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OSTERVILLE GENERAL STORE EXPRESS MART - FOOD
L16 �t1 s(olp-lb-A I i I ,MG Express art W. Bay Rd, Osterville �gIKE Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. nmwgrABm f F.P.(Thomas)Lee 4$ aSS . 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: 128 Issue Date: 05/12/2022 DBA: OSTERVILLE GENERAL STORE OWNER: PNP BROTHERS INC Location of Establishment: 16 WEST BAY ROAD OSTERVILLE MA 02655 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: Indoor5eating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2022 RETAIL FOOD: $100.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Qn FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: August 2018 BOH Approved toilet facility variance and honored "grandfathered" dumpster variance. r 7 For Office Use Only& Initials: Town of Barnstable � Date paid Z ?Z-AmPsI$ !� &UMMBLE, : Inspectional Services "'"E& �' 1639. Public Health Division �fD 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 �y (o DATE_ � NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE):/ E-MAIL ADDRESS: y' �-- k U O� `�� ��.C o Get TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (✓� ) - 3 Y�`� TOTAL NUMBER OF BATHROOMS:i WELL WATER: YES NO .. (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: ' SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? l IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)?_ TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) - FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q\Application FormsTOODAPP REV3-2019.doc OWNER INFORMATION: FULL NAME OF APPLICANTr SOLE OWNER: ES/NO' OWNER PHONE # �j� " �� 3 ADDRESS t;`�2 (f ' A-d �GL�� CORPORATE OWNER: F#1P e)^Mec--,:5 -T-we CORPORATE ADDRESS: 3 51, i(4"e id �O ; W, 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. / / 1. i�► J / / 2. SIGNATURE F 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 httii://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 1 st to Dec. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Appfication FonnsTO0DAPP REV3-2019.doc t r - Town of Barnstable BARNSTABV- MASS. Board of Health �fp µAl A 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Paul Canniff,D.M.D.. FAX: 508-790-6304 John T.Norman Donald A.Guadagnoli,M.D. September 4, 2018 Mr. Harry Patel 16 West Bay Road Osterville, MA RE: Variance to Operate a Food Establishment with One Restroom Facility Express Mart, 16 West Bay_Road, Osterville, Massachusetts Dear Mr. Patel, You are granted a variance to provide one restroom for employees at Express Mart, 16 West Bay Road, Osterville, Massachusetts. This variance granted are as follows: • Section 322-4 Toilet Facilities To provide one restroom, in lieu of the requirement to provide separate male and female toilet facilities for employees. This variance is granted with the following condition: • Seating for patrons is not authorized. Seats shall not be installed on the premises. This variance is granted because the owner testified only family members will be utilizing the toilet facility. This is a family owned business. Also, this restroom will not be open to the public. Sincerely yours, ul arnn , .M.D. Chairman Q:\WPFILES\Restroom Variance Express Mart 2018.docx OpTHE DATE: $95.00 FEE* : �p--k�-�� + BARNSTABLE, y HrAss. $ RE C.BY: Town of Barnstable �i "Er SCHED.DATE: Board of Health ' 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi �o o VARIANCE REQUEST FORM LOCATION r 1 ��y � r Property Address: S T � w r � �� &V V i �� � • Assessor's Map and Parcel Number: Size of Lot: Wetlands Within 300 Ft. Yes Business Name: &�x ttsc-s.& mar No Subdivision Name: APPLICANT'S NAME: lick yx��� Phone �a�- ®j 6-3 �� Did the owner of the property authorize you to represent him or her? Yes _L�,— No PROPERTY OWNER'S NAME CONTACT PERSON Name: `� P C� (�(a�e-- Name: Address: [6 j j) .-����E' 6 SJ V Address: f•6a U). �� �60A` 6 Phone: S 6'�7 - 2 \ - " P 2 F-5- Phone: -sC) EMAIL: o, cg-M . VARIANCE FROM REGULATION(Incl.Reg.Code#) REASON FOR "Wst:E(May attach separate sheet.if more space needed) Cg -- `. NATURE.OF WORK: House Addition House Renovation LJ Repair of Failed Septic System LJ Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as S collated packets. A. Five(5)copies of the completed variance request form Five(5)copies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an I/A system or �sAcondary treatment unit(S.T.U.). _ ve(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health@town.bamstable.ma.us D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version. - i A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or R.S. Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu-Five(5)copies of full menu submitted(for grease trap variance requests only). Fee Submitted*$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance"). _ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Donald A.Guadagnoli,M.D. REASON FOR DISAPPROVAL Junichi Sawayanagi Q:\Application Forms\VARIREQ Rev APR 4-2018.docx OF ZNE �-•� iZ —�^✓'�`� DATE: O f'•072— Tl� -t' $95.00 FEE*• 1639. Town of Barnstable RE'Y: � SCHED.DATE Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi VARIANCE REQUEST FORM LOCATION Property Address: ' w - 6��i1C�'1 Assessor's Map and Parcel Number: Size of Lot: Wetlands Within 300 Ft. Yes Business Name: &�x tn5-S S- nnv No Subdivision Name: APPLICANT'S NAME: �- 1 c1 yY "� 1 :xA& 1 Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON i Name: 6rp-C� �C�� i Name:.- I��V-(r e 1 Address:16 <A,�,j&—Address: �'6 Phone: 5 8 - 2 \ © 2 Phone: -S 0 EMAIL: 40 j^ A 55 12, ii Iri mo VARIANCE FROM REGULATION(Incl.Reg.Code#) REASON FOR VARIANCE(May attach separate sheet if more space needed) W Li NATURE OF WORK: House Addition House Renovation LJ Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit first four on list as S collated packets. _ A. Five(5)copies of the completed variance request form _'fir wive(5)zopies of MA DEP approval letters for Innovative/Alternative septic system(when proposing an UA system or secondary treatment unit(S.T.U.). _ ve(5)hard copies of engineered plan submitted(e.g.septic system plans)and one(1)electronic version submitted to email: health@town.bamstable.ma.us D.Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans)and one(1)electronic version. A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or R.S. Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant must notify abutters by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only). Full menu-Five(5)copies of full menu submitted(for grease trap variance requests only). i Fee Submitted*$95.00 for the following variances: 1)New construction, 2) Septic repairs with increase in flows, and 3)New ° owner/new lessee applying for food, pool or body art variances. Exemptions from Variance Fee: 1) Septic repair without an increase in flow and variances granted at the counter,2)Monitoring Plans,and 3)Temporary Food(not a"variance"). Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Donald A.Guadagnoli,M.D. REASON FOR DISAPPROVAL Junichi Sawayanagi Q:\Application Forms\VARIREQ Rev APR 4-2018.docx Ma YT PactA ,E70c6 2iN — cat \ is- C o cn ©LA -� r� 3 d (� i © 6 aQO ® i rip a �aaY 0 -:7 k.A —a �a� I 128 BOARD OF HEALTH II PERMIT TO A.OPERATE OOD ESTABLISHMENTi�F-_-_. In accordance withr� I ,v_n'dkr;pu=thority of Chapter 94, If II Section 395A and Chaptaei t `;fie G n,e-113ea.v's `permit is hereby granted to: t- _ c Harisiddh K. Path 4- - r =':� PR ,�� '4!�/A.�� _ �='�-= "�X ESS MART I' i Whose place of business is: ` _`16` EST BAY F ,DSfF?VILL-Ef -112 b5`, Type of business _ ���s ��- - - �-yp ess and any restriotj Fs = 1 fC�[� ` 111kE`t'�W_ Tooperate a 4 y food establish'm�nt.in tie T -��s�i�, �BLE ;. RESTRICTIONS IF ANY: [ -_.:`:r�='�-,�>,•.�'=�'=2r��r::= „ �=_• is � SEATING: 0 ANNUAL EYES, SEASONAL: _ :�'-.��M i_�` Y-�-= �. _�.F�-��`: �=;• � _ ;" I TEMPORARY: s —� _E E s =_• = AF t) F HEALTH `, RETAIL FOOD STORE: � �• ' 'ram t90.00 Lul`•1anniff, D.M.D, Chairperson _'`:= FOOD SERVICE ESTABLISHMENT:- ,Fr ° yjCA Sawa ana I 'l. RESIDENTIAL KITCHEN FOR RETAIL SALE `�y �; r "� t �_ '` � F �F �„tra r a 9 ' •�-�_ '"' � Ffor�ald A. Guada noli, M.D RESIDENTIAL KITCHEN FOR BED+BREAKFAST g MOBILE FOOD UNIT: TOBACCO SALES: ` ,..._f.��'e�`y4¢ yK" ..• 1�• FROZEN DESSERT: ��' _ Thomas A. McKean IRS, CHO CATERER: Director of Public Health I Town of Barnstable Regulatory Services ti Richard V. Scali, Director BARNSTABLE r.$ B" MASS.`� ' Public Health Division r�zNST5.41 FaUIRLLU.-WI,-W. M- rM 9 ]Kp$$, �, tJ nrasmns nws•osTeavuu•war eaaxsrnM I""' 16g9' iOrEo i�r" Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 C�i/• _ "'' Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT©gyp DATE: ►-2�r 1 �-- NAME OF FOOD ESTABLISHMENT: X PY Q SS ck-4 , ( 05-kefville� ADDRESS OF FOOD ESTABLISHMENT: I G NA SCy R d, 0_SAP_*tV 1 N A Q,MA- 02655 E-MAIL ADDRESS: �(�.�N St�oZ1_y/�►�p0 . CAM TELEPHONE NUMBER OF FOOD ESTABLISHMENT: NUMBER OF SEATS*: INSIDE: OUTSIDE: TOTAL: 1 * Note: If indoor seating provided, see Licensing regarding Common Victuallers License TOTAL NUMBER OF BATHROOMS: 0"e - ANNUAL OR SEASONAL OPERATION: W^I V A TYPICAL HOURS OF OPERATION MON-FRI: S :�_ TO DAYS CLOSED EXCLUDING HOLIDAYS (I.E. MONDAYS) ISO IF SEASONAL: APPROXIMATE DATES OF OPERATION: / / TO ***REMINDER*** SEASONAL ESTABLISHMENTS MUST CALL FOR INSPECTION PRIOR TO OPENING TYPE OF ESTABLISHMENT: PLEASE CHECK ALL THAT APPLY *FOOD SERVICE RETAIL FOOD BED & BREAKFAST CONTINENTAL BREAKFAST *IF SEATING: ALSO,MUST OBTAIN RESIDENTIAL KITCHEN A COMMON VICTUALLER'S LICENSE MOBILE FOOD FROM LICENSING DIVISION. TOBACCO SALES FROZEN DAIRY DESSERT MACHINES S�Qdi l MaJuAtZQ CATERING OUTSIDE DINING (OVER) L- ***REMINDER*** IF OUTSIDE DINING,YOU MUST BE APPROVED BY THE HEALTH DIVISION AND LICENSING, AND MEET ALL OF THE OUTSIDE DINING CRITERIA IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? CONTACT INFORMATION: FULL NAME OF APPLICANT q - ARR SOLE OWNER: YES/NO ADDRESS a e A-" S__Ln c-v-r u.)1 an , rn A op-a 4 S PHONE # (`job) IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. + STATE OF INCORPORATION_ l FOOD SERVICE ESTABLISHMENTS CONDUCTING FOOD PREPARATION (EXCLUDES RETAIL FOOD ESTABLISHMENTS THAT DO NOT PREPARE FOOD AND CONTINENTAL BREAKFAST): EFFECTIVE JANUARY 1, 2004, EACH FOOD SERVICE ESTABLISHMENT IS REQUIRED TO HAVE AT LEAST TWO CERTIFIED FOOD PROTECTION MANAGERS. AT LEAST ONE CERTIFIED FOOD PROTECTION MANAGER IS REQUIRED TO BE ONSITE DURING ALL HOURS OF OPERATION.***PLEASE PUT THE NAME OF THE ESTABLISHMENT ON EACH OF THE CERTIFICATES*** LIST THE NAMES OF YOUR CERTIFIED FOOD PROTECTION MANAGERS (I.E. SERVSAFE.) 1. Gm s m. 1 bhp G fi�\ EXPIRATION DATE:/ 23 2. EXPIRATION DATE: EFFECTIVE FEBRUARY 1, 2011 EACH FOOD ESTABLISHMENT THAT COOKS, PREPARES, OR SERVES FOOD INTENDED FOR IMMEDIATE CONSUMPTION EITHER ON OR OFF THE PREMISES SHALL HAVE AT LEAST ONE CERTIFIED FOOD ALLERGEN AWARENESS TRAINED STAFF MEMBER. *** PLEASE.._PUT!_.THE--NAME OF__THE ESTABLISHMENT ON THE CERTIFICATE***- """ � ` LIST THE NAME OF YOUR CERTIFED FOOD ALLERGEN AWARENESS TRAINED STAFF. EXPIRATION DATE: / / . SIGNA OF APPLICANT AND DATE Q:Wpplication Forms\Foodapp2.doc I �Tt+e Town of Barnstable Regulatory Services Department r�: • BARNSTABLE, • �• MASS. �$ Public Health Division 7°) i639• � 200 Main Street, Hyannis MA 02601 C> CO Office: 508-790-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health } Fee: $85.00 MAIL TO: TOWN OF BARNSTABLE PUBLIC HEALTH DIVISION 200 Main Street HYANNIS,MA 02601 FAX 508 790-6304 PLEASE INCLUDE THE REQUIRED FEE OF$85.00 APPLICATION FOR A TOBACCO SALES PERMIT 2A7[E L Ng1S, VA LAST NAME OF APPLICANT FIRST NAME MIDDLE INITIAL D/B/A GydgS CIhPot-Gk1 NO'v� STREET ADDRESS 16 \nl Y \ - lit- 02G TELEPHONE# OS- g�16 - �y88 FID# Do you currently possess a state license to sell tobacco.products? Yes No Each employee who sells tobacco products must receive and understand the Sections VII b. and VII c. of the Board of Health Prohibition of Smoking Regulation, (copy provided herein) and the Massachusetts General Law Chapter 270, Section 6.00 (a copy is provided on the next page). Each employee who sells tobacco products must sign the Employee Signature Form (provided herein). Signature Date C:\Users\crockersh\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\K266YKRV\TOBA000 APP2018 dob.docx Establishment TOBACCO SALES Employee Signature Form This form is for official use to indicate that the employee(s) of this establishment received and understood sections VII b. and VII c. of the Barnstable Board of Health Prohibition of Smoking Regulation and the enclosed copy of Chapter 270 Section 6 of the Massachusetts General Laws which describes the penalties for selling and/or giving tobacco products to any person under the age of eighteen(18). Below are sections VII b. and VII c.of the Barnstable Board of Health Regulation: SECTION VII—SALE AND DISTRIBUTION OF TOBACCO PRODUCTS b. Sales To Minors—In conformance with the Massachusetts General Laws Chapter 270, Section 6, no person, firm, corporation, establishment, or agency shall sell tobacco products to a minor. Each employee working in an establishment licensed to sell tobacco product shall be required to receive a copy of the Board of Health regulations and State Law regarding the sale of tobacco and sign a form indicating that such regulations/laws have been received and understood, a copy of which must be placed on file, in the office of the employer and retained. Such signed forms must be made available for inspection, during the license holders normal business hours upon request of an agent of the Board of Health. c, All distributors/retailers of tobacco products or tobacco merchandise must require that, if a customer appears to possibly be under 25 years of age, the customer present a valid State issued picture identification card or drivers license with appropriate photograph to confirm that the customer is of legal age to purchase the tobacco product. The following employee(s) received and understood Sections VIIb. and VIIc. of the Barnstable Board of Health Prohibition of Smoking Regulation and Chapter 270 Section 6 of the Massachusetts General Laws: YvI Signatur Printed Name Date 4� 1 c. �y�� Ald �2t-Zal$ Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Signature Printed Name Date Q:\Application Forms\TOBACCO APP2016.docx l 4�,crtrfs; MASSACHUSETTS.(DEPARTMENT OF REVENUE Letter ID:L20 1 1 776000 } PO BOX 7044 Notice Date:September 21,2016 BOSTON,MA 02204-7044 Account ID:CGL-11475442-007 CONTACT CENTER 'rh r o��w. (617)887-6367 RETAILER LICENSE FOR SALE OF CIGARETTES -0111111111 �il�il�lll�l�� HARDAS CORPORATION o— EXPRESS MART '= 2619 STATE.HWY RTE 6 WELLFLEET MA 02667-8906 Attached below is your Retailer License_fox Sale of Cigarettes_(Form.CT-3T)._Cut_along the-dotted-line . ... and display at your business location.At any time,you can log into your MassTaxConnect account at mass.gov!masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800)392-6089, Monday through Friday, 8:30 a.m.to 4:30 p.m. DETACH HERE 5Sa`rtc'sFr MASSAMUSETTS DEPARTMENT OF REVENUE Form CT-3T Retailer License for Sale of Cigarettes � � z This license must be posted and visible at all i l F,�oc p s a times. The sale of tobacco products to anyone under 18 years of age is prohibited. HARDAS CORPORATION Account ID: CGL-11475442-007 WAVE EXPRESS MART License Number: 1093849088 2619 RT6 WELLFLEET MA 02667 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: October 1, 2016 Expiration Date: September 30, 2018 - ------------------------------------------------------------------------------------- ------------ -------- ------------------------- ;actrrJr„ - - � -� MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T Retailer License for Sale of Cigars and Smoking Tobacco Nr.or�L This license must be posted and visible at all times. The sale of tobacco products to anyone under 18 years of age is prohibited. HARDAS CORPORATION Account ID: CRL-11475442-0 10 WAVE EXPRESS MART License Number: 2069581824 2619 RT6 WELLFLEET MA 02667 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:October 1, 2016 Expiration Date: September 30, 2018 I '�'#f ��',•ice f S'�"3c'T�ir 'r '}`€: . S. f� FO � O s NATIONAL REGISTRY OF - A e4N FOOD SAFETY PROFESSIONALS® N !r CERTIFIES JAYANTMHAI PATEL % HAS SUCCESSFULLY SATISFIED THE REQUIREMENTS FOR THE ' SAFETY MANAGER IBM FOOD t ' w UNDER THE `� CONFERENCE FOR FOOD•PROTECTION STANDARDS Ngg V x PRESIDENT. 2 LAWRENCE J.LYNCH,CAE i ISSUE DATE NOVEMBER 23,2015 0656 �j 4 EXPIRATION DATE:NOVEMBER 23,2020 CERTIFICATE NO:21171061 Jorwimw �r1�ao„ �3zsz } TEST FORM:EXE52 (stuY� 0277�� '60w.NRFSPc � This certificate is not.valid for more �Re [ food S2{etP7ofeSSlon than five years from date of issue. T A K_ r)A ►n PY j-CRJ 4VpSppA TO OPEN A S_ S ESS? C S/��''••, .` � ••••1931'•.�` '�i .` pl1PA A{r • vi � G QR1L 2d, For Your Information. Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS '.'OUR f��Il/k�in.. e vAi% yol must do by M.G-L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this fogiYl ai 20 St."T ainis. Take the complete form to the Town Cleric's Office., 1st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get tl � �5�e _rtifigbe �,at is •Pi•.�tRy ��u reqL ai red by law. � .. � ..• o DATE: 2�18 Fill in please: [M1: ` f APPLICANT'S YOUR fJAME/S: �A � - �r°:La. BUSINESS YOUR HOME ADDRESS:' 2 R E\ j�l L �'�/�\�W CN, M IN- C'12G _ TELEPHONE # Home Telephone Number iEtw'asn ?. tr7�s•'� : E-MAIL: NAME OF CORPORATION: NAME OF NEW BUSINESS X TYPE OF BUSINESS 011 V C �oRlc IS THIS A HOME OCCUPATION? YES r-jo ADDRESS OF BUSINESS G 1 C_ LYE MAP/PARCEL NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town, of Barnstable. This form is intended to assist you ir) obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COjh ,%n ER'S OF This indivi iFro e f y p mit re uirements hat pertain to this type of business. r ad Sign e** T COMMENTS: r �m NJ 2. BOARD OF HEALTH This individual has been� r ed of the permit requirements that pertain to this type of business. Authorize Signature** COMMENTS: 3. CONSUMER AFFAIW(LICENSINHORITY)This individual hensing requirementsthat pertain to this type of business. ND MAU=e** Ul��I rWJ� addij ,COMMENTS: . I li E yoF�Ne r � r(� TOWN OF BARNSTABI E HEALTH.INSPECTOR'S Establishment Name: Date: Page: _of ' _ ` 'OFFICE HOURS , -�--^-- V� PUBLIC HEALTH DIVISION : 800 s:aoA.M. BARNSTABLE. • 200 MAIN STREET 3.30 4:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION PLAN OF CORRECTION Date Verified i mAss. g MON.-FRI. �p ,es9:'e m HYANNIS,MA 02601 508-8624644 No Reference, :R,-Red Item PLEASE PRINT CLEARLY tE0 -. - - FOOD ESTABLISHMENT INSPECTION REPORTTo- cLS6" Name. ��' � 31 a of Tyoe of Inspection Doeration(sl Routine Address. Risk Food Service Re-inspection Level Previous_Inspection Telephone Residential Kitchen Date Mobile a-o er Owner HACCP Y/N' Temporary Suspect Illness Al P"Iff- o �I � Caterer General Complaint Person in'Charge(PIC) Time Bed&Breakfast HACCP - �-* ,, D fS '/ /IG�C�� In Other' Inspector �. Out: C•�� ti( i I l'ivGb V'A( Each violatiori•chEicked requires n.explanation on the narrative pages)and`a citation of-specific provision(s)violated.. -61 Violations Related to Foodborne Illness Interventions and Risk Factors.(Red Items). Anti-Choking 690.009(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) ❑ • 3 6tt4A4 G FOOD PROTECTION MANAGEMENT. - ❑ 12.Prevention of Contamination-from Hands / v OLdi ❑ 1.PIGAssigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM:APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source - ❑ 16.Cooking Temperatures _. tt ❑ 5.Receiving/Condition ❑ 11.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling (� ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding 1 J PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health,Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) �li� AZ ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑.11.Good,Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) � � Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the•Board of Health: ❑ Voluntary Compliance ❑ Employee.Restriction/Exclusion ❑ Re-inspection Scheduled ❑.Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items Embar o Emergency Closure Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ 9. ❑. 9. y ❑ ry p ❑ 23.Management and Personnel- (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more hon=critical.violations, 24.Food-and Food Preparation (FC-3)(590.004) constitutes 6=One critical violation and less than an order of the Board'of Health. Failure to correct violations re 4npn-critical violations regardless of'the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,'4 to 6 non_critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(59.0.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical.violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at-the above address violations.observed,"7 to 8 non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8 non-critic" lations=..C. 29.Special Requirements . (590:009) y p 30:Other DATE OF RE-INSPECTION: Inspector's Signature Print- 31.Dumpster screened from public view Permit Posted Y N Grease TrapPrevious Pumping Date P 9 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 a _ 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.* i 19 PHF Hot and Cold Holding 2-103.11• Person-in-Charge Duties � 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45'F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140`F- 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130'F 7-201.11 Separation-Storage*Applicants* 3-302.11(A) Food Protection* P g 7-202.11 Restriction-Presence and Use* 20 Time as Public.Health Control - 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Re ing by Person.in Charge* Contamination from the Consumer 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q port 3 '590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(4)(B)Returned Food and terateReser ice of Food* .7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources F9' Food Contact Surfaces "' 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE.CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16' Ice Made From Potable Drinking Water* Concentration and Hardness* 163-401.11 A(1)(2) Eggs-155'17 15 sec 22 3-603.1 t Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145'F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* E$°dw//Il2001 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 3AOl.11(A)(2) Ratites,Injected Meats-155'17 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 i' f-SPECIAL REQUIREMENTS'3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* 10 Ratites-165'F 15 sec* ing'mobile food,temporaryand residential Game and Wild Mushrooms Approved By Proper,Adequate Handwashing 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. * 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 1 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Y 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the fvodborne 3401.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following•sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140'F to 70'17 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70'F to 41'F/45'F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * E6-301.12 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* Accessibility,Operation and Maintenance Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(n Labeling of Ingredients' 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:59OFormback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. .-.. - r, .LNn--. . S--„ c� Fss... �1../...... �► THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH --/-~. ✓..................OF........13--e9 _---------._.._--------- Appliration for Disposal Workii Tonitrnrtion ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: C ----------------------- CJ'T ..................................... :. Location-Address o Lot No. of, a ner Address .............. --•- s •------------- ---------------------------------------------------------------------------------------•---------- Inller Address Type of Building Size Lot...Z8 4_1_.......Sq. feet U Dwelling—No. of Bedrooms______________________________ ___ _Expansion Attic ( ) ,Garbage Grinder ( ) RF-S_r_____.__._.. No. of ersons____________________________ Showers — Cafeteria Other—Type of Building _ - _ p ( ) ( ) Ga Other fixtures -----------------------------••- - W Design Flow__ ter.��!�_ � r-.gallons per person per day. Total daily flow........../�?_!P__5__________________gallons. WSeptic Tank—Liquid*capacity ZOGa gallons Lengthy j".�_ Width.6_.�:6..... Diameter________________ Depth___ =8-. x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No.___._.Z-_________ Diameter... _ T_--- Depth below i t_ _!`?T.._. Total leaching area__j-�d_Z'`q. ft. Z Other Distribution box ( �' Dosing tank ��" ��� Percolation Test Results Performed by..••--f2--=-------------------------••---_------•-----_-------_--•--__._. Date........................................ — a Test Pit No. 1 L Z-......minutes per inch Depth, of Test Pit.... Depth to ground water________________________ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ R+' ------------•-•----•---•••••---------••••..........................................•••••••-•••......--••-••--•--•-•---•--•-----._.....---.......-•-•-•-••---- O Description of Soil- ' ''�H.. /r ®.v� ---------- 1�� 3r� ,� v o���....31� -%-Z-� 01 W -----•-----------------------------------------------------------------•------•-------------------------------------------- UNature of Repairs or Alterations—Answer when applicable._.-.T'0......../.r9LT1-_�__.._...... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITLE 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 board of health. Sigd----- --•------------•-----•-••---•..................•------------•---•••-----•- .......................... Application Approved BY.....- �����•7�--�-._ _,._....-•--•---------------------- --•---f-------- Date Application Disapproved for the following reasons:................................................................................................................ ................•---•-••-----•--•-•---------------------------•--•---•-•-------.........---•---------•---'--....--------•-----------------------------------------------------------------------••-•----- . �/ PermitNo.........--•-••---•----••-------------------------------- IssuecL----U/__..----------/h--,. ---•-------..- ........... Date 1- _.u. =-` •-- �y F;ra....�.............I........ • THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH O /�-�/STT3Giz Appliration for Disposal parks Ctonitriirtinn Famit Application is hereby made for. a Permit to Construct ( &)--or Repair ( ) an Individual Sewage Disposal System at: L.:.. ............i..........................4 T2, ....9. ..... ..................... Location-Address or Lot No. 7.?7 T�,En !4 �...-5r f O ner Address �."'-n.... �............... Installer Address U Type of Building ti f' Size Lot.... -------Sq. feet .-4 ;, Dwelling—No. of Bedrooms._..__..::_..__.: ..::...........Expansion Attic ,( ) Garbage Grinder ( ) 04 Other—Type of Building .j���� ...__..... No: of person.............. .I--_--____ Showers ( ) — Cafeteria ( ) 44 Other fixtures W Design Flow._._F ,t`�.�t4_.___5_!i_aTgallons per;p'erson per day. Total daily flow------_________�_ �_. .............gallons. WSeptic Tank—Liquid capacity.Z_.__.__-gallons _..._ Diameter................ Depth..5.__.' .. x . Disposal Trench—No..................... Width.................... Total'Length__.................. Total leaching area....................sq. ft. Seepage Pit No..................... Diameter...er_..�T... Depth below inlet_ _FT Total leaching area..- f�sq. ft. Z Other Distribution box ( Dosing tank Percolation Test Results Performed by.... _k.___...........: .. ................. Date........................................ a Test Pit No. 1.L.Z.....minutes per inch Depth of Test Pit___ �J Z.;�_. Depth to ground water_________________ fi, Test Pit No. 2................minutes per inch Depth of Test Pit........................Depth to ground water........................ -----------...•-- •-••••. .................................. .. --•-------------------•----- ------..........--- --•• -----------•----- DDescription of Soil...: 3 . / �r Cov , 1..' ............... W .... U Nature of Repairs or Alterations—Answer when applicable._____. _....I G:Z' ......FX1 ..............:.:..... ..........l ............................................................ Agreement: The undersigned agrees to nstall the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT '. 5 of th State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Uompliance has been issued by the board of health. , � s Sign d....... Application Approved.BY f. C: 1 '�-. ---------------------•--------. ! -ce' • --••--. Date Application Disapproved for the following reasons:_.'!.........................................................................................................._ ....................................................................-...............-.........3,......................................................................................................... t- Date PermieNo '. ...........:. ........._. Issued; ............................... Date 4 , THE COMMONWEALTH OF MASSACHUSETTS d0ARD F HEALTH .O F.. .. ............:.............................................. (9rdifirtttp laf T antplianre THIS IS TO LRTIFY, at the Individual Sewa e"D,isposal System constructed ( ) or Repaired ( ) '- e1 g by......... A ... . ...................•...... --------- --- - I tal has been installed in accordance with has of TI j of The State Sanitary Coe as'des. in the application for Disposal Works Construction Permit No.___. (. ............. da.ted...... �'_..1� ............ THE,ISSUANCE OF THIS CERTIFICATE SHALL NOT BE'°;CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............ .................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD RF HEALTH ........�jO ... OF....... . ...����............................... ....._............ � No._...:....�.b ._...... FEE......... ..::..... Disposal ! ar-m�it -: �.q . Permission i hereby granted..... •••-• -•--•••- to Construe( R air ) Individ Sewage Dis os S em 0 f ... . at No.-.... -- '!p'Q- � l ---- ` street /ice&_ +�r P.— as shown on the application for Disposal Works Construction P it Dated ....l�Cl................(-.40........... r ......... - .�tf--•- .......---•------ --------------- --- of Board Heal, DATE =..................:,_ _2� FORM 1255 HOBBS & WARREN; INC.. PUBLISHERS VI. -TUC( Z,i 1 r: r LAN KLVj EW FOR OFFICE USE ONLY E RECEIVED ION DUE BY LOCATION egal Description: go&A /y4—/ lanning Board Subdivision Numberr ssessor {s Map and Parcel Numberr �Q/1-7 �9S roperty Address: 16 WUsr— �,��• ,�.,�,� OWNER OF PROPERTY APPLICANT m e: V 5 H W67/Q-77' Name:- 120147 jr� 1:79Rhu' dress: 77*7 2)f�HR w s- Address - Gt� v n1 0 0�2 (JclFi✓ /QJ�`d.�id,Lc 04f 5ly7- D S hone: Epp-ot,��- �70/ Phone:_ ADD Y- /70/ ENGINEER AGENT( interest owner or applicant) 3me: IVA Name:_ Al,,ciF, ) .f i you;o/1t •dress: Address: -gycc ,giiE-7,„J one: Phone: ZYOvn,:F7 CITILITIES ZONING CLASSIFICATION(s) FEC'Fr1ScP } ��ra� District: Public Flood Hazard: 51ze: rriv�te ✓ Groundwater Overlay: aL•cve i=rv!:r:d: At-ove Crotrnd: -- _ Fire DSstri%t: . �:i?rero!!nd: Unde^v,^c�ut)Q; Dater : LOT AREA: sq. ft. Contentsr Fubl2a ✓ Fr2v3te:_ NUMBER OF BUILDINGS L Fire Fr-otectiL)r.: Existing:_—I ��F.IN!+�FA.���c� t:�t�RB CU75 Proposed: Q ?aired: Existing; _ Electrical: Demolition: t�v2ded: _ Fr-oposed: 0 Ariai: ✓ Site: To Close: Undergr-otind: TOTAL FLOOR AREA (in sq.ft. ) f Site: T`'t3-': Gas: Residential: Natural:-Z Office: iN_HlSTOJF:�CAL OIS7F'ICT: (ves)_ (no) prop-ine;_ Medical Office: N Commercial) MLA .A Ur" (mercial use) _ C�INC�ETN- meral CRI7ICAL ENVIRONt1EN7AL lE.rj.E.A. is (L'es) _ (no)_ C' f s>-o�e' ROJECT WITHIN loo, OF WETLAND RESOURCE AREA: (Yes Wholesale)_ (no) Institutional: Industrial: TOWN OF BARNST -� SITF P! AIV RF1/! LE OCT 61994 7 :4 Jr1q- [� LLLLJ ±3 i f 1_L; rr- xtvitwr_c, r)__T mt. N6 cunnl IUNth : Zoning District _ 300 l'I co Old King's Highway District A10 or Listed in National and/or State Register of Historic Places NO Perimeter set backs: Front 3a/ r Side a Rear / Lot Coverage -710 5Q / Tvpe or Use ( zoning ) Flood Plain Zone Elevation Number Of Floors Floor Area: lst 2nd Other (specify) Parking Requirements: Required Provided Handicapped Spaces Are there accessory buildings? P(D Accessory Buildings Floor Area 9 A PLEASE PROVIDE A BRIEF, NARRATIVE DESCRIPTION OF YOUR PROPOSED PROJECT. 6d t F �/'�o/n c (�E— �D i c �C.�r l i� f H1 C�r>9 S�_ ✓!J'l�/S�c u% 5'!�'N ts' x,1 s i/,u s l(- l e SQ F-T � b, x g„ I assert that I have completed (or caused to be completed) this page, the Site Plan Review Application and the checklist on the back of the application and that , to the best of my knowledge , the information submitted here is true. ��1GG1 (signature) (date) FA c,N P� IL �. ---- uE- CFI mammm • i n l - Ci • 2 -0�� i l ` �K. � ,�. � (t � "rtii...R •-. fit% ✓ �� �o.a , r 7, �, �{: �� • x .. �Y`� 'ate '�� - -.... _' -log cary z rlal I I f The Site Plan shall Inciud a or more appropriately scaled map A drawings of the property. drawn to an engln scale. Clearly and accurately Indlca such elements of < the following Information as a pertinent to the development activity proposed: 1) Legal descrlptlon, Planning Board Subdivision Number (If applicable), Assessors' Map and Parcel number and address ( If applicable) of the property. ' 2) came, address and phone number of the property owner, and applicant If different than the property owner. ❑ 3) ►tame, address, and phone number of the developer, contractor, engineer, other design professional and agent or legal representitive. LJ ,) Complete property dimensions, area and zoning classification of property. ❑ 5).Exlsting and proposed topographical contours of the property taken at two-foot (21) contour Intervals by a registered engineer or registered land surveyor. ❑ 6) The nature, location and size of all significant existing natural land features, including, but not limited to, tree, shrub, or brush masses, all individual trees over ten Inches (10") in caliper, grassed areas, large surface rock In excess of six feet (6') in diameter and soli features. ❑ 7) Location of all wetlands or waterbodles on the property and within one hundred feet (100') of the perimeter of the development activity. ❑ 8) The location, grade and dimensions of all present and/or proposed streets, ways and easements and any other paved surfaces. ❑ 9) Engineering cross-sections of proposed new curbs and pavements, and vision triangles measured in feet from any proposed curb cut along the street on which access Vs proposed. ❑ 10) Location, height,' elevation, interior and exterior dimensions and uses of all buildings or structures, both proposed and existing; location, number and area of floors; number and type of dwelling units; location of emergency exits, retaining - walls, existing and proposed signs. ❑ i1) Location of all existing and proposed utilities and storage facilities including sever connections, septic systems and any storage tanks, noting applicable approvals If received. ❑ 12) Proposed surface treatment of paved areas and the location and design of drainage systems with drainage Calculations prepared by a registered civil engineer. ❑ 13) Complete parking and traffic circulation plan, if applicable, showing location and dimensions of parking stalls, dividers, bumper stops, required buffer areas and planting beds. ❑ 14) Lighting plan showing the location, direction and intensity of existing and proposed external light fixtures. ❑ 15) A landscaping plan showing the location. name, number and size of plant types, and the locations and elevation and/or height of planting beds, fences, walls, steps and paths. ❑ 16) A location map or other drawing at appropriate scale showing the general location and relation of the property to surrounding areas including, where relevant, the zoning and land use pattern or bd,lacent properties, the exl6ting etreet m tem in the area and location of nearby public facilities. ❑ 17) Location within an Historical District and any other designation as an Historically Significant property, and the age and type of each existing building and structure on the site which is more than fifty (50) years old. ❑ 18) Location of site with regard to Zones of Contribution for public supply wells as determined In a report entitled "Groundwater and Water Resource Protection Plan, Barnstable, Massachusetts" prepared by SEA Inc., Boston, MA, dated September, 1985, which Is on file with the Town Clerk. ❑ 19) Location of site with regard to Flood Areas regulated by Section 3-5.1 herein. ❑ 20) Location of site with regard to Areas of Critical Environmental Concern as designated by the Commonwealth of Massachusetts, Executive Office of Environmental Affairs. S Division of Land YI- NO Is this a division of fifty (50) acres or morc of land which was In common ownership as of 1/1/88? is this a division of fifteen (15) acres or morc of land which was In common ownership as of 1/1/88 and which was the result of an earlier subdivision within the inst seven (7) years? Is this a development which proposes to divide land In common ownership into thirty (30) or more cesldcritl,.il dwelling units? Is this n development which proposes to cilvitle land In common J J I 1 ownership Into tell (10) or morc busincss, office or Industrial preliliscs? Creatlon of raore than 30 dwelling units Is this a development, tricirl(Illig the exp;rrrslorr of V.Xlstllrl; developments, oral Is planned to create or accommodate morc than J J �//►' ( J 30 dwelling units? Commercial Construction Will the development create retaU or wholesale business: office or Industrial development; private, health, recreational, or educational dcvclol)mcnl with a floor area as follows: 1) New construction greater than 10.000 square feet? ! J /✓1r I 2) Addition or auxillary buildings greater than 5.LK)O square feet? / 11 3) Outdoor conimcrclal space greater than 40,000 square feel? ll 4) Use c11a119(�s whlCl' have a hour area grcater (hart 10,OW square feet? FacIlIt1cs for Transportatlora to or from Barnstable Cous,ty Will the develo1),%leiit construct or cxll;uul f;ac-tltttrs far transportutlon to or from Barnstable County? Access To Tbc Coast Or A Great Pond Is tills deveiaprncnt rt bridge, road or drivew;ry l,r•ovlding direct I I I� vc;lUcul�>Ir access to tile: r:aatil or;t �rc;rl p��rul't 111storle Structures Will the dtwcloprnenl dcnrollsh or substantially tiller an Iilstorle ( J lr1 structure listed with the Nutlon,rl or Massachrisetls ItCglslcr of I Ilslorlc Places, outside rt nriullcllral historic district or outsiae the Old lUnfis flighway i Ilslorlc District? (N'ute: Repairs, upgradcs, changes, alterations or extensions to a singlc family honic are exempt from Commission review unless the proposed repair, upgrade. change, alicrallon. or exterislon Is greater than 25% of the floor area of lire existing dwclllrlg.) f ,7 r 0 ------------------------------------ ---------- -------------------- U. S. POSTAL SERVICE DEPT. OFF. A C T I O N ROUTING SLIP ROOM NO. -------------------- ------------------------------------ ---------- APPROVAL TO: TOWN OF BARNSTABLE SIGNATURE ------------------------------------ ---------- COMMENT 2. SEE ME ------------------------------------ ---------- X AS REQUESTED 3 . INFORMATION ------------------------------------ ---------- READ AND RETURN 4 . READ AND FILE --------- - -------------- -------- ---------- NECESSARY ACTION 5. INVESTIGATE ------- _-- - ------------------ ---------- RECOMMENDATION 6. PREPARE REPLY FROM: KEV J JOYCE, POSTMASTER EXTENSION: OSTERVILLE, MA. 02655-9998 (508)428-6676 -------------------- DATE: 09/29/94 ROOM NO: 1001 REMARKS: RE: CUMBERLAND FARMS SIGN/OSTERVILLE MA 02655 I DO NOT HAVE ANY OBJECTIONS TO THE RELOCATION OF THE SIGN FROM ITS'PRESENT LOCATION. -------------------------------------------------------------------- ITEM 0-13 FACSIMILE (Generated by FORM13 v2.Ob) JOHN' J. SCALDINI . a • r t , t `of:' Medford, 1�Iiddlesex'. a' County, Massachusetts N • N Seae4, for consideration paid, grant to V. S. H REALTY INC. ,a corporation o duly =.o.Vganized under .the laws.!. of the State„of Rhode,,};Tsland,;,having an o usual., Place of business in Dedham, Norfolk County, Massachusetts F: , 1I with..Autirlutm ruvrnttnls ' s ao�. . - 1 . ;rNr� • �„ . } -certain parcel ok land :srituate oh'.West" Baya Road, Os4fville ' ' •,. ,ar ist;able' County,.: Massachusetts, being.-:'shower as :t6ti"`:B'?on' a plan entitled Land .in .Osterville., Barnstabief _-,County, >.Property. of John dated'"June 27, 1962 by `Ed- Kellog�; .E.�' :a copy df which .,said-'plan is , recorded with BarYstable County, Registry of Deeds wit . Deed recorded _in Book 1180,.: Page., 520, t:he premises beingt more �artcularly ra .., bounded and described as. follows: .: � .. SOUTHEASTERLY by West Bay Road, as shown: on said plan, 88 feet; SOUTHWESTERLY by Zot A as shown on..sai3 plan, " 103.39 feet; Yr r NORTHWESTERLY ..:by land.. now or' formerly -of n B. Lebel &`Sons,.' Inc 52 41 feet, and - ' `:`NORTHEASTERLY. by land now .or formerly of".Loomis S. 'Kinney, 117.77 feet more or �ess, :asfshown on said plan 4, r said .premises containing 0 gquare feet, more or�T'less,' according to said: plan: bd � he abode-descacabecl axemisea a e._»a portion of the:.;preTaises. cent a ned: in a `:deed from-'Dana,"M: : Marston to :John §caldin recorded with ! said Barnstable Deeds in Book 1159, Page 112. 5 •� ZL ��ru.^+r ,M.v:_ y .:.�.,ate.. ^,•_�. ' .•' '-:.: ..: .. r • z 7,r L f t 5 r rf'.CJ: _ 7 a: - -�•V `J S:n - \ r_#f; .} 11. '- !'::t':.„'�'� -T.f l� -�t 7� \� '_ ♦. ::a i 7 }; '7 to f. ��qF'�. - l 4 / i r s r r , f: . .£ k k . <`o- /TOWN OF BARNSTTABLE, MASSACHUSETTS - OFFICE OF THE BOARD OF ASSESSORS PARO IDENTIFICATION ICATION MAP PARCEL ROUTING NO. 117 C95000 131 PROPERTY LOCATION TO: OWNER OF RECORD/MAILING ADDRESS 0016 WEST E AY RC CIST V S t- REALTY INC 777 CECHAM ST CANTIN MA02021 APPRAISED VALUE AS OF JANUARY 1, 1982 St 100 IMPORTANT INFORMATION NOTICE TO PROPERTY OWNERS— In accordance with General Statutes of the Commonwealth of Massachusetts,the Town of Barnstable has completed a revaluation of all property in order to equalize assessments. The appraised value as shown represents 100%of the fair cash value appraisal as of January 1, 1982 (which is the assessment date for Fiscal Year 1983). WHY WAS ALL PROPERTY REVALUED?—Periodic revaluation is necessary to ensure equalization of assessments,and to conform to state statutes requiring communities to maintain equalized tax rolls. HOW WILL MY TAX BILL BE AFFECTED?— Individual tax bills are impossible to determine at this time because the budget and tax rate for Fiscal 1983 have not been determined. (See ESTIMATED COMPARISON OF TAX IMPACT below.) IMPORTANT! Do not multiply your new assessment by last year's tax rate. The Fiscal 1983 tax rate is subject to change and due to general increase in property values after revaluation and the implementation of proposition 2%,the Fiscal 1983 tax rate will be substantially lower than last year. FARM ACT, FORESTRY LAND,AND RECREATIONAL LAND adjustments are not included in this notice,but will be applied at a later date. INFORMAL REVIEW BOARD — United Appraisal Company,the revaluation firm, is conducting the town's Fiscal 1983 property revaluation and will make available appraisal personnel for the purpose of reviewing property values. A change in values will be considered only if the property owner can demonstrate that the total appraised value is in excess of market value. The appraisers will discuss market value only,and are not permitted to discuss tax rates or estimated tax bills. Appointments for reviews must be made within ten (10) business days of the postmark of this notice to United Appraisal Company. Appointments can be made between the hours 8:30 a.m.to 4:30 p.m., Monday through Friday by calling (617) 778-0556. Reviews will be held at the new Town Hall, 367 Main Street, Hyannis. Hours will be Monday through Thursday, 11:00 a.m.to 7:00 p.m.; Friday,8:00 a.m.to 3:00 p.m. ESTIMATED COMPARISON OF TAX IMPACT If your new valuation had been in effect last year (Fiscal 1982),using last year's budget,your tax bill,excluding fire district,would have been s 1 . 116.EJr Remember this comparison is solely to show the approximate tax impact that the new valuation will have on your property as compared to the old,and is not to be confused with the new budget voted at town meeting for the upcoming Fiscal 1983 year. DM-038 ziOPER7Y ADDRESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CSTATE LASS PCs I NBHD KEY No. LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T Lana By/Dale S.—D�mens,on YP UNIT ADJ'D.UNIT ACRES/UNITS VALUE D....iplion V S H REALTY INC MAP— cD. FF De b/Acres LOC./YR.R.SPEC.CLASS ADJ. COND. PRICE PRICE #LAND 3 138.200 --CARDS IN ACCOUNT 30 3SIiE 1 X .1 =100 328 233999.91, 767519.9 .18 . 138200 #BLDG(S)—CARD-1 :3 132.700 01 OF 01 #OTHER FEATURE 3 2.300 COST k 273200 4 STORE BLDG U 1 X — 100 *141485.0 . 141485.D 1.00 141500 B #PL 16 WEST BAY' RD OST. MARKET 280900 PVI . PAVING S X = 100 .4 .4 5000 2300 F #RR 1808 0088 INCOME 389300 A USE D APPRAISED VALUE i A 1273JI200 U PARCEL- SUMMARY x S LAND 138200 T BLDGS 132700 M 0—IMPS 2300 E TOTAL .27V - N N,CNS- DEED REFERENC Ty pgTE Rxorew P R I O R T Y E A R V A U E T Book Page InsL MO. vr.p Set-Prop � LAND 13 8 2 D 0 S - 1407/79� :00/00 BLDGS 135000 I I TOTAL 273200 BUILDING PERMIT R E M O D E L E D'19 8 8.. Number Dale Type Ar—mt C O M P L E T E`1/1/8 9. LAND . .. LAND-ADJ . INC ME SE SP-BLDS FEATURE BLD—ADJ UNITS *BLDG ADJUSTED 138200, 23011141500 . 830503 3/87, AC. 5000' FW ECONOMICS... Class Uon is To Year Built Norm. Obsv. - Base Rate Atll.Ralo Aclt9 F/1� Age Depr. Contl. CND. LoC. %R.O. Repl.Cost Naw Adj.Rapt.Value Slo— Haigbl Rooma Rma Balaa /Fi.. Porlywaa F- 37B 001i 000 001 : 69 82 9 95 , 125 80 93.7 141500 . 132700 1 1 Des-plion Rate Square Feet Repl.Cost MKT.INDEX: =1.00 IMP.BY/DATE: ML: ./89 SCALE: .1/00.5 2 ELEMENTS CODE CONSTRUCTION DETAIL BAS1100. .00 2500 GROSS .AREA: 2500 tONYENIENCE .STORE CNST GP-.01 CAN: 25 .00 200 *------------SQ-----------* STYLE 0 0._ t ! ! DESIGN ADJMT -Q-------------------- � . - I EXTER.YALLS -0 --------------------6.1--- ! . HEAT/AC TYPE 0 -------------------0.- --------------- --- ----- INTER.FINISH 0, --------------0. ! ! INTER.LAYOUT _0 _________________ 0. ------ ! ! IN7ER._QUALTY -�-------------------- 50 BASE: . 50: FLOOR STRUCT 0 .0�--------------- --- ---------------------- D W ! ! FLOOR COVER 0 , --------------- --- ------------------L--- E Taal Areas Auk_ 200 Base 2500 ! ! R_0_0_F_ -T_Y_P_E_ 0 ______0_._ �. BUILDING DIMENSIONS ! E LE C T R I C A L O ' 0. _____---------- _-- - BAS. W50. CAN: SO4_E5D N04 WSD .. ! FOUNDATION _ 0 POURED CONC'_ � BAS.NSO . ESD S50 ._ ! � - --- - ----�'- - . --------------- --- ---------- L ! COMMERCIALIAREA,C003 ! LAND '•TOTAL' 'MARKET *-----------�50---'r---~—X' PARCEL' : 138200 273200 *- -- CAN----- - - AREA VARIANCE •+0 tQ STANDARD 50 TOP06RAPHY.1.f.LEVEL . . * .TOPOGRAPHY` * UTILITIES . 2 PUB WATER *..UTILITIES 4-GAS 7*.;UTILITIES: `6"SEPTIC ST:FEATURE.I ;PAVED *'ST.FEATURE *: ST.FEATURE. -* .ST ^COND *.'TRAFFIC -.' :21MEDIUM DWELL LOC *".LOCATIONI *;AMENITIES -* 7AMENITIES *:NUISANCE S NUISANCES 5`. YGSS MQY� t6 n PtictA 0 say vi 1 l e '5o rS- 21Ll 021 � -T L J s r � 9 g d 4. a IK � a C� �aaY O Bellaire, Dianna From: Gerace, Anthony Sent: Friday, May 27, 2022 1:18 PM To: Bellaire, Dianna Subject: Re: Osterville General Store - Bradford hardware- Barnstable Police Good afternoon!! Yes they are category 1 just barely. They most likely will not be permitted next year, I haven't had to hand the inspections to Vanessa, but I assume we will have to put all the inspections and files together at some point Sent from my Whone On May 27, 2022, at 12:42 PM, Bellaire, Dianna <Dianna.Bellaire@town.bamstable.ma.us> wrote: Has their category stayed the same for Osterville General Store? They will be looking for their permits on Wednesday. They paid $50.00. 1 mailed out the Barnstable Police. Also, do you hand the inspections to Vanessa when you are done? Like with new ones?Are we supposed to put the complete file together like inventory sheets etc? the box of people that have applied is on Vanessas desk and the Excel sheet is also on the Q: Drive/Hazmat and then Active 2022- 2023. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us The unfoiniation contained in this electronic transmission("e snail"),including any attachment(the"Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only.Tlus Information.may be privileged and confidential work-product or a privileged and confidential communication.The Information may also be deliberativee and pre-decisional in nature.As such,it is for internal use only.I'he Information mad°not be disclosed Ax-ithout the prior written consent of the Director of Public Health and/or the Town 1.ttorne}11's Office of the Town of Barnstable.If you have received this e-mail by mistake,please noti.fv the sender and delete it from hour system.Please do not copy or foru-ard it.Thank you for your cooperation. From: Gerace,.Anthony Sent: Wednesday, May 25, 2022 12:02 PM To: Bellaire, Dianna Subject: Re: Osterville General Store - Bradford hardware- Barnstable Police Yes that is okay to send permit, and yes the bpd is a category 2, and I actually did not get the name of who the bill should go to. I can call sgt mackena and ask, or just the office I Sent from my iPhone On May 25, 2022, at 10:43 AM, Bellaire, Dianna<Dianna.Bell aire�town.barn stab]e.ma.us> wrote: Thank you. Bradford Hardware sent in a renewal with a check for$150.00 is that okay? Do I send their permit? Also, what category was Barnstable Police and can you give me the name of the guy you spoke with?Or whose attention I send the bill? Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us "11i.e.information contained in this electronic trars.nussion ("e-mail"',including any attachment(the "Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only. This Information may be privileged and confidential work-product or a privileged and confidential communication.T'1.re Lnfoim.ation m,ay also be deliberative.and pre-decisional in nature. As such,it i.s for Internal use only.The Information may not be disclosed without the prior written consent of the Director of Public health and/or the Town Attorneys Office of the Town of Barnstable.If you have received this e-mail by mistake,please notify the sender and delete it from your system.Please do not caps or forward.i.t.Thank you for your cooperation. From: Gerace, Anthony Sent: Wednesday, May 25, 2022 10:42 AM To: Bellaire, Dianna Subject: Re: Osterville General Store I'm on my way there right now Sent from my iPhone On May 25, 2022, at 9:49 AM, Bellaire, Dianna <Dianna.BellaireLa),toNNm.barnstab le.ma.us> wrote: Good Morning, Please read email below. Please contact Mr. Collette by email, copied on this email to schedule an inspection. Please contact Anthony Gerace 2 by email for hazmat inspection. You will need to get an inspection by Ms. Kathryn Soto. I understand the closing may have already happened ened or is close. Thank you. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bella ire@town.barnstable.ma.us 11c information contained in this electronic transmission ("e-mail"),including any attachment:(the".Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only.This Information map be privileged and confidential work-product or a privileged and confidential communication.'The. Information may also be deliberative and pre-decisional in nature..-A.s such,it is for internal use only.The Information may not be disclosed-Snthout the prior written consent of the Director of Public I Iealth and/or the Town Attorney's Office of the Town of Barnstable. If you have received this e-mail by mistake,please notify the sender and delete it from your system.Please do not copy or forward it.Thank you for your cooperation. From: Bob Collett [mailto:bcollett@barnstablecounty.org] Sent: Wednesday, May 25, 2022 9:44 AM To: Bellaire, Dianna Subject: Re: Osterville General Store Hi Dianna- I've been away last week and this week, and will be returning to my office next Tuesday. I am happy to conduct an inspection upon my return if that helps. Thanks, Bob Get Outlook far iOS From: Bob Collett<bcollett@barnstablecounty.org> Sent: Wednesday, May 25, 2022 9:21:09 AM To: Bellaire, Dianna <Dianna.Bellaire@town.barnstable.ma.us> Subject: Re: Osterville General Store Hi Dianna- I've been away since last Thursday and will return to work on 5/31. 3 Thanks, Bob Get Outlook for i.OS From: Bellaire, Dianna <Dianna.Bellaire@town.barnstable.ma.us> Sent:Thursday, May 19, 2022 10:32:18 AM To: 'Tom'<ths.law@comcast.net> Cc: Soto, Kathryn<Kathryn.Soto@town.barnstable.ma.us>; Gerace, Anthony<Anthony.Ge race @town.barnstable.ma.us>; Bob Collett <bcollett@barnstablecounty.org> Subject: RE: Osterville General Store CAUTION:This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. Thank you. The payment would be $50.00 made out to the Town of Barnstable. Anthony still needs to inspect all new owners hazmat to verify. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bella ire@town.barnstable.ma.us 7`he information contained in this electronic.transmission("e-mail"),including ant' attachment(the"Information"),may be confidential or othmvise exempt from disclosure. It is for the addressee only.I7nis In.forn.iation may be privileged an.d. confidential work-product or a privileged and confidential communication.'1 he. Information may also be deliberative and pre.-decisional in nature.ids such,it is for inteinnal rise only.The Information mad%not be discloses{without(lie prior written consent of the Director of Public Health anal/or the Town A.ttoiney's Office of the Town of Barnstable.If you have received this e-mail by mistake,please notifZ the sender and delete it from vour system. Please do not colic or forward it.'fhank you for your cooperation. From: Tom [mailto:ths.law@comcast.net] Sent: Thursday, May 19, 2022 10:25 AM To: Bellaire, Dianna Cc: Soto, Kathryn; Gerace, Anthony; 'Bob Collette' Subject: RE: Osterville General Store Ok—I will file the Hazmat application tomorrow. I believe we saw the existing was Category 1 and they are not changing it. 4 Thank you (From: Bellaire, Dianna <Dianna.Bellaire@town.barnstable.ma.us> Sent:Thursday, May 19, 2022 10:10 AM To: 'Tom' <ths.law@comcast.net> Cc: Bellaire, Dianna <Dianna.Bellaire @town.barnstable.ma.us>; Soto, Kathryn<Kathryn.Soto@town.barnstable.ma.us>; Gerace, Anthony <Anthony.Ge race @town.barnstable.ma.us>; Bob Collette (bcollett@barnstablecounty.org) <bcollett@barnstablecounty.org> Subject: RE: Osterville General Store Hi, That is great news. I am awaiting an approval inspection from Bob Collette before I can release the permit. I've copied him on this email. You have not applied for the hazmat permit to my knowledge-we need you to schedule and inspection with Anthony so he can determine what we need to charge. I've copied Anthony on this email. The food paperwork is in but, you will need to discuss with Kathryn what is needed to pass inspection. Thank you. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us The information contained in this electronic transmission("e-mail"),including ally attachment(the".Information"),may be confidential or otherwise exennpt:from disclosure. It is for the addressee only.1 his Information may be privileged and confidential.work-product or a privileged and confidential.communication.The Information may also be deliberative and pre-decisional in nature.As such,it is for internal use onln..The Information may not be disclosed�%7thout the prior written consent of the Director of Public Health and/or the Town Attornev's Office of the Town of Barnstable. If you have received.this e-mail by mistake,please notify the sender and delete it from your system.Please do not copy or forward it.Thank you for your cooperation. From: Tom [mailto:ths.law(a)comcast.net] Sent: Thursday, May 19, 2022 9:18 AM To: Bellaire, Dianna Subject: Osterville General Store Good Morning Dianna—Looks like we are ready to close on 5/24. 1 believe we are set on your end as far as the tobacco permits. I will notify Kathryn of the date so she can schedule an inspection as well as Anthony for the propane tanks. Am I missing anything? Thank you! 5 i Thomas H. Souza, Esq. Phone: 508-280-5508 Fax: 508-858-5502 1 Childs River Road East Falmouth, MA 02536 In compliance with M.G.L. c. 93H and to protect the privacy of your personal information, we request that you do not email us any document that contains personal information, including the following information, UNLESS YOU ARE WAILING IT IN A SECURE, ENCRYPTED EMAIL: 1) Social Security Number(s); 2) Driver's License Number(s) or state-issued ID number(s); 3) Bank or other financial account number(s); 4) Bank or other financial institution routing number(s); 5) Any credit card or other account number(s); 6) The name of any minor child(ren); and 7) Birth date(s). CAUTION:This email originated from outside of the Town of Barnstable! Do not click Finks, open attachments or reply, unless you recognize the sender's email address and know the content is safe! CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! 6 Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire @town.barnstable.ma.us The information contained in this electronic transmission("e-snail"),including any attachment(the. "Informa(ion"),may be confidential or other%vise exempt:from disclosure, It is for the addressee only. This Information may be privileged and confidential work-product or a privileged.and confidential communication.The Information may also be deliberative and pre.decisional.in nature—As such.,it.is for internal use only.The Information may not be disclosed without the prior written consent of the Director of Public Health and/or the Town.:.-\:ttorney's Office of the Town of Barnstable.If you have received this e-mail by nustake,please- n.otifi the sender and delete it from your system. Please do not copy or forward it.Thank you for vour cooperation. From: Tom [mailto:ths.law@comcast.net] Sent: Thursday, May 19, 2022 10:25 AM To: Bellaire, Dianna Cc: Soto, Kathryn; Gerace, Anthony; 'Bob Collette' Subject: RE: Osterville General Store Ok—I will file the Hazmat application tomorrow. I believe we saw the existing was Category 1 and they are not changing it. Thankyou From: Bellaire, Dianna <Dianna.Bellaire @town.barnstable.ma.us> Sent:Thursday, May 19, 2022 10:10 AM To: 'Tom' <ths.law@com cast.net> Cc: Bellaire, Dianna <Dianna.Bellaire @town.barnstable.ma.us>; Soto, Kathryn <Kathryn.Soto@town.barnstable.ma.us>; Gerace,Anthony <Anthony.Ge race @town.barnstab le.ma.us>; Bob Collette (bcollett@barnstablecounty.org)<bcollett@barnstablecounty.org> Subject: RE: Osterville General Store i Hi, That is great news. I am awaiting an approval inspection from Bob Collette before I can release the permit. I've copied him on this email. You have not applied for the hazmat permit to my knowledge-we need you to schedule and inspection with Anthony so he can determine what we need to charge. I've copied Anthony on this email. The food paperwork is in but, you will need to discuss with Kathryn what is needed to pass inspection. Thank you. Dianna Bellaire Permit Technician Town of Barnstable Health Division 4 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us The.information contained in this electronic transmission("e-mail"),including and-attachment(the "Information"),may be confidential or ot:her%Vise exempt from disclosure.It is for the addressee orrly. This Information may be privileged and confidential work-product or a privileged and confidential. communication.'lhe Information may-also be deliberative and pre-decisional in nature.As such,it is for internal use oniv.The Information may not be disclosed without the prior lvrnten consent of the: Director of Public Health and/or the Town Att.orney's Office of the Town of Barnstable.If you have received this e-mail by mistake,please notifi.r the sender and delete it from your system.Please do not coPl.or forward it.Thank you for your cooperation. .... ��__ From: Tom [mailtoahs.lawCn>comcast.net] ,_w Sent: Thursday, May 19, 2022 9:18 AM To: Bellaire, Dianna Subject: Osterville General Store Good Morning Dianna—Looks like we are ready to close on 5/24. 1 believe we are set on your end as far as the tobacco permits. I will notify Kathryn of the date so she can schedule an inspection as well as Anthony for the propane tanks. Am I missing anything? Thank you! Thomas H. Souza, Esq. Phone: 508-280-5508 Fax: 508-858-5502 1 Childs River Road East Falmouth, MA 02536 In compliance with M.G.L. c. 93H and to protect the privacy of your personal information, we request that you do not email us any document that contains personal information, including the following information, UNLESS YOU ARE WAILING IT IN A SECURE, ENCRYPTED EMAIL: 1) Social Security Number(s); 2) Driver's License Number(s) or state-issued ID number(s); 3) Bank or other financial account number(s); 4) Bank or other financial institution routing number(s); 5) Any credit card.or other account number(s); 6) The name of any minor child(ren); and 7) Birth date(s). CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! 5 CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! 6 DATE SYM REVISION RECORD OR CK. 1 — (o DESIGN CALCULATIONS �- 30 5EAT !?LAST- K 35 OAIa 4EAr = /J EO GAL. CA/ FL OW - RETAJL STGRF_ I I 3 PERS 0/IS�I�R Y X /5 fi TG7"AL DE`IGJ✓ FL_OLti` _ /095 GAG . � �/ U 5 F � ?_ O�1 O GRL S',Ef�T/C T•fAP1 K _ i 2) PF :; 77/—KF r1J ' x I �. �/ S E/�r - 4 SO 6s9e . OSE = /000 TRAP ` �. 3� LEACHING AREA {�E�vJRF�ilE/vTS PJ?OAOSEG cX;STING BOTTOM AREA; /. O. OA4.1 S. F. 'fig 4NL, C/i1R`� RE?A1L i LEAC'1-t/A/G ^AI�AC/TY (65 TTOM �` 0)I:FVIQe- PJ;=�A S71r).RE ! STORE- , 3.14 x-4,< 4-x /. O * 3.I+ i �� • i-_-_ �--- PJN. FLooR EL.= /�i4-•8 -� _ 4�fccSERV�• EACN/NG t'RpAC'/TY = /IflG� GAc. . 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