posted'? V Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' ig a Print: Self Service Wait Service Provided Grease Trap Size. Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness �tlations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003 A Assi nment of Responsibility* 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) g - 14 Food or Color Additives * * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202-.12 Additives Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41*F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F . Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 3-302.11(A) Food Protection* 7-201.11 Se azation-Storage Applicants* p g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(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 g ) Disposition of Adulterated or Contaminated Food - 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and * 4-501.111 Manual Warewashing-Ho[Water 7.206.12 Roden[Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures Raw Seed Sprouts Not Served*7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean ContactEggs Utensils and 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* Eg crrve 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitizatiu�i-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Chemical Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms 2-301.14 When to Wash* * Other 590.009 violations relating to good retail * 3-401.11(A)(1)(b) All Other -145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* Blue Items 23-30) 3-202.15 Package Integrity ( ) Y * 12 Prevention of Contamination from Hands 3-403.11 Remaining * Critical and non-critical violations,which do not relate to then the me 3-101.11 Food Safe and Unadulterated (E) g 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 ( ) K25. Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F 5-203.11 Numbers and Capacities* Within 4 Hours* Management and Personnel FC-2 .003 Tags/Records:Fish Products P 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* Water,Plumbing and Waste FC-5 .006 Cabello of In redients* Supplied with Soap and hand Drying Devices590.004(J) 9 9 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 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* $-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ...r.�.---�-,v-:y.�..v.�.:.s'.s;,a+�-.'s�...w,, -.�......�.,_....4._,.:�..�. .... :•-...�-"a,:,; ,.. '�.c .;.,..,�._�.$..s .psn.r-_ ..a..v-...-.-�!-.� _ - �_ - +. �. � _ - � , ,pitME►ok, TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: - Date: . ..Page:- of � r tip OFFICE HOURS BARNSTAB�E. PUBLIC 2 0 MAN STREET 4 3:30- :30 P.M. DIVISION I300- :30 A.M.. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified p 63q. `0� HYANNIS, MA 02601 _ Morl.-FRI. No Reference R Item soa-asz-asaa . Red lEO MP�� PLEASE PRINT CLEARLY'- _ FOOD ESTABLISHMENT INSPECTION REPORT Name t' �� Date Type of sec ion hh -/ outine Z t%* Address �QG��J Risk d Se Re-inspection Level Retail Previous Inspection f Telephone Residential Kitchen Date: Mobile Pre-operation v ) ` Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out. Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities / EMPLOYEE HEALTH PROTECTION FROM CHEMICALS Z t Glow I J ❑ 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) , G ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating L �3 ❑ 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 j ,�,I� ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories I/6 ' 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) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating - within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 = 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8non-critical violations C. 30.Other DATE OF RE-INSPECTION: Inspecto 's Sign hire/ 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 PI s,5 a re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen Y N ._..,......-� .`..r-. •ra..__.A-. ,�...Y -..r.-...,-._ v--, -... -- _ - .- _ ..- .....,-. ......-. ... .. ..- �.- .« � ..� _.. ... - - -`-- -- _ �..�..--mow �-. .. -., - ---- "- -- - _ -. _. _. ..� .-...i Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) ► FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003 A Assi nment of Responsibility* 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) g } 14 Food or Color Additives 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from t` 3-202.12 Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties Cooked and RTE Foods. 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 1 g Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.1.1 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 * 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 i 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 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* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1 g Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* e/f-n•e 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tem or and residential Sources g, P 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* the appropriate sections above if related to Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail * 11 Good Hygienic Practices 77 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 Game Animals Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.12 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 PP 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28, Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. IKE r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: f Date: Page: / of ypf Oh, - F -1�--- 'b O FICE HOURS BAR E.O' PUBLIC 2 0 MAN SH EET 3:30-4:30 P.M. SION : 0- :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 39. `0� HYANNIS, MA 02601 08-8 -FRI. 6 No Reference R-Red Item PLEASE PRINT CLEARLY �`rFo M°+° 58-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name . Date 3 -Type of Type of Inspection Routine T f t Address Risk Food Service Re-inspection 2 Level a al Previous Inspection Telephone 0 Residential Kitchen Date- Mobile re-operatio 1 - Owner HACCP Y/N Temporary uspect Illness '0 jliu Caterer General Complaint Person in Charge(PIC) Tim, Bed 8 Breakfast HACCP In: I 1%ICE- Other Inspector SV� Out: l AV 3 l - d Each violation checked r uires 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) off.. 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 IF FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) TXglac ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling _ ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) 33-1� 2/ Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ® Voluntary Compliance . ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. P=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 E3 regardless of the number of critical,results in an F. =One critical violation and less than 4non-critical violations 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. 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 t 2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. y 29.Special Requirements (590.009) s o within 10 days f receipt of this order. violation,4 to 8 non-critical vio ations=C. 30.Other DATE OF RE-INSPECTION: Inspector'�.Si re 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 PICs Signa re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y IN n�jJ�� Dumpster Screen? Y N �V� Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage** 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* P g 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 Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served y * P 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products 4-501.112 Mechanical Wazewashing-Hot Water Monitoring 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEMEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eff crtvc rnrzoot 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Raines-165'F 15 sec* in mobile food,temporary and residential Sources R� P �' 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* 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 practices sho 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirementsld be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23.30) 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F * Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26.' Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' I Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. pF*KEr TOWN OF BARNSTABLE, /y.�'qy,' AALTH INSPECTOR'S Establishment Name: -..i - I Date:' - / age: of J (/OFFICE HOURS / y PUBLIC HEALTH DIVISION O 1W*508-862A644 V_ :00-9,30A.M. BARNSTABIE. ` 200 MAIN STREET , 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLA RR CTION Date Verified HYANNIS, MA 02601 MON.-F NO Reference R-Red Item PLEASE PRINT CLEARLY rFDN1P�' 0,FOOD ESTABLISHMENT INSPECTIO REPORT Name Da ype of �e of Ins ec ion ��-ZA O r ion s outine. Address Risk M Fo ervic a inspection i Previo$44 I i n j ff Level tail P Telephone R ntial Kitchen Date: Mobile Pre-op Owner HACCP Y/N Temporary Suspect llne's Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP t ,_, Other InspectorUlm '('ft Q n� Each violation checked requires an explanation on the narrativ, 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) ❑ r 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 - f ❑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) r a , ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY It ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 1 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 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 o la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of violations observed,7 to 8non-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 , ,r within 10 days of receipt of this order. violation,4 to 8non-critical violatioyyns=C. r� 29.Special Requirements (590.009) y p I s Si �'/ 30.Other DATE OF RE-INSPECTION: _ natu e Print: 31.Dumpster screened from public view .� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N IC's r v J #Seats Observed Frozen Dessert Machines: Outside Dining Y N S ature Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N4 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 F14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chazge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) * EMPLOYEE HEALTH_ 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation g 20 Time as a Public Health Control _ 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*Applicant To Report To The Person In Charge* _ * 7.202.12 Conditions of Use* 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* ( ) q Contamination from the Consumer q590.003(E) 90.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * 8g Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* effe ce�mnoor 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 3-40L11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish" 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and AutWildhority Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiRequtces should be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.11 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction � 5-205.11 Accessibility,O Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* with aeration and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 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. AW°FIKEroh �� TOWN OF BARNSTABLE . HEALTH INSPECTOR'S Establishment Name:® l Y � Date: Page: of (J� 1 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-930A.M. BARNSTABLE. 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e v: `0� HYANNIS,MA 02601 - M-8 -FRI. No Reference" R-Red Item PLEASE PRINT CLEARLY �ArFD MPS°' 508-862-4644 FOOD ESTABLISHMENT INSP CT O REPORT Name ate a of sec io s FFoAl utine Address isk P°od Se pection Ina Level Previou I p c Teke hone < / Residential Kitchen Date: Mobile Pre-op' I Own r HACCP YIN Temporary Suspect Illn ss Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP Other _ Inspector t I. Each violation checked requires 6 explanation on the narrative age(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 �q EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) AA ❑ 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 KO Critical(C)violations marked must be corrected immediately. blue&red items a( ) � � , I Corrective Action Required: No El Yes Non-critical(N)violations must be corrected immediately or I within 90 days as determined b the Board of Health. Overall Rating ry P ❑ ❑ p ❑ p y y ❑ Voluntary Compliance Employee Restriction/Exclusion Re-inspection Scheduled EmergencySus ension C N Official Order for Correction:Based,on an inspection today, 1 ms ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations 6=One critical violation and less than 4.non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6von-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8rion-critical iolatio If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. olation, to 8-non-critical violatio C. 30.Other PATE OF RE-INSPECTION: A pest is Si natur- Pr rin,t: , 31.Dumpster screened from public view77 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N - - #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI 's Ig ture Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted. Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) tDem, ssignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41'F/45°F Within 4 Hours* 590.003(B) nstration 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.* 3 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chaz oo Charge Duties -302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45'F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 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 3-304.11 Food Contact with Equipment and Utensils Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* ( ) Variance Re 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 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 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155'F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg ctiw 1112001 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 rf ces Sanitization of utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen operations should be debited under Regina or Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* RegulatoryAuthorfty 3.401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiceRequire rhos ld be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140'F to 70'F 3-203.18 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 .003 402.11 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 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 I Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S.590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF. ror �1 TOWN OF BARNSTABLE- HEATH INSPECTORS Establishment Name: � Date: l Page: of , ti OFFICE'HOURS dp ° PUBLIC HEALTH DIVISION 8:00=9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. I Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified Me3q: `0$ HYANNIS,MA 02601 MON.-FRI. No Reference -R-.Red Item - PLEASE PRINT CLEARLY �OrFo MPS p' 1 508-862-4644 FOOD ES ABLISHMENT INS CT N REPORT C/ Name Date a of T of I s ectio . � O s outine Address Risk Foo _Servi pection yr)pi Level t ' Previous Inspection - Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint HACCP - Time Bed&Breakfast Person in Charge(PIC) Other f In: Inspector Out: Each violation checked requires an a planation 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) ❑ Q. FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands CJ ❑ 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 r ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling .� ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ` ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be.corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4- 590.005 B=One critical violation and less than 4von-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. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9.non-critical: If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials. FC-7 590.008 9 violation,4 to 8 non-c tical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other PATE OF RE-INSPECTION: Inspector' nat 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 a Print: Self Service Wait Service Provided Grease.Trap Size Variance Letter Posted Y N Dumpster Screen Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions - Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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 590.004(F) 7-101.11 IdentifyingInformation- 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* Applicants* P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(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 Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* SanitizationTemperatures* TIME/TEMPERATURECONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* el/ce�mnow 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in-3 10 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 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- Proper,Ad Sources* 10 equate Handwashing Ratites-165°F 15 sec* ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 .Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashin Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification* g ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11. Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 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:590Fomrback6-2doc '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. oFTHEr, TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION a:oo-s:soA.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MARS �0� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY - �prF65 o MP+" 508-862 4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Dat a of Tyne of Inspection O on Rout' - Address Risk e c Level00 r vious Inspection rX Telephone Residential Kitchen Date: + Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint 7j7- Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: ire V Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions'and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ 106 Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands Will ❑ 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 10-1 A ❑ 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 G - PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIO S SP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP O ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations I Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: �� - es 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 Sche led Emergency Suspension C N Official Order for Correction:Based on an inspection today,tHeitem�s ❑ 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 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 ainon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8 non critical violations=C. w 29.Special Requirements. (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view M08114."),4 4 Q1/� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N v #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC, nature S Pr' t 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 IntPrvantinns and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Coot.) '>, / FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-20i.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 1 g Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 3-302.11(A)(2) Raw Animal Foods Separated from EachContainers* 590.004(F) EMPLOYEE HEALTH F 7-10i.11 Identifying Information-Original 2 590.003(C) Responsibility of the Person-in-Charge to _ Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F A 7-201.11 Separation-Storage* Applicants* 1 3-302.11(A) Food Protection* * 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use 3-501.19 Time as a Public Health Control* 3-302.15 - Washing Fruits and Vegetables Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person.in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* - 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Mide From Potable Drinking Water* Concentration and Hardness* I - 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* _ ._ * gg Not Otherwise Processed to Eliminate Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* sg°"°e tiuZoot 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165'F 15 sec* ut eanon on-Hands an Arms* the a 3-401.11 C 3 Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and A Mushrooms Approved By 2-301.11 Cl Condition Hdd A * ( )( ) P Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave appropriate sections above if related to 3-202.18 Shellstock Identification Present* -2-301.12 Cleaning Procedure* _ 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-361.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Lu Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock IdentiScation Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oFtK r TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date:' Page: _of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. aAaNAB�E. 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MON.-FRI. 1639-a m HYANNIS, MA 02601 508-862-4W No Reference R-Red Item PLEASE PRINT CLEARLY i 'FDN1P' FOOD ESTABLISHMENT INSPECTIOff REPORT ) J Name Date Tvue of T of sec ion -� U O e on s outin Address Risk F S spection Level ad Previous Inspection Telephone e ^� Residential Kitchen Date: AD 16 , Mobile Pre-operation R "r' Iry Owner HACCP Y/N Temporary Suspect Illness r- 2 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. Y _ Violations Related to Foodborne Illness Interventions and Risk Factors(Red Itemsi Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ f �-- l� G� Action as determined by the Board of Health. Allergen Awareness 590.009(G) , FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands f s ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities 1��)­ i EMPLOYEE HEALTH PROTECTION FROM CHEMICALS "' �^ ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives L ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals �. FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) / ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating - ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding _ PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control AX, 11, J rG ❑ 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 Advisoriesif Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations7inspection -6Critical(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 today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 771 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. 590.005 6=One critical violation and less than 4non-critical violations 25.Equipment and Utensils (FC 4 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 violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature , Print: 31.Dumpster screened from public view I V `J tD k__Jy�__ Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Sign re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N 1� 7. 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 Assi nment of Responsibility* 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) g 14 .Food or Color Additives _ 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 31202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 18 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 41 590.004(F) - * - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 -590.003(C) Responsibility of the Person-in-Charge to - Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers - Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage*_ Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* _ Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and 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 Warning Labels* 4 r Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B). Compliance with Food Law* _ - _ 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.1](D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* .3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ep°"°e uino°t 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* faces of Equipment* ' Shellfish* _ 4-703.11 Methods of Sanitization-Ho[Waier and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15, Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temponuy and residential 10 Proper,Adequate Handwashing 3-401.11 C 3 Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By - * ( )( ) P Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301..12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* * Other 590.009 violations relating to good retail _ 590.004(C) Wild Mushrooms _ _ 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 11 Good Hygienic Practices practices should be debited under#29-Special 3-201.17 Game Animals* yg 17 Reheating for Hot Holding Requirements. 5 -' Receiving/Condition 2�01-.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 * (Blue Items 23-30) 3-202.1 Package Integrity (C) Commercially Processed RTE Food-140°F 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 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12,_ Reduced-Oxygen Packaging Criteria* _ _ 8-103.12 1 Conformance with Approved Procedures* 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. WE p Tp' TOWN OF BARNSTAB.LE HEALTH INSPECTOR'S Establishment Name: Date: _ ^,age: _ of , COF FICE HOURS L PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARN5TABLE. ` 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MAs L g MON.-FRI. A 039• HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY . FOOD ESTABLISHMENT INSPECTION REPORT % 7" Name Da ype of of section < / [v Oe o ' Address 49 Risk d S -Re-inspection r / Level a air Previous Inspection r Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint c Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other WV Inspector Out: q i 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) ❑ A ' Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ JI FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS I Pill Id ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives " ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved.Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ' R Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: o L2 IV es Non-critical(N)violations must be corrected immediately or Overall Ratingvv within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employ on x si ' = s o c- ❑ n s en n C N Official Order for Correction:Based on an inspection toda�l;-t' items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food"Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations 9 )( ) cited in this report may result.in suspension or revocation of the food if no critical violations observed,4 to 6 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 rightto a hearing. Your request must ( )( ) be in writing and submitted to the Board of Health at the above address violations observed, riti anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other PATE 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 ig ture rint: ,�� Lj Self Service Wait Service Provided Grease Trap Size Variance.Letter Posted Y IN co Dumpster Screen? Y N Violations related to Foodbo�ne Illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red-items 1-22) and Risk Factors(Red Items 1-22) (Cont) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 ' Person- g in--Charge Duties Cooked and RTE Foods. 3-302.14 Protection from Unapproved Additives** PHF Hot and Cold Holding Contamination from Raw Ingredients 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 15 Poisonous or Toxic Substances 590.004 - 4 - - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each * (F) - 7-101.11 Identifying Information-Original Containers * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* * _ _ __ 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003 F Responsibility of A Food Em to ee or An 7-202.11 Restriction-Presence and Use* * _( ). P Y P_y 3-302.15- Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting-by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) . Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 590.003(E) Removal of Exclusions and Restrictions 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Disposition ofAdulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 ' Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* _ 4-501.111- Manual Warewashing-Hot Water --- 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization 7-206.13 Tracking Powders,Pest Control and Temperatures* Raw Seed Sprouts Not Served* P _ _ _ 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* , TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of 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* Eff°nee mnoot 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 A 3-401.11 B 1 2 Pork and Beef Roast-130°F 121 min Eggs* Approved Source 4-702.11 Frequency of Sanitization of Utensils and Food O( )O * 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 * Stuffing Containing Fish,Meat,Poultry or 590.009 A - D Violations of Section 590.009 A -(D)in cater- Chemical ( ) ( ) ( ) Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11 C 3 Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* ( )( ) P Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Idcmificaiou Piesent* - 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * - 2-301.14 When to Wash* - * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec practices should be debited under#29-Special 11 Good Hygienic Practices 17 Reheating for Hot Holding 3-201.17 Game Animals* yg 9 9 2-401,11 Eating, Requirements. 5 Receiving/Condition ' - - g,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11_ PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth*_ - 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Hem Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging.Criteria* 8-103.12 Conformance with Approved Procedures* S:59OFormback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *-Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. - oF�HE roe," TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date T Page: of ry OFFICE HOURS `, �P ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified `b, M63 HYANNIS,MA 02601 5os 862-Fa644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT r .. / � Name _ Datall o Type�Innsspection 9 O 1en S outine' Address %/�G Risk ood Sery c Ion �. Level a al Previous Inspection , Telephone Residential Kitchen Date: A Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint - - Person in Charge(PIC) Time Bed&Breakfast HACCP �. •; In: Other �- Inspector Out: ' Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) � FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities �i4 / 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 j FOOD FROM APPROVED SOURCE TIMElfEMPERATURE CONTROLS(Potentially Hazardous�'y �d`s) IV- C C ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures �(�GF ❑ 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 1��. ✓� PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control 07 "'e- i ❑ 01 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HS ) _ �� �, �` J ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY 11.Good Hygienic Practices �!❑ yg' ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations + Critical(C)violations marked must be corrected immediately. (blue&red items) 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 day,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 in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC=6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.�&Y T _ I N: CV+' r Inspector's Signature Print: 31. creened from public view Permit Posted? N Grease Trap Previous Pumping Date Grease Rendered Y N i #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Sign re Print: ® / 7 Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Cf ��' Dumpster Screen? Y N - ��� Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12-_ Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* *- _ 19 _PHF Hot and Cold Holding- _ 2-103.11 Person-in-Charge Duties 3=302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590,004(F) * - -- -- EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to - - - _ Other* g7-102.11 1 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140'F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-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 3-30215 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 * ( ) q 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'Watfr 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 FoQd Law*_ _ - 4-501:111- Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served Y P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* - - 4-501.112 Mechanical Warewashing-Hot Water J Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3202.13 - _' Shell'Eggs*_ __ _ _ Sanitization Temperatures* ' TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY * -- - Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water 3-401.11A(1)(2) Eggs-155°F 15 sec S-101.11 Drinking-Water from an Approved System*_ Animal Foods That are Raw,Undercooked or 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* _ - gg Equipment* I Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* - 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef uive 1112001 4-602.11 Cleaning Frequency of Utensils and Food- _ _ . Animals-155°F 15 sec* 590.006(B) Water Meets Standards in MO CMR 22.0* Contact Surfaces of Equipment* 1 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* in mobile food,temporary and residential Sources g• P �' 10 Proper,Adequate Handwashing l 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under -- Game and Wild Mushrooms Approved By - 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* - 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 2-301.14 When to Wash* - * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* _ _ 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec * 11 Good Hygienic P►actives practices should be debited under#29-Special 3-201.17 Game Animals 17 Reheating for Hot Holding Requirements. 5 _ Receiving/Condition' - - - -- 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands _ * Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) g * 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 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients[0 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision rY g ,-'1' 9 7 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:590Fom7back6-2doc *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. oFIKE TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date.", Page: of v` q OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. f BARNSTABLE. 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified .659. `0� HYANNIS,MA 02601 - so8-es2�saa No Reference R-.Red Item PLEASE PRINT CLEARLY . 'FD MA�p FOOD ESTABLISHMENT INSPECTION REPORT / / �/ Name l I- Date Type of jypp gf Inspection Opera' ,outin Address Ri e pection A' 1W(A ` Level F Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: 9 w � a Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) 4f, e Z Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ J, , 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 i ❑ 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 C 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 of 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 .❑ I- Non (N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Ern oyee R�stricti n/ xclu o Re-inspection Scheduled Emerge y Suspension C N Official Order for Correction- Based on an inspection today,the items Embargo Emergency CI re Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils B=One critical violation and less than 4non-critical violations g (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009 y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view 4. Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' i ature Pnnt: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N n /) k ,_j �+_ Dumpster Screen? Y N L Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41F/45°F Within 4 Hours* * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12- Additives Cooked and RTE Foods.* *_ 19 PHF Hot and Cold Holding - 2-103.11 Person-in-Charge Duties- - -- - - -- - --- 3-302.14 Protection from Unapproved Additive"s - -- 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 in Information-Original Containers* --2 590.003(C) Responsibility-of-the Person-in-Charge to - - - - _ _ Other* 7-102.11 3-501.16A Common Name-Working Containers* ( ) 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-Stora e* Applicants* -' -"` "' 3-362.11(A) -Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* _ 3-302.15 Washing Fruits and Vegetables * Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 590.004 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils* (11) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g ) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* _ 4-501.111 Manual Warewashing Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served y P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served _ . 3202.13 _ .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* 163-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment* gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eff cn-tnnoor 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,tem ordr and residential Sources g, P Y' 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Genie Regulatory Mushrooms Approved By- 2-301.11 Clean Condition-Hands and Arms* _ Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-30112. Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C_) Wild Mushrooms* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 11 - Good Hygienic Practices practices should be debited under#29-Special 3-201.17 Game Animals* 17 Reheating for Hot Holding Requirements. 5 -Receiving/Condition - -' 2-401.11 _ _ Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 ., Package Integrity* - g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12- _ Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F[0 41°F/45°F P Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 1.003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* * 5-205.11 Accessibility,Operation and Maintenance, Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Town of Barnstable ' O""NSTARUL AR&MA66 P Department of Public Works �f0►Art�`' 367 Main Street,Hyannis,MA 02601 Office 508-790-6300 Thomas J.Mullen FAX 508-775-3344 Superintendent To: Thomas McKean, Board of Health Town of Barnstable From: Thomas J. Mullen, Superintendent, DPW Date: September 21, 1992 Subject: : Variance on Grease Trap, 10 Seaboard Lane, Hyannis The Department of Public Works is in receipt of your letter of September 10, 1992 regarding subject variance. The approval of an under-sink grease interceptor in lieu of a minimum of a 1,000 gallon grease interceptor is inconsistent, to the best of my knowledge, with the Board of Health's previous policy with regard to Food Service Establishments. Because of this deviation from your past policy, which is believed proper, the Department can only approve of this variance if the Board of Health conducts monthly inspections to insure that only minimal or no amounts of grease are entering the sewer system. It is requested that the results of each inspection be provided to the Engineering Division for review. In addition, the Department's conditional approval shall be voided if any of the other conditions outlined your letter are violated. Thoma J. ullen Supe ndent TJM/wj/jk CC: Marilyn K. LeBoeuf 7 Renior Drive Osterville, MA 02655 Imo_ TOWN OF BARNSTABLE tH E OFFICE OF BOARD OF HEALTH 1639' \� 367 MAIN STREET �D MR�' HYANNIS, MASS.02601 September 10, 1992 Marilyn K. LeBoeof 7 Renoir Drive Osterville, MA 02655 Dear Mrs. LeBoeof: You are granted a conditional variance from the Board of Health "Revised Supplement to Minimum Sanitation Standards for Food Service Establishments" Regulation 10 that requires a minimum of a 1000 gallon grease interceptor at all food establishments. The variance will allow you to operate a food service establishment at Unit K, 10 Seaboard Lane, Hyannis, with the following conditions: (1) The applicant shall receive the approval of the Barnstable Department of Public Works. (2) No cooking or steaming of food will be allowed. Pre-cooked meats and pre-prepared breads may be heated. (3) No additional foods may be prepared or served other than those foods listed on the submitted menu. (4) Only disposable single service paper, plastic, and other disposable dishes and utensils are authorized. (5).You must install an under-sink grease -interceptor under the double compartment sink approved by the town plumbing inspector. (6) This grease interceptor shall be cleaned monthly (instructions enclosed). (7) You must install a water flow restrictor device at the triple compartment sink approved by the town plumbing inspector. (8) All other regulations contained in 105 CMR 590.000: State Sanitary Code, Chapter X - Minimum Sanitation Standards for Food Establishment and of Town of Barnstable Board of Health sanitation regulations shall be strictly adhered to. (9) This conditional variance expires October 1, 1993. This variance is not transferable, and will be voided if the establishment has a change in use, change of ownership, or leased to a party other than an applicant. Very truly yours, Susan G. Rask Chairman BOARD OF HEALTH TOWN OF BARNSTABLE SGR/bcs Enclosure cc: Walter Jacobson CVL VLLll.t1 U�u Vlll� TOWN OF BARNSTABLE Received by T�` d'�#� OFFICE OF �1H3lTLBL BOARD OF HEALTH Date MAX& p �p t639.a MAY 367 MAIN STREET" � Ir' HYANNIS, MASS.02601 VARIANCE REQUEST FORM All variance requests must be submitted fifteen (15) days prior to the scheduled Board of Health Meeting. //&7)lk NAME OF APPLICANT EL. ADDRESS OF APPLICANT R,Q-0 O V r y- NAME OF OWNER OF PROPERTY SEABOARD VILLAGE REALTY TRUST SUBDIVISION NAME N/A DATE APPROVED ASSESSORS MAP & PARCEL NUMBERMAP 269/LOT 254 LOT SIZE 1/2 ACRE LOCATION OF REQUEST 10 SEABOARD LANE, UNIT K, HYANNIS, MA 02601 VARIANCE FROM REGULATION (List Regulation) V REASON FOR VARIANCE (May attach letter if more space is needed) PLAN - FUUR COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED NOT APPROVED REASON FOR DISAPROVAL 'Joseph C. Snow, M.D., Chairman Susan G. Rask Brian R. Grady BOARD OF HEALTH TOWN OF BARNSTABLE 8/25/92 To Whom It May Concern, I own Pizza 1 & Subs 2 in Dennisport Mass. There I have an in line grease trap which works wonderfully. You see , the only real grease that we get is from cooking up sausages and that grease goes into my pasta sauce. So the grease in a Pizza Rest. is very minimal. Sincerlyt Marilyn K. LeBoeuf 3. do if1 A TOWN OF"' BARNSTABL S3ESSOR .r� � •�a� M's 40 7S1 r sa i• air ., .Sr.. + •4 C��� . n /4� 7 t j 2 a,G 1� O I G r m not .3*,L i I , AVE 2i l tta ti s + K 41 �6 39 IZAC �2 �7J 74Ac 42 J�,C .114C �6K 1S ♦O '? -,aac.s Q v Q t'04C 38 4. trio f I 27 NKit Ac e Ac cf p s 7 0 .17 ac J Jp4c �.L • V 'Prices not including 5%sales tax. �.,r ..f COLDS �$f . (HOT): 1•s.1 !" 'GRIND 1i A" .. `:S.UBV POCKTSERS - 'IZZA SMALL 10" LARGEI4' 4 . -"' ' '­.-SW, Gket � •! ;r; ;.S.M•i.�.:sL, 'LAI GJP.o5c0k oN 8.40hWAY ;3 4HAM1 , 9.50WAY 5.50 • y r GENOA :3 25;; 4. 5LINGUCA 06.25 10WAY WAY. SALAMI ; 3 25 r:- 4.15 VEAL CUTLET 3.65 4 50` N ,PECIAL• :. 7.50 '° t �tE,s 12.50 ` yd 1 . �� �' , ,;�`;; �.x ^ .F.� ,.3.25'D; 4.15.':-'CHICKEN CUTLET •3 65 ��4.50'. BALOGNA XTRA HEE ; �,r ^�Y,, . .90�� = ` I i ..t ,�, 1 .10�,� a C SE »t, � MEATBALL 3.25' '4.15 ;TUNA ; ;"i'•\�Q' .S' is : 'ts ,,.'.d rF' .,r 4�c �'r!"'* .44�� =yT .'�.Mi . . - •.r b A f + LICES . � 1.754r T 3 2 1 AN BACON.VEGGIE ME 5 4. 5 � C ADIAN BA ON 3 65 T50 ITEM SLICES.` r 2.00: � K ... � �BLT ° , j 3 25 4.15 ' TURKEY 3.65 r�4.50 > `ITALIAN ' 3 65 ° 4.50 ROAST BEEF 3 65 4 50` .;TOPPINGS AVAILABLE`�� � `. �'} �� � Y� SAUSAGE'z 3 65 . 4.50 Pastrami' 3.65 4.50. i_.: 'Eggplant ' 3 25 4.15 . �(N tom _ '::. -NION CANADIAN BACON HAM -.�� �� �T. With Above: Lettuce, Onions, Tomato, Green Peppers., G -,.`„v.�S''1, F 4.-a' ti °'Faye�. y{. C `PPER PEPPERONI ; .£�ANCHOVIES b �da } � .(Hot peppers by request only.) 1USHROOM SAUSAGE BROCCOLI ;; �,yy, M pfY AN _4 SMALL LARGE ' ;, LACK OLIVES' HAMBURGER.-; GARLIC • ; _` tF t :.; STEAK. CHEESE 3.75 4.50 y t -r3.75 4.50LINGUICA APPLEALAML.: PINE STEAK ONIONS � t •.. r Z. " Ys STEAK $ PEPPERS 3.75 4.50 S �+ r✓� apt t ' . .. x: EVERYDAY SPECIALS "_. s= ' ' STEAK& MUSHROOMS 3.85 . 4 70 • y ELK:: ,"r A, fi 2 � y� STEAK BOMB 4.25 5.25 ' k,_ �`. + � � ` +� �u_ (Onions/green peppers/mushrooms/cheese) AWAIIAN PIZZA -. Pineapple & Ham or Canadian Bacon SM. 5.50 LG. 9.50 "t. y .-, RESH VEGGIE PIZZA Broccoli, Green Peppers,Red Peppers, ,' .Onion, Mushroom, Eggplant, Black Olives and Tomatos; PASTA . EAST , SM. 7.50 LG. 12.50 ' 4 CHOICE OF SPAGETTI OR ZITIi .e t r� , ON THE LITE SIDE : . � =3n . �c4 N3. SAUCE .).5U MEATBALLS 4.50. IDE TOSSED SALAD 1.95 _ JSSED SALAD 3.25 v + F,a 4Y SAUSAGE ® _ 4.50 :^f, , REEK SALAD 3.95 , . h �� CHICKEN �'" 5.5( ' �, • VEAL 5.50 ' 7)SSED WITH TUNA 3.95 - NTIPASTO 4.25 - t* - f Above Includes: Side tossed salad and garlic bread. - � � I I I • � ► i I � i � _ono P I I � I s. � I. I I� ' I I 1 spa K �S W SruK siNK 11t�or, Z bl. ; ; wq T I 1 1 t�at�T�P 1 fr T. I 1 I ! I ' � 1 1 j 1 � I f II II ii lil � i I I r_hv>a i 1 S► --- -- - ' -- --` -- _ ---r--'--- -- --- --'--- - - --'--- --- - - --'- -I--- - - ; '- I - -- -- r _ ; ICII IIIr ! � II 1 I 111 t I . - - -- ------ --- --'--- -- ---r-- -- ST , , I - cis -.I I I I .:.I � I i , � �.,, I � I "i ( I j i I � I `•'i I I I h i I � ! T i I ! 1 ' - , 1 ' ' j • � I I '.; � I � I v�dP . � I I � I S. S� . i I ! Ij ! I I '. GIVI K �S a SANK �St`Nr, v�3on I bL. I I - i � I I 1 f I14 FT. i GRaLIL S I UNIT i -' -- -- -- -- j I ► -c�a►. I r : i ' O I I I I ► Cow , • a -� �T C� 'F ___. - . __1 -- . I , SNI oA 4` TOWN OF BARNSTABLE OFFICE OF 1 PARISTARLi BOARD OF. HEALTH MUSK s� i639' 367 MAIN STREET �cM�Yk HYANNIS, MASS.02601 December 15, 1993 �I Philip LeBoeof 7 Renoir Drive Osterville, MA 02655 RE: Buffy's Pizza Dear Mr. LeBoeof: You are granted a conditional variance from the Board of Health "Revised Supplement to Minimum Sanitation Standards for Food Service Establishments" Regulation 10" that requires a minimum of a 1000 gallon grease interceptor at all food establishments. The variance will allow you to operate a food service establishment at Unit K, 10 Seaboard Lane, Hyannis, with the following conditions: ( 1) The applicant shall ensure that only minimal or no amount of grease enters the sewer system. (2) The applicant shall furnish the Board a written contract from a licensed septage hauler which states that the under-the-sink grease interceptor will be inspected and cleaned on a monthly basis. (3) The applicant shall simultaneously furnish the copies of the septage hauler's monthly written reports to the Health Department and the DPW Engineering Department during the next three (3) months of operation (January, February, and March 1994) of the food service establishment. The report shall contain the following .: the date the grease trap was cleaned, the amount of grease removed from the under-the-sink grease interceptor, and any observations concerning the effectiveness of the grease trap in regards to capturing the grease. (4) no cooking or steaming of food will be allowed. Pre-cooked meats and pre-prepared breads may be heated. (5) No additional foods may be prepared or served other than those foods listed on the submitted menu. (6) only disposable single service paper, plaatic, and other disposable dishes and utensils are authorized. (7) This grease interceptor shall be �cleatied thbAhty (instructions enclosed) . (8) You must install a water flow restrictor device at the triple compartment sink approved by the town plumbing inspector. (9) All other regulations contained in 105 CMR 590.000: State Sanitary Code, Chapter X - Minimum Sanitation Standards for Food Establishment and of Town of Barnstable Board of Health sanitation regulations shall be strictly adhered to. ( 10) This conditional variance expires December 31, 1994 . However, if a health inspector or agent of the Board of Health discovers that the under-the- sink grease interceptor is not operating effectively, or if excessive amounts of grease are discovered in the under-the-sink grease interceptor or in the sewer line, this conditional variance may be revoked and/or cessation of particular food preparation operations may be required. This variance is not transferable, and will be voided if the establishment has a change in use, change of ownership, or leased to a party other than an applicant. The Department of Public Works stated the Department "can only approve of this variance if the board of Health conducts monthly inspections to insure that only minimal or no amounts of grease are entering the sewer system. " Please ensure Conditions #1, 2, and 3 above are strictly adhered to. Very truly yours, Jw eph C. Snow, M.D. nd of Health n of Barnstable JCS/bca. enclosure cc: DPW LEBolo! l P' TOWN OF BARNSTABLE ypF THE TQ OFFICE OF t DAHD9TAn s BOARD OF HEALTH MA6d p i639' `e0 367 MAIN STREET QED MAY D" HYANNIS,MASS.02601 November 25, 1992 P�Ij10 . LeBoeof 7 Renoir Drive Osterville, MA 02655 vim' s46s� PI-zp Dear Mr� LeBoeof: You are granted a conditional variance from the Board of Health "Revised Supplement to Minimum Sanitation Standards for Food Service Establishments" Regulation- 10 that requires a minimum of a 1000 gallon grease interceptor at all food establishments. The variance will allow you to operate a food service establishment at Unit K, 10 Seaboard Lane, Hyannis, with the following conditions: (1) The applicant shall furnish the Board a written contract from a licensed septage hauler which states that the under-the-sink grease interceptor will be inspected and cleaned on a monthly basis. The septage hauler shall furnish the Board four (4) copies of a monthly written report during the first three (3) months of operation of the food service establishment. The report shall contain the following: the date the grease trap was cleaned, the amount of grease removed from the under-the-sink grease interceptor, and any observations concerning the effectiveness of the grease trap in regards to capturing the grease. (2) No cooking or steaming of food will be allowed. Pre-cooked meats and pre-prepared breads may be heated. I (3) No additional foods may be prepared or served other than those foods listed on the submitted menu. (4) Only disposable single service paper, plastic, and other disposable dishes and utensils are authorized. ( u us�tn a an der-si rease ap un t le artme rovedb umbing ector (6) This grease interceptor shall be cleaned monthly (instructions enclosed). (7) You must install a water flow restrictor device at the triple compartment sink approved by the town plumbing inspector. (8) All other regulations contained in 105 CMR 590.000: State Sanitary Code, Chapter X - Minimum Sanitation Standards for Food Establishment and of Town of Barnstable Board of Health sanitation regulations shall be strictly adhered to. (9) This conditional variance expires However, if the Board discovers that the under-the-sink grease interceptor is not operating effectively, or if excessive amounts of grease are discovered in the under-the-sink grease interceptor or in the sewer line, this conditional variance may be revoked and/or cessation of particular food preparation operations may be required. This variance is not transferable, and will be voided if the establishment has a change in use, change of ownership, or leased to a party other than an applicant. Very truly yours, iw C Swrn M S ask ts h r BOARD OF HEALTH TOWN OF BARNSTABLE SGR/bcs Enclosure cc: Walter Jacobson Thomas Mullen I� r lit) DATE TOWN OF 13ARNSTABLE FEE a�' � ♦� OFFICE OF RECEIVED BY l 0ee11rietc BOARD OF HEALTH 3e7 MAIN STREET HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variances must be submitted FIFTEEN (15) days prior to the scheduled Board of Health meeting. -- 1 NAME OF ,APPLICANT MCL TEL Y� C� C1 . N0. yap al ADDRESS OF APPLICANT l `� a : 11�'- rVvC(Q NAME OF OWNER OF PROPERTY ti Cr� 'Y�r� C-G SUBDIVISION NAME // DATE APPROVED ASSESSORS MAP AND PARCEL NUMBER 'C�` LOCATION OF REQUEST�C� �C�c�. �`r� J� VU SIZE OF LOT SQ. FT. WETLANDS WITHIN 200 FT. OF PROPERTY: Yes No VARIANCE FROM REGULATION(List Regulation) REASON FOR VARIANCE(May attach letter if more space is needed) PLAN - I-rua COPIES OF PLAN MUST BE SUBMITTED CLEARLY OUTLINING VARIANCE REQUEST. VARIANCE APPROVED _ NOT APPROVED REASON FOR DISAPROVAL 2 1993 Susan(�.Res1r,�� Joseph 0.8now,D .U. Brian L Or* � ,��^•' � �x>°'��� Prices not,IncludingS�sales lax ��� °��•��� � �^ ��, + � ,�,'�,���; ''+x� '�� - w�.rv��r�z1�5��''�5.�:`wsrNi,ausn�S +vS.�•1!,;C:•cC"k$`•?��w°„3t� 7? +'"".,:3,t+�keg��tG;s,�a�l�, ,,�' F'. ,�^ ~tea' �`� �. � _ . "I .R.. i• - r. IPA PAZ° r' ir,+.,.•eh:: >p �"'•"�1'�ii� - .�„a+,. • e' .z�!•"�zy.' �_,r=' �! � - DEK oi®, R N[ t. :.• .::.. '+• � ''�` ': r-. u. ., i.'�x � � _ <y��.. -yam.. '��,3,�a+,�`:�.. � ��., wB .; t.,, >F .. ,* _ ,� .... V•40• •'orr' !f"`^� 'fim '�fi .. `"q°.,i. �, ,n� �. =1,WAYS ,�.���� :. • .,4..65 .� ° t. a,.�' �� � , nn gyyg �yy "4 15 CHEF&EBURGER,x- .65, i A tL , 2 WAY. � � ��� •'.5.50 � .� ' _� r 9.50 • .. a__.�.. ��. .,' k, .ew"o''i'F . �...�i -i^ -i5+. >r= •i^' ', _ s :A.. .. ?"fl,LF� y di .:Ay. -•< '{' ,, °iA ...�e- ; :,ss;•� �r;... r,.'&% �. .AJ^ '., ,T ,�� _ }r- .r.A .r :F4�'. .yyj, -d,- _ '3x _ `�,. '1 'tq .J' ` „_ � . r r A.� 4 °3 WAY. 6.25. 1.0.5.. . r ,3:2 '.4 w- : 4 �, ENOA~ 5 :15 LINGUIC �, � 3.65� :50 . , `' . a. " •.6.9 w 4_.. 11:.. SALAMI 3:25 4r15. : ;VEAL CUTLET,. ; , .3.65.•. =.4.50 • . ,,p '.SPE IAL ,. •7.50 z 1250 . '.. », n -, C ._ . _ �._ � y. �.��. ,BALOGNA � " 325'' 4;15 ,� CH•IC.KEN'C.UTIET 365 . 4.5., , :'r. 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HAM � "�With-Above� ;l.ettuc ,, ,h. to,,�.Green,Peppers .w � .- :.r,„ t :..�. } ," �,:: fix. „^"�T!F3".• {Y A'3'/I:k MG4�.Yn�,N:: PEPP r : PEPP.ERONI ANCHOVIES ` t'pe Pars by request o y.) s,,,� „ •. , , y ,ems qu ..`t'� X"N•,�i:t.•...y'4, .��.� 1 ,�.T ^, t•x..�a. '�3 vv' ;•,,� �="' '"3_,,, �*.Ga-' �'�.• }'� 8`ry�. ,�jmr MUSHROOM r : �• : A A E�,.. w � - BROCC-OLI' k SMALLARGE; �r,xA- � i ,1. BLACK;,OLIVES. .. _' HAMBURGER# GARLLC: x :: :� , �. STEAK,BCHEESE �,# 3 75 ., 4.50, ..e.a+..a� .:�`Ls'.... {. ..w. ,. -.�. �'. > -me.rt^:t'Ki•+". �",�a,. ! .g ;,'�,'e;� .r�," 'Smt'�.a ;.w.M1w.:.. » ,�:.,Y .a xyR ��) m.' , x�n�a. :��Y fi_. -� ,��,�'y;i. q .Y� -ry ..' ,..- - � �. xv ".rt• ��r,t�'1 4F`w, >. SALAMI pLINGUICA=:. 'PINEAPPLE STEAK..& ONIONS 75 4.50_ �. ``=3, y. ,y'(, 14sik ': '' '" :;y, 1c„asAae,v ,;.d-r '�i'-�i,.:' a,.: .4 `Mk «K •'w.'", ,� ' ,+'� 'ems. •,_ .,:. .. ,. STEAK B PE 4.501' �. 7 .. T•;r ,vw, :. „q, " V,M•2�,i'#f.' -:s. " 'g:"" '� +. d.s .a;,,7.irrcmlt"r"mi. ,iri. �p E. 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I N S S 6K io Z o/ 2 t At 31 AC M I �f ?1 AC37 « e !jam qt o' t Town of Barnstable v/r v l 610 F/U CS7, Planning Department Special Permit Staff Report - Appeal No. 1993-10 n Date: February 05, 1993 To: Zoning Board of Appeals �tr��,c� 11�292 From: --- - �� e, G aI *�ArT:r:ac yk, Principal Planner Application Summary �con�r7� /j of r-GeW^ k J,A- Appeal No. 1993-10 Applicant: Marilyn LeBoeuf Address: 7 Renoir Drive, osterville, MA Property Location: Unit K,-10-Seaboard-Lane,-Hyannis_,,MA-� Assessors Map/Parcel: ( 769/2'S4� Property Owner seaboard village Trust, Nicholas Franco Trustee Owner Address: 765 .Falmouth Road, Hyannis, MA Zoning: HB - Highway Business District Zoning Overlay District: GP - Groundwater Protection Applicants Request: Special Permit - section 3-3.6(3) (A) conditional Uses (as per B District) - Restaurant, and special Permit - section 4-4.2 change from One Non-Conforming Use to Another - Retail Sales of Drugs to Restaurant. Activity Request: Use of Unit K (1, 178 s.f. ) as ;`Buf Pizza�Restaurant - H:-, Procedural Provisions: section 5-3.3 special Permit Provisions. Background: According to material submitted, the applicant is seeking to establish a pizza restaurant ~Buffy's Pizza*, within Unit K of a retail office structure located at the intersection of Seaboard Lane and west Main Street, Hyannis. The applicant is proposing to occupy 1, 178 s.f. within the structure. From information submitted to site Plan Review, the applicant is planning a twenty (20) seat pizza restaurant with a take-out area and to 1 Staff Report - Appeal No. 1993-10 Special Permit employ two (2) personsl. The Site Plan was approved with Conditions on December 10, 1992. Those conditions are enumerated 1 to 5 on the attached letter. of December 16, 1992. DEPARTMENT COMMENTS: The lot upon which this building is located is 0.52 acres and was developed in 1985. The lot and structure were originally developed as part of an office and bank complex that contained two lots (1.04 acres total) and straddled both sides of Seaboard Lane2. The locus was previously a B - Business zoning District but was rezoned to HB - Highway Business Zoning in November 19833. The 1984 site plan appears to have conformed to the requirements of zoning in that; 1. the dimensional requirements conformed to the B district (as per MGL Chapter 40A, Section 6 allows 7 years grandfathering on a 1980 subdivision of the land) , and 2. the uses (offices and banks) conformed to the Principal Permitted Uses of the HB District, which at the time were identical to the B District use regulations4. Building Floor Area: According to the applicant, the structure contains nine (9) businesses for a total of 8,798 gross s.f. The Town of Barnstable Assessors Records document the structure has 12,420 gross s.f. (see Assessors Card) The applicant should be prepared to address this discrepancy and any implication it may have on the required off-street parking. Location and Traffic: The locus fronts onto West Main Street and Seaboard Lane. The building has access from Seaboard Lane. The location is across West Main Street from a gas station and Angelo's Food store parking lot. It is also in close proximity to West Hyannis Elementary School. It is an area of heavy traffic given the uses and neighboring streets of old craigville Road and Lincoln Road. According to the Cape Cod 1. from Site Plan Review File # 1992-38. 2. from plan titled "Site Plan Showing office Buildings, Hyannis, Barnstable, Mass for Capricorn Realty Trust Inc. , drawn by Eldredge Engineering Co, Inc, dated 9/14/84. 3. from Planning Board Files - Town Meeting' Records, November 07, 1983 Article B-1(d) . 4. 1983 Zoning Bylaw, Section R (8) - Use Regulations Non-Residential Districts, Highway Business District G Staff Report - Appeal No. 1993-10 Special Permit commission, traffic counts in this vicinity were 9,589 average daily trips (year round) with a peak hour traffic of 995 vehicles between the hours of 10:00 and 11:00 am5. The department estimates the 20 seat pizza restaurant, with a take-out area, would generated about 50 vehicle trips per hour during the peak hours of restaurant use, 4 pm to 6 pm.6 Standing: The applicant has submitted a "Letter of Intent to Lease" as proof of standing. This letter states that "in the event a formal Retail Lease Agreement is not entered into and agreed by November 30, 1992, this Letter of Intent shall become null and void . . ." The applicant should be prepared to submit to the Board, for its files, either a signed Lease Agreement (financial figures blocked) or a new letter of Intent to substantiate standing on this appeal. Parking: The applicant has submitted to site plan review a documentation of the existing uses in a 8,798 gross s.f. structure and the required parking by each use (see attached) . According to this document, the ten uses in the structure would require a total of 53 off-street parking spaces. The Site Plan presented shows a total of 38 spaces on this particular lot. Zoning Requirements: The applicants should be prepared to discuss the proposed operation in terms of menu items, hours of operations, signage, interior arrangements and seating. Section 4-4.2 requires the Board to find that; the "proposed change is from one non-conforming use to one other non-conforming use only" and that the "change is no more objectionable or substantially detrimental to the neighborhood.,, Section 3-3.6(3) (A) requires that conditional Uses in the HB District "do not substantially adversely affect the public health, safety, welfare, comfort or conveniences of the community." The applicant should be prepared to substantiate that the use conforms to these requirements for the Special Permit. SUGGESTED CONCERNS FOR CONDITIONS: If the Board should find to grant this request for a Special Permit, it may want to consider the following conditions: 5. 1988 Cape cod Commission Traffic Counting Report 6 . Institute of Transportation Engineers, Trip Generation manual, Fast Food Restaurant without Drive-through window (#833) (this is a limited study group and figures should be used only as a guide. ) 3 Staff Report - Appeal No. 1993-10 Special Permit 1. Issuing the special Permit for a specific number or seats, and as per plans submitted, 2. Limiting the Special Permit to the applicant only, 3. Implementing all conditions (# 1 to 5) of Site Plan Review (see attached) , 4. Limiting alcoholic beverages, 5. Limiting the hours of operations, 6: compliance w th_a11-Health-Department_Requirements_,—and 7. compliance with section 4-3.7 of the Zoning Ordinance - Signs in a Highway Business District. cc: Thomas Geiler, Licensing Agent Thomas McKean, Health Joseph DZU-Z Building Inspector ZBA File 1993-10 4 STATEI IDENTIFICATION NUMBER KEY NO. „,.•,..I. ADo,/Lys ZONING IDISTRICTCODE SP•DISTS.IDATE PRINTEDI CLASS I PCS I NBHD 1 76'9 GSd� WEST MAIN STREET C7 Hd 46C C7HY 10/30/92 3251 00 C006 R2E9 254. MAP- _ FRAhCO.- NICHCLAS D TR .:.,>,„t N,,.fid.t tilt ,i v„i.:. ...-•u�u5,,.,ENr�<,, T UNIT ADJ'D.UNIT ACRES/UNITS VALUE VL wN D 3 1 7 2 i Z D O OC ivR SPEC cl•s ADJ COND. P PRICE PRICE C S IN NT —, x _52J= 8 146 150 188959.9 331127.9 .52 172200 4ELDG(S)-CARD-1 3 773.9C0 �1 � 3G 3SITE 1 MOTHER FEATURE 3 4.50C I ARKET 8455CC a x - 100 803586.0 803586.0 1.00 603600 13 MPL HEST MAIN ST HY II Conn EilD6 u LC 10614-P IAtCME 14559CC - .4 .45 10G0G 4500 F SOL LOT 100 iPYI PAYING S x 1198 1GG ORR 1813 G095 1452 0224 JSE MSR SEABOARD LANE APFRAISED VALUE A , A 95C.6CC PARCEL SUMMARY n LAND 17220C ELDGS 77390C 0-IMPS 4500 TOTAL 95C600 r N CNST PRICR YEAR VALUE I E I R dod S.I. P,— LAND 17220C �k LDGS 77840C C101641 , I,OS/85 a 125000 E 1 S C9C2600 ;11/82 TOTAL 950600 II M/L RDW 11/26/86 BUILDING PERMIT NumDw D.1. T; Amdun, LAND LAND-ADJ INC ME SE SP-ELDS FEAT4 50 88036005 UNITS E27664 3/85 NC 356000 172206 - B.,n Nam OCs+ cN0 IOC. ..R D A.p Cost NM AmRep V.,— S,aM. N.pnl R. BMns •Fla. Psvlyo.Y FsY. i .-... 1 . . .I ..';: ��::,• I n...n.,. i .,. ,4• , •a• Dev, caw I173 1 1OD 121;2 803600 9748OOELEMED 661 110 111 85 86 5 97 125 NTS CO E 1 CONSTRUCTION DETAIL 1.GG My B (DATE SCALE: MKT IND ACOM O.O 6ASy 1uu .30 6618 STYLE GD d20 6D .GO 5632 DESIGN--ADJMT- -02 -ESIGW-ADJUST---17=0 ' FSf 90 _00 90 EXT`ER:W-AttS-- -01 D-fRAME------ �=0 fop 35 _60 48 HE-XT/AC--TYPE- -20 tAIR-$-AI12--CO"-fir:0 fEP 65 .00 25 INTER:f-INISH- -04 1ZYWALt"----------a=e fSf 90 .00 80 INTER:L-AYOU1- -11 -OOD---- --C=e i WJK 25 .00 688 INTER:a-UALTY- -02 -A71E-AS-EXT-ER=--17:0 II FLUOR-STRUCT- -03 -JTYST-SE-AM---17:0 Ia fL-OOR-C-OVER-- -15 A-RIOUS-----------M RO-Orf-1Y-PE-"-- -01 -A8tE-AtSPH-SH"-"�.0 I U - - - --- 761 8,,. _ 6788 ELFCTRIrAt--- -01 y6 RASE---------- ---- - _ U,.nDNGpiMENyONS F01tNDAi-TQN--" -01 REfi-CONr"-"- T --- „ -----CCMfiERC-I --A -FA"CfltTb----------- -- 1 LAND TOTAL MARKET i � PARCEL 1722UU 95C600 AREA 34470 VARIANCE +0 +2658 STANDARD . 50 * UTILITIES 4 GAS * UTILITIES 6 SEPTIC i • TOPOGRAPHY * UTILITIES 2 PUd WATER * TRAFFIC 6 IOr'OGf;APMT 1 LEVEL * ST FEATURE * ST. COND. 1 . rT T.,D: 1 a1ucn • ST FEATURE - * NUISANCES PARKING AND TENANT INFORMATION 10 SEABOARD LANE, HYANNIS Date: December 2 , 1992 Revised December 10 , 1992 UNIT NO OCCUPANT SQUARE FEET PKG . REQ. BY BARN. ORDINANCE 12/2 12/10*rev K Buffy' s Pizza 20 seats 1 , 178 8 8 plus 5 1 pk per 3 seats 5 pk for take out area 1 per every 2 employee L Hair It Is (1/300) 780 3 3 plus 1 B/C/M/N Cape Cod Real Estate ( 1/300) 2 , 190 8 7 plus 1 O/P Barnstable Bottle Shop( 1/200) 1, 900 10 10 plus 1 G SMG Inc . ( 1/300) 600 3 2 plus 1 D Mary Kay ( 1/300) 250 2 1 plus 1 E/F CTN Marketing (1/300) 500 2 2 plus 1 G/H Attorney Thomas Rugo ( 1/300) 500 2 2 plus 1 J Eagle Surveying ( 1/300) 500 2 2 plus 1 I Kendall Hunt Publ . ( 1/300) 400 2 2 plus 1 TOTALS 8 , 798 42 39 plus 14 NUMBER OF EMPLOYEES K Buffy ' s Pizza 20 seats 2 L Hair It Is 2 B/C/M/N Cape Cod Real Estate 4 O/P Barnstable Bottle Shop 2 A SMG Inc . 2 D Mary Kay 1 E/F CTN I'larketing 2 G/H Attorney 'Thomas Rugo 1 J Eagle Surveying 2 I Kendall flint Fubl . 2 The 12/ 10 revi::ed calculations are done " rounding up" the numLer�7 . 1019p ,yo ,Mc o�. •• The Town of Barnstable • •••� Inspection Department 367 Main Street, Hyannis, MA 02601 508-790-6227 December 16, 1992 Joseph D. DaLuz Building Commissioner Michael D. Ford, Esquire Mycock, Kilroy, Green and Ford, PC Box 960 Hyannis, MA 02601 Re: Site Plan Review Number 38-92 Marilyn LeBoeuf, 10 seaboard Lane, Hyannis Assessors Number 269/254 Dear Attorney For d: The above referenced site plan is conditionally approved based on the following requirements: 1. curb-stops will be provided in the grass for parking spaces #22 - 36. (To encourage the front of the cars to extend over the grass, thus providing increased aisle width. ) 2. The applicant will provide parking for 16 employees off- site, within 300, of the site. This is to be done by written agreement. 3. Two trees will be added for aesthetic purposes, one on each side of the handicapped ramp. 4. substantiation of adequate existing drainage will be provided. S. Fire Department requirements for rear egress will be met. Enclosed please find a Certificate Of Review and a copy of the conditionally approved plan. Please be informed that you must comply with any requirements the Zoning Board of Appeals may impose in addition to the above, and that a pumping contract will be required by the Health Department before the restaurant will be allowed to open. should you have any questions, please feel free to call. Peace,, J 9eph D. DaL Z Building commissioner JDD/km g M cc All site Plan Review staff enclosures (2) S921216A r TOWN OF BARNSTABLE SITE PLAN REVIEW STAFF COMMENTS TO: Kathy Maloney, October 15, 1992 Site Plan Review SITE PLAN N0: 38-92 FROM: Thomas McKeanG, Health Dept. PROJECT: MARILYN LEBEOEUF, 10 SEABOARD LANE, HYANNIS The Health Department has the following comments regarding this Site Plan Review application.- Originally, the Board of Health granted the applicant a variance from the Regulation which requires an inground grease interceptor. One condition of the variance was the applicant shall receive the approval of the DPW. However, the DPW granted approval only if the Health Department inspects the under-the-sink grease trap on a monthly basis. Unfortunately, the Health Department does not possess sufficient staff to inspect the grease trap on a monthly basis. (Attached is a letter to Ms. LeBoeuf explaining this. ) Therefore, the Health Department cannot approve the Site Plan without an inground grease interceptor. T j� TOWN OF BARNSTABLE �*1HEfo OFFICE OF IMSTUL :' BOARD OF HEALTH MAN& °o t639• ��' 367 MAIN STREET HYANNIS,MASS.02601 September 24, 1992 Marilyn K. LeBoeof 7 Renoir Drive Osterville, MA 02655 RE: Pizza Restaurant, 10 Seaboard Lane, Hyannis Dear Mrs. LeBoeof: The Board of Health is in receipt of the letter from Thomas J. Mullen, Superintendent of the Department of Public Works for the Town of Barnstable (copy attached) . You were required to obtain the approval of the DPW as a condition of the variance from the Board of Health Regulation #10-Plumbing. The DPW granted conditional approval only if the Board of Health conducts monthly inspections. However, the Health Department does not possess a sufficient number of staff to conduct the monthly inspections required by the DPW. Therefore, you are required to investigate the installation of an inground grease interceptor. If you should have any questions, please contact Thomas McKean; Director of Public Health, at (508) 790-6265. Sincerely yours, Brian R. Grady BOARD_ OF HEALTH TOWN OF BARNSTABLE CC: Thomas Mullen Enclosure MLEBOEOF I �'yo tec roe` �.. _�. The Town of Barnstable gas , Inspection Department Opp 1670. '���► 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner October 29, 1992 Michael D. Ford, Esquire Mycock, Kilroy, Green and Ford, PC P.O. Box 960 Hyannis, MA 02601 Re: site Plan Review No. 38-92 Marilyn Lesoeuf, 10 Seaboard Lane, Hyannis, MA Assessors Number 269.254 Your File #92-4-912 Dear Attorney Ford: In reviewing the above referenced site plan, the attached comments and requirements have been submitted by the site Plan Review staff. Any additional or revised material should be submitted as soon as possible to allow adequate time for staff review. should you have any questions, please feel free to call. Peace, li eph D. aLuz Building commissioner JDD/km cc: All site Plan Review staff enclosures (3) cfIKEP Town of Barnstable Department of Public Works MA°°. a '•��^►�' 367 Main Street,Hyannis, MA 02601 Office 508-790-6300 FAX 508-775-3344 Thomas J.Mullen Superintendent October 29, 1992 TO: Joseph DaLuz, Building Inspector FROM: Thomas J. Marcello, P.E. , Project Manager C SUB JECT: SP NO 38-92 A current site plan is required. The plan as presented is dated 1982. The parking spaces appear to be non-conforming, as well as the driveway distance between parking spaces. A drainage plan as exists along with an Engineers Stamp for drainage design is requested. Number of spaces for parking is required based upon actual usage of building. TJM:sdm 7 h' 9 �gg2 SPX03992 J iol� Town of Barnstable PlrEIVEQ Planning Department I TO: Joseph Daluz, Building Commissioner iJ FM: Robert Schernig, .Director Anna Brigham, Associate Planner RE: Comments on Site. Plan Review #38-92 Leboeuf, Hyannis,.. . retail to restaurant. October 27, 1992 c 1. Since this appears to be a multi-use building, please tell us the number of units and uses in the entire building, then calculate the parking needs. 2. We recommend a landscaping plan. 3. As noted in the letter dated October 8 1992 from . . Mycock, Kilroy, Green and Ford, P.C. , the applicant will ° need to apply for a Special Permit from the Zoning Board '. of Appeals because a pizza shop is not a permitted use in the HB District but it is permitted in the B District. See Sect. 3-3-S 3) A) . 4. Please clarify the non-conforming building issue as mentioned in the letter dated October 8, 1992 from Mycock, Kilroy, Green and Ford, P.C. 5. Please clarify the relationship of the other lots) as noted on the site plan dated June 14, 1982 by Eldridge Engineers Co. Inc. Is this site plan up-to-date? It appears that the proposal west of Seaboard Lane is not applicable to this proposal. 2- a r l�/ri'r TOWN OF BARNSTABLE SITE PLAN REVIEW STAFF COMMENTS TO: Kathy Maloney, Site Plan Review October 15, 1992 FROM: Thomas McKean -IT a. SITE PLAN N0: 38-92 Health Dept. PROJECT: MARILYN LEBEOEUF, 10 SEABOARD LANE, HYANNIS The Health Department has the following comments regardin this Site Plan Review application: g• Originally, the Board of Health granted the applicant a variance from the Regulation which re uires an inground . . grease interceptor. One condition of the variance was the f applicant shall receive the approval of the DPW. However,,the DPW granted approval only if the Health Department inspects the under-the-sink grease trap on a monthly basis.; Unfortunately, the Health Department does not possess sufficient staff to inspect the grease trap on a Mont basis. (Attached is a letter to Ms. LeBoeuf explaining this. ) Therefore, the Health Department cannot approve the- Site Plan without an inground grease interceptor. Py�FTHE.T TOWN OF BARNSTABLE mW �, OFFICE OF f1EJ7TEBL : BOARD OF HEALTH °°sue t6j9' O �'-'� 367 MAIN STREET 'F MAY HYANNIS,MASS.02601 September 24, 1992 Marilyn K. LeBoeof 7 Renoir Drive Osterville, MA 02655 RE: Pizza Restaurant, 10 Seaboard Lane, Hyannis Dear Mrs. LeBoeof: The Board of Health is in receipt of the letter from Thomas J. Mullen, Superintendent of the Department of Public Works for the Town of Barnstable (copy attached) . You were required to .obtain the approval of the DPW as a condition of the variance from ...the Board of Health Regulation #10-PlumbingPlumbing. The DPW granted conditional approval only if the Board of Health conducts. monthly inspections. However, the Health Department does not possess 'a sufficient number of staff to conduct the monthly inspections required by the DPW. Therefore, you are required to investigate the installation of an inground grease interceptor. If you should have any questions, please contact Thomas McKean; Director of Public Health, at (508) 790-6265. Sincerely yours, Brian R. Grady BOARD OF HEALTH TOWN OF BARNSTABLE CC: Thomas Mullen Enclosure MLEBOEOF MYCOCK, KILROY, GREEN & FORD, P.C. ATTORNEYS AT LAW P.O. Box 960 171 MAIN STREET SPECIAL COUNSEL BERNARD T. KILROY RONALD J.SEIDEL ALAN A. GREEN IIYANNIS. MASSACHUSETTS 02Fi01 RICHARn P.MORSF.,JR. MICHAEL D. FORD TFLEPIIONE (508) 771-5070 MARK D. CARCHIDI TELEFAX (508) 790-1954 OF COUNSEL LAURIE A. WARREN ' EDWIN S. MYcocx MARIDETII KING October 8 , 1992 Site Plan Review Committee Town Hall, Town of Barnstable Hyannis , MA 02601 Re: Site Plan Review for Buffy' s Pizza, 10 Seaboard Ln Hyannis, MA Our file # 92-4-912 Dear Site Plan Committee members , Enclosed please find the application with a plan for site plan review on the above property. This application is required by Section 4-7 . 3 (2) : establishment of any new use of any building . The applicant proposes to change the use of one unit in this building (Unit K- 1, 178 square ft) from retail (The Medicine Shop) to a restaurant with 20 seats . The non-conforming building (footprint of building is 6200 sq . feet; gross square feet of leasable space is more than 8000 sq . feet) on this site was approved when the lot was in the Business District . This non-conforming building is in the Highway Business Zone which allows restaurants provided a Special Permit is obtained from the Board of Appeals and the proposed use of the site does not substantially adversely affect the public health, safety, welfare, comfort or convenience of the community. In addition, this change would come under the provisions of Section 4-4 . 2 of- the Zoning Ordinance . No changes in the building or on the site are planned as a result of this proposed use. The proposed use of Unit K requires parking spaces for 13 cars (6 four 20 seats , 5 for take out and 2 for employees) . There are presently 40 parking spaces provided on the site and most of these spaces are not in use du 9 the hours of peak use of the restaurant . 11� W. e..srti.+✓CIRMTAI�h.T'f•,•..n Tf.�ts:v..•.5:i J� SITE PLAN Nll)VI3E2 i ,3 $a 2 I \ pg . 2 Site Plan Review for Marilyn LeBeouf 10/8/92 If you have any problems with the contents of this application or questions regarding the materials , please do not hesitate to contact me . In addition, please notify this office when this project is being reviewed by the site plan committee . Thank you. Ver trul y ur's , ichael D. For 0985p Enclosures : Application, Assessors Map, Site Plan cc : Marilyn LeBeouf I I TOWN OF BARNSTABLE SITE PLAN REVIEW DATE: 14 October 1992 TO: Thomas McKean, Health Dept. FROM: Kathy Maloney, Site Plan Review RE: site Plan Review Number: 38-92 Marilyn LeBoeuf 10 Seaboard Lane, Hyannis Change of Use. Retail to Restaurant. Please submit this form, with any comments or additional requirements you may have re the above referenced application, to the Building Inspectors office by 10/29/92. I have the following/attached comments/requirements re this application for site Plan Review. I do not have any comments/requirements re this application for site Plan Review, at this time. (�• /X (signature) nn1 1�0 S O� v WA vaf ianCQ, `1'� a1"' � �Q4v'cj''1►�ln WYI�`^�1 ZIP(ov\es v-C c-�S c�GSC ��fAv7t�� t4c- ,QAbf� A-�4 - sA� MS. Lie e P"C- 47 ,� i� —,-0 -atn 3(N SC-C-)U1\� �c�Se in �,tl for pg . 2 Site Plan Review for Marilyn LeBeouf 10/8/92 If you have any problems with the contents of this application or questions regarding the materials , please do not hesitate to contact me. In addition, please notify this office when this project is being reviewed by the site plan committee . Thank you. Ver trul y ups , ichael D. Ford 0985p Enclosures : Application, Assessors Map, Site Plan cc : Marilyn LeBeouf r TM E TOWN OF BARNSTABLE �Of T�� OFFICE OF DssalTSDL i BOARD OF HEALTH MAN& 1639 `{�' 367 MAIN STREET HYANNIS,MASS.02601 September 10, 1992 Marilyn K. LeBoeof 7 Renoir Drive Osterville, MA 02655 Dear Mrs. LeBoeof: You are granted a conditional variance from the Board of Health "Revised Supplement to Minimum Sanitation Standards for Food Service Establishments"Regulation 10 that requires a minimum of a 1000 gallon grease interceptor at all food establishments. The variance will allow you to operate a food service establishment at Unit K, 10 Seaboard Lane, Hyannis, with the following conditions: (1) The applicant shall receive the approval of the Barnstable Department of Public Works. (2) No cooking or steaming of food will be allowed. Pre-cooked meats and pre-prepared breads may be heated. (3) No additional foods may be prepared or served other than ,those foods listed on the submitted menu. (4) Only disposable single service paper, plastic, and other disposable dishes and utensils are authorized. (5).You must install an under-sink grease interceptor under the double compartment sink approved by the town plumbing inspector. (6) This grease interceptor shall be cleaned monthly (instructions enclosed). (7) You must install a water flow restrictor device at the triple compartment sink approved by the town plumbing inspector. (8) All other regulations contained in 105 CMR 590.000: State Sanitary Code, Chapter X - Minimum Sanitation Standards for Food Establishment and of Town of Barnstable Board of Health sanitation regulations shall be strictly adhered to. (9) This conditional variance expires October 1, 1993. a^ This variance is not transferable, and will be voided if the establishment has a change in use, change of ownership, or leased to a party other than an applicant. Very truly yours, Susan G. Raskd Chairman BOARD OF HEALTH TOWN OF BARNSTABLE SG R/bcs Enclosure cc: Walter Jacobson k� � O fs {'h a _ TOWN OF BARNSTA�.> Ac 2 f IN _ f1� .u. � c . o.c b K, f*� aims . Zs/ Jf ito � �e _ ,�1ly�, . a C Ai •C 17 .1 2 _£ nit I Y OC.US to / /TI v ? �- iAA D� •o � �iawi ,it+t sawn ORfl 2 0 �. ... 4c Ota •t ti F t � itQ 21 At e, •� p t1AC _ O K 14AcF : ►6 Q 39 "• /7J to AG i; r jr•c 22 r J s b r.�i •J 4a At 19Ac•3 /)I. .Jy4C 1 .7tlAC 42 /S r� Q o �4c I A `'• t Lo t 1 2 7 /a Ac �IAt L 71 t� ti 37 W - I (31j • *It ` •�f .. ♦n i