Loading...
HomeMy WebLinkAboutST. JOSEPH HOUSE - FOOD i ���,�'p.Se Q h 1st01iSQ� Hyctirw��-3c�--2 4(o- ` t►+ Tcky Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. BA NSTABLE. F.P.(Thomas)Lee,. MA3sq. 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt. 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: 17 Issue Date: 01/01/2022 DBA: ST. JOSEPH'S HOUSE OWNER: CATHOLIC SOCIAL SVCS. OF FALL RIVER INC Location of Establishment: 77 WINTER STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $5.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: r {4 ✓ v Mai VHGE Town of Barnstable For Office Use Only: Initials: Date Paid AmLPd$ '•. &UMSTABIE, : Inspectional Services Public Health Division CEO MA'S a Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL X NAME OF FOOD ESTABLISHMENT: St. Joseph's House ADDRESS OF FOOD ESTABLISHMENT: 77 Winter Street, Hyannis MA 02601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: rrosa@cssdioc.org x TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( 774 ) 470 - 5976 ` K TOTAL NUMBER OF BATHROOMS: 9 �/ WELL WATER: YES NO X ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: .IQ_ OUTSIDE: 0 TOTAL: 30 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? N/A IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? N/A YPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE l� RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED& BREAKFAST CONTINENTAL BREAKFAST X 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 OWNER INFORMATION: FULL NAME OF APPLICANT Catholic Social Services of Fall River Inc. -St. Joseph's House Shelter ✓' SOLE OWNER: YES/NO D.O.B N/A OWNER PHONE # 508-674-4681 ADDRESS 77 Winter Street, Hyannis MA 02601 CORPORATE OWNER: Same as above CORPORATE ADDRESS: 1600 Bay Street, Fall River MA 02724 v PERSON IN CHARGE OF DAILY OPERATIONS: Elizabeth Gibbons 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. Jeniffer Stewart 05 / 04 / 2026 1. Jeniffer Stewart 12/ 08 /2026 2. Muriel Woolfork 11 / 15 / 2022 �>� \ --, �a Zqi/a®� 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.townotbarnstable.us/healthdivision/avt)lications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January l st to Dec.3I51 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC l st. Q\Application FonnsTOODAPP REV3-2019.doc prrt Town of Barnstable BOARD OF HEALTH John T.Norman r' Board of Health Donald A.Gaudagnoli,M.D. BAMRNSeAB _ 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, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 17 Issue Date: 01/01/2021 DBA: ST. JOSEPH'S HOUSE OWNER: HOUSING ASSISTANCE CORP Location of Establishment: 77 WINTER STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $5.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q/ FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: r WE Town of Barnstable For Office Use Only: Initials: '° W Date Paid�� Amt I'd$�^ ,�,MASS. ; Inspectional Services ��� ' v Mass. 1639. ,0 Public Health Division Check# AIFD MAC A Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A/FOOD ESTABLISHMENT DATE i J� Q?_O NEW OWNERSHIP RENEWAL ✓ NAME OF FOOD ESTABLISHMENT: OS Irl IS6U5 ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: a1q)ATV-�� TOTAL NUMBER OF BATHROOMS: 3 WELL WATERS NO ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: 1 / 1 /Zl TO t NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 QAAppl ication Forms\FOODAPP 2020.doc OWNER INFORMATION: �+ FULL NAME OF APPLICANT ���C S�C.IQ l �trv� c .S of �cl ve.r- Joc. SOLE OWNER: YES/NO D.O.B OWNERi PHONE# 1�� " C� —24GG*8 I I� ADDRESS (.0 �'_��_t� � l l we lkjQ CORPORATE OWNER: scir'e as �� CORPORATE ADDRESS: l f PERSON IN CHARGE OF DAILY OPERATIONS: �uscj n MQ,-r--c o re l I ct 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 e v 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/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FounsTOODAPP REV3-2019.doc f. �Prt Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BAPUMM►uM 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, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 17 Issue Date: 12/10/2019 DBA: ST. JOSEPH'S HOUSE OWNER: HOUSING ASSISTANCE CORP Location of Establishment: 77 WINTER STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $5.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Ga� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: cF� For Of; Initials:'�.. Town of Barnstable Date Paid alAmt Pd$ BARNSPABLE, , Inspectional Services MASS. �- s63y ,RFD MAC a CashPublic Health Division i Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: i C � /7 d S (1 �. K ► l ADDRESS OF FOOD ESTABLISHMENT: �B � h v fl-ianpisc� MAILING ADDRESS(IF DIFFE/REENT FROM ABOVE): E-MAILADDRESS: ( / i �- 6SSC1401(_= 0/7,6 TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( - -` (4-7 V -,Sq 7b TOTAL NUMBER OF BATHROOMS: 3 WELL WATER: YES_NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/ /_ TO NUMBER OF SEATS: INSIDE: 6® 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? 0\4- IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)?O Ok TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL.THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED& BREAKFAST 4 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 OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: -YES/NO A.O.B OWNER PHONE # ri — ADDRESS boo lk-( a- C, �c CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. N i 2. I y S / 0W- SIG ATURE OF APPLICANT DATE i ***FOOD POLICY INFORMATION*** F SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/aJ)plications.as]). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec. 31`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc Down of Barnstable BOARD OF HEALTH Paul 1 Canniff,D.M.D. A.Ga Board of Health Donald A.Gaudagnoli, M.D. anMusc,ALL = John T.Norman MAC F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 17 Issue Date: 12/20/18 DBA: ST. JOSEPH'S HOUSE OWNER: HOUSING ASSIST. CORP./CONNIE RALEIGH Location of Establishment: 77 WINTER STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $5.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - —---- -- - MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: I PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: I i 1 oFIKE�. For Office Us Initials: �. Town of Barnstable �� Date Paid F., �` Inspectional Services1639. ; �prEO MIS s�0 �' Public Health Division C Thomas McKean,Director Ck 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 hid APPQLICATION FOR PERMIT TO OPERATE A F OD ESTABLISHMENT DATE 4- - O NEW OWNERSHIP RENEWAL e— NAME OF FOOD ESTABLISHMENT: 731T, �© k f ADDRESS OF FOOD ESTABLISHMENT: :77 is MAILING ADDRESS(IF DIFFERENT FROM ABOVE): 1 G' O E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 7Nlb- TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: tk TOTAL: 3 O 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(formerlyresidential kitchen) ) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL, MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FormsTOODAPPREV2018.doc r is{ PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT (1hp �G 3� SOLE OWNER: YES/00:" D.O.B OW. R PHONE # ADDRESS CORPORATE OWNER: FEDERAL O. : CORPORATE ADDRESS: Bev 6t A11,1114*r- 1 PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Aller en Awareness Expiration Date ka(tt /1 20) 2. / / L4 11 116 - IGNATURE O APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openinc!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec. 3152 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1 st. Q:\Application FormsT00DAPPREV2018.doc McKenzie, Marybeth From: McKenzie, Marybeth Sent: Wecnesday, December 02, 2020 2:52 PM To: 'Stephane Ruault' Subject: RE: Request for milk Hello Stephane, The variance you are requesting to leave milk,a temperature controlled substance (TCS) out at room temp for 2 hrs before discarding will be approved, but please factor in the time that it takes for the milk to reach 41 degrees again in the refrigerator because that time needs to get factored into the cumulative time of 2 hours. That is good that the mop sink enclosure is getting addressed now and will hopefully help. Please post the email and procedure so all the staff can view it and that any Health Inspector will know the procedure. Thank you, Marybeth McKenzie R.S. Health Inspector Town of Barnstable (508) 862-4644 From: Stephane Ruault [mailto:SRuault(c-L°cssdioc.orq] Sent: Monday, November 30, 2020 5:49 PM To: McKenzie, Marybeth Subject: Request for milk Good evening Mary Beth, As we discussed last week, I am requesting the permission from you to serve milk to our guests, following the protocol described below: -Staff take gallon of milk out of the fridge at 6am and mark the time on the bottle -Staff place milk left back in the fridge at lam—and mark the gallon - Next shift staff place milk back on the table at 8am and mark the bottle again -Staff remove the gallon of milk at 9am an:d dispose of it. If need be, another gallon of milk will be placed on the table at 9am, marked by staff and will be removed from the table at 11am and trashed. If this protocol suits you we would probably start within a week. Our long term solution will consist of using professional thermos, like most coffee places use. Please let me know if this suits your requirements. Many thankls. Best regards. PS: I have filled the proper work orders for the installation of paper roll dispenser and the building of a partition in the bathroom to isolate the cleaning area from the toilet itself. Stephane Ruault House manager Saint Joseph's House 77 Winter Street—Hyannis MA, 02601 Tel.: 774-470-5976—Fax: 774-470-6984 1 °F IKE i TOWN OF BARNSTABLE - HEALTH INSPECTOR'S .Establishment Name: - � Date: Page: . of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARN LE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 7 639. �•� HYANNIS,MA 02601 - M-8'-FRI. No Reference. R-Red Item-: - PLEASE PRINT CLEARLY �A 508-862 4644 'EDN1P�a FOOD ESTABLISHMENT INSPECTION REPORT Name Date T e of T4pee4JnsDection O ,outine Address Risk od Service e- ction Level Re O Previous Inspection '4,0,Z X, Telephone i ✓ Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP In: Other Inspector !�. Out: 1-1 f ��- - Each violation checked requires 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 e ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ' ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling t_ If ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time Asa Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) r, ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ✓ J ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories i Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violation �� Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Requir 7 Y Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating y y ❑ Voluntary Compliance Employee Restriction/Ex son Re-insp ction Scheduled mergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4non-critical violations 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Re uirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 31.Other D E OF E- PECT ON: Inspector'sSignature Print: 31.Dump er screened from li Permit Posted? Y N Grease Trap Previous Pumpi g Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N 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) <: It '. FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at TemperaturesAccoiding�o 1 590.003 A Assignment 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 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 - - PHF Hot-and Cold Holding - 2-103.11 Person-in-Charge Duties- - -- - 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) *- -- EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * 2_ 590.003(C) -. Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 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(Ay Food Protection* p g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 _ _ Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7:202.12 Conditions of Use* -590.004 11 Variance Requirements ..590.003(G) Reporting by Person in.Charge* Contamination from the Consumer 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* ( ) q _ _ 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* - REQUIREMENTS FOR- •• _ 3-306.14(A)(B)Returned Food and Rrated orce,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* I 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) with F c Compliane wood Law*- _ - _ _ * 3-801.11(D) Raw or Partially Cooked Animal Food and Compliance - * 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 Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* _ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* - 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 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 ctsw 11112001 _ 4-602.11 - Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment*• * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and-Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3.2ni 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 10 Proper,Adequate Handwashing g' P Game and Wild Mushrooms Approved By - - * 3-401.11(C)(3) Whole-muscle,Intact beef 3tuAs Ids°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 die appropriate-firms above if related to 3-202.18 Shellstock Identification Present* 2 301.12 _ Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under t/29-Special Requirements. 5 Receiving/Condition, - 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 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* LIS 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 3-202.12 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[0 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Amlaie�nt 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S: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� rokti TOWN OF BARNSTABLE - HEA-OFFICE HOURSR'S Establishment Name: Date: Page: of BAR E.O PUBLIC 2 0 MAN STREET EEVT 3:3 4 0- :30 P.M. DIVISION 0 :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:3 MASS. •�' HYANNIS,MA 02601 - MON.-FRI. No Reference: R.-Red Item• PLEASE PRINT CLEARLY { 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT - CJ Name Date MReof Type ns) c ion 11 l ip R ine E Addre s Risk ai on ' Level Re Previous Inspection Telephone Residential Kitchen Date: be Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint _ - Person in Charge(PIC) Time Bed R Rreakfast HACCP �-- - - In: Other Inspector Out: NA I Each violation checked requires an explanation on the narrative page(s)and a citation of specW 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 i EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY I ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) i Corrective Action Required: ❑ No ❑ yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Voluntary Compliance Y Y ❑ ry ❑ 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 re ardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations 9 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of )( ) 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 8non-Critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Ins t's Signature Print: 31.Dumpster screened from public view "V" Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N pIC's Signature Print: #Seats Observed Frozen Dessert Machines: Outside Dining Y N g Self Service Waft Service Provided Grease Trap Size Variance Letter Posted- Y N10 V 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 3-50.1.14(C) PHFs Received at Temperatures Accoit)ing tom 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 - •j 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous of%kfic ed stances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*Other* 590.004(F) - *. - * 2 590.003(C) � Responsibility of the Person-in-Charge to _ 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* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rated or of Food Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP - .. - - - Food 7.204.14 Drying Agents,Criteria* 21 3-801.1](A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( P 4-501.111- - Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations * 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitizatiou Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water-from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) , Comminuted Fish,Meats&Game Pathogens* Ep t-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source _ 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 - Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 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 Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority I 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y 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�03.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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 Conveniently Located and Accessible Within 2 Hours and From 70°F[0 41°F/45°F 3-203.12 Shellstock Identification Maintained* y Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 1.007 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. oFt . TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: l;( Page: of ry OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNMBLE. • 200 MAIN STREET 3:MON.-F P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p 659-amp HYANNIS,MA 02601 M-8 -FRI. sos-8s2-asaa No Reference R-Red Item PLEASE PRINT CLEARLY FOO ESTABLISHMENT INSPECTION REPORT Name Date' Tyne of Type of Inspection p Routine Address Risk i Re-inspection L� Level Retail Previous Inspection Telephone Residential Kitchen Date: f/ Mobile Pre-operation L L Owner HACCP Y/N Temporary Caterer _. Person in Charge(PIC)ihyk /� Time Bed 8 Breakfast �HA�CCPIn: y Inspector v Out: Each violation Checked•requires an ezplana Ion 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 Tobacco Violations marked may pose an imminent health hazard and require immediate corrective Q SG Action as determined by the Board of Health. 590.009(E) ❑590.009(F) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands, I ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ; ❑ 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 Ah ❑ 5.Receiving/Condition ❑ 17.Reheating ,r7� ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling U�-- ❑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 7: ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories D -- Sit✓ Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Non-critical(N)violations must be corrected immediately or Corrective Action Required: ❑ No ❑ Yes within 90 days as determined by the Board of Health. Overall Rating 'ul ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations. If no critical violations observed, 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations 9 or more non-critical violations=F. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must water,sewage back-up,infestation of rodents or insects,lack of C=2 critical violations and less than 4non-critical. If no critical 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=C. refrigeration,or no PIC or alternate PIC present. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N IC's Signature Print: Self Service Wait Service Provided Grease Trap,Size Variance Letter Posted Y N A- Dumpster Screen? Y N � _. _�--,.�.....w?4ht'[r-..n'°'_�,,,4'ai.fa.*P"�..^.,-�'-�s�»•_ .. •,.._.. -.�,y_: ,.�-...r-+.v - a.,+ .. w -•-awa,...,�ces.s-.yq.r- ... .r -�-. i --�ru. .o,.... ,- o...u„yy., _ _....-f. �---�. ;.rv,,..'._ ��.�y,,:_-_ .. � ..zL,+ �' ,..� Violations related to Foodborne Illness Violations Related to Foodbome Illness Interventions !r Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Pp * A licants 7-201.11 Separation-Storage*3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 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* 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 y - Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* * Raw Seed Sprouts Not Served* Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shel�sh and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency r f cesSanitizationqiof Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan. Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Stuffing Containing Fish,Meat,Poultry or 590 00y Chemical* (A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* in mobile food,tern o and residential 10 Proper,Adequate Handwashing g• P �Y Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165'F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices Reheating for Hot Holding practices should be debited under#29-Special 17 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* 0-8- Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities3-501.14(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 Product 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 s 3-501.14 Fs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement B Cooling PH( ) g * 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 h'• p * 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plana 16-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 18-103.12 Conformance with Approved Procedures* S:590Formback6r2doc *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. oFT Kok , ,70WN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: CAP- PUBLICage: of OFFICE HOURS HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-a:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. . , More.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 2659. HYANNIS MA 02601 50a-Bs2-4saa .FDM�,p FOOD ESTABLISHMENT INSPECTIO 4 REPORT Name / Date a of Type of Inspection Ore -Routine Addres Risk rvice Re-inspection Level Previous Inspection �-Cl° ,n^ Telephone Residential Kitchen Date: /v Mobile Pre-operation Owner HACCP YIN Temporary Suspect III Caterer a Complaint - Person in Charge(PIC) Time .Bed 8 Breakfast ( Z . In: Other Inspector Out: Each violation checked rea, es an explanation on the narrative page(s)and a citation of specific provision(s)violated. All Violations Related to F,Zo Iborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked m-,-,Pose an imminent.health hazard and require immediate corrective Tobacco 590.009(F) ❑ i Action as determir Ay the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTI bN MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑.1.PIC Assi ed/Knowledgeable/DutiesLo ❑ 13.Handwash Facilities rVt- EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2 P'eporting 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 HSP46 ❑ 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 checked indicate violations of 105 CMR 590.000/Federal Food Code. ® ❑ Emergency Closure Voluntary Disposal C] Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 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 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 be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008 9 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's /Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y IN #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature f Pnnt: N r y Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) "Demonstration ment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41'F/45°F Within 4 Hours* 590.003(B) of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 1400F 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 N, 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* REQUfi.+F-MENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLt POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g � ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurizs.',,Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages wiG.'w!-ning 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 Pasteurizes.- Igs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially CoZLAI Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Se.,ed 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 None-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS * 4-501.114 Chemical Sanitization-Temp., H. CONSUMER ADVISORY �. 3-202.14 Eggs and Milk Products,Pasteurized P•.P 18 Proper Cooking Temperatures for PHFs y * Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water 3-401.1IA(1)(2) Eggs-155°F 15 sec 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* Effective 1/112001 \,' 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* ` 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 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 590D09(A)-(D)imcater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* Proper,Adequate Handwashing 10 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 1 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commerciall 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* 12E5-203.11 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can tie found in the 6 Tags/Records:Shellstock 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* 13Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F hem Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Tags/Records:Fish Products Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3 402.11 Parasite Destruction* Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient24. Food and Food Protection FC-3 .004 * . Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45'F 25. Equipment and Utensils FC-4 .005 3�02.12 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 11.008 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. Op THE III TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of Y 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 9cbp M639:p 0� HYANNIS,MA 02601 MO No Reference R-Red Item PLEASE PRINT CLEARLY reo 62-064 MPS FOOD ESTABLISHMENT INSPECTION REPORT Name V Date� l Tvoe of T Ins io ✓1n 1 O e i s outine. `- ' ► ` Address 54 Risk Servic ection Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary. Suspect Illness Caterer General Complaint Person in Charge(PIC) a Bed R Breakfast HACCP In: Other [Inspector Out: e s 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) Ej 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) 3 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands s ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities J��r EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 1 �" ❑ VIE 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives �- ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals Ab, 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 t ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling Qr ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control L ❑8.Separation/.Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygie tcc� r'ic Practices ❑22.Posting of Consumer Advisories 666!!! Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 11 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 0 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. B=One critical violation and less than 4non-critical violations g 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 C= Seriously Critical Violation=F is scored automatically la hot 2 critical violations and less than 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 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address t 8 non-critical violations. If 1 critical refrigeration. violation,4 to 8non-criical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N / #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI 's Sign Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N e"P(_117ev r re �IU 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' 2-103.11 Person-in-Chazge Duties 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130'F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEiTEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 6 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effe c"°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 I 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-155'17 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Shellfish* 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* 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 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to leaning Procedure* 165'F* foodbome illness interventions and risk factors. 3-202.18 Shellstock Identification Present* 2-301.12 C * 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 Wild Mushrooms ( )( )O practices should be debited under#29-Special 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.11 Package Integrity y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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) Coaling 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 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45'F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004 Labeling of Ingredients* Supplied with Soap and hand Drying Devices (J) 9 9 I 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures 1 6-301.11 1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I 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 1 Reduced-Oxygen Packaging Criteria* 1 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. °p7NE Tqy TOWN OF BARNSTABLE.. HEATH INSPECTOR'S Establishment Name: ITT• J u,�/��i /fy yd-e. Date: -,.Page:_ of. e 4. OFFICE HOURS - °� PUBLIC HEALTH DIVISION' 8:00-9:30 A.M. - BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p Me3y.pm� HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY. -862-4644 'EDN1P� FOOD ESTABLISHMENT INSPECTION REPORT 508 Name _ JJ J Date3 T e of Type of Inspection / r Routine r Address II^^ ` S' Risk Food Servi Re-inspection VV`� T Level Previous I sp ction Telephone Residential Kitchen Date: �,(/f�y r u, -Id Mobile Pre-op rat- n v Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP In: Other > Inspector WS 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) ❑ �' ,2z Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling 1717.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) I I I 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 o Embar checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 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 to 6von-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 observe ,7 to 8 no violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violatio ,4 to n n critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspecto' Signatu P t: 31.Dumpster screened from public view Permit Posted Y N Grease Trap Previous Pumping Date Grease Rendered Y N VI14 4AGE #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature r Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted: Y N Dumpster Screen? Y N t Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41 EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590:004(F) 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se aration-Stora e* Applicants* 3-302.11(A) Food Protection* p g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 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 Disposition of Adulterated or Contaminated g � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Mot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment* o Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef cti-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 4-702.11 Frequency of Sanitization of Utensils and Food Shellfish and Fish From an Approved Source 3-401.1l(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS _3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* 1 p Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 1 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. $ Receiving/Condition 8. g g 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 8 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 TagsiReeords:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. t °p THE r TOWN OF BARNSTABLE HEALTH.INSPECTOR's Establishment Name: I__ _V Se p/'1! 1.4 a Date: Page:. of h OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified v a}9: HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY. F, MP.6 508-862-4644 - FOOD ESTABLISHMENT INSPECTION REPORT Name Date Tyne of section a v Routine Address �f Ris ood Service spection r`n r a Level R Previo�ll'l pe�ion 1.2 Telephone Residential Kitchen Date: z//L v Mobile Pre-op �Q Owner HACCP Y/N Temporary Suspeess Caterer General Complaint - - Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector C Out: Each violation checked requires an exp anation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives 10 ❑ 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`/ n El 10.Proper Adequate Handwashing CONSUMER ADVISORY 'y Loc. -e I''' ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: o ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. "' I� ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the i s Embargo Other: checked indicate violations of 105 CMR 590.000/Federal Food C de. ❑ 9 Emergency Closure Voluntary Disposal ❑ 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 6=One critical violation and less than 4non-critical violations g )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6.non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations o rved, to 8 non-critica iolations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation to 8 n c it? violations C. 30.Other DATE OF RE-INSPECTION: Inspecto ' Signature 31.Dumpster screened from public view '� 1 1` \ 0 In Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's S re Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted. Y N Dumpster Screen? Y N Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) [De-. signment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) onstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3 202.12-+- Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties - Cooked and RTE Foods.* - - 19 _. PHF Hotand Cold Holding -' 3-302.14 Protection from Unapproved Additivs*e Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person--in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130`F* Applicants* - 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3.302.15 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) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR. 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual 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* 1 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. Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 16 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* ej/-nve uinoor 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency rf Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004 C Wild Mushrooms* 2-301.14 When to Wash* 3-401.11 A 1 * Other 590.009 violations relating to good retail O ( )( )(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 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 on-c 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3 403.11(E) Remaining Unsficed Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F * Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* _. 8-103.12 Conformance with Approved Procedures* S:590FormbackI6-2doc *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. No......&951::14�t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HIEALVT L LU .................OF.....juna.w� .. .. ...................................... Appliratiou for Disposal Works Tonstrurtion rumit Application is hereby made for a Permit to Construct or. Repair (jam)-an Individual Sewage Disposal System at: ................... ........................................................................................... .ocation-AAd L. or Lot No. _,p ......................................................... Z P ddres ....... ........ 0.M.ft.7 1 Y-- * ........................ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder ( Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( Otherfixtures ..................................................................................................................................................... Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width....._.._._...._ Diameter._______-____-_- Depth_...._........_. Disposal Trench—No..................... Width.................... Total Length__.................. Total leaching area....................sq. ft. Seepage Pit No_____________________ Diameter.__..._..___.__..._. Depth below inlet_................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) , Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water..................._._.. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water____-______-----._--_--. ........... .. .............. q ... ......................................................................................... 0 _.Y c ,V Description of Soil......................tvm. V ....................................................................................... --------------------------------------­------"------------------*----------------------------*----------------------------------------------------------------------------------------**-------------- ......................................................................... .................................... 4---------- 'LX when aLpplica U Uature of cRepairs or Alterations—Answer Ple--------- -6 V.0c.................................................................... W Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL I TL 1Z 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the bo of health. Signed, ...... ...... Q7---------- Date Application Approved By.......... ........................................ ....... 7--------- Date Application Disapproved for the following r asons:.............................................................................................................. ...........................I...........................I.................................................................................................................................................. Date PermitNo........................................................ Issued....................................................... Date ----------- No...... `l::.L THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH.g� �• Application for-, , al Works witrnrtinn rami# Application is hereby made for a Permit to Construct` ( ) or Repair (,,..+an Individual Sewage Disposal System at 1 h`.� .f"�nf ? .............. / Location ddressu or rn-K; 9""' , )s Lot No. z. Q ner = i Address Installer Address Type of Building x m Size Lot--__-_---------------------Sq. feet ,_4 Dwelling—No. of Bedrooms-_................f...........•...___._._Expansion Attic ( ) Garbage Grinder ( . ) p`4 Other—Type of Buil 11 ..................... `---.. No. of persons__...__._._.._...._..__._.__ Showers ( ) — Cafeteria ( ; ) a' Other fixtures ...�.,__.... .?�-------------•---....------.-•-•---••--•-•--•-----•••••-••••--•--•--••-••--•-••-••-••••...-••-•••--............-----•-- Design Flow..........................------.- W I......gallons,.per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity.....}...._gallons Length................ Width................ Diameter---------------- Depth.............`1 x Disposal Trench—No. ..................L Width.................... Total Length.................... Total leaching Area___--.-_--.---------sq. ft�t Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank aPercolation Test Results Performed by.......................................................................... .Date........................................ 14 Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to`ground water........................ RI' s ......................• •-•--•-•----••-•.........---.....--•-- Description of Soil.................. y .l ..r.. p f ........ j V ••••••••••-•--•---••••-•---•••-•---•-••----•••--•-•--•-••••••-•••-•-•-••••-••••-•-•-••-•••---•-•--••...........•--•-•-• ................................................... ..........................................•------..........._................_...----........................._"...................... F U ature of Repairs or Alterations—Answer when applicable Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TN1E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the b�fd of health/ Signed. ,` ✓ " � ��f rf .............: �•••...•---- = '...................� f� ------ Date q Application Approved By---•-•-- •. ---• '.e ........--•----•.............................. .. •l= J-----•••-- Date Application Disapproved for the following reasons--------------------------------•-------------------•---•-----------------------•-------•••........----........... ..-•--•-...•--.-•---•---••-...........•••--•••-•••••-••••-•-•-•--•••••••------••.....................•--•--••---•••-••-•----••••--•--•••--•--•••-••---•-•-••••--••••-•-•-----•....-----•-•----•--------- Date PermitNo................•-•-•-----------------.................. Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I �� � �rr�i�irtt#�e of f�nrnt�rli�anrr THjS IS .10 CERTIFY Thatttsyhe Individual Sewage,Diisposal System constructed ( ) or Repaired ( — by s °._d.. _---------••......................1 ------- -- ---•-- Installer ' �-� r a — L, has been installed in accordance with/the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..... �"'4�..L__....•. dated-............... ------------------------•--•-•-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCT107 SATISFACTORY. ¢¢uu DATE1�-1.. Inspector -•-------------------------------------------------•----•-••••--••--• THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH 1 . NO.........'... .... FEE..... kr �Permission is hereby granted..---.�..I. ..... .: .'_.9�_ � � ! - ------•-•= ...1 !'_4.. ` ................................_ to Const c ) r Rep it n Indivldu 1 S,' a e Disposal System at No... .V /'5 f.- l._.. .,. 7- {r- _4d-•l. Street---- as shown on the application for Disposal Works Construction Permit No............. ...... Dated.......................................... � 1 Board of Health DATE.......... YXV' .......................................................... FORM 1255 A. M. SULKIN, INC., BOSTON i`r 0 Fzs..$...I.S..0....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................Town................0F.........Barnstable ---------------•--•-----------............--•--•---- App iration for Dispouttl Works Tontrnrtion famit Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 89 Bassett Lane, Hyannis, MA 02601 -----------------------_-.--..........-..-----------.-------••--•------•---..........--.------ ..................................... Central Station ofL�ape Cods P. 0. Box 1-148, Hyannis; MA 02601 -------------------- - -... ............................................. --........---...------...••--•-••-•.......-••.....-•--.........-•----.._..................----•--- w A & B Cesspool Serviceow°e` 128 Bishops Term Ce,ddifyanniq MA 02601 ............................2.................. Installer Address UType of Building Size Lot............................Sq. feet ,., Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q, Other fixtures ------------•---•--------------- - w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Li, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ M ........... •---------------------- •.........----...... ---------------------------- .----------------- --------------------------------------------------------- 0 Description of Soil...............S3�,nd..-•--••-----•-----..........---...........----•-----••--------------------•-•----------------------------- x U -----------•-•---------------------------------•--•••----•----......-----------•..............---------------••----------------------•-•---------...------------------------....-----•----------------- w UNature of Repairs or Alterations—Answer when applicable_.____installation--cC---a..l_,000_.gal-,-,,...pre--cast, stone..Packed leach---pi.t-__ ....................................... _. Agreement: The undersigned agrees to install foredescribed Individual Sewage Disposal System in accordance with the provisions of iIT14—L 5 of th ate Sanitar Code—The undersigned furthe a es not to pl e the system in operation until a Certificate of ompliance has een y the Si . .....�. ..... ........ . ......� . 6�261 .._..__.... D ApplicationApproved By.................................................................................................. ...........6126� Date Application Disapproved for the following reasons------------------•------------------------------------------------------------------------------•--------•--•--- -----------------------------------•-•---•---------•---•-----........----•---------......-----......._.........--------------------------------•------------------------- •--------................... Date Permit No...... ............................................. Issued­ 6/26 4 .................................... Date THE COMMONWEALTH OF MASSACHUSETTS 5� BOARD OF HEALTH --------_-------....T.awn.---.....OF..........Bse ..................................................... Appliraiinn for Ropos al Works Tonstrnr#inn jhrmft Application is hereby made for a Permit to Construct or Repair ( X) an Individual Sewage Disposal sal System at: 89 Bassett Lane., .HY.�n1j5,..MA.....A �Qi..............•- ................__......_ - -----....---------------------....------------•---••----.._..----••-----------••-•----••-•-••---•. Location-Address or Lot No. Central Station of Cape Cod.................................... P.....0,__Frax..il?CRY--?Iiar-.- 4••--A2bE13...........-•---- Owner Address A .. B Cess..00l._Service tall.e•......................................... 12$.BishQPs--Tama cep---Fl3aa n �--�iA--•-•-02,6CLI...••-- � Installer ddress Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms_______________2..........................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of ersons........_. a YP g ---------•------------------ P 3............... Showers ( ) — Cafeteria ( ) dOther fixtures -----------------•--------------------------••------•-.-------•---------------------------------•----•-----------•------- ........................ Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'ca.pacity_____._.....gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date....................................... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 -------------------------------------------------- ---------- -.... ----------- ------------------------ ----------------------------------------- •••...----.---- 0 Description of Soil..............Sand................................................................................................................................................ x U ..............•--•-•-----•--....--------•--•-••-------------------------------......----------•----------•---------------•------------•-----------•----------••-------•--------------•-------•-----•-•... w UNature of Repairs or Alterations—Answer when applicable._____-instal-at- 1;40f3 gai:; pYe=Cast, ston�..Packed-.each.Fit..(.Qyexfio�)-............................................................................................................................ Agreement: The undersigned agrees to instal foredescribed Individual Sewage Disposal System in accordance with the provisions of TITL% 5 of the- tate Sanita 'y Code— The undersigned furtll q a ees not to ce the system in operation until a Certificate of Compliance h bee ss by the ealthJ ---c - ....� = - S - ------ ------ b� 6 8t►-...... \ Date _.._. Application,A'PProyed BY -•--•-•------------------------------•---------•--•----------------------------....---•-- 4/26/ ---------•--- � r... Date Application Disapproved for the following reasons:................................................................................................................ -------------------------------------------------------------------------•---•---------•------------......_.....------......--•-------•-------------•-------............................................ Date PermitNo.--- . ............................................. Issued..6/26/84------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............T 6lkirl..................OF.......B a rn sia b l e................................................... f9rdifirFab of TnnapliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (s ) b� & B Cessp o01 Service ..328 Bishgps Terrace,._�ti> 5,-.Terrace ............................................... Instal ler 89 Bassett Lane, Hyannis , NIA----02601------Centsl_.Stati-cA--.... Cape-- sad---------------------------------------- at................................ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit N .'.................................. dated_... /26 .......................... THE ISSUANCE 9F THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM f/WIL F�U� ION SATISFACTORY. DATE....fe.. .7. - ill-----------•-------------•--------------.----- Inspector... ...__ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 84- fr Town....OF.........Bxta�ble ......................... 1 No................../ ... FEE_$.. ..QQ----- Permission is hereby granted------A & B Cesspool__Sei@-----------------•-----------•--•--------.........------.....---•-•........._.... to Constr t ( ) ors Repair ) an Individual Sewage Disposal System Bassett Lane N .......... 02601 -..C®....._,5t gn..ijf...Ca.Pe...Cnd Street as shown on the application for Disposal Works Construction Permit . ..................... Dated.._..6/_26/..84�_...._.............. ............... .....�------------....-----•--------------------•--------------....---•-----•-------•- Board of Health DATE............................................................................. FORM 1255 A. M. SULKIN. INC.. BOSTON J HOU/1n*A/11/TAfn10ERP* TEL 617-432-6983 617-771-5400 77 WINTER STREET/ HYANNIS, MA 02601 May 31, 1984 John -Kelly, Health Agent Board of Health Barnstable Town Hall Hyannis, MA 02601 RE: Septic system at 87 Winter Street Dear Mr. Kelly: This is to confirm for you that Housing Assistance Corporation agrees to pump the septic tank at 77 and/or 87 Winter Street on a regular basis until the municipal sewer line is extended up Winter Street. We will have Macomber and Sons pump the system in July after one full month of occupancy, and then pump again on a monthly basis as needed. Thank you for your help and support in helping to get our shelter operational. Sincerely, +1 Fred6 'c B. Pr esbre Executive Director bll/FBP � 2S' 7 6- .d 1ST4 cn --.- _ . / ,�. --------4_ /'bo �.�.v 73, 1* { 4 R ��_� � � .� .. ��.�. .����� ��. .mow�. _. � �.�.�w—_���.� � � ��� � _ �.�.���_ __� .� ��..�.-- —__.. -�� __� _ �� �� � �.-�.��� _.�.r�..�. 1" t '1' � � I��. r t ,...- � L � { �. 'a3_..�. _ .._...._. _. _ _ �� ...� �.. __s .. �.r.�... .._..-�—+- +. �..��_ .�..�.�.�,�._.�� .-.-..�.�-.+.«��� ��r.��� _.�.� �.�.�...-.! �._-.� � _:.�..�_�,V.. _.�.._� �_ _mow..-- .��_�....�..�. -.-�..� �..-�- ��_ � _�.. S ., ti *+ i y- f � .�1r�`�, s= Fr � '�' r '� rya `�� ,,4�*` � }w,�� �'�.,' a �.,N y .-r � G• ,. erx s y ; a s + •_t � �*� +' .� r L s,t, ,R ,r a i', t yrr �i�' '.yt * P X -t'eS �+rr. �e .i t�. r4 �'Yt.1 r �". • �-� ftrAt?"., xr•1�F*t"p.�s »�+ '0' ! t M v r ' i+S' sS ,'r YI r ti atT.. +S # y+w• r �,� r' q• , J. .i,,i } )ti..ry " `'f t r ) �{,,. »# vi C ' �' , _ �`.°^ �x',�'.' � Xrst ?.v .y.Aa �'. '� a• F yi""• d Y �'. g,r , .:�.+ 'f '1,"��1`:x � _ �z•r t 41 L M i,,,Z k...h ; i .• .r Vic.,. .,,Ka.. a i �J � - q, 5 �� E• �- `� �, � /)"° .r t.•tja �. k t x :2�� r ..Y ..v 11 e.+ h s14,'ir ttL �r 't`•rf' '- J,. Y. €. +�, <• a ,' � '2+taa t,r r"�'. g 'S.., .[ r'»'t nfv '3•'�. : id *$•l y nt .iwa `'.+ +'+� 4y'. y t�r +'3»r, * 'r .' q y "L �•'?r'r il".`tr {, '✓ :�' .+ a r .�' tx :t'r *� .,r. '• . t �^3 ttl' .4 ;I� ti »t "' 'r t, >. a ,iy't Z. �* � �' -• Si . 4 �, � � � s Jp f _�• �+a r.. t -+� r Y .,ti x a •.,y a •i ;y a C z y i4 p..f 4. t s,t tt TyA Septbmber 21,,h 19$4; nYq r •Ft �.e u -I t ►" 3 < f �-' s, +• L.,* o x�. + r v a)) I .t a • , • i � y+ ••� 't' t .a fit, r. 1'f5d 4 c r ; .. L "S• ♦ S _ q ya ! -.r', tt j 44 !a . �. 'l.P yyf.,•i.•t'.r} a 1 1!.]; » `' y � •J A L i - 'i ir» 4 c, c,'f r R ` r s�"�j.j {4 ,.*< d• Z r. p ✓ ., r;,+ 1. �. � .t - 1 ;� yr 43 �YJp`�"y r4• a�'"t'" rW ,r rf �+".�� :`,. r `{ .* i Cam'*' ,, # ».:;�r'n'''' a t+ - t' ". _ � T ' .1'�) '•rF tgq T• t. 4 '�� ,� - l .'' '1 - ' r y�r>++ h' a r`r" •L 1 d't,Qy ) 1• ` . + t yr •" +4` t^' x A Y�f�'.,Y �'r.,. .. �5 ZF `tt . 11'�'d� ' ` "Wr,'^ 1t'iR J :A y '�'',j•V,� 1 dl F ' W X y f +M- j` ]s �' � � )'4.1-'- V Fra� d+. � •. p 1' a Fµ .S Baker Director, Family Shelter r j .•_X'�`� 4 S 1` •�Ir A R rr)1 1 ram♦ Eighty=Seven'Winter Street h 77,`,itiinter Street /3t rl r .. t 1 �r' y ; , yq g r 4t,b7 r ».r rv'` .vim L + a ., f t' is `Hyannis;��Ma.'.„02601 t yr �_ � � r k � 'ter• -.y, �' t .-De ar Mr. Baths .... >ri :f n ti S• t p s a » 4trtS K L ' t+ j. F C.,� Y Vyy,�v ..t -.r rl lei s} � s �, 4.:f.�• la � _ ..c 'o" r y h-•�, are An receipt of ydur `recent Metter concerning ;your purchase of 'a Hobart commercial adishasher and',booster. v c Ar_- y ?,_'r; r ,.� t I l k'ryS ;t• +. . .1A ;f', V ` , �� �` After•khedishwasher is:instalied and 'operating•correctly,.please; r r z r " , call for" an .inspe ti Ou •r, �p 'number is,775 1120, extension „ ,r on 1e hone +c r t e .182 ,y, ...'I t i .} <. `. C •a ygiK. 'r tf �a:Z ♦ 'rs 'T'tJ - t i ,Ta(:' , 1 .. � r t ry - �•, 'L.e t 4'- 3 f'�; .: :r. C• 1 - +.L You .r yv truly,.-,4 r•it ,, �' E • - ,.t: a- q+\` t .� I f rl,ys t;r_ _ re ver 4 Y. ",S 3 • 4 F '�` M a+'.K'k'�x r ' } t r .vim 'r' #,i �` i ♦. t ] t ^.w. L 3 r:it .. » r i. C. tx ..'F {s•3 nt''i.,.� M yr t A: •'4 z) <2, '. . 4 T,. AJohn M. Ke11Y., rector�-orf.Public,;Health 4P t: t � ' ) , e'. �:y S �Byt. y,',4,i 1 �, d a. ""'r,5.,�.<. .t ht$row t..z; a r G"L �.. xi' r ''y s.t4 -_v ram!• r iy, a 3. 'L K:. / y. �`;"d,tia r t': '• r r ,,a , <.'t ^�!' 4•' ?. •4:'d t '4" '1" •s�. i•+.'€'? `t. l+. •''ar tW ` a s.r a� , t t r y r .r 1 a : 5=r t r i}f ' r . • ' d , r 1 {. 1 ? F• , + X �. ;y, t ' r {t t A#,�.1y '�Y I, s. +C• r*.. '`. ��. s tT 4'kti?. 4 r'i j ' .7�t` :� � F��': r �. '� `r tf '" r y,�. •t1. t pf'.# t ,wA.. .. fC F.*� t t ,� i s ' : a M 3L t- a a rt r4 •' �... t r2 rK i t �s ., y j r j 1< .. rye.^ L.+r .t •� _ k ,}. y�' aft,.,L k e s t M4 s �.� � t» t ) •,.R f � ..Rz a z' t r. ;_ saa,' i ws`�1,.r e � , t k,i" rj ♦ x A •iY Zi . r •,.. +C. u; :ef '� r + ., s r :fir .4 v4 /' 4•,it ` S r r ' L -''`, r ; �.:n,S • i".. r i>!*�.,,., r • t i., ,r •`i s• V e �,^v s ram'' ,f' .,� , y :�i`z g y f� `rn,._ r� » � t a Y•„ _ �-�N .� ii. .J "'A;rY+t �, �.,•`+r,„ySr �tr •x .+z_~;C6>< �: f, .t ^+r a '` .a .i§ '' C r',.♦ R yr• .+ y.r t " 'A`•" y r r r ); r d t t f x ^°: , r ITr J3 t *� ♦ "IA 3•. 3 t 1 t *l 1 fi� °')'9a,_rr+T,,' ,»� 41-:? k7"�"� � - ' 'r J `' ' r '^�. 'i r..• J �r yr : ` � { �t f : r.;.a. ` 1 ry, .•.>"-. `>r�1, '. � R , d ,.'/ r•,•�'.. i •"•+ ,�.};,t2 s tka s`, � r r�` r r _~/ ♦t"k,: '''�, .Cr,>'4 "� r .. •. �ti�. [r ..� d - -,•fir d •.e ry" - a t 4 t.' k 1•,7'{T r ,� a yqh_ �"s..t,� r J�..�` � � 4M"• r .� +i:. y1 t..jxss r`y ro s•'t NTH^S f -4. �F .t"q 'ro. i+ 4xJ ) y f?r.k'fi' o �r "'t . '`, SS Z.,•r t. � i :r<" t t �t rq'�Y. .r t� ,' 4 .{', } er ,:♦ ,'•.ri �.c'i -'i 4� ?'::.{ '}''-, .:T"1' �L}Yhf'3' g, .1 kJ :�� •• C:. $ t. �]y'F. "`air ' "';✓ `` 1',�.i ti •y.O• '1ra t-r ,t 3 3 4 4.� �; 'r ,f•^ 1 y ,C r, - r`e: » +nV , ��t ' ,t n T 'u tr • + _ i �t r - n.•. '"f * t ) r r �{ � - P �'�f Jr� t%''`' thl f•�q. .� i!# f ,�� t '` ..c, .� a � tJ Ifr,,� n,,at r... q•�I �s ' d 7 e:S .. r •... y t .S , *Y4 + y tr•� t _ q l t ti ;;,� r a `i"• 1 `- .r q :� 1•�.ti• ..ti ; ", �•►,s,,.;' '4"i'�:,�r9,` Y . A : � r �r �'r3 .:+,y .� 1 l ,+' ,r» '¢ t. • '• - ,,. e t '•'f I n F•,� . .'x:> 1 r 4 !Y , 'r �' 7 •'.::r ''V� A. � i4 • t • d t 7 t• J fr) - ro j...`' ��,`y ,f A�''�.^d � � f ` ' e � �`.t�'}++tgh f, X•Y��' �� �,.. i 14 ti'� 4' ay 'Y� XtLy, F.�M. ' is Y2.-..t)u » i,. t °,�a��� �:. t r + Y,.�r ►r.S ai•` 4» :)>� .t _ � s sF h 'g r` r r+ � » 1 y c �+A r 1"X 4 T l .t, .� �. �:.L `9 •;a h� y � } s ,�+A• •r i• � ,� \ �,i,�. x `�; Sdt•{i. "r. '� s � a a. .. 'F � �'..% r •' y J!.►. t 3`»''y r� r t h c�•5 ,`d�,i " o- ]h:':.r. d^ ;a.ti. '�- • r r'S .V.�1. ,4•? 'q ','.c..• . r.' HOU/Ind,11111/TWICE RP* TEL• 617-771-5400 77 �YINTER STREET/ HYANNIS, MA 02601 September 19, 1984 Mr. John Kelly Town of Barnstable Board of Health P.O. Box 357 Hyannis, MA. 02601 Dear Mr. Kelly : This is to inform you that we are purchasing and installing a Hobart commercial dishwasher and booster (1800) . The installation should be completed within two to three weeks . Please let me know when you would like to inspect the unit . Thank you for your advice and your kind attention. Sincerely, EIGHTY-SEVEN WINTER STREET Mark Baker' Director, Family Shelter MB:gmb .. .e. STAMP: 7. 27'-11-FXISfINC . )e 1-5 i INS oEXISTING 9� OFFICE 3Z EXISTING ��a�5 ReC^���- � � U' INTERVIEWROOM 0 EXISTING = o OFFICE Y U EXI TING r a - I I I I rL OF �U as Z•w_ �H o EXISTING RECEPTION m a EXISTING AREA NURSE OFFICE EXISTING EXISTING EXISTING EXISTING BUSINESS OFFICE 1 EXISTING EXISTING SPECIr"I TREATr IENT OFFICE OFFICE NC BEDROOI I SMOKING Rl I. LAUNDRY EXISTING LOBBY z RI"I. ROOI"I O c w w � a O LU � � J W C N �T nP�9 S@Ca Cf;Ds2 l in � _ 'w_ z w z \/ cn 0 DOWN F 0 O z ^ _ /\ FX UP i O EXISTING r~ EXISTING EXISTING � EXISTIN OFFICE OFFICE RECEPTION s SHON ER _ III Tfl EXISTING �� ��� DOWN EXISTING DORNATORY ftZiDgbce.lra i✓><f'A�` RAMP / TITLE: or- �1'r`�+Yl� 2oaM ENTRY EXISTNG 1 ST FLOOR (� EXISTING PLAN DINING / ii Liu or EXISTING FUNCTIONS EXISTING DATE ISSUED: TOILETS KITCHEN UP 09-1&Ob REVISIONS: - I I I I I I I I I I I I I I I I I I I I I I I I I LL111JJ— n a} OamNc 22'-C DRAWN BY: JJM 9y-7r=MG PROJECT#: PROJECT NO. DRAWING NO.: EX I ST I NG FIRST F LOQT� PLAN XI I� I SCALE i/4 = 1 -0 Exi FIRST FLOGR INTERIOR AREA (INCLUDING STAIRS) = APPROX. 1.4(oG5 SO. FT. L TOTAL ALL EXISTING INTERIOR AREAS = APPROX. 7.057 SO. FT. r l STAMP: 27-11'eGmNG r-- I , -__fin 11 II 11 II II II II EXISTING EXISTING Ii c OFFICE CLOSETS II o g II II U_ I /A/0 � e 8 EXIST. m z LA`✓ 0 Z II _ II -U < l r-i f Z- o II I I� EXISTING OFFICE SUITE I INTERIOR AREA (INCLUDING j 542.it LANDING F LAV) 300 5Q. FT. � r5 2 I If II II II II 5 II LI-- __--_,- II II II I II II II II I; z II II O 1- II t II w C LU I II II W J F- I I J W U) Vj O c=n w z II ) iI Lu p Q Z Q > II � Z r� _ I p � I d-. EXISTING EXISTING EXISTING BEDROOM BEDROOM BEDROOM II II II ! it II I EXISTING EXISTING it TmE: OPEN LOUNGE DORMATORY II �wN I I EXISITNG -- EX I STI NG LL=—�, 2ND FLOOR AT N ROOI"1 i i PLAN II 0 EXISTING EXISTING ® II II BEDROOM BEDROOM II O I I DATE ISSUED: 09-18-06 ZEXISTING ;i REVISIONS: BATHROOM I I — II J� EXISTING 2ND FLR. DORMS I % IN IIERIOR AREA (MINUS 5TAIRS) - 2CW2 SO. FT. ----------------- >s a DRAWN BY: JJM 8V-7j'(0511NG) G PROJECT#: PROJECT NO. 3 DRAWING NO.: X2 EXISTING SECOND FLOOR PLAN SCALE 1/4" = I ' -0!! - EX2 s =� SECOND FLOOR INTERIOR AREA (NOT INCLUDING STAIRS) = AP> ROX. 23g2 SQ. FT. +4 i s I } . f f i , TM 6 Lie r :f NA ! — }r i 52,7 L1 1 � " ' � -`r�Gl�.. ! �j`''!'��`T � ���,z�'�� � t` L�� x f; �.e� i �''/ti ��rt t�s:� �� • ;�,� �1,�1 � \� i JL A— — c_ 1. /4(j,�.G/�_� ;� Af - , 4 L. !`r s� L'r.� l�+ lri,r y'�c gyp , --�!r sq� .'�• �yeP�.� �y�rle� '[.�,�y7,,{� jfy.�► ,}may _�jf ♦ a �//.]{///j�J.`-,( ��l(. - / +--—•___...__.._ .... _.-_..._._ .._.. ..�,_(�!_.�..._/.._. ___ -y�'��.---_�.�+{/_y7_�__-___.__._._..._._.___..____._—_..___._ - --_-----_---.-----.-------._—.. ._...._F� U' F�'►J/ b � ! t y — v+' �'fyiY `.1 4.l•+ /' f w.+ r . r -f�{ I M. �I *�rdS �I f/+ J Y" L�I,,,i.. t, .- .... .. t M1 ..... A. r� 1 ' (/�3