Loading...
HomeMy WebLinkAboutOSTERVILLE FARMERS MARKET - CLOSED TEMP FOOD PERMITS 2019 �STe2v \ 1 �� � �,�erS � � `� � � � ! -� o S M E A No.2-153LY UPC 12OU amoad com - &We In USA '`SUST"AINl18tJ< FORESTRY IIVRWNE . o.N/M�ivMrNM TEMP FOOD CHECKLIST EVENT NAME:FARMER'S MARKET HYANNIS OT REQUEST:N I CONTACT NAME: MARTINA MEHL EVENT ADDRESS: 1336 PHINNEY'S LN,HYANNIS CONTACT PH#: 508-790-4200 ext 103 EVENT DATE: 05-24-19 TO 09-13-19 CONTACT EMAIL: I martinaecapecodbeer.com —_ VENDOR FOOD HANDLERS 15 YR SS 3 YR SS ALLERGEN LICENSE EVENT FOOD CAPEABILITIES N/A N/A N/A N/A N/A NO PERMIT REQUIRED-SELLS PRODUCE 1 � CAPE COD CRANBERRY HARVEST ITina Labossiere Ix n/a X X IJELLIES,JAMS,PRESERVES Deb Grenier X n/a n/a FOSS FARMS Doug Foss X n/a X X Tomato Sauce sold in jars LOCAL SCOOP I N/A I N/A N/A N/A N/A NO PERMIT REQUIRED-WILL HAVE ANNUAL MOBILE PERMIT WITH US MONOPATI Marla Lemanis Ix n/a X X JOLIVES,OLIVE OIL,HONEY,BAKED GOODS,PEANUT AND ALMOND BUTTER NEOME'S PORTUGUESE STUFFIES INeome Hollis Ix In/a IX X FROZEN STUFFED QUAHOGS-APPROVED BY TM NOBSKA FARMS Marianne Fricke IX n/a n/a X HOT SAUCE,JELLY,CHOCOLATES,HONEY COFFEE&CHILI SEASONING Rooster Fricke n/a UNDERGROUND BAKERY Ian Sullivan X n/a X X PRE-PACKAGED BAKED GOODS,FOCCIA BREAD,COOKIES,COFFEE CAKE,PIES Laurie Decost X n/a X SERVSAFES EXPIRE ON 06-24-19,SO OPTIONS AFTER THAT DATE IS NO SAMPLING AND NO TEMP.FOODS OR GIVE ME NEW SERVSAFES WITH RENEWALS VALCOURT SUGAR SHACK I N/A N/A N/A N/A N/A NO PERMIT REQUIRED-PURE MAPLE PRODUCTS I WICKED GOOD KETTLE CORN Jeffrey Paine X N/A X X KETTLE CORN i L � e red Thomas McKean,Director PE Town of Barnstable !� Regulatory Services -y E swiMsrAate. • Richard V. Scaii,Director $ARNSTABI..,;. Public Health Division t: 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 :, a� MAIL TO.TOWN OF BARNSTABLE PUBLIC HEALTH DIVISION 200 PLAIN STREET UVAINNIS,NIA 02601 FiLK 508 790-6304 PLEASE IrCLUDE A CHECK FOR$40.00 ONE DAY;$50.00 (2+DAYS)AND A COPY OF YOUR FOOD SANITATION TILAINING(E.G.ServSafc)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE 2419 NAME OF SPECIAL EVFNT�� /jyf 'n'o—, WAS THIS EVENT APPROVED BY THE BOARD AT A PUBLIC MEETING? Y X N NAME.OF PERSON(S)REQUFSTING PEkMIT BAD I e V rGV.0 / C-"C. Cad Se.ey TELEPHONE#S-0$-790- Y ZOO X 102"- CELL# '7 7 N - 8 3 to - HOME ADDRESS J 7�(0 Pn nt�/S fah G VII,LAGF, y�Y1 ri I S NAME OF ORGANIZATION CONTACT PERSON ,1-,�f� -14C j/ TELEPHO/NE SAP ~_ : 2D�(� ADDRESS-,aK-)- 5-7!� �(���TL7 �/�f 2ft�{'L-5 G� e2Gr 6,Z FOOD TO BE SERVED(LIST EXACT FOODS) 1 NAMES OF TRAINED FOOD HAND ERS(TO BE ONSITE DURING EVENT): (ATT CH C(jPIF,S OF SERVSAFE&ALLFRGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED }! /�/'T.f � `i`'�/S DATE TO BE SERVED G� TI'mE.-6 orn RAIN DATE 12 One WHAT TIME WILL ALL F,QUIPMENT BE SET-IIP&READY FOR INSPECTION? :OO j2jW HOW WILL FOOD BE KEPT BELOW 41 DEGREES F 1*7 Z!A HOW WILL FOOD BE HELD AT 140 DF.GREF.S F. HOW 15 FOOD COVERED (� (j,&'Wz HOW IS FOOD SERVED z2l:rfGIe_d TYPE,OF BAND-WASHING FACILITY oz2 (ST =NAT ' E.OF APPLICANT) s ServSafe CERTIFICATION AMY COSTA for successfully completing the standards set forth for the ServSafee Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute(ANSI)-Conference for Food Protection(CFP). � Fir r� 1803 5436 ER EXAM FORM NUMBER .,, 7/31/2019 � ✓` ��• 7/31/2024 DATE OF EX t' DATE OF EXPIRATION Local lows apply.Che ! 5 cy For recertification requirements. tee:. .. r, Sher 4 rr 3 '' #t065� t nos ciation Solutions c Pa. tfI CKCORf�lKE WItI SmSote hgo tie tro&-6 of ttm NRAFY.NaimO Ra*wwif AswodivnO or J O, c.c devon 1ttEt '3 s ` � �� � �t f0$ttas< s�� i `Y.1 �� Carmen uSwEtf yae>fiorn<!233 5.Wacker Arno,5Ui1E 3600,Chicopo,.ti.b0606A3B3or Serv5aL:9rcunumM.x�7. S WN The Commonwealth of Massachusetts Fee �s• to to. 9 r. Town of Harwich $75.00 Food Establishment License Number: FS-19-184 Issue Date: 07/09/2019 Mailing Address: Location Address: HAPI PY TO BE 671 ROUTE 28 PO BOX 574 SOUTH-ORLEANS,MIA 02662 t IS HEREBY GRANTED A LICENSE TO OPERATE: L NUTED FOOD SERVICE This license is granted in conformity with the statutes and ordinances relating thereto,and expires December 31,2019 unless sooner suspended or revoked and is not transferable. Board Pamela HoweL,RN.,Chairperson Franc Boyle,Vice Chair of Cynthia Taft Bayerl Matthew Cushing,M.D. Health RonDowgialln,D.M,D _NI Eldredge,RS,CIVor Designee Health Director t , CERTIFICATE OF ALLERGEN AwARENEss TRAINING Name of Recipient: Amy Costa Date of Completion: August 7, 2019 r� Date of Expiration: August 6, 2024 Inned I3y: 7h.e abwue-na»red person is hereby isstted this rertVirate for rovipleting an alleigeu awareness training progra tl recovn ized by the Massachusetts Department oJ•Public Nealtb � Berkshire -r in arcordanre with 105 CAIJR 590.009((;)(3)(n). .<, EC Area lleiilth 1 dUr;+t 4:H Center 1'iYt�,Ccld,=•lassuchusetts 77tis cert sate will be. ��alid for Jive(S)years f rom date of coiripletioa. • +viv.H•.m.tic�acl:igcrgytraii�in�;.or}; A it August 8,2019 Dianna Bellaire Town Of Barnstable Health Department 200 Main Street Hyannis, MA 02601. Dear Dianna: Enclosed.please find an application for a new vendor at our Farmer's Market.You have already received via email the following on April 8,2019: 0 overall.APPLICATION form for the whole market. ® overall description of our market. ® Floor plan for the market • Operational Guidelines My ALLERGEN AND`SERV SAFE.certification in case necessary as the MARKET MANAGER. If you need anything further please let me know. Thanking you in advance, Martina Mehl Cape Cod Beer Inc Work:508-790-4200 Ext 103 Cell: 508-451-5993 Martina@CapeCodBeencom Cape Cod{ Beer • 1336 Phinney's Lane Hyannis, MA w 02601 508-790-4200 www.CapeCodBeer.com THIS SECTION CONTAINS APPLICATION AND PAPERWORK FOR NAPPY TO BE Plans to sell: Kale Chips Certificates: Servsafe and Allergan certificates included. Bellaire, Dianna From: Bellaire, Dianna Sent: Thursday, August 08, 2019 4:02 PM To: Leanne@capecodbeer.com Cc: Bellaire, Dianna Subject: Happy To Be-Hyannis Farmers Market Hi; I spoke with your health inspector and under the new food code,vacuum packed, packaged kale chips, don't require a temporary food permit. Happy to Be is all set to attend the Hyannis Farmer's Market by Health Division standards. 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 1 i Town _of Barnstable oFtME lti Inspectional Services Public Health Division BARNSTABLE w BARNSTABLE, 6315Tq (•CMMY11C-Cowl i.111" 's MASS. N S. Snl'JF•o 9.N 1i•ly 4fXtM,+IMF 9c� i6;9, Thomas McKean, Director ,E3g_zo;a ArED""°r 200 Main Street, Hyannis, MA 02601 : D� Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 05-17-19 Event: FARMERS MARKET - HYANNIS Permission is hereby granted to: Cape Cod Cranberry Harvest Name of Person: Deb Greiner & Tina Labossiere Address: 33 Rocky Way, Harwich, MA. 02645(C)50.8-451-5993 To•serve: Jellies, Jams, & Preserves ServSafe certified: Tina Labossiere & Deb Greiner Allergen Awareness: Tina Labossiere Only at the following location: 1336 Phinngy's Ln, Hyannis, MA 02601 VALID ONLY ON THE FOLLOWING DATES: May 24—September 13, 2019 rida s 3:00 m-6:00 m APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TO OF BARNST BLE BOARD OF HEALTH 1 c 1 , Director of Public Healt � p Town of Barnstable oFI"e r Inspectional Services AJL Public Health Division BAMSTABLE BARNSTABLE, * - a Risys�•csae,v .cnun•rrrnxms . � 1KAS3. vm—tw5 nit,•n--n nir•u,s*prannpr se3q. �m� Thomas McKean,Director 16J9-2014 �prfD MAC AGz 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 9.4 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 05-17-19 Event: FARMERS MARKET - HYANNIS Permission is hereby granted to: Foss Farms Name of Person: Douglas Foss Address: 35 Grand Oak Dr, Forestdale MA 02644 (C)774-836-3723 To serve: 5 Ingredient Tomato Sauce in Jars ServSafe certified: Douglas Foss Allergen Awareness: Douglas Foss Only at the following location: 1336 Phinney's Lane, Hyannis MA 02601 VALID ONLY ON THE FOLLOWING DATES: MU 24-September 13, 2019 Fridays 3:00 m-6:00 m APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. OF B ST LE BOARD OF HEALTH _ ean 3 Director of Public Health Town of Barnstable ° THE r ti Inspectional Services BARNSTABLE Public Health Division - .. * ■ xnw+sri�•umi[.c�run•nrrnn: * BARNSTABLE, MASS. ��� Thomas McKean, Director c a ATFa 15 µay a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a.permit is hereby granted to DATE: 05-17-19 Event: FARMERS MARKET - HYANNIS Permission is hereby granted to: Monopati Name of Person: Maria Lemanis Address: 7 Queen's Way, Sandwich, MA 02563(C)508-888-1045 To serve: Olives Olive Oil Honey Greek Baked Goods, Almond & Peanut Butter ServSafe certified: Maria Lemariis Allergen Awareness: Maria Lemanis Only at the following location: 1336 Phinney's Lane, Hyannis, MA 02601 VALID ONLY ON THE FOLLOWING DATES: Ma. 224-September 13, 2019 Fridays 3:00pm-6:00pm APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. OF BARNSTAB E BOARD OF HEALTH ean "' �`: Director of Public Health i Town of Barnstable 16 IKE I ° Inspectional Services A..a"PALA A.'s A Public Health Division BARNSTABLE c errwsv,O�.cJnear:�•uinrr.•inaxllis * BARNSTABLE, • nan ONi nI,PS 0V.IFn V A<PPT4PtF 9 111A$$. 9 ii39-201z '. Thomas McKean,Director �� plFOM 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5,of the General Laws, a permit is hereby granted to: . DATE: 05-17-19 Event: FARMERS MARKET - HYANNIS Permission is hereby granted to: Neome's Portugese Stuffies Name of Person: Neome Hollis Address: 68 Main St, Kingston, MA 02364(C)508-566-9399 To serve: Pre-packaged Frozen Stuffed Quahogs ServSafe certified: Neome Hollis Allergen Awareness: Neome Hollis Only at the following location: 1336 Phinney's Lane, Hyannis, MA 02601 VALID ONLY ON THE FOLLOWING DATES: May 24—September 13, 2019 1 Frida. s�pm-6:00pm APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION,IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY, URNSTAB E BOARD OF HEALTH can Director of Public Health Town of Barnstable oF�"E row Inspectional Services A6 . a411 %61n A • BARNS-TABLE Public Health Division MSTA.LEK1,1Sv1U.MN,,.,,Y,AMS '+ IARNSTABLE. • - naa.,^.a>mas•n.,�.m.w-RF:rumsr,pw 9 MASS. 1639.201 1639. Thomas McKean,Director , ATfD►A°�A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 . PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section,5, of the General.Laws, a permit is hereby granted to DATE: 05-17-19 Event: FARMERS MARKET HYANNIS Permission is hereby granted to: Nobska Farms Name of Person: Rooster Fricke Address: 40 Palmer Ave, Falmouth, MA 02540(C)774-836-5206 To serve: Hot Sauce, Jelly, Chocolate, Honey, Coffee, Chili Seasoning Mix. ServSafe certified: Marianne Fricke Allergen Awareness: Rooster Fricke Only at the following location: 1336 Phinney's Lane, Hyannis, MA 02601 VALID ONLY ON THE FOLLOWING DATES: Ma, 2�ptember 13, 2019 Frida. s�prn-6:00pm APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. F BARNSTAB BOARD OF HEALTH an Director of Public Health i Town of Barnstable oFtHe, Inspectional Services Public Health Division BARNSTABI,E * BARNSPABLE, - -- SAMen51E•C5REW11E•COTUIT•HY/.LAIRS 9 S8 M4P5 E$MITI• lr li•PF. MMSTMQ Thomas McKean, Director 1F-s_ ls ATFD MA+a 200 Main Street, Hyannis, MA 02601 �� Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section.395A and Chapter I I I,-Section.5, of the General Laws, a permit is hereby granted to: DATE: ME 17, 2019 Event: FARMERS MARKET HYANNIS Permission is hereby granted to: Underground Bakery Name of Person: Ian Sullivan Address: 780 Main St., Dennis, MA 0.2638(C)774-836-5206 To serve: Pre-packaged Baked Goods, Foccia Bread, Cookies, Coffee Cake, Whoopie Pies ServSafe certified:Ian Sullivan & Laura Decost Allergen Awareness: Laurie Decost Only at the following location: 1336 Phinngy's Lane, Hyannis, MA 02601 VALID ONLY ON THE FOLLOWING DATES: May 24—September 13, 2019 Frida• s�pm-6:00pm APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. F B AB E BOARD OF HEALTH cKean Director of Public HealthA i Town of Barnstable oFt"E TOhw•- Inspectional Services A. 4 " Public Health Division BARNSTABLE BARNSTABLEI w eersysr.�.M1•eertearle-�run.kr•,xmo - k20.=.tAi .•.•(Tv'll`Jlilt.l\.Ci piiPkR.lf v 639 ,0� Thomas McKean, Director ""4 a l�0 MAC 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter l 11, Section 5, of the General Laws, a permit is hereby granted to: DATE: 05-17-19 Event: FARMERS MARKET - HYANNIS Permission 7s hereby granted to: Wicked Good Kettle Corn Name of Person: Jeffrey Paine Address: 109 Marion Rd; Mattapoisett, MA 02739(C)508-336-6043 To serve: Kettle Corn ServSafe certified: JeffrePaine Allergen Awareness: Jeffrey Paine Only at the following location: 1336 Phinney's Lane, Hyannis, MA 02601 . VALID ONLY ON THE FOLLOWING DATES: May 24-September 13, 2019 Frida. sy 3:001)m-6:00pm APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST CBE SECURED FROM APPROPRIATE AGENCY. RNST LE BOARD OF HEALTH �71OF c an Director of Public Health ti May 1,2019 Dianna Bellaire Town Of Barnstable Health Department 200 Main Street Hyannis,MA 02601 Dear Dianna: Enclosed please find a check in the amount of$1.80 for our Farmer's Market application.. You should have already received via email the following; • overall APPLICAT..ION form for the whole market. • overall description of our market. • Floor plan for the market • Operational Guidelines • My.ALLERGEN,AND SERV SAFE certification in case necessary as the MARKET .MANAGER. If you need anything further please let me know. Thanking you in adv I , Martina Mehl f� Cape Cod.Beer Inc i f Work-508-790-4200 Ext 103 11 Cell: 508-451-5993 lvlM arrti nar"`cUCapeCodB.eer.com Cape Cod Beer 1336 Phinney's Lane • Hyannis, MA 02601 508-790-4.200 www.CapeCodBeer.com I r ® r May 1, 2019 .Dianna Bellaire Town Of Barnstable. Health.Department 200 Main Street Hyannis,MA 02601 Dear Dianna: Attached is the required documentation for the Vendors for the Farmers Market at Cape Cod Beer. CAPEABILITIES: Basil, Tomatoes, Cucumbers,.Salt,other fresh vegetables as the season merits. No additional certificates needed. CAPE COD CRANBERRY HARVEST:jam ,jellies and preserves. Sery Safe and Allergen included. FOSS FARMS: Tomato sauce sold in jars. Sery Safe and.Allergen included. LOCAL SCOOP: Frozen Pre-packaged Ice Cream Pops. Sery Safe, Allergen, Ice Cream Truck Vending Cert. included. MONOPATI: Extra Virgin Olive Oil: Black Olives, Figs, Wine..and Spirits, Grapes,Honey and many other types of fruit, vegetable,or spices. Sery Safe and Allergen included, NEOME'S PORTUGUESE STUFFIEST Frozen Stuffed Quahogs NOBSKA FARMS: Hot Sauce,Jelly, Chocolate, Honey, Coffee, Chili Seasoning.Mix. Sery Safe and Allergen included. UNDERGROUND BAKERY: Foccia Bread, Spent Grain Bread, Cookies, Coffee Cake, and Whoopie Pies, all pre-packaged. Sery Safe and Allergen included. VALCOURT SUGAR SHACK:.Maple syrup and Maple sugar products. Sery Safe and Allergen included. WICKED GOOD KETTLE CORN: Popping and Selling Kettle Corn on site,sold in twist tied bags. Certificates includes Liability Insurance, Allergen and Sery Safe included Cape Cod Beer - 1336 Phinney's Lane • Hyannis, MA 0260.1 508-790-4200 www.CapeC-odBeer.com i Thomas McKean, Director lvwqr Town of Barnstable Regulatory Services sARNST"LL Richard V. Scali,Director BARNSTABLE v� s63q ,�� , '�FCM9. Public Health Division s I 200 Main Street,;Hyannis MA.026.01 Office: 508-862-4644 Fah: 508-79.0-6304 NLAIL TO:TOWN OF BARNS ABLE PUBLIC HEALTRDIVISION 200 MAIN STREET HYANNIS,MA.02601 FAX 508 790-6304 PLEASE I\CLUDE'A'CHECK FOR S40.00.ONE DAY;S50.00 (2+DAYS)AND.A COPY OF YOUR FOOD SANITATION' TRAINING(E.G.ServSafe)CERTIFICATE ANT ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE April 8, 2019 NAME OF SPECIAL EVENT Farmers' Market at Cape Cod Beer WAS THIS EVENT APPROVED BY THE BOARD AT A PUBLIC MEETING? Y X v NAME OF PERSON(S)REQUESTING PER.MIT Martina Mehl, Events Coordinator- Cape Cod Beer TELEPHONE#508/790-4200 x103 CELL# 508/451-5993 HOME ADDRESS 1336 Phinney's Lane VILLAGE Hyannis NAME OF ORGANIZATION CONTACT PERSON TELEPHONE ADDRESS FOOD.TO BE.SERVED(LIST:EXACT FOODS) See attached letter NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): See attached (ATTACH COPIES OF SERVSAFE&ALLERGEN-CERTIFICATES) ADDRESS WHERE TO BE SERVED 1336.Phinney's lane, Hyannis, MA DATE TO BE SERVED Fridays 5/24-9/15 TIME 3pm-6pm RAIN DATE None WHAT TIME WILL ALL EQI IPMENT BE SET-GP&READY FOR INSPECTION? 3 pm HOW 4VI:LL:FOODBE KEPT BELOW,41.DEGREES FCOolers/Freezers/Ice Packs HOW WILL FOOD BE HELD AT 140 DEGREES F. See attached Where applicable HOLY IS FOOD COVERED Food Will be covered or prepackaged HOW IS FOOD SERVED See Attached TYPE OF HAND-WASHING FACILITY On Site i (SIGNATL E.O APPLI AN FARMER'S MARKET LAYOUT Cape.Cod Beer—existing building Houses bathrooms, hand washing sinks etc. a r 9 1 Beer Garden lent ; These are cement 1 planters that we have used in past years-to define and contain the 2 11 beer garden 3 12 4 13 b 5 0 14 0 CES Electric 6 �o Our very fabulous 7 neighbors: We envision this being a •- table/station manned by a. --r e dotted lines would be Police staff member to welcome .� style barricades—saw horse.style— guests and"police" to that we would be able to remove make sure people are not befor and after market. departing with alcohol .......... „ e, Farmers Market Meets Happy Hour at Cape Cod Beer Mission and Guidelines Dates: Fridays from 3-6pm.starting 5.24.19 through 9.13.19 Fees: With the success of last season's market we have decided to continue to absorb the fees for our vendors for 2019. Al I vendors should note that this may change,but that fees will be in Line with those charged with other local markets. Priorities: • The safety of our visitors • The upholding of all-applicable town.and state regulations • The enhancement of our guests experience The profitability of the market itself for all participants Goals: To promote locally made,locally grown,and local,producers. o To uphold Cape,Cod Beer's commitment to Customer Service,Environment,Quality and Community—and have the market reflect these"pillars"in how it is operated and perceived by its visitors. • To educate Cape.Cod Beer's'visitors on the importance of supporting local producers& growers. Operational Guidelines Vendor Equipment:.Each vendor is responsible.for providing and removing any and all equipment and supplies that he or she requires doing business at the site, including signs,tables,chairs and the like. The use of canopies(10.x10 only)and umbrellas are allowed however; each vendor must provide secure anchoring of all canopies and umbrellas using weights and or tie downs. In addition,all vendors are responsible for removing all garbage from their site. Recycling is mandatory. —ask us where to recycle your stuff if you need to. Signs: All individual vendor signs must remain within the allotted vendor's exhibit space and must not block traffic or pedestrian's right of way or interfere with other vendor's.displays;All:items:offered for sale will be clearly labeled and priced and each vendor will post sign of the farm/company name. Source/Origin is required if not grown by your farm. Scales: In addition,all vendors must utilize legal scales with a current weights and.measures stamp.If selling pre-packed produce,weight/price must be posted. Permitted Market Items: Vendors shall sell only agricultural,horticultural or food items that they themselves have grown,produced or processed. Baked goods and other processed or specialty foods can be sold with the approval of the. Market Manager and require a permit from the Barnstable Board of Health. Please disclose all products when filing your application with Market Manager. Changes may require'additional approval from Board of Health.The Market Manager will maintain a file of all Board of Health Permits. The:Market Manager has the right to ask that products be removed from stalls by the vendors if they detract from the overall quality ofthe.Market. Items not produced by the vending farm or business shall be clearly marked, stating where they are grown or produced and must be approved by the Market Manager. Enforcement of Rules::The Market Manager is responsible for enforcing the market rules.Possible violations or unresolved issues will be discussed prior to the next market date.If a vendor fails or refuses to adhere to any decision duly made;then the vendor may:be expelled for the balance of the market.season. Participation: Vendors may miss up to three weekly markets in the 2019 season;they must notify the Market Manager by Wednesday that.week prior to the date of absence.More than three missed dates or"no call no show"will result in. losing :your spot. Cape Cod Beer • 1336 Phinney's Lane • Hyannis; MA • 02601 508-790-4200 www.CapeCodBeer.com e :.. .. e1vAAvSU A Ao",k LERTIFICATION , MARTINA MEHL' j c� - (� for successfully completing the standards set forth for the Sen!SQfe�Fed Protecton Manager Certification Examination, V which is accredited by the American National Standards(nstltu a tANS1j-Conference for Food Protection(CFP). X ,F t ER EXAM FQRMNUM6gER ; z ,. g 11113/2018 11/1 3/2023 g DATE OF EX DATE OF EXPIRATION 3, 121 '. Local laws apply.Che cy for recertification requirements O Sfser ; !l0655 ... ciation Solutions. - �l In=ordonce wi ' ServSofe logo ore trademoAs.of the NRAEF.National.Resiaurani:Associotior4and i6euic design Contoo us wiih:gvesfions al 233 S'Wacker Drive,Suite 3600,Chicago,IL.60606-6383 or SenSafe@�eslauranrorg s CERTIFICATE CIF ALLERGEN AWARENESS TRAINING '0 . Name O RtrCl l Ilr„MARTINAMEHL , J Certlficat'Number 3664743 Date of Ccilnpletlori 'f"�'%?o'S Date of Expiratlor 1,r21/2o23 ■ Issued Bp ?he above-named person is hereby issued this cetrj§cate NATIONA { 3 ' J for completing an allezgen awareness training program MR a �,•„e�A�a��x RESTAURANT HOt10t1YB01 ._:.._._._Asa ^n_ " recognized by the Massachusetts Department of Ptzdlic I-Iealtb ASSOCIATION, in accordance-with 105 CMR 590.009(G)(3)(a), Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite.102 wwwres.tauratit.org This certificate will lie valid forve(5)years fionz date ofroinpletion. Southborough,MA 01772 508-303-9905 www.marestauiantassoc.org 1\10 PPW& THIS SECTION UgCLUDES APPLICATION AND PAPERWORK FOR CAPE.A BILITIES Plans to Sell: Basil,Tomatoes,Cucumbers,Salt,other fresh vegetables as the season merits. No additional certificates needed Certificates:No additional certificates needed. Thomas McKean,Director V Town of Barnstable aF �y a ; Regulatory Services aaxxsrAsie Richard V. Scali,Director BARNSTAB KAW 1639. Public Health. Division 1 200 Main.Street,.Hyannis, MA.02601 Office: 508-862-4644 Fax: .508-790-6304 MAIL TO TOWN OFBARNSTABLE PUBLIC HEALTH DIVISION 200 MAIN STREET HYANNIS;,MA 02601. FAX 508 790-6304 PLEASE INCLUDE A.CHECK FOR$40.00 ONE DAY;S50.00 (2+DAYS)AND A COPY OF YOUR FOOD SANITATION TRAINING(E.G.ServSafe)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE April 8, 2019 NAME OF SPECIAL EVENT Farmers'Market at Cape Cod'Beer WAS THIS EVEN-7 APPROVED BY T.HE:BOARDAT A.PUBLIC MEETING? Y X N NAME OF PERSON(S)REQUESTING PERMIT Martina Mehl, Events Coordinator-Cape Cod Beer TEL.EPHON.E#508/790-4200 x103 CELL# 508/451-5993 'HOME ADDRESS 1336 Phinney's Lane VILLAGE Hyannis NAME OF ORGANIZATION Cape Abilities CONTACTPERSON Jarnes.Barnes " TELEPHONE 5087785040 :ADDRESs 89'5 Mary Dunn Road, Hyanns FOOD TO BE SERVED(LIST ENACT FOODS) Produpe, :Salt NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): Barnes Barnes (ATTACH-COPIES OFSERVSAFE&ALLERGEN CERTIFICATES) ADDRESS WHERE TO.BE SERVED 1336 Phinney's Lane, Hyannis, MA DATE TO BE SERVED Fridays 5/24-9/13 TINIE.3pm-6pm RAIN DATE None WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FOR INSPECTION? 3 pm HOW WILL FOOD 13E KEPT.BELOW 41 DEGREES F n/Z HOW WILL FOOD BE HELD AT 140 DEGREES F. n/a SHOW ISF.00D'COVERED n/a HOW IS FOOD SERVED Gloves TYPE OF:HAND-WASHING FACILITY on Site (SIGMA :URE O APPLICANT) THIS SECTION INCLLDES APPLICATION AND PAPERWORK FOR CAPE COIF CRANBERRY HARVEST Plans to Sell:jams,jellies and preserves. Sery Safe and Allergen included. Certificates:Allergen Certification and Sery Safe included. P Thomas McKean,Director �zl�r Town of Barnstable O ; Regulatory Services ` } aAMvSTABLF� Richard V. Scali,Director BARNSTABLE y KASS. 0a Public Health Division 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Far: 508-790-..6304 N/1AIL TO:TOWN OF BARNSTABLE PUBLICAEALTH DIVISION 200 MAIN STREET HYANNIS,IIA 02601 FAX 508 790-6304 PLEASE INCLUDE A CHECK FOR S40.00 ONE DAY;$50.00 (2+DAYS)AND A COPY OF YOUR FOOD SANITATION TRAINING(E.G.ServSafe)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please,see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE April 8, 2019 NAME OF SPECIAL EVENT Farmers' Market at Cape Cod Beer WAS THIS EVENT APPROVED BY THE BOARD AT A PUBLIC MEETING? Y X N NAME OF PERSON(S)REQUESTING`PERNIIT Martina Mehl, Events Coordinator- Cape Cod Beer TELEPHONE#508/790-4200 x103 CELL# 508/451-5993 HOME ADDRESS.1336 Phinney's Lane VILLAGE Hyannis NAME OF ORGANIZATION Cape Cod Cranberry Harvest CONTACT PERSON Deb Greiner,Tina Labossiere TELEPHONE 5082808237 ADDRESS 33 Rocky Way, Harwich, MA F.00P TO BE SERVED(LIST EXACT FOODS) Jellies., Jams, Preserves =J` p n c4 NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING E.VENT): Deb Greiner, ina Labossiere (ATTACH COPIES OF SERVSAFE&ALLERGEN CERTIFICATE ADDRESS WHERE TOBESERVED 1336 Phinney's Lane, Hyannis, MA DATE TO BE SERVED Fridays 5/24-9/13 TIME 3pm.=6pm RAIN*DATE None WHAT TIME WILL ALL.EQUIPMENT BESET-UP&READY FOR INSPECTION? 3 pm HO\3'WILL FOOD:BE.KEPT BELOW 41 DEGREES F n/z HOW WILL FOOD BE HELD AT 140 DEGREES F. n/a HOW IS FOOD COVERED Food will be covered or prepackaged HOLY'IS FOOD SERVED Gloves TYPE OF HAND-WAS.iNG FACILITY on site -fit. SIGNATLR.E OF.APPLICA I`} The Commonwealth of Massachusetts gee Town of Harwich $75.00 °~ Food Establishment License ag�t►P i Number: FS-19-124; FS-19-125 Issue Date: 02/12/2019 Mailing Address: Location Address: CAPE COD CRAN93ERRY HARVEST :33 ROCKY WAY 33 ROCKY WAY HARWICH,MA 02645 IS HEREBY GRANTED A LICENSE TO OPERATE:. LIMITED FOOT) SERVICE This license is granted.in conformity with the statutes and ordinances relating thereto, and expires December 31,2019 unless sooner suspended or revoked and is not transferable. Board Pamela Howell,R.N.,Chairperson Frank Boyle,Vice Chair of Cynthia Taft BayerI Matthew Cushing,M.D. Health Ron Dowgiallo;D.M.D &A�t�Aga Eldredge,RS,OkO or Designee Health Director f / 4 e . S rvsafe -,2 -�.� -, CERTIFICATION DEBRA GREINER for successfully completing the standards set forth for the ServSafe®Food Protechn Hager Certification Examination, which is accredited by the American National Standards Institute(ANSI)-Cesn�fe ence fo'r Food Protection{CFP�. v 3 228638 10470 1 UMBER EXAMFR1vtIIJ &� R x 2/10 i 2/10/202'I r � El n DATE OF E DATE OF EXPIRA71©Na r Y'` .. r '� Local laws apply.Ch - % ency(or recertification requirements: � � ��,ry� u � � / f1 aacam6,ca with rAaritane Ls6au C2015 Natiosrol" d logo are Rake ar6 of the NRAEF. a 0 Conrad es with questions at 175 W l.&.Bw.Ste 1500,Chicago A..6060A or$e[v5ofe®restourarrf.org i / 1 ! .. >) �l�I.�a�-1,�GFtstK l°ti r<SSFr p,� St�+ada tfar �i�i^r�9i rt" Srk. NON .irhi S{11 }� 1 � "I VY arwl, 'vS'. r5 :A L.!� !t {.f i I ♦ 1 r 4,� - l .f><+acY 4��'�d,, f. � t� FK �, n tFw`jf varatp -`� s �y}T n w 1 �x ��•4 t iv a i.0 Kt a+p pa,�ls.}� m��A��i�'� "\�•da, f e�xaf zal�fu�! xic lY) t� )�;• s i 4'i ytEs3 t.hx� ) i f+r���}+�'a'?t `5njrdr1�V.. ' qt(ona{Ae�tdc�r�tt� c>li tS y . � � +.t 2 .lti J{ , � t' K�•!1tst y;.• ) { tea• vda J. t i �.> r 7 txi-t 1„ir�\�F"fd z t 3t r nv.Je>+'• °i;F.k�ilrlq}sa� ,.t�,�d 9 � g C b{ izt S°J 'f rZi�S ,Fril Jrry4 t}�t"nil ' rIr1'�riWI 2 i� r i°N2, dlP�a n� 3 g u 7 tt�. ir�l tl��t a93 c � •il■�1J1 F �.�>-p45rY �5i}r��.zi}Yc{r`'s��t��t€rji^^``155���} 1�•���rlxf accaaoltaoenocaca5 `` 5 � `Sri t� i N A W:NnulcnHnwrWSUaJotic6uutu'i� � �r+l � rtiyy�\`I'�St pnC lff!♦.•OM1{llBrlfl raiCOJPmIe[UJ!i' % fh t 1 g j' ykk tJxa��s}+ iS,{• r L,r: / 1O�r ttCfc r) tt �1< S'*T• i ithti'/ G5 t`TrFgt>'f.•l4�e� ij ,t{-�E'i.+' Nil R�) �� c�F�`��§`4�r[tf`S `�4'•Ps,� r�` t + y�d(i�� �1' tiagt� y�jt; Ss. 'n h�'t�VCtix7�SrY'cD+.�Ya r }� •, 16 r 1g\�x+p4'd�Ss"�t��l �>arftluA�.1Fk•tr fR$�t,•+ }- 'piny j�'Ir",tityi t��4�tir�4���t ip�"r�•t;°7�'���'��•S�.'��� �k f N �t�.t++ �� �.:: CERTIFICATE OF .ALLERGEN AWARENESS TRAINING Name of R.eclpzent; INA OBOWVRE Certificate<)NulnUer `2849o71 ' Date of CoA pl on. 1or!9r�M ` iotuzoz� ❑ . :� Date of�xpiratioli . L7 1 issued BY; ?Iie above-Trartrtd fiersort is h.rref�y issued ibiscerti ecate "� ��-j or com rletin r an allei ren awareness training. ro rain MHO �RE IQNAf 1 b b bl� !�" �:„;,;;�«, T[M ANTCL recognized by the Massachusetts Depart»rent of Priblic Health __"_+p��°�u rop_ OCI�TION0 in accordance with 105 GMR 590.009(G)(3)(a). Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 www.restaurant.org Soutti6orough,MA 01772 This cere rcate will be valid for five(5)years f rotn date of completion 508-303-9905 www.marestaurantassoc.org '�,/ �'! +"/ � p� � � � Yr +� it y°► :. 47�" THIS SECTION INCLUDES APPLICATION AND PAPERWORK FOR cc) Q P FOSS FARMS C(Arc�- Planning to Sell: tomato sauce sold in jars Certificates:Servsafe and Allergen Certificates included. �^ Thomas McKean, Director Town of Barnstable M T � Regulatory Services DIM t � = Richard V. Scali,Director BA LE i639 Public: Health Division x=u 200 Main Street, Hyannis;_ MA 02601 Office: 508-862-4644 Fax: 508 790-63Q4 M.ML TO.TOWN OF BARN STABLE PUBLIC HEALTH DIVISION 20019AIN STREET HYAN'NIS,NtA 02601 FAX 508 790-6304 PLEASE INCLUDE A CHECK FOR S40.00 ONE DAY;S-0.00 (2+DAYS)AND A COPY OF YOUR FOOD SANITATION TRAINING(E.G.Scrvsare)CERTIFICATE.AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE April 8, 2019 NAME OF SPECIAL EVENT Farmers' Market.at Cape Cod Beer WAS THIS EVENT APPROVED BY THE BOARD AT A PUBLIC MEETING? Y X NAME OF PERSON(S)REQUESTING PERNI:I,T Martina Mehl, Events Coordinator- Cape Cod Beer TELEPHON?E#508/790-4200 x103 CELL# 508/451-5993 HO,M.E ADDRESS 1336 Phinney's Lane VILLAGE Hyannis NAME.OF ORGANIZATION Foss Farms COI\TACT PERSON Doug Foss TELEPHONE 7748363723. ADDRESS 35 Grand Oak Drive, Forestdale, MA FOOD TO BE SERVED(LIST EXACT FOODS) 5 ingredient tomato sauce in jars NAMES OF TRAINED FOOD HANDLERS(TO BE O\SITE DURING EVENT): Doug Foss (ATTACH.COPIES OF SERVSAFE&ALLERGEN CERTIFICATES) ADDRESS WHE...RE.TO BE SERVED 1 3.36 Phinney's Lane, Hyannis, MA DATE TO BE SERVED,Fridays 5/24-9/13 TIME 3pm-6prn RAIN DATE None WHAT:TIME WILL ALL EQUIPMENT BE SET-tiP&READY FOR INSPECTION? 3 pm HOW WILL FOOD BE KEPT BELGW 41 DEGREES F n/Z HOW WELL FOOD BE HELD AT 140 DEGREES F. n/a HOW IS FOOD COVERED Food will be covered or prepackaged HOW IS FOOD SERVED Gloves TYPE OF HAND-WASHING FACILITY On site (SI TAT OF APPLICANT) /Fas5 � i Permit#201.9•GR-03 Fcc sr�8Q.oQ UTH�q TflE COMMONWEALTH-OF M M, A'CH�J ETTS' . �-- Tort bfD art�rnoi' wttfi � B-,a#-d of TZeal:E' This.is to certify trial rb'S:.FARMIS Business name 0OUGLAS FOSS Licenses 1133 FISHER ROAD DARTMOUTH MA '02,74$ Address ; IS HEREBY GRANTW'FOR AN ANNUAL (.GRANGE KITCHE4-1133 Fisher Road .Dartmouth MA 0274$) S,ERV1tiE PEk,*MIT' 1 Iter�i � � � . ,. This permit is granted in conformo with the 105'CMR 590 Wilmum Sanitd, S:tandards=for Food / Establishments State Sanitary Code,,Article X and expires December 31,201'9 unless sooner suspended or revoked, PERMITS NON-TRANSFERABLE --� eTssued:l2/�7/fg' WAON w za�` r ♦ t i �C1 � F ^C RTIFIC A., TIO'N ,, DOUGLAS FOSS for successfully completing ilia standards set forth For the ServSafe®Fooi3 Pro �`jVbClertifiaofion C�caminc�ion, . which is occrediied 6y the American National Stanc6ds Institute . { 4 Food Prdedion(CFP). 11 osas77 �04`s Y ,t n i`CA U M B E R E X A M F O.R MNU�MxB E R�° 03/1 03111I202(? 5� DATE OF E u DATE OF .EXPIRATION R` F Loeol laws apply. for mcwtiffa* n'"Imm"Is. F trU855 ® _ ,Q O a baoondaowi6tia�rt s @ZfD15.Ndiad bpodsrad.noibd�h.NRAEF. `. a. ' �'_ Cor4ciaw..ili,qom►on.dlT3wlodew,,BMI:St.lioO.Chl�apo.1.6069�or5«r��p ----------- CERTIFICATE OF ALLERGEN AwARENESS TRAINING Name of Recipl ont DOU:L S FOSS Certifie jk"Nulnber: 2703134 Date of Corpleti�on: "t2/ts/2o,s zi , It91202t ` .Date of ationi 12 ,E l lssuea Ry: The above-namedPierson is hereby issued this certificate ti ___: , v completing an allergen awareness training.program � RESTOAU� raAssasm��seRs - PDBIAaf4Dt recognized by the Massachusetts,Department of Public Health '_ _ ^°� =v^� ASSOCIATION O in accordance with 1OS CMR.590 OQ9(G)(3)(a). Massachusetts Rcst-aurant Association 800.7652122. 333 Turnpike Road,Suite,102 www,restauragt.org. h,MA This certificate will be valid for five(S)years frorn date ofrompletion. Southboroug508-30i,MA.01772 www.mircstatiraz)tassoc.org rtts THIS SECTION INCLUDES APPLICATION AND PAPERWORK FOR lot LOCAL SCOOP s Planning to Sell: Frozen,pre-packaged.Ice Cream Pops Certificates: Sery Safe,Allergen, included 6, n aP4� Thomas McKean,Director VW%> Town of Barnstable °. Regulatory •s. r' Services Richard V. Scali Director L * `lAA L LaansrAsi~ 6 9 Public Health. Division 200 Main Street,Hyannis,MA 0260.1 Office: 508-862-4644 Fax: 508-790-6304 MAIL TO:TOtYN'OF BARNSTABLE PUBLIC HEALTH DIVISION 200 MAIN STREET HYANNIS,M.A 02601 FAX 508 790-6304 PLEASE INC LUDE A CHECK FOR S40.00 ONE DAY;$50.00 (2+DAYS)AND A COPY OF YOUR FOOD SANITATION TRAINING(E.G..SmSafe)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY`DAYS TO PROCESS(Please see instructions on fhe next,page) APPLICATION FOR TEMPORARY:FOOD.SERVICE PERMIT v.ATEApril 8, 2019 NAME OF SPECIAL EVEN Farmers' Market at .Cape Cod Beer WAS THIS EVENT APPROVED BY THE BOARD AT A PUBLIC MEETING? Y X NAME OF PERSON(S)REQUESTING PERI-MIT Martina Mehl, Events Coordinator Cape Cod Beer TELEPHONE#508/790-4200 x103 CELL# 508/451-5993 HOME.ADDRESS 1336 Phinney.s Lane —VILLAGE Hyannis NAME OF ORGANIZATION The Local Scoop CONTACT PERSON Mary DeBartolo TELEPHONE 5082373191 ADDRESS 34 MA 6A FOOD TO BE SERVED(LIST EXACT FOODS) frozen pre-packaged ice cream pops NAMES OF TRAINED FOOD HANDLERS(TO BE O\SITE DURING.EVENT): Gary DeBartolo (ATTACH COPIES OF SERVSAFE'&ALLERGEN CERTIFICATES) ADDRESS'WHERE TO BESERVED1'336 Phinney"s Lane, Hyannis,.MA DATE TO BE SERVED Friday:5/24-:9/13 TIME 3pm-6pm RAIN DATE N.One. WHAT TIME"WILL ALL EQ.U'IPMENT BE SET-UP&READY FOR INSPECTION? 3 pm FIO.W WILL FOOD BE KEPT BELOW 41 DEGREES F Coolers/Freezers/Ice Packs FIOW'WILLTOOD BEHELD AT 140 DEGREES F: n/a HOW IS FOOD COVERED Food will be covered or prepackaged HO:W'IS FOOD SE.RV.ED Gloves TYPE OF HAND-WASHING F.ACILITY on site MAO, I (SIG: TUfitt OF A PLIC.A:'T) C�_ s, ' -s'w y ;� t`'a 45 ,, �� j` h� 'y .* t:�a� s17 � �z Ilk, j ';x' �a,� A fi' ^C ,"m'. � � .a•.r`P #� k -.:.'�" fi,'. .k� $ r -� ,��- a'•T� err`' �! ' '. 3 y * o C 'j d +S t'r' s ro e` e, r x a`l `{ It, ,f.: _ �+ � a E t ?x. s :.�� �:��� � ..,,� 1210 ��,,;,•?,2 ,``::. .rt R'Eii� asASS .I .d gC C {-d r;,:: 2 r '-, �" '�Ni '" s t >�.'1;,✓-r.� �' s f 'P =n'T t a, i x ,� s `` sr r 4 :3 z' ,y ? ,y. :z .z •rJ, ,r F . . . M,ARY D ago y:- -%� .��x:- s. �'x•7 ', r a a;�"z•§sz's. $�<.., x;,:°.,�.,.,,.r,. x'a. 5z . "';,v,r xt,��„s;,r,=<,..;.��.b Fi:sc u�:e.;ac..sa,ss6rlly ocm1pa�ng�'"th Re st�a'ndLnx$r cl s set(otth.f o'r!he .x,�ma: P�`r ot' od Prhoc�iae hdos+�a ok nE�ax(Cc. aw»ws.iirwcfi o�3i i:, ., , fP for S � od accd t w� �x �r �{..�"e" � AN r 0,37191 1 Q 0 R,� u � V` x r00, € £� L/. r+ r}. -r<'� � s?r•r -r x r ^/ ' + .: '�g: ,• a ' 2 # 513�2022r DATE,Of DATE Of EXPIRA 1�0 . p +a s 'tomi frnvs apply Ch eney for receH#Ronlion'fequTrements i? � e �. St Yx ! it e e y ; Ott "Mw � all v �� E s Al gin� IMA F—InMR F�TEIIIO" # { ad @ s { N. 4 ax 2 a S u t �2< �; ae, � y #' 3 r -a (� Go�oe�uswaS+gvci�ana�d175Wbdo�Bbd.S1e1S00 C1+Kugo�BQbtlA«SenSo{C$�ealpU�eMag. �. L ;,; "s£ �y C ::, ' t ?•� ?. � ,� �• ?7� �:,r {', •..?� s ::�A ���- 'Ik �'� ��:, � G ;� a=': ��t.- � r �� .:a 7• `:'ia �� �:h, �r�; 'S -a� � t j .�. °Ct :'st ,,,..z -�„' g iS �:• �'. *Y. n 3 Y 3 £ .i-r g .F01, .s{ MM z3 ,.,.,- - F r .. :»x av a,x'rk+ s .M.'°g^ *..?� s`' ) �.^e� a' ;x'€'. L•� -�+ r7i 'i Qu °T :.5 u Y ERR W. EN LE AWAR 3 ^r •z a �a o ' € t` RY DtbAk MA 10 ' x; S Y 5 Y 3 ti �'' Certificate Number zssz3„s�7 , 4 F C Date of C`, le66-n ' 1 5!a/2022 a lcN t r Date of Expzratlon { ru f ❑ x 6IV ,e ms { 5 ISSLLCtI r the above-earned Pierson is hereby asrterl tha,ierti xcrte or corn letin.arraller en au ateness rrrirtiii ;io art ^ y� T I recognized ly"the Massazhrrsetts.IDeparttnerit of PrIblrc Ff�rtlth . c _ _ ASSOCIAl I©N '` s c 114assirhnsctts`Keatauni '; trz crcco�tlr irce ru:th<105 Gll%tR 590;(IQJ(G)(3J(it), nt Association $00 7bS,2122 a 333 r urnpikc Road,Sti4c 10z, tivwvv rrstaur."1nt org $Uuthligriiu h;IViE1 01772.:: Dils rertr torte will be valyd'or ve S ' ears ro"rrt dgte.o rorir leMott:. z f f p . 50$-303 4405 r � e g,`,g; a, € 3V�YtY nl�;tiStAUt'itllt4{SSbC pcg �«}_ 'E �.. A x ' THIS SECTION I.NCLliDES APPLICATION AND PAPERWORK FOR TYIONOPATI Planning to Sell: Extra Virgin Olive Oil,Black Olives,Fibs, Wine and Spirits;Grapes,Honey and many other types of fruit,vegetable,or spices. Certil-icates: Sery Safe and Allergen certificates included r COMMONWEALTH OF MASSACHUSETTS Town ofSandwich Board of Health Permit Number: 16 Jan Sebastian Drive 19-114 ,�GQ" ArFo., Sandwich., IVtA 02563 Fee: 508-888.4200 $75.00 f This Residential Kitchen License for 2019 granted to: mo nOD at (Baked goods nut bars,peanut/almond/hazelnut butter) T Qajeens Way Sandwich, MA 02563 f Chapter 94 Section 305A and Chapter In accordance with Regulations promulgated under authority o p ter 111,Section 5 of the General laws P This license is granted in conformity with the statutes and ordinances relating thereto, and expires X December 31, 2019 unless suspended or revoked and is non-transferable: A 3/12/19 David B. Mason, R5, Cl-iO `#�,� Date Issued Director of Public Health This permit/license does not represent nor preclude approval of any other local or state permit granting authority,and does not represent nor preclude compliance with any other local or state.rules or regulations Thomas McKea.n,.D i rector r Town of Barnstable Regulatory Services BARNSTABLE BAMSTABIZ ' Richard V. Scali:.Director v 1659. � Public Health Division I 200 Main Street,.:Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 iYIAIL TO:TOWN OF BARNSTABLE PUBLIC HEALTH,DIVISION 200 1IAIN STREET HY:AN NIS,MA 02601 FAX 508 790-6304 PLEASE INCLUDE A CHECK FOR S40.00 ONE DAY;S50.00 (2+DAYS)ADD A COPY OF YOUR FOOD SANITATION TRAINING(E.G.ServSafe)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE April 8, 2019 NAME OF SPECIAL EVENT Farmers' Market at Cape Cod Beer WAS THIS EVENT.APPROVED BY THE BOARD AT A PUBLIC MEETING.? Y X N NAME OF PERSON(S):REQUESTINiG PERMIT Martina.Mehl, Events Coordinator_ Cape Cod Beer TELEPHONE#508/790-4200 x103 CELL# 508/451-5993 HOME ADDRESS 1336. Phinney's,Lane VILLAGE Hyannis NAME OF ORGAN'.17ATION Monopati CONTACT PERSON Maria Lemanis TELEPHONE 5088881045 ADDRESS 7 Queens Way, Sandwich, MA FOOD TO BE SERVED(LIST EXACT FOODS) olives, olive oil; honey, non-ph greek baked.goods. peanut butter, almond butter NAMES OF TRAINED FOOD HA-DLERS(TO BE ONSITE DURING EVENT).- Marla Lemanls (ATTACH COPIES OF SERVSAFE.&ALLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED 1336 Phinney's Lane, Hyannis, MA DATE TO BE SERVED Fridays 5/24-9/13 TIME 3pm-6pm RAIN DATE Nolte WHAT TIME WILL,ALL EQUIPN7:ENT BE SET-UP&READY FOR INSPECTION? 3 pm HOYV WILL FOOD BE KEPT BELOW 41 DEGREES F Coolers/Freezers/Ice Packs HOW WILL FOOD BE HELD AT 140 DEGREES F. n/a HOW IS FOOD COVERED Food will be covered orpre.packaged HOW IS FOOD.SERVED Gloves 'I YPE OF AN -WASHING FACILITY on Site (SIGNATURE OF APPLICANT) t 0 4 a ® CERTIFICATION ery a e © MARIA LEMANIS "'0 a ': ' _ F for successfully completing the standards set forfti for the ServSafe®Food Protedlon l+ a aJer Cerhficahon.Examination; w6ic6 is accredited 6y the American Notional Standards Institute(ANSQ!,C ferens,,for Food Protection(CFP). e� Y 773395 50705 � �t UMBER EXAMFORMNU$ 13 � 9/-1 4 9/14/2020' ' DATE OF E � DATE OF EXPIRA7ION �k� � Load laws apply.Ch ncy.For recerliFication requirements. \ k She #OGJJ f ;y i.acc.;onta wA Maritime In6ou 02015 Notioned RPIW.Cwo hodmnor6 4 the NRAEF. Contod us wA questions at 175 W kxk on 81vd:$te.1:500,C6iengo;,&..6060d or5enSofcereslaym}a:o'g.. CERTIFICATE CIF ALLERGEN AWARENEss T o � Name of Re'clplezit +R ?�Ennn�tIs l Certificate:Number: 3464567 tom' 3 Date of Completion 6r26r2016 Date of rxliratioi 8r26J2023 ', o �z ❑ / � Cl Issued By: ..........._.._.:.._ t5 The above-named person is bereby issued this certocate � for con-Weting an allergen awareness training program , r .. NATIONAL RESTAURANT Rn teurq¢I recognized by the Massachusetts Department of Public Health _ __ ^^'° "' _ ASSOCIATIONS in accordance with 10S CMR 590.009(G)(3)(a). Mussachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 www;restaurant:org This certcate will be valrlforfive(5)years fro»:date of completion. Southborough,MA 01.772508-303-9005 mvwmarestaurantassoc.org THIS SECTION CONTAINS APPLICATION AND PAPERWORK FOR NEOME'S PORT'UGUESE STUFFIES Plans to sell: Frozen,stuffed quahogs Certificates: Servsafe and.Allergen certificates included. Thomas McKean,Director �,,* Town of Barnstable Regulatory Services snlwsreau = Richard V. Scali�Director BE tense. . s639� `� , Public Health Division 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 MAIL TO:TOWN OF BARNSTABLE PUBLIC HEALTH DIVISION 200 MAIN STREET HYANNIS,MA 02601 FAX 508 790-6304 PLEASE INCLUDE A CHECK FOR$40.00 ONE DAY;$50.00 (2+DAYS)AND A COPY OF YOUR FOOD SANITATION TRAINING(E.G.ServSafe)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please see q�p V instructions on the next page) S Nil APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE 1 1�JQO NAME OF SPECIALEVENI��MM r n'Ylt S %rk�� 1���-�",S/-}4Q�T� �i WAS THIS EVENT APPROVED BY THE BOARD AT A PUBLIC MEETING? v Y N NAME OF PERSON(S)REQUESTING PERMIT TELEPHONE# � ' ,33-:-�JCp CELL# -��CP LO "1 3 HOME ADDRESS 12-Solomn-&a rd . VILLAGES+Sf)6WV— I`V1•A (a53-] NAME OF ORGANIZATION COLD rkX--'' �i� CONTACT PERSON N)CLr-+)f)a l Y IP.V\I TELEPHONE, -JqQ-�2-00 Id 3 ADDRESS I tYl�1P�' -s lane-- ,::H1 Aan n i 9 V`P� 0a LD d FOOD TO BE SERVED(LIST EXACT FOODS) -1 f 071 ►rl NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): N rne- 4-4 oe It cL-, (ATTACH COPIES OF SERVSAFE&ALLERGEN CERTIFICATES) ADDRESS WHERE TOTr SERVED JJI.D ne 'S 0X l M-k 03kuo I DATE TO BE SERVED rJ ZJ -� I TIME 3-Lo 7 n RAIN DATE NIA WHAT IBM WILL ALL EQUIPMENT BE SET-UP&READY FOR INSPECTION? HOW WILL FOOD BE KEPT BELOW 41 DEGREES F ! ak Ze n bf bw na on C ,J I C e, HOW WILL FOOD BE HELD AT 140 DEGREES F. _�A HOW IS FOOD COVERED n ntkaae�m CA $alcAs+kc has end-then lr�str�e �. �k , HOW IS FOOD SERVED NIA t6, leci TYPE OF HAND-WASHING FACILITY 00 S&M a o � V� (SIGNATURE OF APPLICANT) NUMBER FEE J -4 THE COMMONWEALTH OF MASSACHUSETTS- 19-19 $100.00 Town Kinqston ............................. of-------------- ......--------- ............................. This is to Certify that -------------N.eo-Te's P.9.r.tug.u.e-s-e-.St.uffies............................... ............................................ --------------------- --- -- - ------- ---- - -- ----- ------------ NAME 11 68 'Main Street Kingston, MA 02364 - -----ADDRESS IS HEREBY GRANTED A LICENSE For ...CATERING. ... ......... .. ...E.R-ING...F.A.C-I.LITY............. -----------------------------------------------I.............................................................. .................------ ... ...... ... . .. ....... ..... ............................................. .................................................................... --------- ------- ............................................................................. ------------------------------------ ............................................... ........................................ ------------ .......................................................................... ...............................................------------------------ ........ ........-------------------------- .................................................------- -------------------------- This license is granted in conformity with the Statute I s and ordinances relating thereto, and December 31 , 2019 expires----- ................................... ................................................... ... unless sooner suspended or revoked. .............. ............ ------ ------------------------------------......................... ------------------------------ -- -------- December 31 201-9-. ........................... -------- ............................... ---- --------------------- .......... ..../....................................................... --------------Afth'Qr--Boyj1p'-'H0A1th'A----------t------------------------------- ......................... --------------------------gl;m............................ FORM 433 A.M.SULKIN CO.-CHARLESTOWN,MA �� r. r 9 y � s v [S^' ,Yvj�,�'�.�,�� m,^�rr'�' ..�,f„��`�•�,:,—�.�, ,.`.. '� �`}�.?,_ ._ .'a4,.. +t�.N;' `j c..�{ .s ..A `�. -f '*3`"`y s-aie� -� ; NEOMES4HOLyLI$S . . yp n Wtlo'has met all the . - • s= yr P R O 1VI E T R I C •` s professional requirements for certlficatlon In zl' _ . food servlce,safety;�and sanitation.. _ � ® 4V1 0k IV- ti t #0659 VQ 11 ' Exam 3421 Recognized By Conference For Food-Protection vu i � __ Certificate No2026827 ' Exam Date 11/07/1.8 a s a� Ryan McMillion:Client Services Maria er = Test Code . '620304`3421 F t = xQ. s. Expires-...on 11/07/23 - Prometnc 17941 Coryorate Dnve Nottingham MD 21236 I 600824 2736€ _ }. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) A- /- DATA W oO5 under -( �n d C�re (►� �c� i j�� r o 1 v. f. 1 s Muc FALCP A Yn o,[ (s G Intgkl� re_ Consic4e �� �_ � P ZIP K "keld i Fe eTaf RMIX gyp,, .�/..�1 ►'[� � 01 ou ' ISfi - aloe e0 s lA rf f{1ERay,t�§L F ���� L � � .�1 rflo� �, I p I S vl�� gu�c��li► (I s cd sceociItj �rc1 e�- �'.. ..r,�.,-�.:�,'.�"r r''ry�s-<.,,:.'.,a?.7a±",E.s�,�a..-:.,,1it.\4�...F/{l..,_^tw.a,�r.',-.t,.-S.:j.q.+'�...>`r.a:,=+.�`+�v4,.;..t:.:�k��>.,'.,�#".,��sf-"�-..a.,i,.,,.,.,yJ�<-:- +'::.•:.:_�.�,..:f.,c:.e:.L`.",t :.1...,'.,..:.r.5.^,�,,.;.a,,»y-x,,-�-,,s.e..F. �..:eaS..�,..¢:1()/::'ts� j�`�tN�.` '4r".r �7.✓� .F,{--:.i.s - �s 'd7x�. '" oma}: r- - - : x!W M . ` .J' ..r,-.7'.. :::� `' �•.... �S.�*'�.. - .. .. l �i� a.»v- `su�i.,`.a v r �.., '£ ,.i: Xs'" P'{'�aT,���.. ... e:.:} "";4 Y {. ti:'. � „�: , -:,�, �...�. .�.:nr h �,._a3 {` r...u,'';-.u,.da§ .a'.r ,., vs'i"i;..Ra.�'� : .,.�.....�i....'a..s `.�..l.GA:'.d.-,�'..A.:as..,L_.5�.::..�^.> b ..-:�7.:.s'k-�'�-.:ei...�.r.�.rrrk s�-kt.,; ::,.'i:..:�}:s�.�+,..�.:.vw-.,elm. x ' ; � - €'�'iL..`wit t - (CID . ;nP .,a W: r, fir, tY i• pZ., v This is to certify that '> t Neome Hollist ` �M2r��IKi� 1, N has completed ;; '" Learn2Serve Seafood HACCP g bm+Fi�f+y'S>t;b Oti P- / y` Completion Date 10/13/2018 I Course Duration 1.0 4 + ref , 360training � � ' M R, . r`" m� < £°�R, Certificate# 000014656190 360training.com ♦ 6801 N Capital of Texas Hwy Suite 150 ♦Austin,TX 78731 ♦ 877.881.2235 ♦www.360training.com i . p n ;$;!x -_.`rr., }4. � a:. :7 �.-+. ,�. �.. .t � � .i $!:.r .�:. a+ _:..^u+,a. Pr:..m'< s � ��.: i+>• .�Ae'?�,:�}.a. g,�� ...:i s���t�...�`:-,'':ys t..K.f.�y�',w rN: y�f,��. � ra�'y�y.._,,:<,,-t�-0 $�`, m'i".�.>�r a '{ �'*�,y F. °:� t �'vi. c ,ye:.,ox r. j a�u 't t^�- '�.. .!`,+�J_.Ae-i{�..;.�:'• t,rk', i. dlr•-2 "x1 u0 i �t'+r y,h+r,.a✓x! t t� h:y6''4t,S.eat I_�,•� •� _ i<*n�r�,y, !' j3� •1' �.,s � k .,„o, xw- _ 1.7 .. i 't f .r..x Pp Y `:� ;Wy`,�L``- {. (( fi 8 t =F .: x t�fa4 i t f i h. ✓"'; i ''�Y �, , rrt..�,. :r', ��n.4, 1n! .(�Aw. .9 � .fT u .(.k� 7� u i'.n 1 v` is�1"w � ,e•�l F',a d�. '& j' S J✓�•.53` 1 l ,l A� �'#y .k; I i L_ I 1 ..' ,F.-. .. -. m ..r.. .,i .. .,,„ - �y#• � ,Lt... .""' Xn"� ,n'ka:.u. ty;, k'Y w �(yj { .It z !i 'L .., �" 3 "-+�3 Hsr. 1: i ✓ ,.� '+. _ ,�:. � h [tt .'r ,� ,r€ '.•- _ ( :..�,. - l4:, r .,.«-. ,-.:a,\4 a ,: •<.. : ,�_ .. '.:n? •s.'�:> ,v . t/ :. ; ,rF. '.t ¢' e Y x. s�..Fs+. .y�.�. :.r""-c.. -, .r s�..''� -y, .m .,3, .•. .^s .x.. .1�. ... e..r ,>r kt;'A..,.. ��,.. a.� t.x•rm+' „r-.., .# '.:;A .� +�' ':".� ,.ht-- `� {� y� r, .�, v:��,� b°`.'�: � ��..�,•fbt n.& ,'r. t,9'...u4.,. • Z ...—. e .t\.. ..... w,.. ,., l.. ••� .,. `Si, a;u'�,.�:::.� 4 ,�,• �,,....•#r ,,:::�..,. ..L;►'4 < r •: �-� - .� a ♦ rJlaY.--, h. E, �.:�'(��.. -r-.. �`+C•"b.• �?:, � �'`".:- ,+..�. 9(�rA. '.e':., (,��. �, s `..s'W '.kt<.i"'1^--...v. i ([ .s �. i� � ,,;� j x�iqq¢¢t +� � 8 �`cF,�.. _ �3. Y•�., �'� �'{''c, ,ra' °k }}1 � tif� - `�' �d"r� *�,,.•. ,/; ��`I�,n.�TF?,?�`pf . �. ,ems.: \j .:1 -•,of $ .,.., .� .,- 3 p .. b,.5.4�te-""4 r •'� G ='Q' �. .e7 '?S ,-. ..�:, 5.. "�:..4 .� `�''.''"6t :i:. � is ,.<-� M-��a w Y _ � .�..�" 'N�a�a � '{�: � ..p ', �� mi ...n„..a' .,; .: sa9,.•d�.-•h,.:,.f�,•wsa.... ..�'k.r,Gs...ss..-:�..L...a...s... .._ ...4,...k`.,.+m..,a:,.l:,..m..,.,�.�:.:..3._...sm...i...-.3:....a...�':.-„ ..G."e..:,....:...ra.•:.n.,.,. o-... .a ;.s�a.,.€ •aA- +-us,.raa..,4�.-..,efi.......,.e3,.Gr..•m..: .r, -,,a�w.,§. F,r^�i c V" , tatC x6: 4 LRi0-' This is to certify that ;i Neome Hollis 4 ` ,�¢ has completed M `• .� t } $ rfrs t Food Allergy Training ; 3' �y4, 4�,,r, $ti5f> Completion Date 10/31/2018 Course Duration 1.0 VM 360tra r3 � '"lS�r 'M� �`�u{ "' .,Fr• ® ■ ining.cogll. Certificate# 000014828918 �Y � t • 360training.com ♦ 6801 N Capital of Texas Hwy Suite 150 Austin,TX 78731 • 877.881.2235 ♦www.360training mm f W' YF VIIt .,;;i+.. .y,....x..qq r .:�,,...�, �,,.. :.w. :""..K r .. • Y , r k.Ji,.'atz t c� �� .c ,•,� /' -, ..s:,,, lkw.'fit if 5-`•,.��t' o-. ' ..qr. "y''� t.".,!t�,n tea': yi rah{" : q. _ e �� A _ _ 1 � ..r✓., t 1 -�1. $ ,,�' -y k 'v 4 -Z - '�,..:. .. 1is } rF II r ` t imp i FLt w "><•.:�::�! ).. t;, a`,1,,!, '.v :«+;7a 1 • td:+y t n�f;.r t t ,°^'qe = w ,. �. ;';,c, ! '# f '�, V"\;M }�, �.:�� :D � .rt���f+„ .�' s�t'y�J`�lt k, a�y�.. ��F'.!A L -zb t ayi •1 f.�;s. _, -.��'+,�`� � r •i;.�R y p•�s '4,4`y.�{ �- ��.s. _ � s armer_ ,'ar et_gut„, � � • , _— ,..... kitchen per'll ts, retail food t e wits o fo a ufaetur ng licenses'at wh1 tch, the food ix as prepared should be in to`the local eal e, Ument along w "th the vendotr's application. The defnnition or identification of aa"a " ®r f�°esh fruits'and vegetables is not addressed in federal or state retail regulations. The Food Protection Progrann is currently working with the Division of MariAe.,Fisheries (D)MV'F) and thb Department of Agriculture to pilot the retail sale of shellfish at & 6r's iliarkets it collab®ration with local boards of health. Shellfish harvesters, including aqua;'M uri9ts.,,. im�ust ,. obtain]approval from DMF and FFp in accordance with state statute and r6gulaa ons' Bo,.aird;s,6f health1who have received applications for shellfish vendors should contactTFF_phor to 'any lYoc`al1 approval under 105 CMR 590.000. Finish and crustaceans may be sold at a farmer's market provided they are soldr'only froth a, vendor that holds a Massachusetts Division of Marine Fisheries retail seafood-d '6ter permit ' 'adrdit oh to.the local board of health food permit. If the finfish and crustaceans at the farmer's market are-sold from a retail truck, the permit required from the MassachuSetts,.DlVlsiton of` a MMarine, Fisheries.is a retail seafood truck permit. A retail seafood tick permit aall`ov�s>>tl permit hoilder to .use the permitted truck at various,locations within Massacl useitt}s zetall truck'permit.with the,approval,of the, local 1� ,.Eo�vever When, rmh5slii:anci •e n first eean .. - .-.) _�.-. .°.... . ., � .. .. _'..-„ ,!. - . _.r� `..�..'' 1�.�_.�.,: i 5'�.i t ,' ;.S.111 )aj_ ,..:= � ''. ...,- Lf-Y.:. -L. acre t l.rspQTtled,irn private vehicles and soldi ai,4'booth,at?a� firmer s�nnarket l( ��e ,: mo. �re.Gt�ir, from �� a,p�e_ . xted seafood txack),, a separat•.�&91,, s,.;_ ;dealer permiit.,vss rreque%r a t fob Gh� en or cl t -, :each_ i7a '_`�et ltocatfon 0 4 , . q i ;V-27 r, fust,:be " i as h a�;feIM � ' ��J .. ..� ��,,.... ,/ tx...:. -y,�,+� ;,.,,dLa 1, „Y .s, •ao , I i'(. a Y1 Qolo a S� 11t�1s'� lU� `M. a, ar z Qf 7 S` tea 'i0 (eclilC'G� a1P, P"a v6 ; LIABL ITY INSURANCE PROGRAM GIi TAURMCFc� UISURANCE GROUP httr)://www.fliprogram.com 844-520-6992 Great American Alliance Insurance Company 301 Powered by Veracity Insurance Cincinnati,E.Fourth Sheet,25 S cinnati,OH 45202�201 Solutions,LLC -- -- COMMERCIAL GENERAL LIABILITY COVERAGE PART— OCCURRENCE FORM---__.__.. -- -- -- CERTIFICATE PAGE IT IS AGREED THAT THIS CERTIFICATE IS ISSUED TO THE CERTIFICATE HOLDER LISTED BELOW TO CERTIFY COVERAGE UNDER THE COMMERCIAL GENERAL LIABILITY INSURANCE MASTER POLICY LISTED BELOW.' INSURANCE COMPANY:GREAT AMERICAN ALLIANCE INSURANCE COMPANY POLICY NUMBER: NAMED INSURED:BEAUTY HEALTH 1£TRADE ALLIANCE PL2260060 CERTIFICATE HOLDER: Neome Hollis ADDRESS: 12 Solomon Pond rd,East Sandwich,Massachusetts 02537 CERTIFICATE NUMBER: POLICY PERIOD:01/0212019 to 01/0212020 12AIA.M.Stand ardMmeat the Addressof The Certificate F059207X Holder LIMITS OF INSURANCE General Aggregate Limit(Other than Products-Completed Operations) $ 2,000,000 Products-Completed Operations Aggregate Limit $ 2,000,000 -- —Personal and Advertising Injury Limit--`- $ 1,000,000 General Each Occurrence Limit $ 1,000,000 Damage to Premises Rented to You Limit $ 300,000 Any One Premises Medical Expense Limit $ 5,000 Any One Person Professional Coverage Extension $ Not Purchased Each Claim $ Not Purchased Aggregate Professional Coverage Deductible $ Not Purchased Each Claim Liability Deductible None FORM OF BUSINESS:Sole Proprietor/Individual PREMIUM: $ 171 BHTA Fee: $ 74 TOTAL ANNUAL COST: $ 245 (The cost is 100% earned/non refundable) CODE NUMBER: 11168 PREMIUM BASIS:Gross Sales EXPOSURE: Up to$50,000 BUSINESS DESCRIPTION:Farmers Market Vendor THIS INSURANCE IS SUBJECT TO ALL THE TERMS AND CONDITIONS,INCLUDING APPLICABLE ENDORSEMENTS,OF THE COMMERCIAL GENERAL LIABILITY INSURANCE MASTER POLICY.A COPY OF THE COMMERCIAL GENERAL LIABILITY INSURANCE MASTER POLICY ACCOMPANIES THIS CERTIFICATE.ADDITIONAL COPIES WILL BE PROVIDED TO THE CERTIFICATE HOLDER.PLEASE READ THE POLICY AND ALL ENDORSEMENTS. NO ADMISSION OF LIABILITY MAY BE MADE EITHER VERBALLY OR IN WRITING FULL DETAIL OF ANY INCIDENT SHOULD BE SENT IMMEDIATELY BY EMAIL TO CLAIMS(a)VERACITYINS.COM OR BY LETTER TO VERACITY INSURANCE SOLUTIONS,LLC 260 SOUTH 2500 WEST SUITE 303,PLEASANT GROVE,UT 84062. FORMS AND ENDORSEMENTS applicable to all Coverage Parts and made part of this Policy at time of issue are listed on the attached Forms and Endorsements Schedule IL 88 01 (11/85). ADMINISTRATED BY Veracity Insurance Solutions,LLC 260 South 2500 West Suite 303 Pleasant Grove Utah 84062 888-568-0548 info aa fliorooram.com ADMINISTRATOR'S SIGNATURE: � w.x• �.a-12 .,. .. i.,.,,`� r..$ ..r. •t.s .\, s.Y,-�.,.-a 'xr.<.tr,. �t•`>'1 .s-.,:� v. '*s .:- ._� .,•� .�.s°1 . -a:...: r � , ✓.fi,:- 3 .w .. :..,,: j. , t a. ! ` } <, i.> > i,. 4 r j .< ..., (( 'v,yE,. - (...<� I {�k ,.. ,r .+'.°a 'it .L _ .•,',y ,'' f �c,s � {.a` .f £4x:f{ {i ':M. "s ,e. , .,'„<..>.x. e, - ;- , �r<< rx....:= a!•s' Fi u .i_, ti .?: t .,� �r�5 r�;5;, 3`. ✓ �-� a Y... fP I` k d .?� w AIL A t a `aif ��z '. This is to certify that a ' a Fit Ne m' e. Hollis ! � 1 ` « has completed � I -N g 1 n I a Fo'6d Allergy Training #, XPW 1,4 d l ..y.. 3 La. yg3� q* Completion Date 10/31/2018 r4 � �x Course Duration 1.0 s. ' `91 €fir 360training Certificate# 0.00014828918 � ,,€ { -^e <„� - - e 360t�ainin com • 6801 N Capital of Texas H Suite 150 Austin,TX 78731 • 877:881.2235 • www.360training.com 9 P �"JY g � a<, ,, .' sxe}'. ..,g, :..�r. ae^F ..:z�xr �,. "s` _a> 3 `f ,.e u'i 4'i: \. ;,` :; -.•.x mT i ,t < a f .:.. 'E,R...A.+ir.!f � ... .,- ...s�..>S ..., s,,:. .,➢ 1P Z,�•°� $ . ...,.. ». ,, .a,•.<.«. .� aE �a .:. .- -: ., r< �, vr..,. .®a ,....,. ,.. vu'r< - .�. . r � ... :.,....E:: m.. <_..� .. ,..�: ...,.. .,.<. ,s,a at .:•s,. .< -..� _a..3'a 3g i..v..:..Y`' # �r,t i ,� `& . ..... .,. .xa. ......,_y3 v.. ...:-, `��. .,Ei {E ,>.«., „\ :.: v:hY' <. ... t t `.;E e•, ? Via. i .y'wf _ #'t F 'a § x'>v.. p ...a.-:., .... ..��. °.:� 1�.R,,.,)a ✓'/,... I �+: x..S �.-,8 � '.xf.. 43;'.;,b y`�"''�c� 3 ,,� k N, A "A V .1. zl� A'z v, V N 4W' 171 :w' 4 n-J1'i�'--'vw" V V J,IE"� 3 FW _3 . ........ N, 4. kP % This is to certify that, Noome, Hollis J Learn28erve Seafood.HACCP " -M NSK A vW"�X 2A Completion Date 10/1 3/2GI 8 =52 N' Course.Duration 1.0 N .360training coryl. , Certificate 000014656190 360training.coin 4 6801 N Capital of Texas Hwy Suite 150 Austin,TX 78731 ♦ 871.881,2235 4.WWW.360training.cot-n q 6, 4 2-U�' s . "M I N� R, A' pg"�y -K — , �jq�W'—g 3 0."A� IV at P' V- 'A i�'I 'w-- U a �:' `�„' ,�¢6 � ��� _� 4t$S,�g .G��� •..mot ''., 'a} " k,3a� y .uA �; "'' g+', ,." L,, o�R,s s,`t`�•x ` .�iXn@� �,;,tea a�y�s«� �. � a .;,Y s �-fin z'V'£�s�Pr ��� �sre � �v�r � yak �'g� ma's-t ��Er��r r� �, "� "':�� .,�.r��^.� r `�.�f'' +✓,� „�„�`' a -•a� x � rrf% f�," ,'v«` z��„��,�-�s��„ �,.z�*,",,_d �� � �.y�v ��+Bw� f.� � �,. :�? ��`ir,�,'�g�a�``� ��� t s,_. � .✓ �.•a� t>4, „?P- � "�r �s r> �a�a^d.ga.�a` a. 'r`�. ,stye11wd"�' z •°"wya� `r, '„rs r �c•Xf .r ,s '�'_.xz su EP". ��. s "` �zr^'�S+N a `� a •d4r `>a go ��. r IN m %J,�ul L2 Fscrk?, F.�,Gau � 3 ':'. ...y�,� 9p"✓1£r � r�:�� .;::�'a�F't� �.;�ra �' 4� ,�,�.,. fit . R f F• ry d k- R RS t -b 3 w�''j ION -�s 7 ' 4r r sr .may , s r� � - � e�5.����«RF�..✓;.,ra^ PY ,z• 2 k n syaia-'a4^.a^ v fa. r '�, „z 3 ,..z,•,- ,ptaoe'pL ,&°, � 1. rx �,f� '9 ,� " r BE 6, £.` A 5,x+, v IN i NE l!RL ,4 IR, tr am ,� �� :x���"'• ,� .e S XZY�rr .G 3htx-��F � "�t� �"�r' .,1✓ �v�� ;� i$ x ..;AS,fia R �•�w,'".',-�"S'r� y �:r :''#� F k' 'F A , pq a xa � k� �� s �r., aa�� �r�.` � ya r' H t x J � 5y�d .:xiu fie.:as e0 t�•= .Y�s - y a 't a. k y r a z VA •m;y.cr� i +�'�� Y a 3 i.�+€ ,a •t c a ` c�,, � EXa = 4 .-,a v, a �J S Qrn gp nnJF2't eco riz Cofererceor �,\\oodProect�or� M � ar, � a "�,''^ �•`,f �a W•r,.. N z� 3 S«er' a a�Z�°Yx�` r«:.H' g ,.,,.#^,.'3�k�•y �'S' s u3. s'z wl kx "RO °"rat, "h .7 �• .s�v, �y ':.y -�c s� �5 .,,s..:�-;� :�t�c ilfdaf �No<� 2026827 E •r",'''' Q ,� M,a 5� �� �,��sr t� ,rs r � ;.,��. ,;tny'�3• � ;.-�z�r?,.�. r, M � u�,s r `�r�z' �� ��� � a• �ai`�&tr x s tc �x. a�f r r.�fi k 4't� sn �s" � ,a_�§`��s ss t.;a� .m�R 4�. �- }z. � v,b. a,k� r%"a s,:.. Fy r �' eSt Mode 62 3043421 Ryas Mc �Ili�r �Gliet�t S�ent�cesiVlaager. _ � � e � F x �� w�.. `'--,,._ ,-�.,.f=��.a�.a?.. -ss.�r,_ i :.�. = =—•s:-.-.�....c.w.:�;.« _.m,.z „a, r.-,�.5,,.....,..._ ,:::x �"- � d �. � r � �.sF# : x •� '� .nit it a, }r xa a_. ' ��Fxa�r3 2� F�ec�gn¢ecd8,y��n�fer ce Fvr oad��YateG�an gmq�, 8�"�"": 8 Bellaire, Dianna From: Neome Hollis <neomehollis@gmail.com> Sent: Friday, February 22, 2019 4:58 PM To: Bellaire, Dianna Subject: RE: Contracts for Quahogs Hi Diana, I have attached 2 credit applications from reputable, DMF licensed seafood markets. 1 is Chatham fish & Lobster,the other is Wellfleet Shellfish Co. I will mostly be purchasing my quahogs from either one of them. I do have 3 others as back up in case quahogs become scarce. I haven't purchased specifically for selling yet(only for my own personal use) or I would have included a receipt. You can see the other markets listed below under trade references. To reiterate, under Barnstable's Farmers Markets rules and regulations, I am not a shellfish harvester or aquaculterist who are required to obtain a DMF license. I also will not be selling live or raw shellfish or finfish. My product is a fully cooked prepared food, to be sold frozen. 1 also attached a tidbit at the bottom of this email from fda.gov explaining the labeling and how mollusks(quahog) are not one of the top 8 food allergens and need not be under an allergy disclaimer on a label. Any questions at all don't hesitate! Best, Neome 1 r �aT CUSTOMER ACCOUNT APPLICATION Neome Hollis Appllranr regal Name Neome's Portuguese Salinas Trade Name/Dams;Business As . 12 Solomon Pond rd Easl sandwich MA 02537 oelNery Add— city Slate Zip 608-566-9399 neomesportugueae^<Nffiae.cortl only facebook&instagram Telephone Number -Email Add— Susin—absile 12 Solomon Pond rd East Sandwich MA 02537 Billing Address City state Zlp etrityNlcia I'1'C}ti.r'1 Neomel Hollis Proprietor 5013,666.e398 rlC'1CI yF.�SS Aaountt Payable Contact Tide Telephone Number A fr4"1��.neomebeliarose@aol.com none i}rl ri q E-mail Address Fax Number kit jsf>m, C{orp ❑5-Corp Limited Liability CamPan E.LC) ❑IJmf[ed Partnership(LP) Proprietorship: tJ Non-Profit �LJ Government ❑Other sole Proprietorship a3.2221086 State of Formation Federal Employer to(FEIN) 1 nwnih 0 Years in Busimrs.?. Years Under Present Ovmenhip; Owner/Officer/Authorized Corporate Agent Information Owner M3 �:L'im� i�i1lIS t'�nYt.6'•ram" Full Name '-- Title G_S 1-..c_'?(7 " Ho �t�YYIcA'1-Yn'n�-� fry . t—f)'X ome Address dome Prone `1Pin1�e'!47CGiGi"dst(��Co�,CvTv) �7)a Owner#2 none Full Name Title Nome Addrers Home Phone Email Address Cell Phom Chatham Fish&Lobster Co Phone(508)432-7180 PO Box 176 orders@chathamfishandiobsreccom Fax(508)432-2663 South Chatham MA 02659 2 i Owner#3 none Full Namt Title Home Address Home Phone Email Address - Cell Phone Has the business or any of Its owners declared bankruptcy within the last 3 years? y16. Yes/No If Yes,Please explain nia Trade References �Ir��latitil fi�>tt it"icfrKe-� �frxiv,��.:; Vendor Name Account City/State Telephone Email �� DArJ Vendor Name Account City/State Telephone Email C-fec�t�lrxua �61ti altt�cS�chk CuS96-7-57"2, ��Vendor Name Account City/State Telephone Email r__jj 1 S!GLS"Ci.S �..�al -�i,.� 'Z74Htc3-2_lAe1 vendor ame Account# City/state Telephone. Email Bank Reference oC1{la nd. i f�si. 'nr�tLict, 1Y1� C in cros=r Bank City/State Contact Name Telephone Email Checking Account Is Loan Account Number Payment of the purchase price for goods and/or.services acquired shall be made pursuant to the terms set forth on each Invoice,and Applicant agrees to pay all charges according to the payment terms established In said Invoice,The entire outstanding:balance due on all invoices shall become due in full immediately Upon any of the following:(i)a default in the payment of any invoice,or(ii),a default by Applicant.under any related subsequent agreement;Including,without limitation,any guaranty provided at any time in support of this Application.Unless otherwise agreed'in writing,Applicant agrees to pay interest In the amount of 1.5%per month,or the maximum rate that Applicant may lawfully contract to pay,whichever is less,and in all events calculated in accordance with applicable law,on any payment considered past due until collected.Applicant agrees to pay all costs of collection incurred by Seller,Including reasonable attorneys'fees and expenses. XLr +' L� '` w.)LC4c g )t�:E)VYIc....t 01, (Signature) Print Name Title - Date Chatham Fish&Lobster Co Phone(508)432-7180 PO Box 176 orders6Dchathamfishandlobsteccom Fax(508)432.2063 South Chatham MA 02659 3 Wellfleet Harbor Seafood Company,Inc Mac's Seafood/Wellfleet shellfish Co. PO Box 1768 Wellfleet Ma 02667 Tel:508-255-5300 Fax:508-255-5303 w ! CREDIT APPLICATION AND GUARANTEE Date:' W.2j) 2,01� 6 /�7� Company Name rt�lYr�tlt�t„d.>c71Itt 1r Shipping Address Billing Address: :` k.ry)�_ Business Phone 522 _' tcfc-C4 f tC Fax: 4IA Accounts Payable Manager i '. L7Elt � Ext i 1 A Can you process emailed invoices?I,ES Email:fl(-gv,r,iYX lu tc:k.r i; ;e+ ;Co., FEIN or Taxpayer ID: c� Form of Business: Proprietorship Parnership( ) Corporation( ) Lim led Liability Corporation( ) Other(please specify) Date Business Started I Type of Business,15�,C,� Business Prpparty is:leased( ) owned ) 11 ( by whom ()Wlm r l 1"tt' k �S)Py n �vll� 'il3't m v w rt OWNER AND/OR OFFICERS c Y .4i .' Name: � f 1i1�k'1' )�1� Title: f�L ne,r Phone- Home Address: I I C'=,�t�rY�_> q���rr�t�l Ct{- /� n1t!�.� t L \. Name: Title: ; Phone, Home Address: Name: Title; : Phone: Home Address: If more than three Owners/Officers,please attach of the endof this document. 4 Credit Application and Guarantee Page 3 Buyer has read the foregoing Credit Application for Account and Agreement for Account with WHSC Inc.Buyer further warrants and affirms under the penalties of perjury,that all of the preceding information Is true and correct,and knowingly been given In order induce WHSC Inc to expend Trade Credit based upon the statements and representations contained herein.This agreement application and guarantee is governed by and construed under Massachusetts law. Buyer further agrees that any action hereunder is sub,ect to the jurisdiction of the Massachusetts courts,and consents to service of process by the proper autrorities. tt j AuthoHZed Name(Phntt) Signature Date CONTINUING PERSONAL GUARANTEE It is understood and agreed that the guarantor(s),liabil ty under the Guarantee shalrbe UNLIMITED. The undersigned hereby personally guarantee to WHSC Inc payment of any obligation of the Company,both past,present and future,and l hereby agree to bind myself to:pay on demand any sum which is due to WHSC Inc by the Company whenevecthe Company shall fall,to pay the same.It is understood that this guarantee shall be a continuing and irrevocable indemnity for such indebtedness of the Company:LAD hereby waive'notice of default,non-payment and notice thereof and consent to any modification or renewal of the credit agreement hereby guaranteed, and to all renewals of extension of credit.The undersigned guarantor agrees to pay,in the event. the amount becomes delinquent and is turned over to any attorney for collection,all attorney's fees plus attendant collection costs. Signature Name(please print) -�-A,,"L,7.1.21 Date Signature Name(please print) Date Signature Name(please print) Date Please return completed forma via postal mail or fax address listed on page one.. 5 Credit Application and Guarantee Page 2 TRADE REFERENCES List four suppliers where you have an active account. Name Address Phone# 2 fit,h)0411 fj4'1V1b(k( I`,l 1"e,,ad itki Lj ye—CTfii- 1)' 1.1 - PCA" ")) 31 -,(, �_') (Y&Wlk 1".)r X., wW )ijA.Cj 41 ry)6 le'e r; 12.1 ii. I te, L D j o ­ ;�'*)V",31e�'a,IC_ BANK REFERENCES Name Address Phone# Account# N�A CREDIT TERMS 1. If the account is not paid In full as agreed and legal recourse is required,applicant agrees to pay all costs and expenses of collection,Including attomeys fees,and shall also pay costs,expenses and attorney's fees Incurred on appeal. Z Applicant agrees to send WHSC Inc written notice of any changes In the form of ownership of applicant's business within five days of such changes. 3. The undersigned certifies the above Information to be true and correct,that Is submitted for the purpose.of obtaining credit,and agrees to the Terms and Conditions of WHSC Inc. 4. The undersigned consents to an investigation into the creditworthiness of the applicant, and furl ier agrees to dissemination of credit information about the applicant,to inquiring sources. 5. All invoices are due net_days following the date of the invoice.A service charge of one and one-half(11 1/2)percent per month maybe assessed on delinquent invoices. This is an annual rate of 18%.An invoice will be issued for each service charge and added to the monthly statement, 6. Claims:Buyer will promptly inspect delivered product upon delivery at Buyers receiving point,and shall notify seller by some written means within 24 hours of delivery,of any short-weight,spoilage,damage,complaint,or other unsatisfactory condition of product and shall retain and preserve such product for inspection by Seller or Seller's representative for Verification.Buyer further agrees to first pursue all rights and remedies against any Insurer,Carrier or other Bailee involved where Inspection reveals the short weight,spoilage,damages or other unsatisfactory condition which may be due to faulty handling,shipping and/or storage for which the Insurer,Carrier of other Sallee may be liable.Failure to comply with the foregoing terms shall invalidate any claim by Buyer against Seller with respect to any such matters. rood.ar..«�g 0e,* x + " '. .^>-:.,"X?: <— -3 psl. govn o,.ns.f;..,d g. ,n.rx,7w,s C-iai.;••<n4.,t ;:a,+or PY,«,uiiin:�co nK�„f nld.tt ,1,..,:tr...J xl!„,xd�.�y,_de,'a n.a�•-fi.l*uf :Pi� � , "'S,Not SuEJec t To FALCPA Ii Are there arty foods exempt from FALCPA labeling requirements? A- - Y, U,,di,,f4ikT.A g I res v,.� (r;n an.l v ge ?wal a2 an; R lal Idt n ,I.nl,cc..:t Invi.. at ,hc o,LLc'n i x-L a i h ! I rd t-,nix 1,highly rxv r,il nnldn.,r,iLL I\,rv:s,;iracha aa,O i, R` , .... t Ir x I m-li y 1..6,„t,t AL. k x,:f.Iur, 'b a:a Tara 2� it - i is C,ny,anncR,n,t. ;.n(.m•,rarJ.vn,iantnr m, .,; 1`7,Are molluscan shellfish considered a major food allergen under FALCPA? d a, -': Aruu,r:IN-tnd,t hAIXTA. ,h,of h(.x, € &A—;ha., ( —re.xlelf 1,n i ' 'p"` � * �" .:, nr,air i..., �.uacnw'•.. 21 z Y Mayor Food Atla ens(food source name s and exaexmpiesl F` #i°;: >� �.:. _ gym,. _•r �. Fe.Does FALCPAprondeanyspecificdimctiwfordectaring the presence of Ingredients Irom tho Three food groups that aro doslgnatod as"major �.� food aLterge sh tee nuts fsh and Crustacean shellfish).? 1.:I41(TA a'. I. d, pMfi,rNni W M.la�L,nit c,l-,4,1. :.w.luua ihc,pru mu=ct. :. dxt•L,:rdf ds4 ic„ 1 IToun„.a. 0a.,rla laA .h crop) S G F9.Under socban403(wl(t)otthe MCAO,a majorfood allergen mustbe declared using the name of the food source from which themajorfood allergen is derived.Section 403(w)(21 of the FDBC Act proddes that:in the use of fish or Crustadean shoUtlsh,the farm•homo of the food 'source from which hi major food allergen is derived'means the : "special'al fish or crustacean shellfish.What is the"speriei'of fish or Crustacean sha0fish for purposes of section 403I42)? Ai—,A4,1 m m.r.hr"apccics of fah,n c.a. mAdifiiiif: )w;..MK<x<a�spf}inq d 5,:,.rn rrti,..V)shr,ut.t h-uc,.g dx. m M E l tk p I:1 tLA i s a-xi L tt ae f x1 Luc t t i of cn btr rzct mat Viz. •h, w ti... .....,x a mew,, ' t Q'T"pehere cGsear6t _.;g - t+. e, x•, :::. Sent from Mail for Windows 10 From: Bellaire, Dianna Sent: Friday, February 22, 2019 3:42 PM To: neomehollis@gmail.com Cc: Bellaire, Dianna Subject: Contracts for Quahogs 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 CAUTIONThis email Iriginated 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! 7 THIS SECTION INCLUDES APPLICATION AND PAPERWORK FOR NOBSK A, FARMS Planning to Sell: Hot Sauce,Jelly,Chocolate,.Honey,Coffee,Chili ng Mix Certificates:Servsafe.and Allergen Certificates included. S � `� �tJ Mg '2 je Cr�tr >>�tea �j Hof c � jtet5 y DEPARTMENT OF PP!E iC H=_aL3rt, BUREAU OF EV✓RCN.`,E Tsd HEALTH FOOD PROTECT16N PROGRAt4i 305 S OUTH 5-=.EET.JAMAICA PIAIN,MA 02130 L10EN$E In Accordance with Massachusetts General Laws ChapW,94 Section 365C C f .' NUMBER ISSUED EXPIRES TYPE MA-9028 09/09/2018 09/09/2019 Process or Distribute.F.00d for Sale at Wholesale v ISSUED TO NOBSKA FARMS,1NC. ELKS LODGE 44.PALMER AVENUE FALMOUTH,MA 02540 COMMISSIONER OF PU5UC.H€ALTH' ATTiv':JOHN ROBERT FRICKE RECIPIENT'S COPY POST IN A`CONSPICUOUS PLACE 6.3 f 71 Thomas.McKean,Director Town of Barnstable y� Regulatory-Services saatas ASS Richard'V..Scali,Director BA UNSTABI,E Mass 39. Public Health Division b . J 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 NI.AI:L TO:TOWN OF.BARNSTABLE PUBLIC HEALTH DIVISION 20.0 PLAIN STREET H'YANNIS,NtA 02601 FAX 508 790-6304 PLEASE INCLUDE A CHECK FOR S40.00 ONE D.AY;S50.00 (2+DAYS)AND A COPY OF YOUR FOOD SANITATION TRAINING(E.G.ServSafe)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE April8, 2019 NAME OF SPECIAL EVENT Farmer's Market at Cape Cod Beer WAS TI3IS EVENT APPROVED BY THE BOARD AT A.PUBLIC MEETING? Y X N NAME OF PERSON(S)REQUESTING PERMIT Beth Marcus,/Cape Cod Beer TELEPHONE# 508-790-4200.x 102 CELL# 774-836-5206 HOMEADDRESS 1336 Phinney's Lane VILLAGE Hyannis NAME OF ORGANIZATION Nobska Farms CONTACT PERSON Rooster Fricke TELEPHONE 617,480.0876 ADDRESS 9 Nobska Road, Woods.Hole, MA FOOD TO BE SERVED(LIST.EXACT FOODS) Hot Sauce,_Jelly, Chocoalte, Honey,Coffee, Chili Seasoning Mix I� NAMES OF TRAINED FOOD HANDLERS(TO BE O\SITE DURING EVENT): 1/"e 1 �C'�+ (ATTACH COPIES OF SERVSA.FE&ALLERGEN CERTIFICAT ADDRESS WHERETO BE SERVED 1336 Phinney's Lane,,Hyannis, MA DATE TO BE SERVED Fridays 5/24;-9/13 Tfi1E 3pm-6pm RAIN DATE. None WHAT TIME WILL.ALI..,EQUIPMENT;BE SET=UP&READY:FOWINSPECTION? 3:Rm ,,HOW,WILL FOOD BE KEPT BELOW.4I DEGREES F coolers/Freezer/Ice Packs HOW WILL FOOD BE,HELD,AT 140 DEGREES F. n/a HOW STOOD COVERER food will be covered or prepackaged HOW IS FOOD SERVED gloves TYP F HAND-WAS.HE FACILITY on site /d`tj ,� 1 `' t (S. 'RE OF A PLICANT) � s a o a i x x S�e rvS.a-fe ,r CERTIFICATION MARIANNE FRI CKE for successfully completing the standards set forth for the ServSafe Food Protection Manager Certification Examination; which is accredited by the American National Standards Institute(ANSI)-Conference for Food Protection(CFP). v ER EXAM Fp.RM N';UMgER' N 3/19/2019 „ 3/19/2024�^ i5, r DATE OF EX DATE OF EXPIRATION . ,, .2 3_ T Local laws apply;Ch cy for recertification requirements. n #0655 Sher � i ciotion Solutions Wow 1n vn occordarKe. e ServScdo 690 am trademarks of the NRAU.National Restaurant A—iaeoA and d±c am Jcsign ' Contact us widi.gveslions at 233 S.Wacker Drive,Suite 3600,Chicago,W 60606-6383 or'.ServSaWmstourant.ory: CERTIFICATE OF ALLERGEN AwARENESs TRAINING Name of Reclpiert ROOSTER AT fV06$KA FARMS q. Certificate Nuiiiber.•3818293 d W, Date of Carnpletlor 3118r2Q19 r `�'► Date of EXprat�on 3118/2024 l�'ti ■ Issued 3y: The above-named person is hereby issued this certjj�rate for completing an Allergen awarevress training program NATIONAL.'moo f RESTAURANT. recognized by the Massachusetts Department of Public.Health a.^ �°'� ASSOCIATIONS in accordance with 105 CMR 590.009(G)(3)(a). Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 www.restavrant.org ?b1s certiflcate will be valid,for five(S)years f roan elate ofcorrtpletion. Southborough,MA 01772508=303-9905 r www.marestaurantassoc.o r r THIS SECTION INCLUDES APPLICATION AND PAPERWORK UNDERGROUND. BAKER'S Planning to Sell:Eton-Perishable Baked goods breads cookies Certificates:Allergen and Sery Safe included. Thomas McKean,,Director vas Town of Barnstable °. Regulatory Services .t}axxsrnsle Richard V. Scali,Director BARNSTABI,E Mass 1639- L Public Health Division 200 .Main Street,,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 MAIL TO:TOWN"OF&X-RNSTABLE PUBLIC HEALTH DIVISION 200 MAIN STREET HYANN.IS,,MA 02601 FAX 508 790-6304 PLEASE INCLUDE A CHECK FOR S40.00 ONE DAY;S50.00 (2+DAYS)AND A COPY OF YOUR FOOD SANITATION' TRAINING(EG.ServSare)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO PROCESS(Please see instructions on the next page) APPLICATION,FOR TEMPORARY FOOD SERVICE PERMIT DATE April 8, 201.9 NAME OF SPECIAL EVENT Farmer's Market at Cape Cod Beer WAS THIS EVENT APPROVED BY TIIE;BOA.RD AT:A PUBLIC:MEIETiNG? Y X N NAME OF PERSON(S):REQUESTING PER Beth Marcus/Cape Cod Beer TELEPHONE,# 508-790-4200.x 102 CELL# 774-836-5206 HOME ADDRESS 133.6 Phinney's Lane VILLAGE Hyannis NAME OF ORGANIZATION Underground Bakery CONTACT PERSON Ian Sullivan TELEPHONE 508-385-4700 ADDRESS 780 Main Street; Dennis, MA FOOD TO BE SERVED(LIST EXACT FOODS) Prepackaged baked goods Foccia Bread, Cookies,Coffee Cake, Whoopie Pies NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): Ian Sullivan/Laurie Decost (ATTACH COPIES OF.S.ERVSAF'E&ALLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED 1336 Phinney's Lane; Hyannis,NIA DATE TO BE SERVED Fridays 5/24:-9113 TIME 3pm-.6pm RAIN DATE None WHAT TIME WILL ALL EQUIPVIEN'T BE SET-UP&READY FOR INSPECTION? 3 pm.- HOW NV.ILL FOOD BE KEPT BELOW 41 DEGREES F n/a HOW r.WILL`FQOD BE AT 140 DEGREES.F,. n/a EIOW49 FOOD COVERED food will be covered or prepackaged HOW IS FOOD SERVED gloves TYPE O MkND-WASHING FACILITY on site IGNATURE OF APPLICANT) COMMONWEALTH OF MASSACHUSETTS NUMBER BHP-2019-0777 o�N of pFy _ Town of Dennis FEE Board Of Health $110.00 �p`y1 UNDERGROUND BAKERY DATE ISSUED part t7sa: NAME December 13,2018 i 0 DENNIS COMMONS R PHASE I U-2 -------------------------------------------------------------------.-..------------------------------- ADDRESS IS HEREBY GRANTED A FOOD SERVICE (UNDER 50 SEATS) Sery Safe Certified In accordance with Regulations promulgated under authority of Chapter 94,Section 305A and Chapter 111,Section 5 of the General Laws a Pennit is hereby granted. This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires-__----_-___December 31,2019 unless sooner suspended or revoked. ---------- - - -- ��/----------------- Board Of ----------- ---/'---��---- --- Health ---------75---= ---- --------- - - - --------------- ------------ - - - - --- Health Director - I EXAM FORM mo, 103719 CERTIF'aCAT N®. 11:L9680' Sery S-- ..-- a-f.- .e,- TIFIC • r ro IAN D SULLIVAN for successf&a fly cOn'0 *19the standards set forth for the ServSafe'rood Protection Manager Certification Examination, (f� which is accredited by the American Natidnai,Standards institoto(ANSI) Conferences for Food Protectiotl(CFP), 06/24/2014 u�re�.�t�nnrc:vf►►rtl�fti�.cta99>t Arthur Bloomclnisi DATE OF EXAMINATION 9b Lake Sttaer Plylilptan,Ma 02367 06/24/2019 DATE OF EXPIRATION Loeni_law3 nppty.cligcch with your local reviatory agency for recerlification requirements. `7 a •5.4 it W� � .... - r ' :9t►fb,:8da9$�s!am8(F.lttlaeWu►�nF Aaubl:InQM�!9�,tttti,tt,r, - l ttt.t� :,tlti s tip! 1�p / n rpm gat ' rtml .. .! .r, p;•tea ad n.. ,teu,s.;nk:�• 1.1 e-. e• _ IF X A M F OR M 'N 0, 3:Q979 C9RTIFY CA. TE N0. 3LI1961803 i f ' r FIC A- TION....- f ro LAURIE A DECOST forsuccessPtrlly colrlalding Rile standards set forth for the SMSafe'Food PYOtCttiOnMana ger which Is accrodited by the American national Standards Institute(ANSI)-Couferonce fo Reiatr tfo.><( a f ation, r Fp 1 V/iVti'b�:C�d'l9BCfl'9!Sil lt'1t9'llflb�%:Qa19tt. . Arthur.Illoomquisl DATE OF EXAMINATION )(I Street Plymplon,Ma 0167 06/24/2019 DATE OF EX P IWA'i'ION Local law.'apply.Ch mich with your local r. uleter � yttBortcylerrece►tllicaPinnrequiremunts. • • ab��3�8�acea���t$tAmeactettaat�nl�ou.,�. � r -- CERTIFICATE A.LL,E.'.R- GEN AwARENEss TRAINING Name t Certifx �a . .t �i++ e ©o4;a t tynF- cn �r Date of , let' +. `�' , © y ' = Date o + Issued Up r Cat the above-navietl berson is ber c-hy issmd this tort#Fcate for corr*leting an alleigen azoccr wnas trainingprorrctm � N recognized by the IVlgssarinese. . -partment of Prtblic llealtl� ¢Y��t Da /1 ONOIp z .in accordance with 10S CI-YR 590.009(G)(3)(a). IV[assachusetts RestaurMt Association 800,765,2122 $ 333 Turnpike Road,Suita.102 AVVAV restaurant 01*9 TwS mgfleate will be valid for five(5) yearsfrom date ofcompletion. Southborough,MA 01772 i 508-303•-9905 www.a�nrestaurnntassoc.or� 4 , Pw� ("'PL, D wka 04" `HIS SECTION CONTAINS APPLICATION AND PAPERWORK.FOR VAL,COURT SUGAR SHACK Plans to sell:Maple Syrup, Maple Candy _ e Certificates: Servsafe and Allergen certificatesincluded. Thomas McKean,Director Town of Barnstable Regulatory Services BARNSiABL& Richard.V. Scali,Director WNSTABLE irtass - Public Health Division ate. 200 Main Street, Hyannis, MA 0260 Office: 508-862-4644 Fax: 508-790-6304 MAILTO,TOWN OF;BARf'tiSTABLE PUBLIC HEALTH DIVISION. 200 MAIN STREET HYANNIS,:N'LA 02601. FAX 508 790-6304 PLEASE INCLUDE A CHECK FOR S40.00 ONE DAY;S50.00 (2+DAYS)AND A COPY OF YOI?R FOOD SANITATION TRAINING(E.G.ServSafe)CERTIFICATE AND ALLERGEN CERTIFICATE ALLOW SIXTY DAYS TO:PROCESS(Please see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE April 8, 2019 NAME OF SPECIAL EVENT Farmer's Market at Cape Cod Beer WAS THIS EVENT APPROVED BY THE BOARD AT A PUBLIC.V.EETING? Y X N NAME OF PERSON(S)REQUESTING PERMIT Beth Marcus/Cape Cod:Beer TELEPHONE# 508-790-4200 x 102 CELL# 774-836-5206 HOME,ADDRESS 1336 Phinney's Lane VILLAGE Hyannis NAME OF ORGANI7_ATION Valcourt Sugar Shack CONTACT PERSON Richard Valcourt TELEPHONE 5.08/7.90/4200 ADDRESS Petersham, MA FOOD TO BE SERVED(LIST EXACT FOODS) Maple Syrup NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT); Richard Valcourt (ATTACH COPIES OF SERVSAFE$ALLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED '1336 Phinney's Lane, Hyannis, MA DATE TO.BE SERVED Fridays 5/24-9/13 TIME 3pm-6pm. RAIN DATE None WHAT TIME WILL ALL EQUIPMENT BE SET-LP&READY FOR INSPECTION? 3pm HOB`WILL FOOD BE KEPT BELOW 41 DEGREES F Coolers/Freezers/lce Packs HOW.WILL FOOD BE HELD AT 140 DEGREES F. see attached Where applicable HOW IS FOOD COVERED food'will be covered or prepackaged HOW IS.FOOD.SERVED see,attached -TYPE Of HAND-WASHING FACILITY on"site iG A AT F APPLLCA\T) z I� M IIII d 9Mn pro AM:awl s; te 1Y�'cniew Mx![ �. `� s ,�3 s a � WI saw ,,` a T to ANA, AVG" All 0 _vm kl S r ' ihf� rl�ttrs«xaae #� r h a g AMR- �-- RIDV £� z I 51 two (\�d�4/_ } r v y asn� S"`^g" of ✓ 'Y_ mates 61 P Py a cad S f ty t itr� Y arTf ON rr8° yak -v ewe k �r t % Al k v- Mang li&aR4lfit {1959t�ffiG+ z r rg K k � v Cb 3gxt�afaGs a � l r VIA ? �A7222tkVf3Q2F4r1Q73) 3 k� s s 3c e s t -lap J s � r � >z 0 .x A, logo '. 7; RE � e aka y al RM IM e� y �.� a� .p�✓t'"*�'R2':�.��� ��, � ``pox � � �' � a�a a '� w� THIS SECTION INCLUDES APPLICATION AND PAPERWORK FOR WICKED GOOD KETTLE CORN � Planning to Self:Popping and.Selling Kettle Corn on Site. Sold in twist tied bags. .J Certificates: letter TOB Board of.Health,Allergen and Sery Safe included. limeti 'Town of Barnstable Regulatory Services t BAR1MSrAB14 Richard.V. Scali,Director I BARNSTABLE s6g9. � � Public Health Division e ° Thomas McKean,Director 200 Main Street, Hyannis, MA 0260:1. Office: 508-862-4644 Fax; 508-790-6304 MAIL TO:TOWN OF BARNSTABLE PUBLIC HEALTH.DIVISION 200 MAIN STREET HYANNIS,MA 02601 FAX 508 790-6304 LEASE INCLUDE A CHECK.FOR S35.00 DOLLARS AND A COPY OF YOUR FOOD SANITATION TRAINING (E.G.ServSafe)CERTIFICATE,ALLOW SIXTY DAYS TO PROCESS(Please see instructions on the next page) APPLICATION FOR TEMPORARY FOOD SERVICE PERMIT DATE April 8, 2019 NAME OF SPECIAL EVENT Farmers' Market at Cape Cod Beer WAS THIS EVENT APP.RAVED BY THE.BOARD AT A,P.UBLIC MEETING? X X N NAME OF PERSON(S)REQUESTING P:ER.NI1T Beth Marcus/Cape Cod Beer TELEPHONE# 508.790.4200 x 1.02 CELL# 774.836.5206 HOME ADDRESS 1336 Phinney's Lane: VILLAGE Hyannis NAME OF ORGANIZATION Wicked Good Kettle Corn CONTACT PERSON Jeffrey Paine TELEPHONE 508.336,6043 ADDRESS 109 Marion Road, Mattapoisett, MA. FOOD TO BE SERVED(LIST EXACT FOODS) Kettle Corn NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): Richard Toas (ATTACH COPIES OF SERVSA.FE.&:A.LLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED 1336 Phinney's:Lane, Hyannis, MA .DATE TO BE SERVED Fridays 5124-9M 3 TIME 3-6 pm RAIN DATE None WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FOR INSPECTION? 3 pm HOW WILL FOOD BE KEPT BELOW 41 DEGREES F n1a .HOW:WILL FOOD BEHELD AT 140 DEGREES F. n/a HOW IS FOOD COVERED bags I4OW IS FOOD SERVED popped and bagged,twist tied T PE OF HAND-WAS.I4.ING FACILITY On site .4 ° SI i Af U APPLICANT) Si..... a s i ✓ > c77,7y 9 F r 77r - iE , �s � ✓ 'fir" 1t sh �#w,& � F� S �� an,�;��� t�. e y a� ✓ 75w�ttzi� . . Y za'r. RAM w Ada 44' y F x yw #b r y � '. ✓v r xW rMO s i •uW', Efr)wPa�, '�aax a ""tea` r 0�r ate. ' * ` - ti ,� ,� y f a aWT MA 211 r Ml r P-a SW if Y Y ,61, 1eaRt lAai,'la.� �.5 'a' '➢ d Ma TtS kS � t w a k'x�� ,. K"C � 1LY14 6E Mitt ii i 3/ R ema 6 ,.Ti�R 5/� 7%Yi, �'F' ibT ton� d'- R'�t Q317 /4��i�+'�.Z,� 4���V�' Y• 4. may'S�i 'Y Etww do X•� S` e. ._ c ';;iz't d 3'} ,' - ' ,y / y rf y b x -; , - r s v Ce- N: a F x Qx C sa i �j.��.j f may} .:';`;ta} .�"�;w< (.�;:*«.. ,�t ,yA�y�t - i`� IGi7'3R`i4t:I f n,/ ,tiY➢fiil � 1I `x `7S/'s`I'YiiYlt 4a "�.x•:''"v ..�,"az w.'a"a ..h7-tT,�. ay,C- .i— ':F s..+� d ",4d y .. m qD Snrtao Staniacis#�ro�uiEabl�shnta#eSana Acfe su /ry�tf/� �[ 1b �ir�l � k4:'8'' zit #t #7 �1 ,GY1✓ '��' �zx a 1F i1� ti1� RX 2 ti➢> Ybe+R,-` fir` -#Y #Y - - ea€ ata.::dx. '+ wr'�,�t"' z .�YF dke :M« 3 Y a unn # RA %'-W 1�7` i ,ys� ,, E:. r..�� ' ! s �'s ��� e d � "'z'a � ��'r 'ry'" 'a� a- .z, fie, g.Y( ?/j - ,y`Kx` .➢F-, ,'"f'Z' ,1 E '"�R a'.,':Sw3ww',w -: c'§� akFcc4, Kewgd'Kg::y»,: 4Y tE y r w A,a`a r i C i t � � �r7 j�+�*r p p ,fir? Y o` rE 5 ,r x � .f�+Ta1 Fi1F:��,��rrtit �.: �� �•����E �, , ��g< a� �t ` a '' ����<s�y s,;a ';' z h ��� �z���c,s�s �,,.c s�rye i ✓� r F `fir ✓ ram✓ i "rz w i�C y✓�✓., NOW i W _ ✓r F✓ iyf�s �a F zip fa H E' f z FmA� w` _ NiMIN R rze 3 �t�'"€rw§w k�i�,w„"• ¢w i3EE N `'' Fe f w a jtf y y ✓ "C� g;�S� a"�a VAT rowl E x t Y4�r y ay w f/�rq✓,3T iYa �� vex F�vw�s:��° r rx `✓mow aiY '✓ - y 41.we v _ 4" '6 A r E f' ✓ E il�� zaly2hF FF➢�� Y ra✓ � � ✓ o- a� s'e��€ �frn 'aim v �Y s ✓a�"�3� 'y� ✓ �` �. ,y✓F f�`..: �� 'w y E J.��wE u�� a R��33rJ � f � .���� �ti'���� ,; � sb zap a �x ✓ a S� a- � rw ; »,r t �a a€�aa',.ayy'S'"*m S n3n����✓E � u ,rw�§�r�a�z§�.�'�s :mz:-� �� ; � s . 3 -✓ ��, ,l �,>�" E.E, r y ��„ .. �� �� v ��Kfr� '�r�✓�� �i � �' � a'�we�.sf �£ k 5 r � � '�:`�•' h .��"'�'::�3" f f yssy��zdyr"°i i E E€ ��s�.``�`-. �i _ y<w. : �. a ��yy� y E✓sf '„ ,�., Y Ya ry/CF£ �dw x r•:f YEI E f YaY FYtN* '�� h a�3 Y yv 6. , o, xK,.. "'S� '` S'>k, `�'r,. ,� .. R{`".�mga>•�,?�.�' ': ^a .F+ h E Y�# ""' �`�,o .," x,.infiw - �?c�x 5" - �>r;F�} w K a fry' -,✓ate ✓ I e + &A� ervSafee CERTIFICATION. JEFFREY PAINE For wccessfuify wnypletirg die standardi.set Forth for I},e Se r5ofe®Food Protection Manager Celt cation Examination, wfucf i$accredited by the Americon National Standards lnslit.le(ANSI}Conferenaa for Food Protection(CFP). 006138 10550 w UMBER EXAM FORM NUMBER r ) 4/261 t+ t 4/26/2022 .PATE Of E DATE. OF EXPIRATION f Local Iv.$apply.Ch ncy a recsvti5wt on requirtmerts. I yI aos55 a�i..o6i iaoi2anttdw Ego aeead�w'u of As nP.A9: �mts N;6oad :aaeo w•wn q,dw+ar 175 W j%,Iq 2W.:S.I=.a..vu,-1 6060A w 5.�5dsQrs:bwoM.ag.: i CERTIFICATEOF ALLERGAW `S IN I Name of Recipient: JEFFRr_r PAiNe Certificate Number; 2892660 Date of Complalon: 5l5/2017 Date of Ex��ixat on: sa6l2o'22 Sim ' 1 WOW By: r The alr6ly named person Is ht'tebyc issued this cer/lficofe Nt i 1 lAl fort�rna Weting an allergeh altlar'rticss trar'niilg paogrrattt #2F v'C tlR tNl s a t rt rcco rnixA=rlli}j lh.e Massach1rsetn Dt ji el7new of Fuhlie Flertlth a � �'� �Na S iTt t7ifP>tlaatite with IOS Cn>'12 591I00.9(C )(%)(�aJ. Vlwswchit8ctts Restaurant r?►oNiatiop $UO b . 12Z 333.limpike Raad,$rite W wwwr6taut ht.org Snitthborough,MA.Ull7� 7l.,is cartifrafe-will be valh lot•fi ve(S)years f roin date of c:owpleflon. 508-303-9903 , O� �tiwij:tt�arestuur;ulraseuc,org 31010 ex�,�+,,�sv,�d+t�cr,�rimrrurk- saa ... :rmasxess asa5u I Bellaire Dianna 61-levol,064-ee- From: martina@capecodbeer.com Sent: Friday, May 10, 2019.12:39 PM To: Bellaire, Dianna Subject: RE: 2019 Farmer's Market Attachments: TOB Follow Up Paperwork.pdf 14i Dianna: Attached please find the revised.paperwork necessary to complete our FM application..[have included the spreadsheet you sent to me, along with notes for each vendor that you asked about further documentation. Please note: Cape Cod Cranberry harvest—Tina is the only food handler at this time. Deb has her Servsafe but riot allergen paperwork. .I will forward that.once.[.receive it. Foss.Farms-- Licenses attached Nlonopati—License attached Nobska—Marianne is the only food handler. Application has been.revised to indicate this.License is also attached Underground:Bakery License is attached. Wicked.Good Kettle Corn—Richard Toas is nott on the application. Fle is the fonner owner. Jeff Paine is the current owner and is listed on the application_License is attached. Hopefully this clarifies a few things...please call me with any questions/concerns. 'Thanks! Cheers, Martina Mehl Cape Cod .Beer Inc. P: 508-790-4200 ext 1.03 F: M8-815-3454 Web: www.CaapeCodBeer.com r FB: www.facebook.corn/capecod beer Twitter: www.twittel,.Colll/car)ecc)dbeei- ............BeFxe printing this email or any attachments,please think about your responsibility and commitment to the ENV IRt:)NMENT. From: Bellaire, Dianna <Dianna.Bellaire@town.barnstable.ma.us> Sent:Thursday, May 2, 2019 12:33 PM To:.martina@capecodbeer.com Cc: Bellaire, Dianna <Dianna.Bella ire@town.barnstable.ma.us> Subject: 2019 Farmer's Market Hi Martina; I will be leaving for the weekend at 2pm today. I have some days off. I will be back on Monday. I've attached the 2019 Checklist and items I still need or have questions. I've placed my comments under"event food" category. There are some people that don't need a permit. I've given you the new code "condensed" by Tom Mckean for exemptions on permits. When you have someone who is not located in the Town of Barnstable, I have no way of obtaining whether they have a current operating permit with their town. I need a copy of their most recent business permit. The expire typically at the end of the year. So last year's expired last year. There were some people who had other food handlers listed that didn't match up to the Servsafe Certificates. So, please review. I know sometimes they change their mind about who will 1 i attend the show. We just want to make sure before the inspector goes out there the food handlers match the Servsafe Certificates. You have also have two people with Servsafes that expire half way through the market time frame. If you need anything or have any questions, please feel free to contact me. I will be back on Monday and we have time, no worries. Thank you and enjoy your weekend. 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.barnsta'ble.ma.us CAUTION:This email originated from outside of<the Town of Barnstable! Do not click links, open attachments or reply, unlessyou recognize the sender's.email address and'know the content is safe! 2 i DATE(MMIODNYYY) A6 1Z CERTIFICATE OF LIABILITY INSURANCE 5/06/19 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS:UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY:AMEND, EXTEND:OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF IN DOES NOT CONSTITUTE A CONTRACT BETWEEN THE;ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE,OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: Ifthe certificate holder is an ADDITIONAL INSURED,3he policy(ies)must have ADDITIONAL INSURED provisions or be endorsed., If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy',certain policies may require an endorsement. A statement;on: this certificate does not confer rights,to the certificate holder in Iieu ofsuch endorsement(s)CONTACT PRODUCER.Allied Specialty In'surance,Inc NAME. 10451 Gulf Blvd PHONE FAX ... (AIC,No Exti: (AlG,No Treasure Island, FL 33706 E-MAIL 8002373355 ADDRESS: ___. INSURER(S)AFFORDINGCOVERAGE ! NAIC.If ............. _........., .........._ ,....�...... _..... .. INSURER.A T.H.E. Insurance Company !12866:, INSURED Pine Meadow Farah Enterprises INSURERS: ............. Cape. Cod Kettle Corn wsuRERe: 109 Marion Road Mattapoisett., MA 02739 INSURERD: INSURER E: ..INSURER Fi COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE'LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED_ NOTWITHSTANDING ANY REQUIREMENT;TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR �-7rADDL;5UBRE - :t POLICY EFF. I POLICY EXP -�- LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMiDDtY ! MMIDDlY X COMMERCIAL GENERAL LIABILITY ' I 1 EACH OCCURRENCE $ 00010,00 ,—.....,.�.... A X j CP.P0106980-00 � 05/03]_9 -0S/03/20 �PR£MSE5 Eaocg @� $ 10.0:!0(10 CLAIMS-MADE X!OCCUR. I 1 W._.... I- MED EXP(Any one person) s € ( PERSONAL BADV INJURY s,.- 1,000,-000 J GEN'L;AGGREGATE LIMIT APPLIES PER; GENERALAGGREGATE $ 2,0 0 0,'000 POLICY JECT LOC PRODUCTS-EOMROP AGG is 1,0 0 0s,:0 0 0 .. _ I OTHER: ( $ AUTOMOBILE LIABILITY - COMBINED SINGL LIMIT S: ^I ANY AUTO E BODIL"3NJURY(Per person) Is_. .. I ...I-OWNED SCHEDULED' � �' j i_ DIL�INJ-BO URY(Per accident) $' AUTOSDNLY i ;,AUTOS E AMAGE sRHIREp NON-OWNED O PEYD AUTOS ONLY AUTOS ONLY - UMBRELLALIAB i�___I OCCUR, ' i EACH OCCURRENCE I$ EXCESS LIAB AGGREGATE CLAIMS-MADE! i ` 5 DED RETENTION$ I s WORKERS COMPENSATION :PER OTH- I AND EMPLOYERS'LIABILITY ... I STATUTE Y!N ANYPROPRIETORJPARTNEPJEXECUTIVE i N f A E.L.NCH ACCIpENT $ OFFICERIMEMBEREXCLUOED7 i € ~� j(Mandatory in NH) 4 } E.L.DISEASE-EA EMPLOYEE'.S _„ ... !if yes.describe under . DESCRIPTION OF OPERATIONS below i 1 E.L.DISEASE--POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) DATES: 05/24/2019 07/19/2019 CERTIFICATE HOLDER, CANCELLATION, FARMERS 'MARKET .:AT CAPE COD BEER SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1336 ,PHINNEYS .LANE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BARNSTA$LE MA ACCORDANCE WITH THE POLICY PROVISIONS. A ...,.0.. DREPRES TfA�TIY - O 1988-201,54CORD CORPORATION. All rights reserved. ACORD 8(2616103) The ACORD name and logo are registered marks of ACORD Bellaire, Dianna From: McKean,Thomas Sent: Friday, April 12, 2019 11:15 AM To: Bellaire, Dianna; Crocker, Sharon Subject: New Food Code/ Farmer's Markets FYI Here is a copy of Section 105 CMR 590.010 in the new food code: ----------------------------------------------------------------------------------------------------------------------------------------- (D) Public Markets and Farmers Markets (1) Exempt Market Operations. No permit from the board of health is required to sell the following products from a public market or farmers market: (a)Whole, uncut fresh fruits and vegetables. (b) Unprocessed honey, or raw honey as defined by the National Honey Board (c) Pure maple products. (d) Farm fresh eggs which are stored and maintained at 450F (7.2°C) or less. (2) Market Operations Approval. (a) Except as specified 105 CMR 590.010(D)(1), a vendor at a public market or farmers market shall not sell or serve food unless it has been approved to do so and has obtained a valid permit from the board of health. 1 Town of Barnstable Regulatory Services.Departm ;irector Public Health Division 200 Main Street,Hyannis MA 02601 ofqOFFICE: 508-862-4644 Thom FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event OAAAt5 &rAotek M )K911i(" Date / .-q /` Table/Cart/Trailer Identifier ion Name Vj_i OOQ /"5R;tke Telephone Co 0 7782 1 9 _Permit Holder's Name e^ Cer n Telephone DESCRIPTION OF VIOLATION PFORMATION d PP rmi./Displayed ref7a approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food ntact Surfaces Cleaning and Sanitizing Foods C ed 1 roper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures _ Reheating Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS y _ Refuse-Container(s)Provided/Covered flu ca,01l 0,-e-4% Adequate Toilet Facilities Provided Inspector's Signat Print v'O,4, PIC's Signature Print r Town, of Barnstable Regulatory Services Department61 - 1 Public Health Division SAPIMABM 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Tho as F.Geile , irector FAX: 508-790-6304 Thoma A. cKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event AA i 1-M1-e 5 i*A Date 2=z12,q/-7 Table/Cart/Trailer Ident LionName C ( �n !r'ar Telephone Permit Holder's Name t/ % Telephone Z09 0039' DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing 'f-- Foods Covered MA _ Proper&Adequate Handwashing/Temporary Handwash C ra C S QY1 G' L�I�9,e S Station Location LA n _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS U� i c _ Cooking Temperatures Reheating Cooling _ Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered _ Adequate Toilet Facilities Provided Inspector's Sign Print011 PIC's Signature 4 Print Town of Barnstable Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA 02601. OFFICE: 508-862-4644 mas F.Geiler,D' or FAX: 508-790-6304 (Thorna . c ean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event � �� �Pr Date /"�`� A-5 Table/Cart/Trailer Identification Name 0 A a,0Z r Telephone Permit Holder's Name mo(vajqoji an.-, Lernnni STelephone !0�tDB / O 4;5' DESCRIPTION OF VIOLATION IT INFO ATION ali rmit/Displayed approved Menu Items Offered Only V inn S { J���zcl�_f�r►� FOOD PROTECTION MANAGEMENT Ca-,,-�Ul _ PIC Assigned/Present Onsite ( JG( � Z) PROTECTION FROM CONTAMINATION _ Food ct Surfaces Cleaning and Sanitizing _ Foods Covered --- ,( �Q _ Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating Cooling _ Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered _ Adequate Toilet Facilities Provided Inspector's Signature Print PIC's Signature n Print Town of Barnstable Regulatory Services Depart7Thom Public Health Division 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 eiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event rnner Date d Table/Cart/Trailer Identification Name t)V1 a Telephone 6�,)$. ' Permit Holder's Name 0 ea" Telephone DESCRIPTION OF VIOLATION PERM ORMATION slid Permit/Displayed pproved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _-PkC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing oods Covered Proper&Adequate Handwashing/Temporary Handwash dr L�. �s e, Station Location - P 5 I _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating Cooling _II Hot and Cold Holding lie and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet Facilities Provided cz— Inspector's Signatur Print 5 ; 't PIC's Signature Print i Town of Barnstable Regulatory Services DepartmenZDirector aAJUMABM Public Health Division200 Main Street, Hyannis MA 02601OFFICE: 508-862-4644 ThoFAX: 508-790-6304 Tho TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event 1 Datef 1`� Table/Cart/Trailer Identificat��ionn Name ` f mess Telephone S COig ,56(; q9 3 9i T Permit Holder's Name Telephone DESCRIPTION OF VIOLATION P INFORMATION ' al d ermit/Displayed _proved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing UP ods Covered Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating tiling 5 S ... CA Hot and Cold Holding A -a .nS A 6 4'-+1 Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered _ Adequate Toilet Facilities Provided Inspector's Signatur, ____ Print M ' Print PIC's Signature �� i Town of Barnstable OFSME 1p� Inspectional Services Public Health Division • BARNSTABLE, v� 039. � Thomas McKean, Director ArE°MAC a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 08/06/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Lara's Cuisine LLC. Name of Person: Lara Ferri Address: 17 Trout Farm Lane, Duxbury, MA 02332(C)781-534-8445 To serve: Assorted Pesto Sauces and Relishes ServSafe certified: Lara Ferri Allergen: Lara Ferri Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:OOPM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health f ovvil of Barnstable IrA 4 � 15 g Nit= Health Division �' 1•�+ ��Asa �x �:�� ���ir'o�;t^c s ey$� MU U 41:. Off W# :ego? i 04 mW { u.*4� i$; 3'Y+<.'.'s, t k &�t`� +Ai40 .�F Pxfiit v �C ( S n t tG iR m 4 " Ito$� v �' � �strn,re�a» *r,!�?T,•�,z. •�..,... �;�•mro,•. ' �.*x�.acmr�:��:..�.... �,«m�M«a u�:,z;��;»o„ :-m� 0'Al't,to D z� AM, Air,sx •v :ooff" 00 *'. a Wis Poo* ' W mMw nW...:•wkazw6va��,Mm. �3�wAVA�s«Allmxi ux,wrea, om. .rt, a ,,."i ' .,6,.•� A pper�.,,pp�, w,m.;II'S�2: t,n ,s,'„�fr' 9 O .... _. ServSa fie CERTIFICATION LARA FERRI for successfully completing the standards set forth (xx the ServSnfe� Foo�il roI n Manage Cerfification Examination, which is accredited by the American National Standards Institute(AN -Conferenae�for Food Protection KFP). u "fir a AJ,' _ c� 546846 51669: O UMBER EXAM,wFOR M N "4, 19 4/25/2021', ... , DATE OF E DATE OF EXPIRATION Local laws apply.C encY for recertification retuirements. 4 ?� 4v% ' She In �wA Maritime Lrboa a �203 5 National R Gam/ a logo are fradecrwrla of the NRAEF. Contad us-A que,ti—at 175 W ldckc Blvd.ste 3 soon Chicago L 6060A.w ServSafeOreska nt.or% n -st", Zrw ,ter CERTIFICATE OF ALLERGEN AWARENESS TRikINING � � t Name of Recipient: 14F2A FERRI , l� Certificate Number. 22?9'fl C�( �. Date of Completion; zi,si2o,s rti Date of Expiration: y,s�2o2, ■ t �s c� 1 Issued BY. ?he abo e nearned person is hereby isstied lhis certificateman NATECJNAL ' for completing an alleigen awarenes train mgPrograara RESTAURANT recognized fry the Massachusetts Department of F�rblu Health � __._ ASSOCIATION in accordance with 10.5 CMR 490.00.9('G)(..))(a). Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 www.restaurant.org Southborough MA 01772 This certificate z ill l�e valid for five(_S)y}ears from date ofrornpletiora. 508-303-9905 : 1 vrommarestaurantassoc.org � PERN41T TO OPERATE A FOOD ESTABLISHMENT TOWN OF ROCKLAND k. bate: 12121 120l BOO (201 in accordance with Regulations promulgated under atttlaoritV of Chapter l l... Section 1.27 A of the General Laws, a permit granted to: � »a's Cuisine 90 Resenvir Park Drive, Rockland,NIA 02370 Type of Business and any restrictions.Catering The above-named business is hereby permitted to operate as a Food Establishment in the`FotNn of Rockland. This permit may not be transferred to another operator-or location_ iw- f—d 1 < St .•c Nei -130H,chairman *$r O Vitoria Ceibei- 3ot3`is�Ctairnmr - SwC'c�targoli -E1"�trl � toes l Permit Expires: December 30,2019 E COMMONWEALTH OF MASS C�-il..USET� S H P-201 9-0086 Town of Quxbury 'h rrrd o tCe lth ..il'' RA{s.,.? i.. U I S S i`i S .A.J.'i ".. e.1,SS ,i:. t 31 ADDRESS IS HEREBY GRANTED A 100D This permit is oratited in conformity with the Statutes and ordin aricchs. re ti- thereto. "vnc" expires December 31, 2019 unless s(,*rier suspended of ,I-vt.'ke€ : -- _._..... . .,_ Board of Health NOTE RESIDENTCAL K.TCREN t Health Agent is YY) /DDIYV(163 E(MM - �► CERTIFICATE OF LIABILITY INSURANCE DAT0E(MMI DIYY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NUTMEG INSURANCE AGENCY INC/PHS NAME: 46508229 PHONE (866)467-8730 FAX (888)443-6112 (A/C,No,Ext): (A/C,No): The Hartford Business Service Center 3600 Wiseman Blvd E-MAIL San Antonio,TX 78265 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Sentinel Insurance Company Ltd. 11000 LARA'S CUISINE LLC INSURER B: 17 TROUT FARM LN INSURER C DUXBURY MA 02332 INSURER D INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD M/DDIYYYY M MID DIY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE-OCCUR DAMAGE TO RENTED $1 000 000 PREMISES E occurrence X General Liability MED EXP(Any one person) $10,000 A 46 SBW UM9324 06/19/2019 06/19/2020 PERSONAL&ADV INJURY $1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $25000,000 POLICY❑PRO LOC PRODUCTS-COMP/OPAGG $2,000,000 JECT RX OTHER: A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accide t ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS AUTOS HIRED NON-OWNED PROPERTY DAMAGE AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS- AGGREGATE MADE DED I RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE I JER ANY YIN E.L.EACH ACCIDENT PROPRIETOR/PARTNER/EXECUTIVE N/A OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below EMPLOYMENT $10,000 ENT PRACTICES A 46 SBW UM9324 06/19/2019 06/19/2020 LIABILITY DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION Quincy Farmers Market SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 1 MERRYMOUNT PKWY BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED QUINCY MA 02170-3836 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9)1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD �1 v Town of Barnstable Regulatory Services Department >�t+rsrescE. Public Health Division "'"B&1639. 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO ® TEMPORARY FOOD EVENT INSPECTION FORM 0 c� Name of Special Event Date Table/Cart]Trailer Identifi ati n Name P" ITelephone Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing Foods Covered .f _ Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures _ Reheating A _ Cooling Hot and Cold Holding +aon L) Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered �. _ Adequate Toilet F ' ' ' s Provided Inspector's Signature t PIC's Signature Print Town of Barnstable lit 6 Regulatory Services Department R63I01 >�arws�rm.�raal;. Public Health Division "9. 200 Main Street, Hyannis MA 02601 � OFFICE: 508-862-4644 Thomas F.Geiler,Director Zldft FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event Date Table/Cart/T railer Identifica 'on ame elephone Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION / _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered jZ Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating Cooling _ Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet Fac' ' ' rovided Inspector's Signature PIC's Signature Print Town of Barnstable Regulatory Services Department Public Health Division w MItN$7'A$t.E, • 039. 200 Main Street, Hyannis MA 02601 15 got OFFICE: 508-862-4644 Thomas F.Geder,Director FAX: 508-790-6304 41 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special EventO25UA Dat Table/Cart/Trailer Identification Nam - A� elephone Permit Holder's Name 46(&7� - Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed f� Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT �� _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered ��(/// i _ Adequate Toilet Faci' ' vide Inspector's Signat re -----��M Print PIC's Signature Print Town of Barnstable Regulatory Services Department Public Health Division a�a 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM n Name of Special Event ate Table/Cart/Trailer Identification Name Telephone n Permit Holder's Name Telephone i DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed Pre approved Menu Items Offered Only J FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION �% e Food Contact Surfaces Cleaning and Sanitizing ) I 6 6'�✓ _ Foods Covered f Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures Reheating _ Cooling Hot and Cold Holding s Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories IX OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet acili ' s Provided Inspector's Signature JfA PIC's Signature Print Town of Barnstable �FTHE Tom, Inspectional Services ti Public Health Division + BARNnABLE, y MASS. i63679• g Thomas McKean, Director �� ArFD MA'S a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Arnie Bakery Name of Person: Arnie Smith Address: 1254 Main Street Osterville, MA 02655(C)508-519-4951 To serve: Croissants, Cookies, Scones, Muffins & Coffee ServSafe certified: Arnie Smith & Mica Andreotti Allergen: Arnie Smith Natasha Ivanov Only at the following location: 155 W. Bay Rd Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:OOAM-1:OOPM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTA LE BOARD OF HEALTH cKean Director of Public Health i Town of Barnstable Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event f"Agff JE:ks' W ® Date Table/Cart/Trailer Identif ation Name i'C. Telephone Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION Valid Permit/Displayed Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures Reheating _ Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet Fa ' ' ' Provided v Inspector's Signature rint fit/ PIC's Signature Print Town of Barnstable h fi Regulatory Services Department Public Health Division BAPNWABM 1639. 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO a TEMPORARY FOOD EVENT INSPECTION FORM r !(� ! / Name of Special Event A� J )e � A ^ /� /® Date Table/Cart/Trailer Identification Name g .k Telephone Permit Holder's Name f , Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION Valid Permit/Displayed Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered + _ Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating _ Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet Facilities Provided _ X04 Inspector's Signature i"'I�/! � fi � �7ft � riot l� / ✓/ 1.t� > \� PIC's Signature (� Print �4 Town of Barnstable Regulatory Services Department Public Health Division 16"3 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event '47�111h OW J Da te/ t�,"2//1/7// Table/Cart/Trailer Identification Name 19U' a ephone Permit Holder's Name<r6 Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed _Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing _ Foods Covered Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures _ Reheating Cooling _ Hot and Cold Holding _ Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered _ Adequate Toilet Fa • • ' Provided O Inspector's Signature tint PIC's Signature Print BPS It Town of Barnstable Regulatory Services Department Public Health Division KAS86. 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM A. AA Name of Special Event mv e Table/Cart/Trailer Identilll "on Nam e ephone Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION Valid Permit/Displayed Pre approved Menu Items Offered Only �J FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing _ Foods Covered Proper&Adequate Handwashing/Temporary Handwash I NAM Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating Cooling _ Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet Facp' ' Provided Inspector's Signature n PIC's Signature Print i Town of Barnstable Regulatory Services Department Public Health Division �Inss 200 Main Street, Hyannis MA 02601 1YIA�A,� OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event Date Table/Cart/Trailer Identification Name ephone Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing Foods Covered Proper&Adequate Handwashing/Temporary Handwash Station Location Q' _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) C-9/ TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating _ Cooling Hot and Cold Holding _ Food and Food Protection j� CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered Adequate Toilet Facilities-Provide t Inspector's Signature Print PIC's Signature Print t Town of Barnstable Regulatory Services Department l3a�rrsxnlsnt.�. Public Health Division p,� 200 Main Street, Hyannis MA 02601 rub OFFICE: 508-862-4644' Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event ' VT Table/Cart/Trailer Identification N me -4121� one' Permit Holder's NameAilly ArAbTelephone DESCRIPTION OF VIOLATION PERMIT INFORMATION ej// _ Valid Permit/Displayed Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing Foods Covered Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating _ Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet 174aUitijes Provided Inspector's Signature PIC's Signature Print Town of Barnstable * Regulatory Services Department »nluvsrABI.E. Public Health Division 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event Date 0 Table/Cart/Trailer Identification Name � elephone Permit Holder's Name9-qCYSHk;?&5 Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION Valid Permit/Displayed _ Pre approved Menu Items Offered Only A Ah gcf) FOOD PROTECTION MANAGEMENT -W5 _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing Pl,,A _ Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location 8bkVS)N i Good Hygienic Practices(Use of gloves,use of tongs or tissues) Pffsa,� TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating _ Cooling �J J Hot and Cold Holding - w) Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered _ Adequate Toilet Fad 'ties Provided r Inspector's Signature d ri n I PIC's Signature J Print U { Town of Barnstable N. Regulatory Services Department Public Health Division SAIWWASM �tAes 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event ® Idl Date Table/Cart/Trailer Identification Name �elephone Permit Holder's Name A, Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT ' PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered G4 Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) J TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating _ Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered _ Adequate Toilet Facilities Pro id d Inspector's Signature Print PIC's Sign re Print i Town of Barnstable Regulatory Services Department Public Health Division 1,, ' 200 Main Street, Hyannis MA 02601 �A OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event Date Table/Cart/Trailer Identification Name Telephone Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing R Foods Covered Proper&Adequate Handwashing/Temporary Handwash Station Location / Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating Cooling Hot and Cold Holding _ Food and Food Protection Q� CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered Adequate Toilet Facil' ' s Provided iz b' Inspector's Signature Print PIC's Signature Print Town of Barnstable Regulatory Services Department Public Health Division >�tass 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event ate L-01 Table/Cart/Trailer Identification Name elephone I VI— Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed /Z _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing _ Foods Covered Z ry C _ Proper&Adequate Handwashing/Temporary Handwash J Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures y Reheating _ Cooling Hot and Cold Holding Food and Food Protection ul 442,W---y CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered Adequate Toilet Facilities Provided Inspector's Signature PIC's Signature P nt Town of Barnstable Regulatory Services Department w�trtsrnsc>E. Public Health Division ""S& bss� 200 Main Street, Hyannis MA 02601 a,� OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Evento�,S (- alm Date //WM- /V Table/Cart/Trailer Identification Na e r VSA� Telephone Permit Holder's Name<n6 6 a Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed e Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PI Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing _ Foods Covered IL _ Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating A Cooling All" _ Hot and Cold Holding k7 7 Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered Adequate Toilet Facili' ovi N , Inspector's Signature Print PIC's Signature rint s Town of Barnstable Regulatory Services Department • sr�� Public Health Division 200 Main Street, Hyannis MA 02601 lam+ OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event f Date- Table/Ca rt/I'railer Identification Name s one Permit Holder's Name _ Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures _ Reheating _ Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY Posting of Consumer AdvisoriesAM's) .6fo OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered Adequate Toilet Facilities Provided Inspector's Signature Print PIC's Signature Print Town of Barnstable Regulatory Services Department Public Health Division SAntve ABLt suss. 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event ® 4 0, Date Table/Cart/Trailer Identification Name Telephone Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures Reheating Cooling _ Hot and Cold Holding Food and Food Protection 0 CONSUMER ADVISORY _ Posting of Consumer Advisories "W OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet Facilities Provided Inspector's Sign t re Print PIC's Signatur Print i Town of Barnstable Regulatory Services Department Public Health Division mass 6 200 Main Street, Hyannis MA 02601 3�a,� OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM AA Name of Special Event C Date Table/Cart/Trailer Identific tion N$me Telephone Permit Holder's Name f Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating _ Cooling _ Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered Adequate Toilet Facili' rovide i Inspector's Signature Print ` f� PIC's Signatur Print t� �/���w��V// � I Town of Barnstable Regulatory Services Department Public Health Division LM 1639 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event o fA 1147 L Date y Table/Cart/Trailer Identification Name elephone r Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed h _ Pre approved Menu Items Offered Only .A FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories , OTHER REQUIREMENTS Refuse Container(s)Provided/Covered _ Adequate Toilet Facilities Provided Inspector's Signat a Print R PIC's Signature Print j. Town of Barnstable Regulatory Services Department SAWWASM Public Health Division bss� t`' 200 Main Street, Hyannis MA 02601 a�� OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM horl Name of Special Event Date Table/Cart/Trailer Identific tion Name - '41Mr Telephone Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures _ Reheating Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered _ Adequate Toilet F ili'es rovi d Inspector's Signature Print p� PIC's SignatureJIM' Print It e ti Town of Barnstable FI E r � Inspectional Services Public Health Division + BARNSTABLE, M" $ Thomas McKean, Director plEO MA'S A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/26/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Jaiu Pierogi Name of Person: Casey White Address: 271 Western Ave Lynn MA 01904(C)413-221-5328 To serve: Assorted Cooked and Frozen Pierogis ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Casey White Allergen: Casey White Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: 1 DATE ONLY: 07/19 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY, TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable �FTHE Inspectional Services Public Health Division ■ BARNSfABLE, MAsa� Thomas McKean, Director W i639 �0 A'FD MA'S°' 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/26/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Jaju Pierogi Name of Person: Casey White Address: 271 Western Ave, Lynn, MA 01904(C)413-221-5328 To serve: Assorted Cooked and Frozen Pierogis ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Casey White Allergen: Casey White Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: 3 DATES ONLY: 07/19,08/16 & 09/13 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Diredtor of Public Health Town of Barnstable oF�"E ram. Inspectional Services Public Health Division � BARNSfABLE, ' MASS. s639;q. Thomas McKean, Director qj �0 AIFD MA'S A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/26/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Michael's Donuts Name of Person: Michael McFadden Address: 39 Bittersweet Rd, E. Falmouth, MA 02536(C)617-424-1299 To serve: Apple Cider Donuts ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Michael McFadden Allergen: Michael McFadden Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-l:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health I i Town of Barnstable Otl rows Inspectional Services Public Health Division * BARNSfABLE, v� " 9; Thomas McKean, Director ATFD MA'S a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/26/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Michael's Donuts Name of Person: Michael McFadden Address: 39 Bittersweet Rd, E. Falmouth, MA 02536(C)617-424-1299 To serve: Apple Cider Donuts ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Michael McFadden Allergen: Michael McFadden Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-July 23, 2019 FRIDAYS: 9:OOAM-1:OOPM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable oFt"E ram, Inspectional Services � do Public Health Division • BARNSTABLE, 'c6 639. �� Thomas McKean, Director pTFO MA'S A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Arnie Bakery Name of Person: Arnie Smith Address: 1254 Main Street, Osterville, MA 02655(C)508-519-4951 To serve: Croissants, Cookies, Scones, Muffins & Coffee ServSafe certified: Arnie Smith & Mica Andreotti Allergen: Arnie Smith Natasha Ivanov Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health I Town of Barnstable Inspectional Services Public Health Division • BABNMBLE, v� 1.39: Thomas McKean, Director A�fD MA'S a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: B-Side Coffee Company Name of Person: Tracy Shields Address: 82 Enterprise Drive, Chatham, MA 02633(C)774-209-9828 To serve: Coffee & Assorted Baked Goods ServSafe certified: Tracy Shields Allergen: Tracy Shields Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health i Town of Barnstable �FTNETpk, Inspectional Services Public Health Division + BARNSTABLE, i63Q. S. Thomas McKean, Director prFD M 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Bradford Farmhouse Toffee Name of Person: Amy Bradford Address: 27 Pleasant Street, Middleboro, MA 02346(C)617-849-4314 To serve: Toffee Caramels and Caramel Sauce ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Amy Bradford Allergen: Amy Bradford Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:OOAM-1:OOPM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable �FZHE 1 Inspectional Services Public Health Division + BARNMBLE, 9cb 1639. ��� Thomas McKean, Director prFO MA'S a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Sect-on 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Chrissy's Crumble Name of Person: Christine Le Blanc Address: 117 Garfield Street Watertown MA 02472 C0617-733-2622 To serve: GF Granolas. Crackers, Date Bites, Cookie Cakes & Brownies ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling andor serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Christine Le Blanc Allergen: Christine Le Blanc Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-l:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable oFz"E r Inspectional Services Public Health Division * BARNUABLE, 9Qp 1 MASS.. �m� Thomas McKean, Director Alf°MA'S a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: DaSilva Farms Name of Person: Felicia DaSilva Address: 430 Jepson Lane, Portsmouth, RI 02871(C)401-528-9442 To serve: Frozen Chicken, Beef& Pork and Eggs ServSafe certified: Felicia DaSilva Allergen:, Felicia DaSilva Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health I Town of Barnstable FINE 1ph, Inspectional Services ti Public Health Division ■ BARNSTABLE, + �cb 639; Thomas McKean, Director AlfD MA'S a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Forever Yong's Name of Person: Susan Shannon Address: 162 Bay Shore Drive, Plymouth, MA 02360(C)508-828-8188 To serve: Kim Bap, Rolls, Broth, Baked Goods, Soups, Salads, Wraps, Vegetable Dishes Sauces and Dips ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Susan Shannon Allergen: Susan Shannon Only at the following location: '155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable FT"E' Inspectional Services BARNSfABLE, Public Health Division * '": ��� Thomas McKean, Director AIFD MA'S s 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Foss Farms Name of Person: Douglas Foss Address: 35 Grand Oak Road, Forestdale, MA 02644(C)774-836-3723 To serve: Marinara Sauce ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Douglas Foss Allergen: Douglas Foss Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable oFtHE r�, Inspectional Services Public Health Division + BARNSTABLE, Thomas McKean, Director A'E0 MAC a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Frank's Cucina Name of Person: Frank Tammaro Address: 691 Main Street, Warren, RI, 02885(C)508-776-4272 To serve: Biscottis, Cakes, Tarts and Cookies ServSafe certified: Frank Tammaro Allergen: Frank Tammaro Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health I Town of Barnstable �pTNE 1p�� Inspectional Services Public Health Division BARNSfABLE, 1639. � Thomas McKean, Director ArfD MA'S A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Fraulein's Bakery Name of Person: Lilly Rempel Address: 1133 Fisher Road, Dartmouth, MA 02748(C)508-930-8604 To serve: European Sweet & Savory Strudels, Cakes, Pastries, Tarts & Cookies ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential j kitchen are prohibited! *** ServSafe certified: Lillpel Allergen: Lilly Rempel Only at the following location: 155 W. BE Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable oFtNE TOwti Inspectional Services Public Health Division * BARNSTABLE, 63MASS. ,�$ Thomas McKean, Director ArfD MAC a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Honey I'm Home Name of Person: Tim Cleland Address: 8 Atlantic Street, Plymouth, MA 02360(C)781-336-7681 To serve: Breads Pies Galettes Scones Muffins Granola Cookies Biscuits Brownies and Bars ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Tim Cleland Allergen: Tim Cleland Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL, GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable yoFtMETpk, Inspectional Services �7 �O Public Health Division * BARNSfABLE, 9cb 1639. � Thomas McKean, Director pIFDMA+a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Jaju Pierog_i Name of Person: Casey White Address: 271 Western Ave, Lynn, MA 01904(C)413-221-5328 To serve: Assorted Cooked and Frozen Pierogis ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Casey White Allergen: Casey White Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: 1 DATE ONLY: JUKE 21, 2019 FRIDAYS: 9:OOAM-1:OOPM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable OFIHE Tp Inspectional Services Public Health Division * BARNSfABLE, v "'Ass' i639• Thomas McKean, Director ♦� ArFD Mai a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Jammed With Love Name of Person: Christine Allison Address: 43 High Street, W. Bridgewater, MA 02379(C)781-789-7546 To serve: Jams, Jellies and Condiments ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Christine Allison Allergen: Christine Allison Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health i i Town of Barnstable �FIME Ta,. Inspectional Services Public Health Division * BABNSrABLE, ' v Mass.039. Thomas McKean, Director At6D MAC A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/18/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: The Local Juice Name of Person: Laura Howes Address: 539 South Street Hyannis, MA 02601(C)774-238-6410 To serve: Cold Pressed Juices, Nut Milks and Granola ServSafe certified: Laura Uchman Allergen: Laura Howes Only at the following location: 155 W. BE Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH - Thomas A. McKean Director of Public Health Town of Barnstable THE T � °F °wti Inspectional Services �tdas Public Health Division BARNSTABLE ■ # EAPd57n;4E•f9+TERV;IP G?7Ufi�Nv44rlli ' BARNSTABLE, • nssca,nr�5• �vvntee+.=.r eaan,+va.e MASS ie3e-aoia 1639• Thomas McKean, Director ArFD MA'S A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMERS MARKET - OSTERVILLE Permission is hereby granted to: Martha's Vineyard Smokehouse Name of Person: Jill Riedell Address: 23 Watcha Path, Edgartown, MA. 02655 To serve: Smoked Bluefish Spread & Filet, Smoked Yellow Fin Tuna Spread, Smoked Mackerel, Bonita & Bass Filet ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Nathan Gould Allergen: Nathan Gould Only at the following location: Osterville Historical Society, 155 W. Bay Rd. Osterville VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-I:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE" SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE. BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable oFt"E lOhy Inspectional Services Public Health Division * HARNSTASLE, i 9cb MASS.. Thomas McKean, Director .or fD MA'S a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Michael's Donuts Name of Person: Michael McFadden Address: 39 Bittersweet Rd, E. Falmouth, MA 02536(C)617-424-1299 To serve: Apple Cider Donuts ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Michael McFadden Allergen: Michael McFadden Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: 1 DATE ONLY: June 21,2019 FRIDAYS: 9:00AM-I:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable �FIKE Tp Inspectional Services Public Health Division * BARNSfABLE, 9cb 63S. ,�� Thomas McKean, Director ArFD µay a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Monopati Name of Person: Maria Lemanis Address: 7 Queens Way, Sandwich, MA 02563(C)508-888-1045 To serve: Olive Oils Olives Peanut Hazelnut and Almond Butters Baklava Greek Baked Goods & Cookies ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Maria Lemanis Allergen: Maria Lemanis Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health i Town of Barnstable oFt"ET°wti Inspectional Services Public Health Division BARNKrABLE, 9cb 6;9. 1 Thomas McKean, Director ATFD MAC a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Say Cheese Name of Person: Joanne Chipman Address: 247 Rounseville Road, Rochester, MA 02770(C)508-728-1688 To serve: Pre-Packaged Cheeses-NO SAMPLING ServSafe certified: N/A Allergen: Joanne Chipman Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:OOAM-1:OOPM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health I Town of Barnstable y�pIHETph, Inspectional Services v7 �O Public Health Division * BARNSfABLE, v� 6,39: � Thomas McKean, Director ArfDMa+a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax:"508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Stir Crazy Restaurant Name of Person: Channa Uy Address: 570 MacArthur Blvd, Pocasset, MA 02559(C)508-904-4408 To serve: Assorted Spring Rolls, Soups, Noodle Entrees & Rice Entrees-ALL FOODS MUST BE SERVED AND KEPT COLD! ServSafe certified: Channa Uy & Kimchhay Chou Allergen: Channa Uy Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES:Weelcly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable oF�"E r Inspectional Services Public Health Division • HARNSfABLE, � 9cb 639; Thomas McKean, Director AlFD MA'S a 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Tekla's Braids and Breads Name of Person: Janet Mohre Address: 9 Easterly Drive, E. Sandwich, MA 02537(C)508-364-0319 To serve: Scandinavian Sweet Breads, Rye Breads, Cakes and Pies ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Janet Mohre Allergen: Janet Mohre Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable °F THE l°� ' ti Inspectional Services �aan� .,� Public Health Division BARNSTABLE * BARNSfABLE, * n.ne!usrne!t•�Jnezr:_ie-<x�rurrarcaxeis MA98. nan^nr,ni,r<.•os-=n�:r�.e.n-es*w.nn�aei r Thomas McKean, Director � ,l , 200 Main Street, Hyannis, MA 02601 J 1 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMERS MARKET - OSTERVILLE Permission is hereby granted to: Treasure by the Sea Name of Person: Jean Tempesta Address: 10 Tiller Drive, East Falmouth, MA. 02536 To serve: Jam, Jelly, Pickles, Cranberry Bread, Blueberry Bread, Apple Cinnamon Bread ***All foods shall originate from an approved source per Section 3-201.11, the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen are prohibited! *** ServSafe certified: Jean E. Tempesta Allergen: Jean E. Tempesta Only at the following location: Osterville Historical Society, 155 W. Bay Rd. Osterville VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable loft"E'as• Inspectional Services ti Public Health Division * HARNSfABLE, 9cb MASS. . Thomas McKean, Director ArFD MA'S A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/13/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: Washashore Bakery Name of Person: Sandy McPherson Address: 14 Central Square, Mashpee, MA 02649(C)508-419-6835 To serve: Assorted Cookies, Pies, Quick Breads and Cinnamon Rolls ServSafe certified: Katherine Allen Allergen: Katherine Allen Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable y�F4HE Tpk, Inspectional Services J O y Public Health Division + BARNMBLE, 9 MASS. Thomas McKean, Director i639• �� pTfD MAC A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 PERMIT TO OPERATE In accordance with regulations promulgated under authority of Chapter 94 Section 395A and Chapter 111, Section 5, of the General Laws, a permit is hereby granted to: DATE: 06/28/2019 Event: FARMER'S MARKET-OSTERVILLE Permission is hereby granted to: My Fathah's Salsa Name of Person: Benjamin Johnson Address: 9 Oyster Hill Drive, Sandwich, MA 02563(C)508-523-4358 To serve: Shelf-Stable Salsa ServSafe certified: Benjamin Johnson Allergen: Benjamin Johnson Only at the following location: 155 W. Bay Rd, Osterville, MA 02655 VALID ONLY ON THE FOLLOWING DATES: Weekly: June 21-Sept. 13, 2019 FRIDAYS: 9:00AM-1:00PM APPLICANT MUST CONFORM TO ALL ZONING REGULATIONS IN ADDITION, IF SOCIAL GATHERING IS IN TOWN PROPERTY, PERMITS MUST BE SECURED FROM APPROPRIATE AGENCY. TOWN OF BARNSTABLE BOARD OF HEALTH Thomas A. McKean Director of Public Health ication.pdf Barnstable Public health Division APPLICAT1ON FOR TEMPORARY FOOD SFRV ICF,PURNITT D4T£. SXJ 1. j. NAME OF SPEX:IAL.FVEtiT OStely le Farmers3'-Market;2019 Season , Ni'A3'rITISEVE,NT.4PPROVFD.RVTBC,BOAROA'f"UBLIC%W.F,1'1!NG? .X Y —N ,N.ALN7EOFPER.SO'.v(S)RFQ(JE5TtM1GYERMII' 3ENN"IFERWMIJAM&sxuFTrifvcDlR4'CTOR ITUE•PI NiE7 SUt3,42&SNh1 f.'EIA,S,5tt8-..ZBft-}tfiS2 HOME:ADDRESS H,S W.t BaV Rna„rd�� } VILL AGE 2.te—Ing NAME OF ORGANTZATION !Y! GONTACI'PFRSO,ti'.,.�.� �_. SLr. TELEPHONE •���'•S%'hj._��'J Sy ADDRESS G� G��Sr � trtr .- �nuhc li to fly "? FOOD TO BE SERVED(Lls'r Ex ir.r FOODS) ti ,S O7 TRALgED FORD HANDLERS(TO BE ONSITE DTMI1C EVENT): _<r Vic:✓ ADDR&SS WHERETO"SERVED_(htety7lfc istnrirsl Mbscntta 7CS WesTBav Road.Oslmg iAy655 DA'I'E IY)KE SFR VED.ileac 27-SeM�e 13 TIME.9 3.1m fix I o:ar WHATTIMI-WILI,A(I.EQUIPHENTBF.SET-L;P&RFADV FO.RFN.-SPRCI'.ION' ITOW WILL FOOD BE KErr BELOW 47.DI+:(;RM, E EIOW WIL,FOOD BE MULD AT 140 DEGREE-,F... J . HOW IS FOOD COVE:RFD IIOWISI-'QODSFRVFr) •S ilr9u- "7 . (Cca G% <� TVI'EOFHAYD-1VASHlNGFACILI7'Y SIGNATURE __ ,r-'�t�'t'u'•.. ,t �. u ServScif' e"�' CERTIFICATION . BENJAMIN-� JOHNS,Q,. . ...,'..:.,.,- for/� successfully completing the standards set forth for the ServSafe®Food Protection Manager Certification Examination, vJ which is accredited by the American National Standards Institute(ANSI)—Conference for Food Protection (CFP). ;- 10671911 q ER . EXAM FO MBER , RM NU 3/9/2019 3/9/2024 � Y DATE OF EX DATE OF EXPIRATION Local laws apply.Che cy for recertification requirements. i ®i Sher #0655 ciation Solutions- B. � In accordance wi ie ServSafe bgo are trademarks of the NRAEF.National Restaurant Association®and the arc design �" Contact us with questions at 233 S.Wacker Drive,,Suite 3600,Chicago,.IL 60606-6383 or ServSafe@restaumnt.org. ve- c _rryxn- �,�.._ �_v.,v-rr•g-sz�r5�""v-ar::�vxr •rsx•�'carrvvrax�r�w—'z�9"� �-sr -i-r -ar-e-v- r u�rir..—••.••..,.-�rx•^x-^axx:am zrczvsysrausr:err-cy«vc•<z'x^r�r.�,s-zz^.�'.s-�,•z ar- t i P r CERTIFICATE OF ALLERGEN AwARENESS Tl fi Name ame of Recipient: BENJAMIN JOHNSON C.ertlf c te.lVllmber: 3468129 r Date of Completion: 6/2 812 01 3 Date of Expiration: 6r2ei2o23 Issued By: The above-named person is be reby issued this certtficate' � for ronirletr'ri�rartaller�renazcarenesstrainingprogtarrt �� � �f RESTAURANT tea,, ti uYrtzi f m^'.a�fr:. .93SiP recognized Iy tfre Massachusetts Department of'Ptiblic Health ASSOCIS�ION in accordance with 105 CAM 590,009(G)(J)(a_). Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 tv%mrestaurant.org: Southbxorough,CIA 01772 h This certificate,i;ill be valid for fzz=e(_S)years f roin elate'of rotrtpletioti. 503-303-9905 Y���, � wlvrv.m:ucstmrantassoc.org _ q (�` r � �`�.SS.T3S_4..FS��.F Efr� �.>refl�YG"�".SA ^��n��'93��d�El�i�:b.C�K2�ASS���"ar'��isc�.32Aier x�.L B�.'S- z S•• .CYGLbtT!4�EFC!!�s�1193�.1 C sb` From: McKenzie, Marybeth Sent: Thursday, June 28, 2018 12:09 PM To; 'Jennifer Williams' Cc: McKean, Thomas; Stanton, David; Bellaire, Dianna Subject: Osterville Farmers Market Helao Jennifer, Hope all is well and thank you for following me on the inspections during the market and working to correct violations! I have been working,the past three days, on getting everything in order for your Farmers Market. I am going to list the issues that I have come across with some of the vendors and go over some issues that were noted during the farmers market so that we can work on correcting them and educating your vendors. Our main concern is safety for both the public and the vendors, so if you have any questions at any time please feel free to contact me and I will try my best to answer them or help you find an answer. First off I like to let people know that the food code is science based and it works both ways in protecting the public and businesses. It is also a very good resource for business and if it is followed it makes for a very safe business plan which can help with the liability of running your business. Also, acting as the manager, person in charge,you are taking on the responsibility and liability of the vendors that are on your site so it is in the best interest for all to do things correctly.This is rather long( so grab a cup of iced tea), but I am trying to itemize it so it will be the easiest to read and understand, but once again please let me know if you have questions. If you are aware of some of this information then please forgive, but I am trying to make this process easier and I noted a few areas that need to be addressed which would help make a safer and better market.So here it goes! I know how some people can be with setting up in the same location, I get it, but when you look at the market site take note of the shaded areas.The vendors with the most potentially hazardous foods should be kept in the coolest place if possible.This will help with keeping all the products in the correct temps and the constant refilling of ice. There are a few things that I would like to go over with you regarding new vendors. When a new vendor comes to you to sell their product they should have all their information for you, especially where the product (the permitted kitchen) is being made before they start selling the product. I am saying this because by having it all in place before hand you can check on what product is allowed to be made in these residential kitchens. Residential kitchens are only allowed to make non potentially hazardous food, basically food that is safe at room temp ( cookies, brownies, bread- no cream filling or anything than might need refrigeration). So when they first come in and you see that they have a residential kitchen certificate and they are making/selling jarred pickles or quiche,you should questions this and call the health departments that are permitting them to verify that that product has been approved to be made in that kitchen.That is fine to do and we, as health departments, appreciate that it is being checked on. If they are doing any special processes, like canning (except for jams and jelly), in a residential kitchen then this should alert you to asking more questions too. If you ever have a question about a process or what is allowed, please reach out to the inspectors, we are a good resource.A few of the:residential kitchens that were selling product on 6/22/18 were not actually permitted to make/sell those products, I verified it with the different town health departments, and they will be listed below. From now on, all residential kitchens will have to have a letter from the permitting authority stating exactly what products are allowed to be made/processed in that residential kitchen when applying for a permit from the Town of Barnstable. Hand washing is probably the one of the most important things a person can do in the food industry and that is why the health department requires handwashing stations. Bare hand contact is not allowed in the state of MA, therefore, proper handwashing and using utensils,gloves,tissue paper is required to handle ready to eat foods.Also, handling money and then handling food product opens an avenue of cross contamination that can get people sick and therefore effect their company. I believe when people realize how important it is to protect their food from contamination then in the long run it protects their company too. Michael's Donuts,was one vendor that I noted that had people helping him and were not trained in proper hand washing or plastic glove protocol. One person, wearing gloves,would serve the product, take one glove off, take the money, and then re-glove one hand.You need to wash your hands in between changing gloves/processes. While on site I corrected this action, by having one staff person collect the money while the other, with clean gloves, served the donuts. Michael, as the person in charge, must instruct his staff on proper hand washing and handling of food product,that is his responsibility and protects his company in the end. This brings up hand washing station requirements. Mike's Donuts did not have the approved hand washing station on site. He did not have any hot water(110=/-it was in a non-insulted container(plastic bottle) or the grey water bucket that should be located under the spigot to catch the used water.All vendors that are either offering samples of food product or serving individual unwrapped roduct will need to have the approved handwashing station.The hand washing station must have n in ulted container that will hold the water at 100-110 degrees. It needs a spigot type "faucet",a basin will catch the used water, a soap dispenser, and paper towels. Cape Cod Popcorn vendor had the perfect set up and I sent a lot of vendors over to look at it. Cape Cod Popcorn had his paper towels bungeed through the handle so they couldn't blow around,which was a great idea. Vendors that need the handwashing station can be located next to each other and share the set up, but the:access to it cannot be blocked. Some suggestions concerning the hand washing station: If the vendor has all prewrapped product and test samples, which must be done at the site of the permitted kitchen before arriving to the market. Then they would not need a hand wash station because there would not be any risk of bare hand contact. I know how some people can be with setting up in the same location, I get it, but when you look at the market site take note of the shaded areas.The vendors with the most potentially hazardous foods should be kept in the coolest place if possible.This will help with keeping all the products in the correct temps and the constant refilling of ice or changing ice packs out. . All food product must be covered to protect it from contamination. Mikes donuts had all their product uncovered.The cooled product had the lid propped up and the cooling product was uncovered too. I understand that the cooling product can't be covered with a solid lid or sneeze guard type, but it can be covered with escreen.This allows the product to cool and protects it. All trash cans need to have lids too.This cuts down on attracting pests to where food is being prepared/sold and makes for a cleaner safer market. Any vendor selling potentially hazardous foods must keep the foods in the correct temps. So, logs will be needed for temperatures. Please have them record the temperature of the product before leaving the facility, arriving on site/setting up, and once every hour(because of the heat and opening the coolers the temperatures can rise quickly). I will be requiring to view the logs so please tell the vendor to have them on site.The thermometer should be in the warmest part of the unit to verify that all product is within the safe zone,41 degrees or below. Helpful hints, that I have learned from other vendors, is that if they precool the coolers with either ice water(they empty it and dry it before putting product in) or in a walk in cooler(if a ailable)the product doesn't have to cool the unit off and it helps maintain the correct temp. Also, itthe coolers are covered with clean thermal blankets it will help insulate the coolers while they are on site. The vendors should have their certification for food managers or certified food handlers on site and that person, with the certification, must be on site too. The allergen advisory must be posted, if a menu with a price is listed.This advisory protects the company and gets communication going between the vendors and their patrons. I usually keep extra advisories with me just in case someone needs one too, but you may want to make a copy of the verbiage too just in case someone needs it. Please refer to the Temporary Outdoor Food Vending requirements-Weekly Events-for all other requirements too. Here are the following issues noted concerning the vendors at your market. I have alphabetized them to make it easier so if one is missing then there wasn't a problem. I have also included some tips that might help make things easier for the vendors: Aine's Bakery—Different Certified food Manager on site then what was in the application. She didn't have any verification that she took the course. So an invoice for her class will be needed to be provided until she can print her certificate. She was aware of this and I did tell her that during the inspection. Product for individual sale/served (which is fine to do), but a hand washing station was not available at her site and will be needed this week. Maybe she can be next to another person so they can share. Dasilva-selling eggs which was not on permit please revise the permit. Also, eggs must be kept at 45 degrees or below.Thermometers need to be readily available to read in the cooler units, if they slid down to the bottom under all the product it become a pain in neck to dig through and find the thermometer. A suggestion that I have learned,from other' ood establishmene, is to put the thermometer in a large ziplock bag or a plastic container so it doesn't slip down between product and it is easier to find in the unit. Forever Young-will not be able to sell any product beside baked goods.Their catering permit was only approved for baked goods,this was verified by the health department that permits the kitchen. Kimchi and other products she was selling can be very dangerous products,we can go over that when I see you. So only non potentially hazardous baked goods may be sold and if she is doing sampling then she will need an approved hand wash station. I Foss Farm- Need verification of lab testing to show that the product is shelf stable. I have notified him and he will be sending it to me. Also, is he is doing samples then a hand washing station will be needed. He:must keep his open jar(sample)at 41 degrees or below which he stated on his permit, but was not being done.This can be easily accomplished by bringing a cooler and filling it with ice or cold pacts. I spoke to him and told him that he needs to show the laboratory testing that the product is shelf stable and is safe to leave at room temperature, if it is not provided then he will have to keep his product at 41 degrees or below. Honey I'm Home OMnot prepare or sell quiche because it is a PHF and it cannot be prepared in a residential kitchen. I have also notified that health department about the quiche and they have verified that is was not approved to make there. I have spoken with him and he understands. No samples served at this vendor. No signature is on the application which needs to be corrected I will bring it with me so he can sign it. Franks Cucina-was not on site last week. Kalamata-Was not there; making chips in residential kitchen and hummus in permitted food establishment. I spoke with him about sampling and handwashing station,temperature logs, thermometers, and other requirements. Let'Us Farm-was given a Cease and Desist for making salads on site without any license. He only sells kale, unprocessed, so he doesn't need to be permitted, but he cannot prepare any product or will be required to meet all the state requirements. Little River Bee works—raw honey only, so no need to permit Local Juice- needed thermometers in their cooler units.The product was correctly stored on ice at the time of inspection. Martha's Vineyard Smoke House- not there last week Mike's Donuts- Had issues that need to be addressed before the next time he starts to cook. ichal needs to teach the people, whom are helping him,about proper hand washing and glove use.An approved hand washing station was not on available at his station/site. Product needed to be covered, lid was needed on the trash and the cider, if pasteurized, needs to be refrigerated after opening if not used quickly. Extra containers and utensils should be on site to use in case the mixing bowls get contaminated. Monopati- No approved handwashing station available and was giving out samples. I am checking with the Sandwich Health department to find out what they are approved to make in their residential kitchen. My Fathah's Salsa- not permitted but selling product. I have been working with the owner in getting the permitting information and informed her that to sample she will need a hand washing station. I have received her laboratory testing stating that the product is shelf stable. If a product is being left out at room temperature then it must be laboratory tested to confirm it will remain safe. Also,the chips offered will need to be covered and served by the staff.The open container of salsa was being kept cold I on ice in an insulated bag,which worked perfect, and the salsa was served by the vendor with a spoon. They did a good job with that part. Nonna Elena- not there Say Cheese- need to keep thermometers in the coldest location of cooler and log her temperatures, which she was correcting on site. I understand that she is a broker of cheese products, but I am wondering where all this product is stored and it must be stored in a licensed facility. I am not familiar with this type of business so I will be speaking with her at the market and checking with the state on what is allowed. Stir Crazy—was not there and if she plans on going tomorrow please make sure that she is only selling the:product that was approved and that an approved handwashing station is set up for her use. Also, temperature logs,thermometers,trash with lid, etc. Telka's product was sold out by the time I got to her so I will be checking things this week. Treasure By the Sea- Is not permitted to sell pickles that are made in a residential kitchen,this was verified by the Falmouth health department. Once again PHF's are not allowed to be produced in residential kitchens and no laboratory testing was done to see if the product is shelf stable and it was being kept out of temperature, not refrigerated, at the market. Valcourt Sugar Shack No sampling without a handwashing station. Wa;shashore Bakery—will need a handwashing station to serve open product individually and give samples. I hope I have covered everything, but if anything else comes to mind I will contact you. Once again, if you have any questions, please contact me. I will be happy to help and I look forward to see you at your market tomorrow. Regards, Marybeth McKenzie R.S. Health Agent Town of Barnstable 5o8-862-4644 r � I ti V t To: Barnstable Board of Health From: Jennifer Williams, Executive Director Osterville Historical Museum/Osterville Farmers' Market Re: June 25 BOH Hearing We are requesting an additional 9 dates for Mike's Donuts to participate in the Osterville Farmers' Market (every Friday from July 12 to September 13, 2019). He has passed all inspections during his two consecutive successful seasons at the Osterville Farmers' Market. We are additionally requesting 3 dates for Jaju Pierogi to heat pierogis in an electric griddle. The full ingredient list (non-hazardous food) has been provided along with layout of booth. (Please see materials submitted.) On June 6, we met with Tom McKean and he expressed his favorable review of our requests as we discussed both vendors in detail. We appreciate the board's consideration of these two vendors and would be happy to provide further details as needed. Town of Barnstable Regulatory Services Department Public Health Division ( 1 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event had Date Table/Cart/Trailer Identification Name jL1 Telephone (C' Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed re approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT !� Lv" _ PIC Assigned/Present Onsite Q� — — -� CtYVL PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing _ Foods Covered �� -- `>¢Q(`.i;. �` LL� l h P Yti�L�� _ 09 Proper&Adequate Handwashing/Temporary Handwashqo- !( Station Location �V ' "1 -tz ft�;e- _ Good Hygienic Practices(Use of gloves,use of tongs or tissues TIME/TEMPERATURE CONTROLS rw _ Cooking Temperatures Re eating _ Cooling Hot and Cold Holding wo(d and Food Protection ! lt% �-/Y CO SUMER ADVISORY `Y� C _ Posting of Consumer Advisories 1<4� OTHER REQUIREMENTS /�y c Refuse Container(s)Provided/Covered LP Adequate Toilet Facilities Provided Inspector's Signature Print �j� IC's Signatu e e �U�&—Wint 427 -j Town of Barnstable Regulatory Services Department l Public Health Division 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event Date Table/Cart/Trailer Identifiication Name �- Telephon Permit Holder's Name e i r Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed Pre approved Menu Items Offered Only FOQ'D PROTECTION MANAGEMENT PIC Assigned/Present Onsite t PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing /C Foods Covered ` T�� C� Jx51P(&4 jA— V` Proper&Adequate Handwash ing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) a .,,.- TIME/TEMPERATURE CONTROLS W _ Cooking Temperatures Reheating Cooling Hot and Cold Holding _ Food and Food Protection M.Le" (U L C SUMER ADVISORY C s l� �j vC �! Posting of Consumer Advisories 7v —e �f OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered in 0 Adequate Toilet Facilities ProvidedS'e Inspector's Signature Print PIC's Signature V Print I Bellaire, Dianna From: Jennifer Williams <jwilliams@ostervillemuseum.org> Sent: Monday,June 10, 2019 9:25 AM To: Bellaire, Dianna Cc: Crocker, Sharon; Miorandi, Donna Subject: Re: Osterville Farmers Market-2019 Hi Dianna, I was sorry to have missed you at the end of the day on Thursday following my meeting with Brian and Tom. Residential Kitchen Permits: Per that meeting, no further details are needed from each board of health re: the residential kitchen permits. Also, Say Cheese is not required to have a peddlers license, so she is all set according to Tom. Application to the BOH: Please email me whatever application I need to fill out to be on the agenda for the next BOH hearing (June 25) for 9 dates for Mike's Donuts and 3 dates for Jaju. Both Tom and Brian are in support of this. Mike's Donuts will start his three dates on June 21st (June 21, June 28, July 5). Also per Tom's recommendation, we will request the additional 9 dates of the market for Mike's Donuts to be in place. Since Mike's Donuts successfully passed inspections for the past two seasons, Tom is fully supportive of this and has said that he will recommend adoption of this to the boh. Jaju is requesting heating on an electric griddle. They are asking for 3 dates--not because of a regulation (there is none)--but they are only able to attend three markets. They will also be favorably recommended by Tom as he concurred they are plant-based with no potentially hazardous foods. Healthy Street Food is not requesting heating--that was last year. Everything they do is pre-packaged. There is no need for additional boh approval. Serve Safes: The two requests for 5-year serve safes that remain--Mike's Donuts and Treasures by the Sea--are also set at this point according to Tom. They are not required at this time... Market Fee: The museum is happy to pay the additional $80. Last year, we were told we paid too much the prior year. This year it is the reverse. We have traditionally paid $100 per year. This was based upon two things: the number of market dates (12) and our non-profit status. Can you confirm this? Anything in writing would be. most helpful. I have a few additional documents that I will be sending you to complete your requests. I am looking forward to working with Donna! Our farmers, vendors, and patrons are excited for the season to begin...After over a decade, we have a very strong market fan base... Many thanks! Jennifer On June 3, 2019 at 3:36 PM "Bellaire, Dianna" <Dianna.Bellairentown.barnstable.ma.us> wrote: i Bellaire, Dianna From: McKean, Thomas Sent: Monday, June 10, 2019 10:20 AM To: Crocker, Sharon Cc: Bellaire, Dianna Subject: Re: Osterville Farmers Market-2019 Sharon This is - With the exception of the three dates for cider donuts. We are helping her hopefully get approval for all nine dates for the donut cooking From: McKean, Thomas Sent: Monday, June 10, 2019 10:17 AM To: Crocker, Sharon Cc: Bellaire, Dianna Subject: Re: Osterville Farmers Market-2019 Good Morning, Sharon, please ask Jen Williams to coordinate the interested vendors, who wish to cook, on the same three dates. It is not scheduled separately for each separate vendor. The reason is to ensure inspections are scheduled and coordinated on those specific dates. As for the request for donuts on nine dates, that is a separate request on the same agenda. This requires Board of Health approval also. The few Servsafe certifications that are expired or deficicient will be updated on a future date per Ms Williams. From: Bellaire, Dianna Sent: Monday, June 10, 2019 9:56 AM To: McKean, Thomas Cc: Bellaire, Dianna; Crocker, Sharon; Miorandi, Donna Subject: FW: Osterville Farmers Market-2019 Tom; Could you please clarify all the results given to me by Jennifer Williams below? I've given her the information for June board meeting and Sharon is adding her to the agenda for June regarding the 9 dates. Could you please comment on the others?. Thank you. Dianna Bellaire Permit Technician Town of Barnstable Health Division 1 I Bellaire, Dianna From: McKean, Thomas Sent: Monday, June 10, 2019 10:18 AM To: Crocker, Sharon Cc: Bellaire, Dianna Subject: Re: Osterville Farmers Market-2019 Good Morning, Sharon, please ask ten Williams to coordinate the interested vendors, who wish to cook, on the same three dates. It is not scheduled separately for each separate vendor. The reason is to ensure inspections are scheduled and coordinated on those specific dates. As for the request for donuts on nine dates, that is a separate request on the same agenda. This requires Board of Health approval also. The few Servsafe certifications that are expired or deficicient will be updated on a future date per Ms Williams. From: Bellaire, Dianna Sent: Monday, June 10, 2019 9:56 AM To: McKean, Thomas Cc: Bellaire, Dianna; Crocker, Sharon; Miorandi, Donna Subject: FW: Osterville Farmers Marlket-2019 Tom; Could you please clarify all the results given to me by Jennifer Williams below? I've given her the information for June board meeting and Sharon is adding her to the agenda for June regarding the 9 dates. Could you please comment on the others? 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 F From: Jennifer Williams [mailto:jwilliams@ostervillemuseum.org] Sent: Monday, June 10, 2019 9:25 AM To: Bellaire, Dianna Cc: Crocker, Sharon; Miorandi, Donna Subject: Re: Osterville Farmers Market-2019 I i Hi Dianna, I was sorry to have missed you at the end of the day on Thursday following my meeting with Brian and Tom. Residential Kitchen Permits: Per that meeting, no further details are needed from each board of health re: the residential kitchen permits. Also, Say Cheese is not required to have a peddlers license, so she is all set according to Tom. Application to the BOH: Please email me whatever application I need to fill out to be on the agenda for the next BOH hearing (June 25) for 9 dates for Mike's Donuts and 3 dates for Jaju. Both Tom and Brian are in support of this. Mike's Donuts will start his three dates on June 21st (June 21, June 28, July 5). Also per Tom's recommendation, we will request the additional 9 dates of the market for Mike's Donuts to be in place. Since Mike's Donuts successfully passed inspections for the past two seasons, Tom is fully supportive of this and has said that he will recommend adoption of this to the boh. Jaju is requesting heating on an electric griddle. They are asking for 3 dates--not because of a regulation (there is none)--but they are only able to attend three markets. They will also be favorably recommended by Tom as he concurred they are plant-based with no potentially hazardous foods. Healthy Street Food is not requesting heating--that was last year. Everything they do is pre-packaged. There is no need for additional boh approval. Serve Safes: The two requests for 5-year serve safes that remain--Mike's Donuts and Treasures by the Sea--are also set at this point according to Tom. They are not required at this time... Market Fee: The museum is happy to pay the additional $80. Last year, we were told we paid too much the prior year. This year it is the reverse. We have traditionally paid $100 per year. This was based upon two things: the number of market dates (12) and our non-profit status. Can you confirm this? Anything in writing would be most helpful. I have a few additional documents that I will be sending you to complete your requests. I am looking forward to working with Donna! Our farmers, vendors, and patrons are excited for the season to begin...After over a decade, we have a very strong market fan base... Many thanks! Jennifer On June 3, 2019 at 3:36 PM "Bellaire, Dianna" <Dianna.Bellaire@town.barnstable.ma.us> wrote: Jennifer, I've reviewed all the applications given to me. I've made an Excel Sheet which lists every vendor. You will see"m ye ll ow"what we need from each vendor. I know some of your people �._. are residential kitchens and they have more criteria. I've attached the email from last year, written by Marybeth Mackenzie, stating what you needed in regards to vendors and residential kitchens. I didn't start the applications last year. I was hired towards the end and Marybeth gave me a copy of that letter. 2 I You are required to have 5 year Servsafe Certificates. I am giving my completed file to your new inspector this year, Donna Miorandi to review and state if she has any other requirements or changes. I've spoken to Tom Mckean and Sharon Crocker and your event requires a payment of $180.00. You did pay $100.00 last year but, that was incorrect. The year before you paid $180.00. So, we will need $80.00 more dollars. I've processed the $100.00 check already. Can you please make a check for the difference made out to the Town of Barnstable. If you have any more questions regarding this issue, you can call and speak with Sharon Crocker. If you have any questions about the documentation, please email me or call me. There are 2 vendors which were allowed only 3 dates. I need the 3 dates for Stir Crazy and Mike's Donuts. I have to print those dates on the permits. 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.B ellaire@town.barnstable.ma.us Jennifer Morgan Williams Executive Director, Osterville Historical Museum: 1 lome of the Crosby Boats President, Cape & Islands Historical Association PO Box 3 • Osterville, MA 02655 3 Jennifer, I've reviewed all the applications given to me. I've made an Excel Sheet which lists every vendor. You will see "m"yellow";what we need from each vendor. I know some of your people are residential kitchens and they have more criteria. I've attached the email from last year, written by Marybeth Mackenzie, stating what you needed in regards to vendors and residential kitchens. I didn't start the applications last year. I was hired towards the end and Marybeth gave me a copy of that letter. You are required to have 5 year Servsafe Certificates. I am giving my completed file to your new inspector this year, Donna Miorandi to review and state if she has any other requirements or changes. I've spoken to Tom Mckean and Sharon Crocker and your event requires a payment of $180.00. You did pay $100.00 last year but, that was incorrect. The year before you paid $180.00. So, we will need $80.00 more dollars. I've processed the $100.00 check already. Can you please make a check for the difference made out to the Town of Barnstable. If you have any more questions regarding this issue, you can call and speak with Sharon Crocker. If you have any questions about the documentation, please email me or call me. There are 2 vendors which were allowed only 3 dates. I need the 3 dates for Stir Crazy and Mike's Donuts. I have to print those dates on the permits. 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 Y ^n^ r t 2 Lon Town gat BarnstableHealth 1•>ay lerts. �� orts A�pl,ca�l�ns )O> _.. .................... ................ ._......_ __.... _._...�__._.:............... ..__--;-- _.;...........:......�.._. ..._... Pay Check n Pay Type Permit Owner Business Location. Parcel Pay Date Amount Method dumber + .=i O~.=F:�;!..,.F 1:STt1F CA.:,. "y�(c:'.dii 15: . 1 `iT tr' 11 ijs6 06 i 412 `.'9 g1i)rJ Check 'j F t:�s)7i 5L?c.iE"1 r ?P7C' OoiclV:,c Farmers PYa ke. `t STC�F. CA—'. C S : . 15`s,. c,T .,-=,ti 1 Ki.fi 05"',7-?218) r.100 Ch�;'i �:{i (-J F ;e`p 3 i SOCIETY J �c'CrY1265 {:�A. t1W .J cc�n�1� ST�R>.'•' LE i. Tr'; ;t>:_ 1 ` ST •At 115� 6 07102017 $30 Check 664IS ,}> digs �,.;i RDAa L] - 1' T _(1=la'_ �' Ic l' 15 s 1 S 1 AY... 1 1 vL: r; , J e ::? 181C1 {'tt i�: .�+ I.fl_ R cc.{�1 ROA ,�e 4i-,�. ET} W; fa rig make . coots t � ,y -, `1 e�=4ilse. "1"��'" it�l BAY 116ti.%:�5 I�t6 77 2.`r� '�'1i)L, Checkozz r'l.h: 3C)CiETY ',dC His..,r:c._, SLi:::IBiY, :1C. TE7.F_ over'He 155 AM[Ba',, G5201.5 ';`l oC! Check 529E H!s.xc.a.Sof , EST AY ilGC86 0601200 1 3 i Check 6271 rat R< � ,{.� Fxn-Yr� l;ut,,�, �i .�,,•,;.:e MEN '�' SGCIEII :?JC s Town of Barnstable Office:508-862-4644 Fax:508-790-6304 Regulatory Services Department Public Health Division �+ MASS; Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt ------- .Food Service Permits Payment received: $100.00 (Check) on 6/4/2019 Permit number: FY19 i ;Check number: 5060 Check amount: $100.00 Name on check: Osterville Historical Society Inc, PO Box 3, Oster i Business: Osterville Historical Society Owner: Osterville Farmers Market OSTERVILLE HISTORICAL 'SOCIETY INC { :Address: 155 WEST BAY ROAD, Osterville I I Note: TempFY19- Osterville's Farmers Market-should pay $180.00 i of Town of Barnstable Office:508-862-4644 -y Fax:Regulatory Services Department 508-790-6304 B'STAHL& Public Health Division MAW Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt ;Food Service Permits Payment received: $100.00 (Check) on 5/17/2018 Permit number: Osterville F j I Check number: 5002 Check amount: $100.00 Name on check: Osterville Historical SocietyInc. .Owner: OSTERVILLE HISTORICAL SOCIETY INC l Address: 155 WEST BAY ROAD, Osterville Note: 2018 Farmers Market 06/22-09/14& 10/06 Town of Barnstable Office: 508-862-4644 �L.� Regulatory Services Department Fax:508-790-6304 *' &ULVS ABL& Public Health Division Mom Thomas A.McKean,CHO ba 200 Main Street, Hyannis, MA 02601 Payment Receipt Food Service Permits Payment received: $30.00 (Check) on 7/14/2017 J i Check number: 6646 Check amount: $30.00 Name on check: osterville historical society Owner: OSTERVILLE HISTORICAL SOCIETY INC Address: 155 WEST BAY ROAD, Osterville ;Note: Pigs & Pearls event-Osterville Fish, Rendezvous Cafe, Porky's BBQ, Washashore Bakery &Michael's Donuts Town of Barnstable Office:508-862-4644 Fax:508-790-6304 Regulatory Services Department anKN aep: • Public Health Division Y MASS: Thomas A.McKean,CHO a 200 Main Street, Hyannis, MA 02601 Payment Receipt -------------- ------------ -- --------- ----------_------ ---_-- --- —, Food Service Permits Payment received: $180.00 (Check) on 5/30/2017 .Check number: 6598 Check amount: $180.00 Name on check: Osterville Historical Society, Inc. I ;Business: Osterville farmer's market Owner: OSTERVILLE HISTORICAL SOCIETY INC 'Address: 155 WEST BAY ROAD, Osterville Note: Osterville Farmer's Market C"C� • C'clYYe �arr1 _--. __.- .._-.--- -__._._ _..__.__.___- __..___. ----_-_-- Town of Barnstable Office:508-862-4644 1. Fax:508-790-6304 Regulatory Services Department enx.N OLL Public Health Division MASS. Thomas A.McKean,CHO .� ` 200 Main Street, Hyannis, MA 02601 Payment Receipt -----------------____---_.-__._.__-____.----___.___........_-.---.--_---_._____.---------_.__.---------.___._..--.---------_..___._-------------------__._.__ Food Service Permits Payment received: $100.00 (Check) on 6/27/2016 Permit number: Ost Farm.Mkt j I .Check number: 6421 Check amount: $100.00 Name on check: Osterville Historical Society I Business: Osterville Historical Society, Inc. Owner: OSTERVILLE HISTORICAL SOCIETY INC ,Address: 155 WEST BAY ROAD, Osterville j 'Note: 2016 Osterville Farmers Market (� " Iry Town of Barnstable Office: 508-862-4644 .y Fax:508-790-6304 �. Regulatory Services Department Public Health Division RAVOTAOM Thomas A.McKean,CHO 200 Main Street, Hyannis, MA 02601 Payment Receipt Food Service Permits Payment received: $100.00 (Check) on 10/7/2015 Permit number: TEMP-FY2016 Check number: 6292 Check amount: $100.00 Name on check: Osterville Historical Society Business: Osterville Historical Society Address: 155 West Bay Road, Osterville .Note: Pigs&Pearls- 7/25/2015 �,� v er oo S te, I i i - I Town of Barnstable office:508-862-4644 Fax:508-790-6304 Regulatory Services Department siays�nSM Public Health Division Mom• Thomas A.McKean,CHO s639. .6 200 Main Street, Hyannis, MA 02601 Payment Receipt - - ........... :Food Service Permits Payment received: $100.00 (Check) on 6/17/2015 j i Check number: 6271 Check amount: $100.00 Name on check: Osterville Historical Society, Inc. .Owner: OSTERVILLE HISTORICAL SOCIETY INC .Address: 155 WEST BAY ROAD, Osterville i Note: 2015 farmers market- ost. farmers mkt p Ana pis `30 -- C� W Bellaire, Dianna From: McKean,Thomas Sent: Monday, June 10, 2019 8:37 AM To: Bellaire, Dianna Subject: RE:Wording for Osterville Farmers Market All foods shall originate from an approved source per Section 3-201.11 the Federal Food Code. Selling and/or serving of any unauthorized foods from a residential kitchen is prohibited. From: Bellaire, Dianna Sent: Friday, June 07, 2019 4:29 PM To: McKean, Thomas Cc: Bellaire, Dianna Subject: Wording for Osterville Farmers Market Tom; Please email me the wording for the foods prohibited on residential kitchen permits. 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 1 TEMP FOOD CHECKLIST EVENT NAME:FARMER'S MARKET OSTERVILLE OT REQUEST: N/A _CONTACT NAME: JENNIFER WILLIAMS EVENT ADDRESS: 155 W.BAY RD,OVILLE CONTACT P_H#: 508-790-4200 ext 103 EVENT DATE: 06-21-19 TO 09-13-19-WEEKLY FRIDAYS CONTACT EMAIL:iwilliams@ostervillemuseum.or VENDOR FOOD HANDLERS 15 YR SS !3 YR SS IALLERGENILICENSE EVENT FOOD AMIE BAKERY Amie Smith !X IX !N/A CROISSANTS,COOKIES,SCONES,MUFFINS&COFFEE -- iMica Andreom X Natasna tvanov x AUNT DAILIES N/A N/A �N-/A -X I NO PERMIT REQUIRED,RETAIL-PREPACKAGED DRY PASTA BRADFORD FARMHOUSE TOFFEE Amy Bradford N/A-APPROVED'X 1X X (TOFFEE,CARAMELS&CARAMEL SAUCE � I B-SIDE COFFEE CO. ITracy Shields IX I IX X COFFEE&ASSORTED DESSERTS CHRISSY'S CRUMBLE _Christine Le Blanc X X �X IGF GRANOLA,CRACKERS,DATE BITES,COOKIE CAKES&BROWNIES — - DASILVA FARMS !Felicia DaSilva >NEED , X FROZEN CHICKEN,PORK,BEEF AND FRESH EGGS EXPIRED Need to Provide before end of season FOSS FARMS Douglas Foss Ix X X IMARINARASAUCE FOREVER YONG'S Susan Shannon 'NEED X I X �KIM BAP,ROLLS,BROTH,SOUPS,SALADS,WRAPS,VEGETABLE DISHES —_ EXPIRING (SAUCES AND DIPS Need before end l of season FRANK'S CUCINA _!Frank Tammaro X !X X _ PRE-PACKAGED BISCOTTI'S,TORTES,TARTS AND COOKIES WILL BE SAMPLING BLSCOTTI j FRAULEINS BAKERY !Lilly Rempel X I Ix X I EUROPEAN SWEET&SAVORY STRUDELS,CAKES,PASTRIES,TARTS&COOKIES I__! --I expires 7/25/2019I -- HIPPY PILGRIM 'N/A _ N/A N/A_ IN/A I NO PERMIT REQUIRED-RETAIL NON TCSFOODS HONEY I'M HOME ITim Cleland X IX X IBREADS,PIES,GALETTES,SCONES,MUFFINS,GRANOLA,COOKIES,BISCUITS BROWNIES&BARS JAMMED WITH LOVE Christine Allison X X X IJAMS,JELLIES,&CONDIMENTS -- JAJU PIEROGIS (Casey White IX I IX X Approved for 06/21 until BOH Meeting T _ ASSORTED PIEROGIS LOCAL JUICE !Laura Howes IN/A jX !N/A lCOLD PRESSED JUICES,NUT MILKS,GRANOLA � f Laura Uchman IX N/A TEMP FOOD CHECKLIST . MARTHA'S VINEYARD SMOKEHOUSE Jill Riedel X __ X X SMOKED BLUEFISH AND TUNA SPREADS,SMOKED BASS,BONITA&BLUEFISH FILET MICHAEL'S DONUTS Michael McFadden X X X APPLE CIDER DONUTS APPR.3 YEAR PER TM _� Approved fqr 06/21 until BOH Meeting MONOPATI Maria Lemanis X —! X X OLIVE OILS,OLIVES,PEANUT,HAZELNUT&ALMOND BUTTER,BAKLAVA J GREEK BAKED GOODS AND COOKIES SAY CHEESE Joanne Chipman N/A X PRE-PACKAGED CHEESE-NO SAMPLING-ONLY NEEDS ALLERGEN BECAUSE TCS FOOD STIR CRAZY RESTAURANT Kimchhav Chou X _ N/A X ASSORTED SPRING ROLLS,SOUPS,NOODLE ENTREES&RICE ENTREES Channa U X _ X ALL FOODS MUST BE SERVED COLD PER VARIANCE LETTER TEKLAS BRAIDS AND BREADS I Janet Mohre Ix X IX SCANDINAVIAN SWEET BREADS,RYE BREADS,CAKES AND PIES I TREASURE BY THE SEA I Jean Tempesta X IX X JAMS,JELLIES,FRUIT BREADS,PICKLES&PUFF PASTRIES W/JAMS APPR.3 YEAR PER TM WASHASHORE BAKERY Katherine Allen I X _ IX X ASSORTED COOKIES,FRUIT PIES,QUICK BREADS AND CINNAMON ROLLS —� r ii TEMP FOOD CHECKLIST le s K EVENT NAME:FARMER'S MARKET OSTERVILLE OT REQUEST: N/A CONTACT NAME: JENNIFER WILLIAMS EVENT ADDRESS: 155 W.BAY RD,OVILLE CONTACT PH#: 508-790-4200 ext 103 EVENT DATE: 06-21-19 TO 09-13-19-WEEKLY FRIDAYS CONTACT EMAIL:'williams@ostervillemuseum.or VENDOR FOOD HANDLERS 5 YR SS 13 YR SS ALLERGEN LICENSE EVENT FOOD AMIE BAKERY Arnie Smith X X N/A CROISSANTS,COOKIES,SCONES,MUFFINS&COFFEE Mica Andreoth X atasna ivanov A AUNT DAILIES N/A N/A N/A X NO PERMIT REQUIRED,RETAIL-PREPACKAGED DRY PASTA BRADFORD FARMHOUSE TOFFEE Amy Bradford N/A-APPROVED:X X X TOFFEE,CARAMELS&CARAMEL SAUCE i� B-SIDE COFFEE CO. Tracy Shields X X X COFFEE&ASSORTED DESSERTS HRISSY'S CRUMBLE Christine Le Blanc X X X GFGRANOLA.CRACKERS,DATE BITES.COOKIE CAKES&BROWNIES DASILVA FARMS Felicia DaSilva NEED X X FROZEN CHICKEN,PORK,BEEF AND FRESH EGGS EXPIRED Need to Provide before end of season FOSS FARMS Douglas Foss X X X MARINARA SAUCE OREVER YONG'S Susan Shannon NEED Ix X KIM BAP,ROLLS,BROTH,SOUPS,SALADS,WRAPS,VEGETABLE DISHES EXPIRING I SAUCES AND DIPS Need before end of season FRANK'S CUCINA Frank Tammaro X X X PRE-PACKAGED BISCOTTI'S,TORTES,TARTS AND COOKIES WILL BE SAMPLING BLSCOTTT FRAULEIN'S BAKERY Lilly Rem el X X X EUROPEAN SWEET&SAVORY STRUDELS,CAKES,PASTRIES,TARTS&COOKIES expires 7/25/2019 HIPPY PILGRIM N/A N/A N/A N/A NO PERMIT REQUIRED-RETAIL NON TCS FOODS ONEY I'M HOME Tim Cleland. X X X BREADS,PIES,GALETTES,SCONES,MUFFINS,GRANOLA,COOKIES,BISCUITS BROWNIES&BARS JAMMED WITH LOVE Christine Allison X X X JAMS,JELLIES,&CONDIMENTS JAJU PIEROGIS Casey White X X KNEED Approved for.06/21 until BOH Meeting fI~ ASSORTED PIEROGIS �A$?IbY,20191 Called left message and emailed-no response yet. MARTHA'S VINEYARD SMOKEHOUSE Jill Riedel X X X SMOKED BLUEFISH AND TUNA SPREADS,SMOKED BASS,BONITA&BLUEFISH FILET ICHAEL'S DONUTS Michael McFadden X X X APPLE CIDER DONUTS APPR.3 YEAR PER TM MONOPATI Maria Lemanis X X X OLIVE OILS,OLIVES,PEANUT,HAZELNUT&ALMOND BUTTER,BAKLAVA \{ ___7GREEK BAKED GOODS AND COOKIES TEMP FOOD CHECKLIST AY CHEESE Joanne Chipman N/A X PRE-PACKAGED CHEESE-NO SAMPLING-ONLY NEEDS ALLERGEN BECAUSE TCS FOOD STIR CRAZY RESTAURANT Kimchhay Chou X N/A X ASSORTED SPRING ROLLS,SOUPS,NOODLE ENTREES&RICE ENTREES Channa Uy X X ALL FOODS MUST BE SERVED COLD PER VARIANCE LETTER �j TEKLAS BRAIDS AND BREADS Janet Mohre X X X SCANDINAVIAN SWEET BREADS,RYE BREADS,CAKES AND PIES TREASURE BY THE SEA jean Tem esta X X X JAMS,JELLIES,FRUIT BREADS,PICKLES&PUFF PASTRIES W/JAMS APPR.3 YEAR PER TM WASHASHORE BAKERY Katherine Allen X X X ASSORTED COOKIES,FRUIT PIES,QUICK BREADS AND CINNAMON ROLLS t s, TEMP FOOD CHECKLIST EVENT NAME:FARMER'S MARKET OSTERVILLE OT REQUEST: N/A CONTACT NAP JENNIFER WILLIAMS EVENT ADDRESS: 155 W.BAY RD—OSTERNI CONTACT PH#508-790-4200 ext 103 EVENT DATE: 06-21-19 TO 09-13-19-WEEKLY FRIDAYS CONTACT EMAIL:'williams@ostervillemuseum.or VENDOR FOOD HANDLI 5 YR SS 13 YR E,ALLERGI LICENSE EVENT FOOD AMIE BAKERY Amie Smith X X N/A CROISSANTS,COOKIES,SCONES,MUFFINS&COFFEE Mica Andreoth atas a vanov AUNT DAILIES N/A N/A N/A X NO PERMIT REQUIRED,RETAIL-PREPACKAGED DRY PASTA BRADFORD FARMHOUSE TOFFEE Amy Bradford N/A-APPROVED.X X X TOFFEE,CARAMELS&CARAMEL SAUCE B-SIDE COFFEE CO. Tracy Shields X X X COFFEE&ASSORTED DESSERTS CHRISSY'S CRUMBLE Christine Le Bla X X X GF GRANOLA,CRACKERS,DATE BITES,COOKIE CAKES&BROWNIES DASILVA FARMS Felicia DaSilva NEED X X FROZEN CHICKEN,PORK,BEEF AND FRESH EGGS R FOSS FARMS Dou las Foss X X X MARINARA SAUCE FOREVER YONG'S Susan Shannon�NNEkSX X X KIM BAP,ROLLS,BROTH,SOUPS,SALADS,WRAPS,VEGETABLE DISHES G SAUCES AND DIPS FRANK'S CUCINA Frank Tammaro X X X NEED:NO FOOD LISTEp C FRAULEIN'S BAKERY LilIV Rem el X X X EUROPEAN SWEET&SAVORY STRUDELS,CAKES,PASTRIES,TARTS&COOKIES expires 7/25/2019 HIPPY PILGRIM N/A N/A N/A N/A NO PERMIT REQUIRED-RETAIL NON TCS FOODS HONEY I'M HOME Tim Cleland X X X BREADS,PIES,GAZETTES,SCONES,MUFFINS,GRANOLA,COOKIES,BISCUITS BROWNIES&BARS JAMMED WITH LOVE Christine Alliso X X X JAMS,JELLIES,&CONDIMENTS JAJU PIEROGIS Casey White X Ix KNEED 4 dates only-06/21,7/19,08/16&09/13 JEXPIRED I ASSORTED PIEROGIS 4/30/2019 0_ — , .Q_ MARTHA'S VINEYARD SMOKEHOUSE Jill Riedel X X X SMOKED BLUEFISH AND TUNA SPREADS,SMOKED BASS,BONITA&BLUEFISH FILET MICHAEL'S DONUTS Michael McFadc X X `NEED APPLE CIDER DONUTS APPR.3 YEAR PER TM TEMP FOOD CHECKLIST MONOPATI Maria Lemanis X X IN_ OLIVE OILS,OLIVES,PEANUT,HAZELNUT&ALMOND BUTTER,BAKLAVA CREEK BAKED GOODS AND COOKIES SAY CHEESE Joanne Chipmai N/A X PRE-PACKAGED CHEESE-NO SAMPLING-ONLY NEEDS ALLERGEN BECAUSE TCS FOOD STIR CRAZY RESTAURANT Kimchhay Chou X N/A X ASSORTED SPRING ROLLS,SOUPS,NOODLE ENTREES&RICE ENTREES Channa Uy X X ALL FOODS MUST BE SERVED COLD PER VARIANCE LETTER TEKLAS BRAIDS AND BREADS Janet Mohre X X X SCANDINAVIAN SWEET BREADS,RYE BREADS,CAKES AND PIES TREASURE BY THE SEA jean Tem esta X X X IfAMS,JELLIES,FRUIT BREADS,PICKLES&PUFF PASTRIES W/JAMS APPR.3 YEAR PER TM WASHASHORE BAKERY Katherine Allen IX X f 1 ASSORTED COOKIES,FRUIT PIES,QUICK BREADS AND CINNAMON ROLLS TEMP FOOD CHECKLIST EVENT NAME:FARMER'S MARKET OSTERVILLE OT REQUEST: N/A CONTACT NAME: I JENNIFER WILLIAMS EVENT ADDRESS: 155 W.BAY RD,OSTERVILLE CONTACT PH#: 508-790-4200 ext 103 EVENT DATE: W21-19 TO 09-13-19-WEEKLY FRIDAYS CONTACT EMAIL:'williams@ostemillemuseum.o VENDOR FOOD HANDLERS 5 YR SS 3 YR SS ALLERGEN LICENSE EVENT FOOD AMIE BAKERY Arnie Smith X X N/A ICROISSANTS,COOKIES,SCONES,MUFFINS&COFFEE Mica Andreotti li X Natasha Ivanov X AUNT DAILIES �N/A N/A N/A I X I NO PERMIT REQUIRED,RETAIL-PREPACKAGED DRY PASTA BRADFORD FARMHOUSE TOFFEE Amy Bradford NEED :'; ;;:X X X TOFFEE,CARAMELS&CARAMEL SAUCE :NEED: . LETTER-FROM TOWN OF MIDDLEBORO'FOODS.t1LLOW.ED IN HOME,KITCHEN B-SIDE COFFEE CO. TTracy Shields X X X COFFEE&ASSORTED DESSERTS I CHRISSY'S CRUMBLE Christine Le Blanc X X X JGF GRANOLA CRACKERS.DATE BITES COOKIE CAKES&BROWNIES ;NEED. LETTER:FROMTOWNOFWATERTOWN;FOODSALLOWED.INHOME.KITCHEN. DASILVA FARMS Felicia DaSilva 'NEED X X _FROZEN CHICKEN,PORK,BEEF AND FRESH EGGS ,E)Cl'.IRING `. FOSS FARMS Douglas Foss X X X MARINABA SAUCE 1 FOREVER YONG'S Susan Shannon NEED X I X I KIM_BAP,ROLLS,BROTH SOUPS SALADS,WRAPS,VEGETABLE DISHES EXPIRINGI: _ SAUCES AND DIPS I NEED: `..LETTER.FROM TOWN OFaPLYNIOUTH.EOODS ALLOWED IN HOME"KITCHEN FRANK'S CUCINA Frank Tammaro X X X NEED:NO FOOD LISTED FRAULEIN'S BAKERY Lilly Rem el X X X _ 1 EUROPEAN SWEET&SAVORY STRUDELS,CAKES,PASTRIES,TARTS&COOKIES expires 7/25/20191 HIPPY PILGRIM N/A N/A iN/A N/A _ INO PERM ITREQUIRED-RETAIL NON TCSFOODS 1 HONEY 1'M HOME Tim Cleland X X X BREADS,PIES,GALETTES,SCONES,MUFFINS,GRANOLA,COOKIES,BISCUITS _ BROWNIES&BARS ;NEED', LETTER FROM TOWN OF PLYNIOUTI-I-Fbki45bLJ$ALLOWED IN HOME KITCHEN JAMMED WITH LOVE Christine Allison X X X �IJAMS,JELLIES,&CONDIMENTS -- .. sNEED ".. LETTER FROMTOWNOF<W-BRIDG$WATERFORTOODS ALLOWED IN`-HOME JAJU PIEROGIS - Casey White X X NEED- LETTER FROM CITY OF LYNN.FOR'FOODS,ALLOWED IN HOME KITCHEN 4 dates only-06/21,7/19,08/16&09/13 EXPIRED .ASSORTED PIEROGLS - 4/30/2019 MARTHA'S VINEYARD SMOKEHOUSE Jilt Riedel X X X I SMOKED BLUEFISH AND TUNA SPREADS,SMOKED BASS,BONITA&BLUEFISH FILET' NEED LETTER FROM TO"OFEDGART'OWN FOR FOODS'ALLOWED I1V KITCHEN`: MICHAEL'S DONUTS I Michael McFadden NEED,,i .,.;. X .NEED._. .APPLE CIDER DONUTS _ NEED AS YEAR ONLY_ALLOW13 BEDATES-WHICH DATES __ NEED ' LETTER FROM TOWN OF FALMOUTH-FOR FOODS ALLOWED IN,KITCHEi-4, MONOPATI Maria Lemanis X X NEED 'OLIVE OILS,OLIVES,PEANUT,HAZELNUT&ALMOND BUTTER,BAKLAVA GREEK BAKED GOODS AND COOKIES SAY CHEESE Joanne Chi man N A X PRE-PACKAGED CHEESE-NO SAMPLING-ONLY NEEDS ALLERGEN BECAUSE TCS FOOD NEED NO BUSINESS PERMIT SAYING"SAY CHEESE"WAS PROVIDED ONLY SUPPLIERS =a - --�--- ------�— —----T_--.-_-, I SPOKE W ITIi MS.CHIPMAN ON 06-03-19 - STIR CRAZY RESTAURANT Kimchhay Chou i X N A X ASSORTED SPRING ROLLS,SOUPS,NOODLE ENTREES&RICE ENTREES NEED 3 DATES - :Channa Uy ALL FOODS MUST BE SERVED COLD PER VARIANCE LETTER TEMP FOOD CHECKLIST TEKLAS BRAIDS AND BREADS anet Mohre X X Ix SCANDINAVIAN SWEET BREADS,RYE BREADS,CAKES AND PIES r I TREASURE BY THE SEA jean Te X X I JAMS,JELLIES,FRUIT BREADS,PICKLES&PUFF PASTRIES W/JAMS L ONLY GAVE 3 YEAR :KNEED ,' ',LETTER-FROM TOWN OF FALMOUTH FOR FOODS ALLOWED IN HOME KITCHEN WASHASHORE BAKERY Katherine Allen X X `ASSORTED COOKIES,FRUIT PIES,QUICK BREADS AND CINNAMON ROLLS TEMP FOOD CHECKLIST EVENT NAME:FARMER'S MARKET OSTERVILLE OTREQUEST: A CONTACT NAME- TENNIFER WILLIAMS EVENT ADDRESS:155 W.BAY RD,OSTERVILLE CONTACT PHA: 506.7904200 ex1103 EVENTDATE 06-21-19 T009-13.19-WEEKLY FRIDAYS CONTACT EMAIL-willia @ostmWemueeumo VENDOR FOOD HANDLERS.[5 YR SS 3YRSS ALLERGEN LICENSE EVENT FOOD AMIE BAKERY Amie Smith X X N/A CROISSANTS,COOKIES,SCONES,MUFFINS&COFFEE Mica Andrealti X Natasha lvanov X AUNTDAILIES A N/A N/A X NO PERMIT REQUIRED.RETAIL-PREPACKAGED DRY PASTA BRADFORD FARMHOUSE TOFFEE Ay Bradford N/A-APPROVED3YR X X X TOFFEE,CARAMELS&CARAMEL SAUCE B-SIDE COFFEE CO. Tra Shields X X X COFFEE&ASSORTED DESSERTS CHRISSY'S CRUMBLE Christine Le Blanc X X X OF GRANOLA CRACKERS DATE BITES COOKIE CAKES&BROWNIES - DASILVA FARMS FeBria DaSBva (NEED 1 X X FROZEN CHICKEN,PORK,BEEF AND FRESH EGGS IXPIRING FOSS FARMS D-gWFoss XI ix X MARINARA SAUCE FOREVER YONG'S Susan Shannon INEED X X KK M BAP,ROLLS,BROTH,SOUPS,SALADS,WRAPS,VEGETABLE DISHES [EXPIRING SAUCES AND DIPS FRANK'S CUCINA Frank Tammam X X X !NEED,NO FOOD LISTED FRAULMN'S BAKERY Lilly Rem el X X X EUROPEAN SWEET&SAVORY STRUDELS,CAKES,PASTRIES,TARTS&COOKIES expires 7 25 2019 HIPPY PILGRIM N/A N/A N/A N/A JNO PERMIT REQUIRED-RETAIL NON TCS FOODS HONEY I'M HOME Ti.Cleland I X X IX BREADS,PIES,GALETTES,SCONES,MUFFINS,GRANOLA,COOKIES,BISCUITS BROWNIES&BARS AMMEDWITHLOVE Christine AM— I X X X JAMS,JELLIES,&CONDIMENTS JAJU PIEROGIS Casey White I X X INEED 1 9 dates onl-0 ,7 9 OW16&09 3 (EXPIRED ASSORTED PIEROGIS J4 30 20191 MARTHA'S VINEYARD SMOKEHOUSE Jill Riedel X X I X 5MOKED BLUEFISH AND TUNA SPREADS,SMOKED BASS,BONITA&BLUEFISH FILET MICHAEL'S DONUTS Michael McFadden (NEED X [NEED APPLECIDERDONUTS ONLY ALLOWED 3 DATES-WHICH DATES? Il NEED A 5 YEAR MONOPATI Maria Lemanis X X [NEED 0 OLIVE OILS,OLIVES,PEANUT,HAZELNUT&ALMOND BUTTER,BAKLAVA - GREEK BAKED GOODS AND COOKIES SAY CHEESE ne Chip— N/A X PRE-PACKAGED CHEESE-NO SAMPLING-ONLY NEEDS ALLERGEN BECAUSE TCS FOOD (NEED NO BUSINESS PERMIT SAYING'SAE"WAS PROVIDED ONLY SUPPLIERS 1 SPOKE WITH MS.CHIPMAN ON 0603-19 STIR CRAZY RESTAURANT Kimehha Chou I N/A X ASSORTED SPRING ROLLS,SOUPS,NOODLE ENTREES&RICE ENTREES ONLY ALLOWED 3 DATES.WHICH DATES? ChannaU X X ALL FOODS MUST BE SERVED COLD PER VARIANCE LETTER TEKLAS BRAIDS AND BREADS. anet Mohre X X X SCANDINAVIAN SWEET BREADS,RYE BREADS,CAKES AND PIES TREASURE BY THE SEA can Tem esta [NEED 1 X X [TAMS,JELLIES,FRUIT BREADS,PICKLES&PUFF PASTRIES W/JAM5 ONLYGAVE3YEAR WASHASHOREBAKERY Katherine Allen X I X [NEED .ASSORTED COOKIES,FRUIT PIES,QUICK BREADS AND CINNAMON ROLLS TEMP FOOD CHECKLIST EVENT NAME:FARMER'S MARKET OSTERVILLE OTRE UEST: NIA CONIACC NAME ENNIFER WILLIAMS EVENT ADDRESS:155 W.BAY RD,OSTERVILLE CONTACT PHN: 50&790-0200 eat 103 EVENT DATE 06.21-19 TO 09-1349-WEEKLY FRIDAYS CONTACT EMAIL•'williams®ostervillemuseum.o VENDOR FOOD HANDLERS ISYRSS 13YR SS I ALLERGEN I LICENSE I EVENT FOOD AMIE BAKERY A-i.Smith I X I X N A 1 CROISSANTS,COOKIES,SCONES,MUFFINS&COFFEE Mica Andreotti X Natasha lvanov I X AUNT DAILIES I N/A N/A I I N/A I X NO PERMIT REQUIRED,RETAIL-PREPACKAGED DRY PASTA BRADFORD FARMHOUSE TOFFEE A.V Bradford (NEED {X X TOFFEE CARAMELS&CARAMEL SAUCE .NEED_LETTER FROM TOWN OF MIDDLEBORO FOODS ALLOWED IN HOME KITCHEN B-SIDECOFFEE CO. ITI,cyShild, X I X I X I COFFEE&ASSORTED DESSERTS CHRISSY'S CRUMBLE Christine Le Blanc X X X GF GRANOLA.CRACKERS.DATE BTTES.COCKIE CAKES&BROWNIES - NEED LETTER FROM TOWN OF WATERTOWN FOODS ALLOWED IN HOME KITCHEN DASILVA FARMS Felicia DaSilva [NEED { X X FROZEN CHICKEN,PORK,BEEF AND FRESH EGGS EXPIRING { FOSS FARMS Douglas Foss X I I X I X IMARINARASAUCE FOREVERYONG'S Sown Shannon NEED X Ix I KIM BAP,ROLLS,BROTH,SOUPS,SALADS,WRAPS,VEGETABLE DISHES EXPIRIN I SAUCES AND DIPS [NEED LETTER FROM TOWN OF PLYMOUTH FOODS ALLOWED IN HOME KITCHEN FRANKS CUCINA Eank Tammam X X X [NEED:NO FOOD LISTED FRAULEIN'S BAKERY Lill Rem el X X X EUROPEAN SWEET&SAVORY STRUDELS,CAKES,PASTRIES,TA RTS&COOKIES ' .. exolres 7 2S 2019 HIPPY PILGRIM N/A N/A N/A N/A NO PERMIT REQUIRED-RETAIL NON TCS FOODS HONEY I'M HOME Ti.Cleland X X X BREADS,PIES,GALETTES,SCONES,MUFFINS,GRANOLA,COOKIES,BISCUITS BROWNIES&BARS I NEED LETTER FROM TOWN OF PLYMOUTH FOR FOODS ALLOWED IN HOME KITCHEN AMMED WITH LOVE Christine Allison X X X IAMS,IELLIES,&CONDIMENTS INEED LETTER FROM TOWN OF W.BRIDGEWATER FOR FOODS ALLOWED IN HOME { JAJU PIEROGIS Casey Whits Ix I NEED LETTER FROM CITY OF LYNN FOR FOODS ALLOWED IN HOME KITCHEN { 4 dates onl- 7 9,0§46&09 3 i I EXPIRED ASSORTED PIEROGIS 4 30 2019 MARTHA'S VINEYARD SMOKEHOUSE ill Riedel I X X X ISMOKED BLUEFISH AND TUNA SPREADS,SMOKED BASS,BONITA&BLUEFISH FILET INEED LETTER FROM TOWNOF EDGARTOWN FOR FOODS ALLOWED IN KITCHEN MICHAEL'S DONUTS Michael McFadden INEED { X INEED i APPLE CIDER DONUTS NEED A S YEAR 1 ONLY ALLOWED 3 DATES-WHICH DATES? INEED LETTER FROM TOWN OF FALMOUTH FOR FOODS ALLOWED IN KITCHEN { MONOPATI Maria Lemanis X X [NEED {OLIVE OILS,OLIVES,PEANUT,HAZELNUT&ALMOND BUTTER,BAKLAVA GREEK BAKED GOODS AND COOKIES SAYCHEESE ne Chi man N/A X _ PRE-PACKAGEDCHEESENOSAMPLING-ONLY NEEDS ALLERGEN BECAUSE TCSFOOD INEED NO BUSINESS PER SAYING"SAYCHEESE"WAS PROVIDED ONLY SUPPLIERS I SPOKE WITH MS.CHIPMAN ON 06-03-19 STIR CRAZY RESTAURANT Kimchha Chou I X N/A X ASSORTEDSPRING ROLLS,SOUPS,NOODLE ENTREES&RICE ENTREES NEED DATES Channa Uv X X ALL FOODS MUST BE SERVED COLD PER VARIANCE LETTER TEKLAS BRAIDS AND BREADS anet Mohre X X X SCANDINAVIAN SWEET BREADS,RYE BREADS,CAKES AND PIES TREASURE BY THE SEA an Tem sta [NEED X X IAMS,TELLIES,FRUIT BREADS,PICKLES&PUFF PASTRIES W/IAMS ONLY GAVE3YEAR INEED LETTER FROM TOWN OF FALMOUTH FOR FOODS ALLOWED IN HOME KITCHEN I [ � WASHASHORE BAKERY Katherine Allen I X X INEED {ASSORTED COOKIES,FRUIT PIES,QUICK BREADS AND CINNAMON ROLLS I r TEMP FOOD CHECKLIST EVENT NAME:FARMER'S MARKET OSTERVILLE OT REQUEST: N/A I CONTACT NAME: TENNIFER WILLIAMS EVENT ADDRESS: 155 W.BAY RD,OSTERVILLE I CONTACT PH#: 508-790-4200 ext 103 EVENT DATE: 06-21-19 TO 09-13-19-WEEKLY FRIDAYS I - CONTACT EMAIL:'williams@ostervillemuseum.or VENDOR I FOOD HANDLERS 5 YR SS 13 YR SS JALLERGEN ILICENSE EVENT FOOD AMIE BAKERY Arnie Smith X X N/A CROISSANTS,COOKIES,SCONES,MUFFINS&COFFEE Mica Andreotti X Natasha Ivanov AUNT DAILIES N/A N/A N/A X NO PERMIT REQUIRED,RETAIL-PREPACKAGED DRY PASTA c' BRADFORD FARMHOUSE TOFFEE Amy Bradford KNEED I X X X TOFFFF.,CARAMELS&CARAMEL SAUCE 1Nimi_3d1+ T FTTFR FROM TOWN Of.MIDDLEBORO FOODS ALLOWED IN HOME KITCHEN B-SIDE COFFEE CO. Tracy Shields X X X COFFEE&ASSORTED DESSERTS CHRISSY'S CRUMBLE Christine Le Blanc X X X GF GRANOLA CRACKERS DATE BITES COOKIE CAKES&BROWNIES 1 LETTER FROM TOWN OF WATERTOWN FOODS ALLOWED IN HOME KITCHEN , _tJ DASILVA FARMS Felicia DaSilva (NEED X X I FROZEN CHICKEN,PORK,BEEF AND FRESH EGGS EXPIRING FOSS FARMS Douglas Foss X I X X I MARINARA SAUCE FOREVER YONG'S Susan Shannon INEED X X KIM BAP,ROLLS,BROTH,SOUPS,SALADS,WRAPS,VEGETABLE DISHES (EXPIRING SAUCES AND DIPS 1 LETTER FROM TOWN OF PLYMOUTH FOODS ALLOWED IN HOME KITCHEN FRANK'S CUCINA Frank Tammaro X X X NEED:NO FOOD LISTED FRAULEIN'S BAKERY Lilly Rempel X X X I EUROPEAN SWEET&SAVORY STRUDELS,CAKES,PASTRIES,TARTS&COOKIES expires 7 25 2019 HIPPY PILGRIM N/A N/A N/A - N/A NO PERMIT REQUIRED-RETAIL NON TCS FOODS HONEY I'M HOME Tim Cleland X X X BREADS,PIES,GALETTES,SCONES,MUFFINS,GRANOLA,COOKIES,BISCUITS BROWNIES&BARS LETTER FROM TOWN OF PLYMOUTH FOR FOODS ALLOWED IN HOME KITCHENN—k,7- JAMMED WITH LOVE Christine Allison X X I X I JAMS,JELLIES,&CONDIMENTS r 1n*rrn LETTER FROM TOWN OF W.BRIDGEWATER FOR FOODS ALLOWED IN HOME /7t 7, J JAJU PIEROGIS Casey White X X IDl&UNk, LETTER FROM CITY OF LYNN FOR FOODS ALLOWED IN HOME KITCHEN 4 dates only-06/21,7/19,08/16&09/13 ,EXPIRED ASSORTED PIEROGIS 4/30/2019 MARTHA'S VINEYARD SMOKEHOUSE Jill Riedel X X X I SMOKED BLUEFISH AND TUNA SPREADS,SMOKED BASS,BONITA&BLUEFISH FILET ,iNEEB+ LETTER FROM TOWN OF EDGARTOWN FOR FOODS ALLOWED IN KITCHEN MICHAEL'S DONUTS Michael McFadden f NEED I X INEED I APPLE CIDER DONUTS NEED A 5 YEAR ONLY ALLOWED 3 DATES-WHICH DATES? lam+ LETTER FROM TOWN OF FALMOUTH FOR FOODS ALLOWED IN KITCHEN MONOPATI Maria Lemanis X X KNEED I OLIVE OILS,OLIVES,PEANUT,HAZELNUT&ALMOND BUTTER,BAKLAVA GREEK BAKED GOODS AND COOKIES SAY CHEESE Joanne Chipman N/A X PRE-PACKAGED CHEESE-NO SAMPLING-ONLY NEEDS ALLERGEN BECAUSE TCS FOOD KNEED NO BUSINESS PERMIT SAYING"SAY CHEESE"WAS PROVIDED ONLY SUPPLIERS - -Ti SPOKE WITH MS.CHIPMAN ON 06-03-19 STIR CRAZY RESTAURANT Kimchhay Chou X N/A X ASSORTED SPRING ROLLS,SOUPS,NOODLE ENTREES&RICE ENTREES NEED 3 DATES Channa Uy X X ALL FOODS MUST BE SERVED COLD PER VARIANCE LETTER TEKLAS BRAIDS AND BREADS Janet Mohre X X X SCANDINAVIAN SWEET BREADS,RYE BREADS,CAKES AND PIES. TREASURE BY THE SEA Jean Tempesta KNEED X - X _JAMS,JELLIES,FRUIT BREADS,PICKLES&PUFF PASTRIES W/JAMS ONLY GAVE 3 YEAR ;•PiiiP LETTER FROM TOWN OF FALMOUTH FOR FOODS ALLOWED IN HOME KITCHEN - TEMP FOOD CHECKLIST WASHASHORE BAKERY Katherine Allen X X fNEED ASSORTED COOKIES,FRUIT PIES,QUICK BREADS AND CINNAMON ROLLS Town of Barnstable Regulatory Services Department sn�uasxaBt.�. Public Health Division 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event 01.WE 4 1 Date Table/Cart/Trailer Idenrif 'on a Telephone ; I NAfAMA? Permit Holder's Name Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) — Al GS TIME/TEMPERATURE CONTROLS Cooking Temperatures Reheating Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS Refuse Container(s)Provided/Covered _ Adequate Toilet l7pe4ifiq Pro vid d AAA Inspector's Signature Print PIC's Signature e- � Print hi &(' Town of Barnstable Regulatory Services Department • a�aaz�asT"Lal;. Public Health Division 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event D to Table/Cart/Trailer Identification Name i elephone Permit Holder's Name � Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing A) �h Foods Covered 1Z / A A Proper&Adequate Handwashing/Temporary Handwash IV/ly--I) A?) /h IV Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating _ Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered Adequate Toilet Facilit es Provided ° Inspector's Signature - 'V a Print PIC's SignatureM Print 1 Town of Barnstable Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event Date ell Table/Cart/Trailer Idenfifica It yAn Name' . l Permit Holder's Name el"ephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite �. A v PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing fit U �L Foods Covered Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS Cooking Temperatures _ Reheating _ Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories dwn A wll� OTHER REQUIREMENTS Refuse Container(s)Provided/Covered Adequate Toilet Facilities ovide Inspector's Signature ! Print JK- PIC's Signature i Print A Town of Barnstable Regulatory Services Department lan>�uvsrnsca�, Public Health Division MAN. 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event Q Dat Table/Cart/Trailer Identification lame y le hone - P Permit Holder's Name I'LL, Telephone DESC�RI�PTION OF VIOLATI N PERMIT INFORMATION ��✓✓ f � � v` _ Valid Permit/Displayed / Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT V _ PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing _ Foods Covered Proper&Adequate Handwashing/Temporary Handwash — Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating Cooling Hot and Cold Holding Food and Food Protection CONSUMER ADVISORY Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered _ Adequate Toilet Facilitie ided tZ i Inspector's Signature Print PIC's Signature Print Town of Barnstable Regulatory Services Department • eant+rST"M Public Health Division "`"S&1639. 200 Main Street, Hyannis MA 02601 l� OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM / /. 0V '0"W I , Name of Special Event A? Date Table/Cart/Trailer Identifica 'on Name Telephone Permit Holder's Name Net) Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed _ Pre approved Menu Items Offered Only FOOD PROTECTION MANAGEMENT PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION _ Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location Good Hygienic Practices(Use of gloves,use of tongs or tissues) ' TIME/TEMPERATURE CONTROLS _ Cooking Temperatures Reheating _ Cooling J I Hot and Cold Holding / AA d l.Xs _ Food and Food Protection CONSUMER ADVISORY _ Posting of Consumer Advisories OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered _ Adequate Toilet J7es10'ded Inspector's Signature Print PIC's Signature Print ti �� ------ Town of Barnstable Regulatory Services Department Public Health Division Mass. �` 200 Main Street, Hyannis MA 02601 OFFICE: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO TEMPORARY FOOD EVENT INSPECTION FORM Name of Special Event ® Date Table/Cart/Trailer Identification Name Telephone Permit Holder's Name IqAl � Telephone DESCRIPTION OF VIOLATION PERMIT INFORMATION _ Valid Permit/Displayed Pre approved Menu Items Offered Only . i FOOD PROTECTION MANAGEMENT — PIC Assigned/Present Onsite PROTECTION FROM CONTAMINATION Food Contact Surfaces Cleaning and Sanitizing Foods Covered _ Proper&Adequate Handwashing/Temporary Handwash Station Location _ Good Hygienic Practices(Use of gloves,use of tongs or tissues) r TIME/TEMPERATURE CONTROLS Cooking Temperatures Reheating — Cooling r Hot and Cold Holding Food and Food Protection CONSUMER ADVISORAU9 / — Posting of Consumer Advisories �,. . OTHER REQUIREMENTS _ Refuse Container(s)Provided/Covered Adequate Toilet Fa cil vide Inspector's Signature Print PIC's Signature Print i 6/19/2019 Top 12 FAGs About Growing Gourmet Mushrooms For Profit-Profitable Plants Digest Pro4fahkePlants HUMS ARROUT CONTACT I`he Best SpecialtY Crops for Small Grower:S LAVENDER GOURMET MUSHROOMS MICROGREENS GOURMET GARLIC BAMBOO GINSENG HEIRLOOM TOMATOES HIGH-VALUE TREES WOODY ORNAMENTALS SELL YOUR HARVEST HOOP HOUSE S100 WEBSITE I ou.rnzet Mt.ish.ronrn.s Top 12 FAQs About Growing Gourmet FREE BOOK QsAbOutr wi g oo m 9 ,. ... Aushrouills Profitr } �i E t `t I MIT" I9tW.Y � I No email address or signup required! i i 1 Search This Site i Search this website ... Scarch i i Popular Articles such as oyster and shiitake, are one of the best cash Top 10 FAQs About Growing Woody Ornamentals Although they are traditionally grown on logs For Profit n many areas, now both can be grown indoors in bags, Growing woody ornamentals is one of the best ways to turn your backyard https://www.profitableplantsdigest.com/top-12-fags-about-growing-gourmet-mushrooms-for-profit/ 1/6 6/19/2019 Top 12 FAQs About Growing Gourmet Mushrooms For Profit-Profitable Plants Digest instead of logs. Here are a few answers to new or small ... head more ... ut this productive growing method: Double Your Profits With "Instant.Gardens" riushrooms?Two good reasons. First, by growing One of the most effective Marketing Ire, humidity and light can be controlled to give the i tools for small growers is to develop ... Read. more ... gat they need, when they need. it. This means much )re profits than from log-grown mushrooms. Second, - - - - - - - ---- /ing conditions, up to six crops per year can be j Selling Your Harvest-The Power of Testimonials Whether you're selling flowers at the ;pace, for more income and steady cash flow. local farmer's market, or herbal products ... Read more ... ms in my area?Because you can grow both oyster and j doors, the outside climate doesn't affect them. If you U-Pick and U-Profit such as a shed, garage, barn, greenhouse or even a I A few years ago, Linda van inthat is not being used, you can grow gourmet ' Appledoorn started.Take Your Pick Flower Farm ... Rea.d.Inore�... 3. What are the best mushrooms to grow?Because Growing High-Value Microgreens For Profit I both oyster and shiitake mushrooms are proven } Consumers nationwide are voting for local foods with their wallets, ... Read sellers in the marketplace and consumers know and i IYlore ... ' love them, new growers should stick to those two. I There are other exotic mushrooms that can be Starting a Woody Ornamental Business in 6 Easy grown, often for medicinal use, but they require Steps more skill to grow and knowledge of the markets to Starting a woody ornamental business find buyers. i can be quite ea.sy if you have a plan of ... Read more ... i ishrooms propagated?Mushrooms are a member of includes yeasts used to make beer and wine, and 10 Most Profitable Specialty Crops to Grow nicillin and flavor cheese. Rather than producing seeds Growing specialty crops is the perfect way to turn your gardening... / rooms produce-spores. The spores are collected and Read more ... it the grain is "colonized" or taken over by the growing d "spawn," the colonized grain is used to inoculate a Start An Urban Farm Growing Microgreens Zeat straw or hardwood sawdust. Once the substrate is I The traditional family farm is mushroom spreads, and produces fruit, which we callI changing, as more people move to ... izing process to see! Read.more; ... I - s a part-time mushroom grower?Because it's possible 9 Qualities of a Perfect-Small Business- + ztity of mushrooms in a small space, this is a perfect If you plan to start a small:business who does not have the land, for a conventional crop growing plants, what qualities should )s. Once the inoculated mushroom substrate is packed the ... Read more ... https://www.profitableplantsdigest.com/top-12-fags-about-growing-gourmet-mushrooms-for-profit/ 2/6 6/19/2019 Top 12 FAQs About Growing Gourmet Mushrooms For Profit-Profitable Plants Digest s, it takes just a few minutes a day to check your crop. - - ll gourmet:mushroom rowers have a day job, row Profit From Garlic With These Eight Value-Added g g Y J , g Products to mushrooms, or are retired and don't want to work Gourmet garlic growers always end up with harvested garlic bulbs that are not ... Read.more ... , shiitake mushrooms in compost?Yes you could., but and low yields. That's why most small commercial I Why Ginseng Is The Most Profitable Herb For Small Growers r indoors in a sterilized substrate, such as straw or The popularity of herbs continues to contamination from other wild mushroom spores. Of grow, especially the medicinal herbs. trooms have almost finished their fruiting and the One ... Read more ... led to a compost pile, there will be more "flushes" of t by then the yield is very low. Top 14 FAQs About Growing Gourmet Garlic For I Profit ! Gourmet garlic is becoming more 7. When:are mushrooms harvested?B. oth oyster. and shiitake mushrooms are commercial) Frown popular and profitable every year. To y b ' ... Dead. more ... indoors,_where the temperature and humidity can be carefully controlled to encourage rapid growth in How To Start a Microgreens Business i the fruiting room. The mushrooms appear in � The old saying"Small is Beautiful" "flushes;' and the first flush is the largest. That's the certainly applies to Terry ... Read time for:the first harvest. There can be several more more ... jflushes, but the quantity of harvestable mushrooms is muchsmaller., so many growers just harvest the Sell Your Harvest Direct to Local Grocery Stores first flush. Buying fresh/buying local is a trend that continues to grow every ... Read mushrooms be sold?Both oyster and shiitake 1 r"°re hen fresh-:picked, so most are sold to local customers. _._...___._.__._�.a__,_�_� m_ re harvested, they are delivered to local chefs, food How To Start a Tree Farm and directly to consumers at the farmer's market. if you own a few acre, consider becoming a tree farmer. It's ... Read. trooms donot ship well, most are sold fresh to local . more ... r small mushroom growers, as they don't have to )f-state suppliers. How Growers Can Use a Free Press Release to Market Their Business r'oduets can be made from Small growers can get valuable k few of the most popular publicity for their farm or crops ... Read more ... .room jerky for vegetarians, " ushroom seasonings, j - - --- - — --- s and mushroom growing j L'�\ hftps://www.profitableplantsdigest.com/top-12-fags-about-growing-gourmet-mushrooms-for-profit/ 3/6 6/19/2019 Top 12 FAQs About Growing Gourmet Mushrooms For Profit-Profitable Plants Digest )oms have special nutritional Pickled Mushrooms M� )wn that both oyster and tck a strong nutritional and even medicinal punch. For i roperties that protect cells in the body, high levels of m, vitamin C, niacin, and vitamins B1 and B2. Scientific shii.take mushroom can provide antiviral, cholesterol- , ;cular support, in addition to boosting the immune ay have cancer-preventing properties. an a gourmet mushroom business make?Because the i {weeks to harvest is typical - growers can make a le in a small space. Using an indoor bag system,most 25 pounds per square foot of growing area every year. have a. small backyard. shed. - only 12' by 12' - that can l 'ooms. That's 144 square feet, which could yield 3600 .itake mushrooms in a year. You sell half of your crop at of$12 per pound and half at the wholesale price of$6 i ricome is just over $32,000. Now that's a productive ' i -ost to start a gourmet mushroom business?Since )es not require a lot of expensive equipment, especially tartup costs can be quite affordable, as low as a few :ample, the new LED fluorescent lights are just right 1 their cost has dropped by 80% in the last few years. { is for LED lights is tiny, so even your electric bill can be Nhen gourmet mushrooms are grown indoors, it opens zp a whole new world of possibilities, as growers ca.n >e located in a city or in a small town or rural area. 3)ince the growing is done indoors, the weather- outside s not an issue, so you can get started anytime. To iiscover more about starting your own small-space j r nushroom "farm," read Growing Gourmet Mushrooms 10 for Profit. I Growing Gourmet.Mushrooms https://www.profitableplantsdigest.com/top-12-fags-about-growing-gourmet-mushrooms-for-profit 4/6 6119/2019 Top 12 FAQs About Growing Gourmet Mushrooms For Profit-Profitable Plants Digest Vushroom's For Part-Time Growers .g Profitable Gourmet Mushrooms Mushroom Products For Gourmet Mushroom Growers irooms, profitable specialty crops tagged with: growing r0fit, CfFOW11.107 oyster musliroonis for-profit, growing shiitake Z-) J rooms, profitable plants, specialty crops Grower Guides BAIN—,"IBOO GINSENG GOURME,r .GARLIC GOURNIET. MMUSTIROUVIS HEIRLOOM. TOMAR)ES I f[GJ1-\/ALUI.1' TREES LAVENDER. M.ICROGREj.,,NS a SEL.I.,YOUR.HARVEs'r WOODY ORI\TAMENTALS Explore a Topic $100 WEBSI:TE Bamboo Ginseng h Up s://www.profita bl epl a ntsd ig est.com/top-1 2-faq s-about-g rowing-gou rmet-m ush room s-fo r-profit/ 5/6 6/19/2019 Top 12 FAQs About Growing Gourmet Mushrooms For Profit-Profitable Plants Digest Gourmet Garl.i.c. Gourinct Mushrooms Heirloom.Torn.atoes High.-Value'l,rees Lavender Farming Marketing for Growers Microgreens Profitable Specialty Crops Uncategorized Value-Added Profitable Plants Woody Ort.ranientals i Return to top of page Copyright© 2019 Headstart Publishing, IJIC Site Map https://www.profitableplantsdigest.com/top-12-fags-about-growing-gourmet-mushrooms-for-profit/ 6/6 Barnstable Public Health Division cf)a APPLICATION FOR TEMPORARY FOOD SERVICEPERMIT DATE . NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road VILLAGE Osterville NAIL OF ORGANIZATION A M ( t CONTACT PERSON M I t' SYYI! TELEPHONE J� I 7 S ADDRESS I "I I V 1 Qv i N� _ 0.3�' 1 �' FOOD TO BE SERVED(LIST EXACT FOODS) i,jn 1S i`�.i�Xs . ®OW L_�. SC-0 V1-f-f AMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT,I: ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,Osterville,MA 02655 DATE TO BE SERVED June 21-Sept 13 TIME 9 a.m.to 1 p.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSSPECTION? HOW WILL FOOD BE KEPT BELOW 41 DEGREES F C 6", - 6L k / u t j� — 1 v1$LL`CM� HOW WILL FOOD BE HELD AT 140 DEGREES F. 1jG` L`, ✓�Ot�l3 ` \~ C vwt,�C.S HOW IS FOOD COVERED S"l X EGk (h C:l,e,( 1' _ A.V .) toc1l.tt,E vul C. J HOW IS FOOD SERVED 0 1 I afiP C � IQY '�� ��� �l� o _k k)(2 (L� TYPE OF HAND-WASHING FACILITY (7vkSk SIGNATURE �II �j;LF ...................... k,kk ,Srx,A tC6L a r9 ; Nakho,__Z�&,qv - q/q%o Barnstable Public Health Division Nb APPLICATION FOR TEMPORARY FOOD SERVI�CEPI E74" _ + NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road � VILLAGE Osterville NAME OF ORGANIZATION CONTACT PERSON JD— > TELEPHONE 5CF6 4��.:-'1 1 %- ADDRESS ✓ � � OOD TO BE SERVED(LIST EXACT FOODS) 'f NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): (ATTACH OF SERVSAFE&ALLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED Osterville Historical Museum,1.55 West Bay Road,Osterville,MA02655 DATE TO BE SERVED June 21-Sept 13 TIME 9 a.m.to l p.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECTION? /j HOW WILL FOOD BE.KEPT BELOW 41 DEGREES.F A HOW WILL FOOD BE HELD AT 140,D(E REES F. HOW IS FOOD COVERED /j Y� HOW IS FOOD SERVED ' TYPE OF HAND-WASHING FACILITY SIGNAT C Permit No.: 19-006 ` Date Issued: May 23,2018 The Commonwealth of Massachusetts Fee: $100.00 TOWN OF HOPEDALE Expiration Date: June 30,2019 . Board of Health 78 Hopedale Street - P.O. Box 7 Hopedale, Massachusetts 01747 PERMIT TO OPERATE A RESIDENTIAL KITCHEN In accordance with regulations promulgated under authority of Chapter 94, Section 305A and Chapter 111, Section 5 of the General Laws a permit is hereby granted to: AUNTIE DALIE'S ARTISAN DRIED PASTA Whose place of business is: 7 Dec Court, Hopedale, Type of business: RESIDENTIAL KITCHEN To operate a food establishment in: Town of Hopedale "As a condition of this license, in the interest of public health, the licensee shall not employ or allow to work on the licensed premises any person not present in the United States in compliance with applicable law." lop William Fisher,H&lth Agent �4 • -2.'tlAeS�'�R4Sk33.3BllE3xlid3ft3il.�.G:4v R3 d4AYF289mtlYe!98'd}:'ehQiB.�"ha�.t.'isHlE3kf.:eliEJNsehe±Sti�a4H`a+E�"ki 6E'giali'ii'tNd.'vec.d'ti3��485.59i52F'adfaeegis_^.4m.T5gfi.�ei4Tr Af3"ee3�.tiF_'s'sr_n�2._?29:395�53Ati":£3e1F_ii-2ii3':ii!'d�.._ CEIDIX"FIR CATE Of e e , l / , ALLERGEN AWARENESS TRAINING 1 V i nn— of Recif lient: JON HAYNES Certificate Number: 2866087 I)a1te of Completion: 411712017 , Date of Expiration: 4/17/2022 1<6; Issued By: l.f A')'ebi,155rfe'[♦this('i'rg1i,-ale .. /brrunl hvilgallulllgol1lu•rrli'll(3.s11-tilling,pru'q lll'/ �tNAT-1l�P�lA 1 ,fi t ; END, RF`i li1i.1RAN..l.1)SOC,I;\1'I(7N.: t/1 Ar iYil'tlrllte;''ft?tth 1Oi (;;1111 S�jJ.f.)(Ilj f:Jj.il(,r J. A lassachasctts Re taurant Association 800.765.2122. 333lunpike Ruael,Suite 102 evwvd.re�taut'ant.ori Sout•lihoro ul;h,AlA 01772 Pis e rt/lr'rite'-will he-valtrl Ur kv j ti!1'�YrY� )'!J/!l da/e'U COIN)le'l7Q/1. � .l .� .�` .1. .l� / Stu-<3o3-w0s vvw�t nr(rrrRutr:enCisoc.ort; , •BIT 01,1109s".Www" BWAifl"erva 19A 6iA'")Few"R-0"ft3EVV'4bWRU"&W"WQWOWIvOMIG,-49Hq]�"tcBZ(i"•3B.'ir6i:B9#UMM 9 OW0.PllliiP'}2iA1LiHP9'R31lHiR'0,Nb W*Wea P9'W"W*PPiYTIiiPl erpvSvv-Grwlie 'fl9@'Q4e9Y!!i!'9MP►-Bp r r r r r w7 � o CERV� RCAT� ON JON HAYN ES for successfully completing the standards set forth for the ServSaV Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute(ANSIKonference for Food Protection(CFP). 612620 10551 CEPTt t F �� �.. UMBER EXAM FARM NUMBER 4/4/2 17 NEIA�I,NATION­ DATEs 4/4/2022 DATE O OF EXPIRATION Local laws apply.CH writfi your r ency for recertification requiremenh. t t,'71•ag'- � y C , Natioclaf;Rastauraht As�otiattaer Saf�rtitanc' t• •r � � &� .'F- � +- a � � cis 1n 0"vK6w.),ailh manlima 16kw 2tkf 6 f{"A11 m APm N 064 Z13(Ptv 12t 0 A32 j, (020 15 Nallawl RnaAru (iiA cr(ahact irczt:anaf PnundnGw3(1 AE1 nM rlrrwr ( � Sac Ioya are 4admwkz of the NRAEF s NowtAwOM+ d> ood+(w Mc din a n tk+ t++Mtk eat Ge'v or ukatnd. � Cottaet us wUh ryaaalio"at 175 W)aeki.,,n gl„d 5ro 1500,<:h,eupo;11 6004 rvu P� Barnstable Public Health Division 4 APPLICATION FOR TEMPORARY FOOD SERVICEPERMIT DATE NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road VILLAGE Osterville NAME OF ORGANIZATION b S\Ap C_n � CONTACT PERSON-rraC V SmagiM e I 1 &ELEPHONE 17LI-"�(�C1 CI g ADDRESS PL.L:LL L-)etil^GP ��)C�2� �+�C'�• C�locFlflC�.m I MA bZp?J7p FOOD TO BE SERVED(LIST EXACT FOODS) GOES_ ,rcA h Y1!�4 rk-xYp a G oc NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING VXNT) i G ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,Osterville,MA02655 DATE TO BE SERVED June 21-Seat 13 TIME 9 a.m.to 1 a.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECTION? ''-iC) HOW WILL FOOD BE KEPT BELOW 41 DEGREES F r(ZgY\Ccj I<2 ca HOW WILL FOOD BE HELD AT 140 DEGREES F. h lf)n C 0%f2 1✓1 P 1 1 QY 10�\'< (�O 1� HOW IS FOOD COVERED IQ C bEk_Q__ ()L f)6 HOW IS FOOD SERVED In kb QO CUPS T9'PF,OF HAND-WASHINC FACIVITY YNA SIGNATURE � r • Q r r / .. 9 fJ� r Of 1 Q b� a 1!.40 O ServS a CERTIFICATION TRACY SHIELDS for successfully completing the standards set forth for the ServSafe®Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute(ANSI)Conference foe Food Protection(CFP). f4 rr" �t, t 179259 52�7 CERTIFICA UMBER EXAM FORM NUMBER 5/26 17 5/26/0 2° r DATE OF E AMINATION DATE OF EXPIRAT'IO-N' " Local laws apply.Ch k with your local regulatory enry for recertification requirements. �r SheN n Brown ational Restaurant Association Solutions m #0655 In=ordance with Maritime Irbou 2006,Resdurion ADM N 068- 13(Regula ion 3.2,Sbndard A3.2). 0 @2015 Natiiorml Assxiaion Educational Foundation I WAEF).AM ' reserved.SwSa(eg and the logo are rroc6,arlo of the NRAEF. tl a AssocidiwO and the arc design are trodenwrks of the NW gwlIesk was A ooc' ' al Thu document connot be teproduasd or tered.° F 14102901 v.1401 Contact us with questions at 175 W kdrwn Bbd.Ste 1500,Chicago,IL.60604 or Sew5al ne*wrant.org. c r C aa�a U i r r •� \J A J J I� CERTIFICATE OF ' ' ALLERGEN AWARENESS . 'OrRAINING Name of Recipient: TRACY SHIELDS t Certificate Number: 3250551 I (� i Date of Completion: 2/5/2018 Date of Expiration: 2/5/2023 ❑ .❑ V , 0 �•�1 __�_�_�_ Issued.By: The above-named person is hereby issued this cert�ficate � l for completing an allergen awareness training program NATIONAL�o"� RESTAURANT Qa�u� recognized by the Massachusetts Department of Public Health ASSOCIATION in accordance with 105 CMR 590.009(G)(3)(a). Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 www:restaurant.org This cert�6cate will be valid for five(5)years from date of completion. Southborough,MA 01772508-303-9905 �J 1 wwwmarestaurantassoc.org �� g ORO 4 �?� Q ` _. k "5+-._ - ��, _'" -_. :..w..n•.s ..sW..s,�tYrt.. �" � ,-� <'itr...,a.. -.��. -: „y��. ,m, - -`„'''h;...;,...,'..,.ra�.a,.y,o,... ,,�.. r� Cv� 4- 60 :. '�' ----�.d..a_:: '.-. �. ;..d+- "� -4.+-...�,=�C�t ,,eT..-.; •:,v..,.:= ,w:--•y.ir,.:�-*.: ,�,(,,•R yw„�v,., ..--.,..,h.^ i�: _ .j TP v r ,..�. „ � ,,,..,. ,. ,,, .. ........ ...\.. .... «.:, .E{.... ,,I , :, 3 ,.., ... „.. r,,. ti .. m.. ,z• .x��Ya.»s.... �... � � 3 r, V__E : , b . at : ./ , 5 a_.W � achuu , x a.,„ a „ �x r aw,, x t � �s a �6,2Q1x9 � �t ^s > , SYa F , , 2 msRw. £ EA, s . { �a.,.. ksW,''c E, s•�-.' :, "" <• ;z s a E_ Z :a cr; r� 8Mx "tip ,.�.",�: .. .., , .. ... a-.:x.: G s;.. .-,_:.. .5', ».."„ ".,.... .. r. ,,,. - a < , r ,F1 4. �� sF., Y a E» ..•.: :,.. ,.. xY... ., ': ::r.,a .,.\9.. f ., ..._y ,.. �6,,. S '�.,. ,:1`E: a x qK k: .. , .... .. , .. . �� :246>G c� E \f a . 3 a', �,.. d? x MUJ S ' . .. a L ,,. .. ., 0 N ate$. :,v<a r - „ < .n a. ax w VN ", l £ y P k _1W., h cene an a ca a�rmi withheF,state=tes..and ordnan , s..:rela tin the etar xatd a fires-;=x 3' Dec- 31 •`2E119 y P +: _ E .. „s4c��ner. s � : 'e • -r.revoked..:myx - , � • �: , F• su �d d pp x: \� s`• �F f Y g� Vic: P''.. '„. ,:.: eta �o Seatsl�on PHF ,� 4eats 1304 sf -.-. _ � � g u ,E., <E, s u: r- r .... ..x.,..<. .,.,a .., - ... `m.,L.. ...., c, ,, x_. �:;:fax ... t: Y 'Ai � t .. v, ,f ,1a 1, d \, F SA 3, �E \ \ IIIFY RA ., W 41 E i y»� iv a f e .. ,_ . <a .., ':,, .x .. .,. .aea :,�. ,va�.t�.••.,>_. -- <: ti,,.,..,,-.._,�, :r�..��,> ,:. ,ax�,., < .,. r\,<. .a:x >a� �,.� \,<a.,, P a Uealt4 ll eri� r s .' rs n a e� 3 a \, 4 1 - �� NO, w; . . 16 , v ^ w 3 x --—-------- &I 11154 Ovy In W " "IM h 2 u'R NA, xv P "NBC 01w _4A " oil Doi nwi. JU EGA,, j �Pzj'� .............. KNEIT 'T4 MTV 1 T__ff XI I M, tF RON= OM 04 IRMO, '42,14-45", ... ...... tzFr �VVIKWNMEXTTA bj 0 Pw" 'w _MW Vim%I M ZRA Q. ........M QG I"'01ANA . ........ I—GR ME j3 v IN S'"N A Mit6MitKIM 211* 1 MIMS U­­ Mal 3" "M Hit I now! "",EXPIF 1cW lo'-S' HIS- ism BOB 4 W 'P I Food r­ rims SAN MW Was A NMI S ON g TF -1p; 8, IK "Y wily a" _011 Awl -Wavy" "pli 4 "A' win '04 41 ,,,�%�-- AM— MUG-_X na AMINO 1411, WE MY ' ff q- go vii'M a..... ghSASY' 0AR UAW ""15 %Cll 'CIP0.1 now "TER JVF 2, PRiT, E'DR., A A JIM Wk-M, -qli TN' T-1 RIA(U,� 'QFTUSLAQ�rj All 10 N E,RE VAN: 6M Q- Its Q! any RAW R FUJI IF Nil' n ij�2'It UN 0006 M� M_ wz -0 1 MOM P W 31 115M 1fP1'rr_1rczjj9rc4ff M13=21,14'' —P 1 Z wj-' _K: 1 ov n n n v is "N' Nl�. Mo Ni� W, AN 0, A j W—T A yy 7, k 10 A �kg_ �i _i'A "� A-A Y'Jmv 14045 mop mill "If quo t1f W1 mill a MTV, A?ZEE Q�W W vvh�too gist a 2' """'A I, 'li,4z�' "z 1.0 A A� K\i:�'�"" _'i3il "a W,W Una "M F"161310171""I" "M 1" EWA M 4 "A"MM, 41 V a on awl A A W, it I HOW AA ` P,4 Barnstable Public Health Division PPLICATION FOR TEMPORARY FOOD SERVICEPERMIT o 1 DATE P 11 �l NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road VILLAGE Osterville NAME OF ORGANIZATION FAif m J Q Ck TT®`�-t,Q CONTACT PERSON TELEPHONE Le 1-4-- 141 Lf II L ADDRESS n FOOD TO BE SERVED(LIST EXACT FOODS) mil�,(x Ian j_C&4-r g m,l LS NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,Osterville,MA02655 DATE TO BE SERVED June 21-Sept 13 TIME 9 a.m.to I P.M. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECTION? HOW WILL FOOD BE KEPT BELOW 41 DEGREES F HOW WILL FOOD BE HELD AT 140 DEGREES F. HOW IS FOOD COVERED i n/ HOW IS FOOD SERVED TYPE OF HAND-WASHING FACILITY SIGNATURE Page 1 of 2 PERMIT NUMBER : FEP-2019-0290 FEE : $75.00 y ' •a • 14 f r a s Y M THE COMMONWEALTH OF MASSACHUSETTS Town of Middleborough Board of Health PERMIT TO OPERATE A FOOD ESTABLISHMENT In accordance with Regulations promulgated under authority of Chapter 94,Section 305A and Chapter 111,Section 5 of the General Laws a Permit is hereby grant to: Bradford Farmhouse Toffee Whose place of business is:27 Pleasant Street, Middleborough, MA, 02346 Type of business and any restrictions: Home Kitchen To operate a food establishment in Middleborough Permit Expires on: December 31, 2019 Lx Issue Date: 12/4/2018 For the Board of Health Robert E. Buker Health Officer httn,q://nermiteve,.enm/Middlehnroiigh/hnh/disnermit.a..n?a.nn id=9RRXtnrnce-,q id=41&er... 12/S/901 R ---------------- CERTIFICATE OF ALLERGEN AWARENESS TRAINING Name of;Reclplent:Jy Bradford t, 1 \r14 Certificate Number`-1!675594 Date of Cofm let', P 11./3/2014 Date ofxExpirati' *\1f01.9 or P10 Issued By: The alcove-named person is hereby issued this certificate NATIONAL 7 for completing an allergen awareness training program �" RESTAURANT aesuoree� recognized by the Massachusetts Department of Public Health "tee°eO ASSOCIATION® in accordance with 105 CAIR 590.009(G)(3)(a). Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 www.restaurant.org Southborough,MA 01772 This cert ficate will be valid for five(5)years from date of completion. 508-303-9905 7J�1 wwtiv marestaurantassoc.org Ka w � •�^�t.c �4i _.`� •.��w ..`S fr.� �'" .-'j"�*•' 't` .'..Fri, +,,�,r S Certificate of Achievrementsl� ��°�f•�'.•y � �'a�'" My`�q '4` � _ :y�„�� +5'z"rr. t ` 4} 'Cif !x'� 1 cry.}a 1 a p +t� wPT 39'ar This certificate is awarded to AMY BRAD FORDAW *7.1+. �4 r��.. t " ,I.4 � �q Y. � �• � Vf iln Congratulations! You have completed" ASTME2659 Serv' Safe@ Fpod Handler }. Certificate Issuer _ _ 5� `�'' Employee Food.Safety Online Cour' e_dnd Exam, a �, ft +. j ' a ) + 1 f x „r+. '� 3316420 . r 3/22/2015 .,. 5 Certificate Number 5 Date <. National.RestaurantAssoctatio �;, ., , Arl -'y, , o o y }c 233 S. WockeryDrive, Suite 3600 �. 3/22/2021 ' Chicago, IL 60606-6383 � - Expiration Date —�. > 800.765.2122 in Chicago area 312.715.1010 Restaurani.org I ServSafe.com WWI Up y � w.; 'S, 1r t, ''S Js'� � -+as, '�-�. �'} �"�� •„ �'L"J ."`va fi `'_mot - ❑ .ti (] d Ch `ri Barnstable Public Health Division �2 � S'� dv w� C, APPLICATION FOR TEMPORARY FOOD SERVICEPERMIT DATE 31u I l� NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road VILLAGE Osterville NAME OF ORGANIZATlI'ON,, 0%k:I.SSXW S C42I 0U_ CONTACT PERSON_ C/r' �Q 1 �I L C'," TELEPHONE CP l q- +33-ZfP ZZ ADDRESS (I 6AC-IT_P I&C5� lJ)akj-f �(�w� n'l F\ H?::!-1 a:2 FOOD TO BE SERVED(LIST EXACT FOODS) GGu- yi, I✓1-A-e-d, raw / NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): (ATTACH COPIES OF SERVSAFE&ALLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road Osterville MA02655 DATE TO BE SERVED June 21-Sept 13 TIME 9 a.m.to 1 p.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY F/ORINSPECTION? HOW WILL FOOD BE KEPT BELOW 41 DEGREES F HOW WILL FOOD BE HELD AT 140 DEGREES F. IJ I•'�" HOW IS FOOD COVERED AM HOW IS FOOD SERVED TYPE OF HAND-WASHING FACILITY SIGNATURE � I _ TOWN OF WATERTOWN 1630' Health Department 'A7 M a t Administration Building x 1 - 149 Main Street ' l Watertown,M.A 02472 Phone:617-972.6446 Fax:617.972-6499 Larry Ramdin,MPH,RERS,Cl10,CP-FS ww°w'•watertown-rna.gov Director of Public Health 201 ANNUAL PERMIT To OPERATE A iRESIDENTIAL KITCHEN Permit: BHP-2018-0142 Fee $ 100.00 Date: 1 I f05/2018 In accordance with regulations promulgated under authority of'Chapter'94,Section 305A and Chapter III, Section 5 of the Massachusetts General Laws a Permit is hereby granted to: Chrissy's Crumble Wicked Good.No Grainola,LLC ' F Owner: Chistine LeBlanc Whose Place of Business Is: 117 GARFIELD ST z Type of Business: Residential Kitchen - To Operate a:Food Establishment in the TQWN,OF WATEI2TQN `�'�� uo � � $ � ' a Permit Expires: November 30 20I9 � t t ` wA�ERTo�wN,�so�x�of H»�A`�T� Ltrector'n bloc Heal h t " 1 �� at xx- m ' s a Q �40, K3 � � i ra � w > r J Z Chrissy's Crumble creates delicious No-Grain-ala granolas, cookies, savory crackers, energy bites, chocolates, donuts breakfast scones and raw cheesecakes. We make everything using quality plant-based ingredients mildly sweetened with organic Vermont Maple Syrup — all blended together with love and care. Our products are free of dairy, eggs, grains, oats, soy, and sulfates. We use nuts, nut butters and seeds to create our Gluten free, Grain free,Vegan and Paleo friendly. en- s na. r r71&------------------- -------------------------------------------- -n�k_' i ----------------- IF , , , CERTIFICATE OF V11) �JALLERGEN AWARENESS TRAINING , , 4�^ ; � t Name of Re6 e`nt Ch' l tine MLeblanC � l Certlficatexf'Number CWl l l&88 g +; Date of Completion 07127/2015 , Date of Exp ratlon 07/25" 020 , t Issued By: ' 7he above-named person is hereby issued this cert�ficate , � for completing an allergen awareness training program CC�mpuWorks ' recognized by the Massachusetts Department of Public Health CompuWorks Systems,Inc. in accordance with 105 C.MR 590.009(G)(3)(a). 591 North Avenue,Door 2 +; Wakefield,MA 01880 °Y P:781-224-1113 This certi6cate will be valid for five(5)years from date of completion. F:781-224-0504 , www.compuworks.com �a► ------------------------------ CERTIFICATION CHRISTINE LEBLANCmg for successfully completing the standards set forth for the ServSafe®Food ProI do Manager tlfication Examination which is accredited 6y the American National Standards Institute(ANS -G�o F �nfierenfo Food Protection(CFP). y9 , 623161 1044§0 �U M B E R E X A it F®�t M iq U fvV1 EAR' �du � AR 8/4/2 8/4/2020 � � . DATE OF E . " I DATE OF EXPIRATI'O"N a � �� N Local laws apply.Ch encyfor recertification requirements. .• i` 5 4 I � �AX LA ` f she Orr �A � a #0655 x 0 O In oxordanw with MarRt w(a6ou - - 015 Natiaml logo are tradm &of the NRAEF. C4Nod:us with questwns at 175 W ksdaon Blvd.Ste 1500,Chkcgo,L 60604 or SewSafe8mshnnant,or% Y' Barnstable Public Health Division rj&& 's S-S kw -� I APPLICATION FOR TEMPORARY FOOD SERVICEPERMIT DATE �� I �� NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS EXECUTIVE DIRECTOR TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road �VILLLAGE Osterville NAME OF ORGANIZATION CONTACT PERSON �1 `d/ h .���'i LUr�1.�-� TELEPHONE —7 —�o�`�� I `7 )— ADDRESS I 1TI A� -a, o '� , nd�60 P wh) ICI na$"fa FOOD TO BE SERVED(LIST EXACT FOODS) & NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): j v R ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,Osterville,MA 02655 DATE TO BE SERVED June 21-Seat 13 TIME 9 a.m.to 1 p.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&.READYn�F I �ORIINSPECTION? _ _/a' 1gI HOW WILL FOOD BE KEPT BELOW 41 DEGREES F ULD UL{ 1 XW)2DP) 01DIM-) W 1(:rpA6ZG CP-40� HOW WILL FOOD BE HELD AT 140 DEGREES F. I/{ HOW IS FOOD COVERED W I HOW IS FOOD SERVED_ IV JA TYPE OF HAND-WASHING FACILITY SIGNATURE ------------------ CERTIFICATE OF ALLERGEN AWARENESS TRAINING Name of Recipient FELICIA DASILVA � 71 Certificate�Numiber 351106 l t ' 7731 ./2018 Date of Completion � Date of#ExVIIplration• ' ':2023' lam-"' AYµ o�Z- Issued By: The above-named person is hereby issued this certy7cate ----------r for completing an allergen awareness training program NATIONAL RESTAURANT � ! H9sYlitlle�R recognized by the Massachusetts Department of Public Health '"'"a ASSOCIATION, in accordance with 105 CMR 590.009(G)(3)(a). Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 www.restaurant.org �fiSouthborough,lVlA 01772 This eertcate will be valid for five(5)years from date of completion. 508-303-9905 1 www.marestaurantassoc.org j z � nr lRtrN f''1d w'ra�'a�iClY � h � �ad'S&w'/ : 'S�i'�wy.,a�2' �s•"�at g� k. "�a`e .. ................. ........ S ......... flow, .d ""j i. k - sr ✓` Iwo o v" a t 7 3 ;$ 3floor? r Z ^V2 jiR3�ffkb a s Fyg �6 ; � 3 t rf t } Om- MY up noti �F g68 Y'€4 -y {tl f�V t F g s � .✓M"'-�'t_,s g�°�s:r. ��£� d`�a�Tt'�tte" �'�� d e� ��€'1..,�(df��' C.d �J`d�C' i Y�xxE�,. to Y r, INK ¢ACT` >»m _ R, .✓' g £ sE„ $€ his`:���@��A �. � (�l�,pq�' n 8 'SS=C Op Zo— �. MUM � , ,� ry pig �r �4W, �ml , 1 J 3 dVisa,S^T l#a#tea k# P dG1FA J` F# y � � r � YAW < e ,a ,r y � r ', .fin .. .:. '' -.:,. "-`. +.-" - • Yr w.,,. "• •'_4 ° - F"l. - a`{'.- - - w y rw r r d" f I ; fr ap r' /n r i ' F .fl FV E It 't'<r f '� 1,t -f Ct �'/ 1 P -�1' f' / f iti% l ,r /�,, St,a, ,o 'l hod Island ,and P oviden,� . Plan, at�zonsr_ w 1 . Y J r +k b,. • ]p. _ ,W xLp re. + 1 '�•x ,�. - ,. _ l�A �,o� •ail w ro. , epatment of f` f`ea Ftli t F ffice o�f Food P�o�tecti%ol� r �I 43„ EPS ,' L PORTSIVIOU H..R"ihav n, ve ,sa is�acto This Xs to certiy.:that DASILVA.FARNI<located at 0__ - -- -- ,l _ D �U„_ _ _ T_ , _ gz t ' A: h, ,e nt s pal f ed i' aeon:bamt witha,Cha ter 21 27.off the:i;General Laws"of 195,6,'as�,amended 'is evidenceAthat said est h me q, z, n. y, P :. Thereby.grantedm M ' ...} �A 7 C 6 ':tom YR i Ws-� ✓ t` tr :ry l rr• .41 p , r 7i 'i ;lr ,,y. �.11 �,; •.�,'� '�''� it !'. ri �} }:�� �'� } }. �•p.! i 'a'�J it"l 1+ ! 4'-is�}��'M.: f,i .a����1\J #� S"gyp I� f 4 a p` ., ..- _ , �. ,1. , _ . , a:f .. r 77 V to,operate a Food°Bus nes&J,6r,thelpertod.endzng 09/30/2'019 Ltexcse, lwmber. FPR04831 :: acense Farm Wareho,ue,.Meat;Prodz :cts- 4„ \�t s ,r�tad k v v +,r u .ag , : �W x �Nicole:TAlexa+rider .Scott,bM,D �!,� fiff, ry ", '' - xy -Mmrt:'-Y.=:- �� . 4... ... .�.~ x. SC� t Jp,��S i �� GI .I;7 ! + �" "•.u;,;;�. W . :N 4 �, hector . '-- i-r� ..:•r-•, �Jp b w _ , - , .x _ m THIS'LICENSE I"S NOT T °,`�N`STASMBLE This license must be Iposted where cQnsuxriers''can see it; f : . r T s m Barnstable Public Health Division ke L APPLICATION FOR TEMPORARY FOOD SERVIC/EPERMIT DAT&S ,�dJ/� NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road VILLAG/E Osterville NAME OF ORGANIZATION 1401''.VC �//' 7V/? S CONTACT PERSON—' i Sb,ll)/) )() TELEPHONE �G7�-,�5��Y/of ADDRESS- a�y,gWre- &-I✓6�J)Jazo .i]th. 127A /)_--')3•.,o FOOD TO BE SERVED(LIST EXACT FOODS)hhJ•l' al j fidtielVP i p n kim ffio, PoI15, ikke NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT):661s0/7 0S/?(1./9/7 017 (ATTACH CO OF SERVSAFE&ALLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road Osterville MA 02655 DATE TO BE SERVED June 21-Sent 13 TIME 9 a.m.to 1 p.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECTION? 1q0 A•M� 4X .51 ooe'r.. HOW WILL FOOD BE KEPT BELOW 41 DEGREES F OCc,J=r. wij-�h )(-N HOW WILL FOOD BE HELD AT 140 DEGREES F. ca 0 ji n Q /11.5�1; �C1 d31 h d D HOW IS FOOD COVERED�� S7 i G rovers,_�'an wEa an l i i news HOW IS FOOD SERVED fi"A hand, dpQ.o TYPE OF HAND-WASHING FACILITY &V1 d e j SIGNATURE , r e, r EXAM FORM NO. 10378 CERTIFICATE NO. 11196854 * _ 314 F, *� .��a�, '�. ;F� � ".' �•,"m»ate"'�>o„''�"� rC v6afe CERT� HL""A03"10N TO SUSAN M SHANNON for successfully completing the standards set forth,for the Serv-Safe Food Protection Manager Certification Examination, which is accredited by the American National Standards Institute(ANSI)-Conference for Food Protection(CFP). ' :•�vwAeanrestaurants.com j Arthur Bloomquist 1 O Z O 14 96 Lake Street 1 . a Pl m ton,Ma 02367 DATE OFEXAMINATrION Y A ` . �; s � 6/24/20141 DATE OF EX�tl'RATION with yourlocal regulatory agency.;or recertification requirements. Local laws apply.Check 3 j r a ate. :. t`x . Sherman Brown National Restaurant Assoctatiori Solutions #0655 ©2014 National Restaurant•AssociallonaEducational Fo ndallon(NRAEf)iWl r�>ihts reservved,S rvsa�fe is registered,trademark of the NRAEF,used under license by National Restaurant Association Solutions,LLC. The logo appearing nett to Se'rvSafe is a trademark of the(Natfonal ftestaurant Association. :.,. Is,o ument cannot be produced'or fi 14013002 - v1401u i • THE COMMONWEALTH OF MASSACHUSETTS 4 ° TOWN OF PLYMOUTH I PUBLIC HEALTH DEPARTMENT 2019 BUSINESS LICENSE SHANNON'S GOURMET CATERING C/O SUSAN SHANNON 162 BAY SHORE DR PLYMOUTH, MA 02360 CID#: 51053 DBA: DBA FOREVER YONG'S BL ID #: 100642 LICENSE­#: 32-19 Your 2019 Business License for A LICENSE TO OPERATE A CATERING ESTABLISHMENT is printed below. Please retain a copy for your records. If you have any questions,please call the Public Health Department at 508-747-1620 ext. 10118. THE COMMONWEALTH OF MASSACHUSETTS FEE s n TOWN OF PLYMOUTH $ 150 4 i f 6 PUBLIC HEALTH DEPARTMENT ey 2019 This is to certify that: SHANNON'S GOURMET CATERING DBA FOREVER YONG'S Doing Business In: PLYMOUTH, MA 02360 Has been granted: A LICENSE TO OPERATE A CATERING ESTABLISHMENT In accordance with Regulations promulgated under authority of Chapter 94,Section 305A and Chapter 111, Section 5 of the General Laws and 105 CMR 590.000 Expiration date: December 31, 2019 Signature LICENSES ARE NOT TRANSFERABLE CERTIFICATE OF ALLERGEN AWARENESS TRAINING S Name of Recipient Susan-M Shannon r r Date of Completion: June,,28, 2018 Date of'Expiration: Ju_ne28, 2023 t ()F i'u Issued By: 7h.e above-named person is hereby issued this cert fcate for completing an allergen awareness training program ' recogni.zed by the Massachusetts Department of Public Health Berkshire in accordance with 105 CjWR 590.009(G)(3)(a), ��AHEC Area Health Education Center Pittsfield,Massachusetts. This cert fcate will be valid for fzve.(5)years from date of completion. ,� www.rriafoodaUergy[raining.org Barnstable Public Health Division APPLICATION FOR TEMPORARY FOOD SERVICEPERMIT DATE NAME OF SPECIAL EVENT Osteryille Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DHtECTOR TELEPHONE# 508,428.5961 CELL# 508-280-8882 „ HOME ADDRESS 155 WestBay Road VILLAGE,Osterville NAME OF ORGANIZATION I`U S f Fj- r 4 S CONTACT PERSON I)U4— TELEPHONE ! ..i -e—7 7 ADDRESS G�a�t<l 0 rcJ 4�!f TY�_. f - �(�,) �a P�el �) FOOD TO BE SERVED(LIST EXACT FOODS) NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): 5j ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road.Osterville.MA02655 DATE TO BE SERVED June 21-Sept 13 TIME 9 a.m.to 1 p.m. WHAT TIME WELL ALL EQUIPMENT BE SET-UP'&READY FORINSPECTION? HOW WILL FOOD BE KEPT BELOW 41 DEGREES F HOW WILL FOOD BE HELD AT 140 DEGREES F. HOW IS FOOD COVERED ;i HOW IS FOOD SERVED TYPE OF HAND-WASHING FACILITY SIGNATURE a i t •s ervs _ t ,C E RT.I F1CA., TION,, 4. DOUGLAS Foss io o For suocwAlly completing the skmdards set'+Foith For the ServSafee Food P Mcitto Cghfiaoilon Examineion, which is accredited by the American National Slandards Institute Food Protection OR r k UMBER fXAM� FORMNUMBE3R fix M 03/1 03/11/2020 DATE OF DATE OF EXPIRATION F i LcA IOW%g4AY. IW fbCCrih=&M R qulrer Mft. i ` r sG4 N0855. ® �• � 1noonw VAMOWN • �l01SNfdiad %' !M hw m frodw-&dliiNtAff. Ram k - tOs•D Cmded m-6 m d;wu at 175 W ledmn rlW %1 W0.Clt ww.L 6060/v Sm�Safi@re�la•ai or¢ WF #r wf � wt #► wF �v wf 1rr of #► �.f CERTIFICATE OF ALLERGEN AWARENESS TRAINING Name AR Aplentt DOUGLAS FOSS , Certificate Number. 2703134 j f i s Date of p.Completion. 92„s'?o,s , Date of Expiratlori 'ti19i2021 1 /tom s � 1 Issued By: r# ?he above-named person is hereby issued this certfcate - fJ] or g an alley completing en awareness training program FI!flIQ�II NATIONAL f P g gP S RESTAURANT recognized by the Massachusetts Department of Public Health ASSOCIATION in accordance with 105 CMR 590.009(G)(3)(a). Massachusetts Restaurant Association 800.765.2122 333 Turnpike Road,Suite 102 wwwrestaurant.org Southborough,MA 01772 ?his certificate will be valid for five(5)years from date of completion. 508-303-9905 ill www marestaurantassoc.org /VIV lie 1 46 J J U. 16 V/ - _ a- III �je 4ottYtnn�ueaY �j of $ DEPARTMENTOF PUBLIC NPTH.gUREAU OF ENwR:IAMAIcn Pwr+,MAg Q213Q Faoo-PROTEcnoN Pizoowv.+ Q5 Barrett STREET, LICENSE .. SBCUoR 30 5_ cfiaa .. Laws. `: In A�otdance with Massacfiusatts oenerat Y 1QSQS/t 1tE0[1!2 0I GAr,R ` - at Who leale tribFoodoc Sae €P oDis M 9 20Nf Y r= MA-8957ASSUEDT R 1133}tS}1[;R ROAU� NOR t t111ARTM0U�}I;;MA 02747 commissl ER OF PUBLIC tiEA17N A 1'FN:'AI LYSON N05S z 110Us PI ACE POST IN A CONSPIC RECIPIENT-S COPY. ' .� .:, Fz)s5 �� Per�mi #-2099-GR O'3 gee:5�80 oar I t' s i gyp` •m" ,Y� .. y V THE COIv MON-W'gALTH OF tv145�SA0T!-JT `ToWn Of D-tmkffi Board of=Health This i$to certify that DOUGLAS.F095 • 'lJzcensee . . 9933 FISHER ROAD DARtMO,_UTH;MAy0274$ r . - . . `Address '- rSMtREBY GI kJ4.T'W FOR fifN.ArUNUAL.(GRAI GE Ki IYCHR 9933 isher�Raad Dartmouth MA 02748) ' %ER lia8 PM-p"m`ITTif4 This permit s,granted in conformity with the 105,CMR 59,0 Minim,u�Sar�itat�on S`fanda�ds.for Food Establishments Stafe Sanitary Code,Article X and.expi es December 3l;2019 unless soonpr suspended or revoked.' PERMITS.NON-TRANSFERABL Date-TsSuea-12/27f1$ I Barnstable Public Health Division N , APPLICATION FOR TEMPORARY FOOD SERVICEPERMIT DATE NAME OF SPECIAL EVENT OsterAle Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5961 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road VILLAGE Osterville NAME OF ORGANIZATION CONTACT PERSON %V\YV\AT n TELEPHONE ADDRESS FOOD TO BE SERVED(LIST EXACT FOODS) NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): (ATTACH OPIES OF SERVSAFE&ALLERGEN CER IFT A E ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,OstervWe,MA02655 DATE TO BE SERVED June 21-Sept 13 TIME 9 a.m.to 1 p.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECTION? HOW WILL FOOD BE KEPT BELOW 41 DEGREES F to %�,, HOW WILL FOOD BE HELD AT 140 DEGREES F. 4h, ' HOW IS FOOD COVERED HOW IS FOOD SERVED TYPE OF HAND-WASHING FACILITY SIGNATURE J �� II i i i}ft the - .. t AljwayS { [food Safe a company = ! C 1 ss i I Frank Tam;maro1 Y1~ The Always Food Safe Company Allergen Awareness E . I Employee"Food Safety Online:Course.&Exam ! Date: 02/25/2019(valid+until 2/25/2022) L t y Course reference: ALGN 1 Learner reference: ALGN1002312830 L This training is approved for 1 continuing education hour toward the initial or l recertification application for ACF certification / c t U i f � t Nick Eastwood The Always Food Safe Company #1203 r, ' 'President 899 Montreal Circle,St.Paul,'MN 55102. y The Always Food Safe Company www.aiwaysfoodsafe.corri ? r w Congratulations! Go ahead and frame the big copy--you've earned it! Keep in your wallet for anytime, anywhere proof you passed! For your manager to keep and admire he the t Always c� O 4 Always ays C , Food Safe ' _ Food Safe O,n Mp company M(�.. company M( l I .L/rd�ctl/rcr<lr.�/-.(l/e<rar,<ua.«l<.f,ro<uar i�e<�ln: �/erf.t�ealr/ri lc�.�P7/z<rziiener<rl rf m<a<i�r.�/n, 4 Frank Tammaro r Frank Tammaro p E ' The Always Food Safe Company" a The Always Food Safe Company , Allergen Awareness Allergen Awareness E Employee Food Safety Online Course 8 Exam 8 Employee Food Safety Online Course&Exam f Data: 02252019(validt until 2252022) \ Date: 02252019(validt until 2252022) course reference: ALGN course reference: ALG N. _ Learnerreference: ALGN1002312830 Learner reference:, ALGN1002312830 r 1 f This training is approved for 1 continuing education This training is approved for 1 continuing education hour toward the initial or recertification application for hour toward the initial or recertification application for ACF certification 4z ACF certification 0 Nick Eastwood. The Always Food Safe Company #1203 Nick Eastwood The Always Food Safe Company 1 President e99 Montreal Circle.St.Paul.MN 55102. President 899 Montreal Circle,St.Paul.MN 55102. d1203 Tho Always Food Safe Company www.alwaysfoodsafe.com The Always Food Safe Company www.alwaysfootlsafe.com .� --- - Students:Did you buy this course yourself? ALUMNI REFERRAL CODE Managers:Get the best training for your staff at Give this code to your manager!If they use it,we'll alwaysfoodsafe.com/manager and get refund your purchase(up to 1 course)! ve-alumref-32506-1215584 10%off$25 or more with this referral code! I ,a P 1 o , State of Rhode Island and Providence Plantations Z o ill�NO O 5 3 Departmejit of Health E Office of Food Protection This is to certify that FRANKS CUCINA located at 691 MAIN ST WARREN RI having given satisfactory evidence that said establishment is qualified in conformity with Chapter 21-27 of the General Laws of 1956,as amended,is hereby granted a FSOOD BUSINESS LICENSE; to operate a Food Business for the period ending: 091,3012019 j x ° License Number: FPR0499$ -�- License: Food Processor Wholesale=In- Nicole Alexander-Scott,MD,MPH ; M f x a State 4 CD Director of Health i Nt 6A a THIS LICENSE IS NOT TRANSFERABLE.; This license must be posted where consumers can see it . w a; o r+ N 4-y � O erv. CERTIFICATION . FRANK TAMMAR0--- For successfully completing the standards set forth for.the ServSafee FFood Protection Manager Certification Examination, which is-accredited by the American Notional Standard Institute{ANSI}Conference For.Food Protection..(CFP): 1609 5337, TIFICATE ER., EX*M FORM•,NUMBER 2/13/2018 2/l 3/2023 cocas DATE OF EX MINATION DATE OF EXPIRATION AM ,°S° Local laws apply.Che Ic With your local regulatory ag cy for recertification requirements. Sher .•n Brown ecutive Vice President, Notional Restaurant As ciation Solutions �. 0 In accordance wi tabour Courant.2006,Resolution ADM N 068.2013(Regulation 3.2,Standard A3 ionol Resomu Association Educational I'mm lion(NRAEF).All rights reserved.Sery _t e Se"Safe logo are trademarks of the NRAEF.National Restaurant Association®and the arc design are trodemarla of the Naliond Restaurant Association. This document connet be reproduced or altered. 17110811 v-17 Contact us with questions at 233 S.Wacker Drive,Suite 3600,Chicago,IL 60606.6383 or ServSafe@restaurant.org. f a Barnstable Public Health Division U� APPLICATION FOR TEMPORARY FOOD SERVICEPERMIIT DATE( V.L0w_z NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5961 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road VILLAGE Osterville if NAME OF ORGANIZATIONA;iv/,f,;,y, CONTACT PERSONI" 4 " C,LA61 6 LEoPHONE ADDRESS,,�IIj/, ;?46 / A100aS � �QdClG72/G/ A41 O02—VD FOOD TO BE SERVED(LIST EXACT FOODS) p G �iol+rit C g7 !/1YT/ s � L NAMES%Q;! n D FOOD HANDLERS(TO BE ONSITURING EVENT): ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,Osterville,MA 02655 DATE TO BE SERVED June 21-Seat 13 TIME 9 a.m.to 1 D.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECTTI.O�N? / ,6 QlK. HOW WILL FOOD BE KEPT BELOW 41 DEGREES F lS4d�/�7w�� ![L IN CQ7�tl HOW WILL FOOD BE HELD AT//1,,40---DEGREES F. HOW IS FOOD COVERED /, AgQW-$ HOW IS FOOD SERVED TYPE OF HAND-WASHING FACILITY SIGNATURE L . d �i�je �otrYn�ott�aeaY��j of �.a��ac�ju�ett� '__ � � ' DEPARTMENT OF PUBLIC HEALTH, BUREAU OF ENVIRONPAENTAL HEALTH { H 7 FOOD PROTECTION PROGRAM, 305 SOUTH STREET, JAMAICA PLAIN LICENSE130 1 i In Accordance with Massachusetts General Laws Chapter 94 Section 305C Aft NUMBER ISSUED EXPIRES TYPE MA-9010 07/25/2018 07/25/2019, Process or Distribute Food for Sale at Wholesale ISSUED TO FRAULEIN'S BAKERY DARTMOUTH GRANGE 1133 FISHER ROAD t DARTMOU'l H,MA 02747 COMMISSIONER OF PUBLIC HEALTH t I c ATTN,:LI1,LY REMPEL 1 RECIPIENT'S COPY POST IN A CONSPICUOUS PLACE (on Permit#2019-GR-02 Fee:$180.00 ourN-M Sri ni THE COMMONWEALTH OF MASSACHUSETTS Town of Dartmouth Board of Health This is to certify that FRAULEIN'S BAKERY Business name LILLY REMPEL Licensee 1133 FISHER ROAD, DARTMOUTH MA, 02748 Address IS HEREBY GRANTED FOR AN ANNUAL (GRANGE KITCHEN-1133 Fisher Road, Dartmouth MA 02748) SERVICE PERMIT (1 Item) This permit is granted in conformity with the 105 CMR 590 Minimum Sanitation Standards for Food Establishments State Sanitary Code, Article X and expires December 31, 2019 unless sooner suspended or revoked. PERMITS NON-TRANSFERABLE Date Issued:1.2/27/18 SALMON t -4 wal"—. . CERTIFICATE OF s � ALLERGEN TRAINING AWARENESS ' n i Name of Recipient: LILLY REMPEL i Certificate Number: 2345209 ` s ' Date of Completion: 5/24r2016 s irk Date of Expiration: 5124/1021 ' E s j Issued BY: r+� NATIONAL D)e above-mmtcd person is h,ereGy issued this cert�cale + RLESTAURAN"r \�a l nnunu.pn.� ; ��� Jor•conrpking an,aller���en awareness trrt nirrg program ne•..;,• ASSOCIATION,;, recognized Ly the Massachusetts Department of'Puhlic Health Massachusetts Restaurant Association 800.765.2122 i in accordance with 105 CAM 590.009(C)(3)(a)• www.restnurant.or 333 Tivupikc Road,Suite 102 g , Southborough,MA 01772 this ccr t ficate wi//be valid fa••five(5)years f tau date'of completion. 508-303.9905 r vnwv enaiestnurnnrnssoe.org W 14 Io it n 4 f :Att3t1a1.t;�,�.1.���.,rY_-�t.I<C7`►r J� � O R r is LILLY REMPEL for successfully completing the standards It forth for the ServSafe®Food Protection Manager Cerlificalion Examination, which is accredited by the American National Standards Institute(ANSO-Conference for Food Protection(CFP). .r 13690018 5156 --•:°CE,RT+Ff OAT E-NUMBER I EXAM FORM NUMBER 5/25/2021 5/25/2016 ., DATE OF EXAMINATION �. DATE OF EXPIRATION Local laws apply.CRgck with your local regulatory agency for recertification requirements. 1 , i t Sherman Brown !` RSVP, National Restaurant Assaclatian Solons/ 40655 In accadonce")h Nla iizme tc6ar,Carven16n Z008,Rosdullon ADM IJ 06B•20111Reg�dolion 3.2 Slandotd e19.21< ,• „ W015 National Reacuront Al"Edu=Honat Foumtalian INMEFt•AgtigMs rmared.Sony artd tlw SsNSato togo'are nodemor#s cf tha NRAEF. Ndianol Qeduuiont A.�idfad9f and tta aK dnAen aee Itatalnadu of the Naianet Rataotanl Auack�lion.�r `""" TItt6 deeunt�nt tunnel be roptoducod ar oltorod. Y,l.101 Gontoct us w1h quedions m 175 W lockson Blvd.Ste 1500,Chicogo.IL.6060A or Scvsaleereatourant org. �" I�toav0l _ Barnstable Public Health Division '.b APPLICATION FOR TEMPORARY FOOD SERVIC PERMIT DATE NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428,5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bav Road VILLAGE Osterville NAME OF ORGANIZATION ootA k f CONTACT PERSON (. TELEPHONE 0 1 ADDRESS fT FOOD TO BE SERVED(LIST EXACT FOODS) v( cJ �ial CA X& r-"J) \ �11j t 1� ✓ �S S {��-S NAMES OF D FOOD HAND ERS(TO BE a SITE DURING EVENT): (A COPIES OF SERVSAFE&ALLERGEN CERTMCATES) ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road.Osterville,MA 02655 DATE TO BE SERVED June 21-Sent 13 TIlVIE 9 a.m.to 1 .m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECTION? HOW WILL FOOD BE KEPT BELOW 41 DEGREES F HOW WILL FOOD BE HELD AT 140 DEGREES F. HOW IS FOOD COVERED HOW IS FOOD SERVED a its TYPE OF HAND-WASHING FACILITY SIGN NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS C)0 7S. ....... ...... .............................of.... \ __(T.............................. o Bolard f ealth PERMIT TO OPERATE A FOOD ESTABLISHMENT Permit No.t..vcf—s........ 0... In accordance with.Regulations promulgated under authority of-Chapter 94, Section 305A and Chapter 111, Section 5 of the General Laws a Permit is hereby granted to: -e_76..................... 7....................--------------------------------- Whose place of business is ......... ........... S ........... ......................................................................... Type of business and any restrictions .... ............................................. �............................................................................ Tooperate a food establishment in .................. ..... ....... ..................I.................................................................... (City or Town) Permit Expires oe.c...e.......M...............C.....3.......... 20A....... ............. ....... ---................ ............. ---........ Board .............. of ... ............... Health ... ....... . ........... .................................. FORM 738 A.M.SULKIN CO.-CHARLESTOWN,MA .. ��r► q! #WRrI+* �I ��.�� i�1.A� ►. �14p� #/� � y iYi{ •" f..A-i Y f� •M�! M�' 0��,�;�,Yr,\4 � . * i +Yp'it�i`," .. �►•M`p*MR�eyi�a.�Ay N++l.�rr_�_'.7,W- 4 ,,� �ll+�y�+@ +!""_`R wF qF Q. R'ml7gyi. p�� �"'-w.°' � '•d.''®"q6+,:s'wP!/n!'R'♦ -N-r,k+':�' '."'4..�.'w,Ot .'!•P' 9Rr:e3$#,yAF p,t. R�fj1 .RxY+w,#r" +w�. �a.-�w.i i."_."_'yM•r-w:, :7'^°.'^'a'4t:�.�• 4,. MM.yk ..�yy r.., •s,+.a.Ya'' I,a :e i"r Y _1#► 1 a^4+i.. .t�:t _ •I# ♦�` .#F tit 1'•++:s !iyl ! aerrt #.r.�. .rA�q #:.�,. *.�e.+i + ,,k s:��..•��„`.�r t t �.Pam+ ►'� r- ! r�q f 'e',s spWt'tt�-T}i a fi .a..�' ..r ..t •.t w iF�M►M!.. 'n..#�# ka.t ��i.. pp '&4y.;,s,.!1► ,. ,,,`:. '9 i +� t' .. • t'.. -Ale+ tbt+Mh« t+!i �4�14'�* �JI. �l�+i`'►���i�}9�N1 •:Y�.��. • yrl:er� .�' � +frr, � '�.."'•#�P ,f '� ,* +G"' � �F '"�� .A�lv. s���,stwF�►�t.,,..;,,, Sao•* «,�°'w '. - ' Af 1 .: , 4 4 . * , !. 1o_MA,. Yale« r1a�r#al ��w1Z+, .�f'"*r��s� tf.���'�rrA..4•� � �K,y,w av��'r �.._v .��.�' �+..ei*�1.3l�ilA.a�•: .� 1,!• �.a�.tft:,i��11#i �kih'b i.iy a.,,�"i :11�t�k�r'�4►i�1����1��1�t�fs�r�id141��1�i�i':��rt4x�►-����1�i��:•�_M1/����i����'���'dr��d�i�Jrf4ai�;4®�t�ti�6l+����1R��L �ef`�,��!�,+ra:'�'� # f. s*a i##ice �:�•� a a�,_ f�p •��� ggWt am` 1 up pop, ►"�t�t�A�+ �� .;�'� +cam i1��y^�r-'.':.. r• �t �r:�RO+veq ,• !� � 1' 1 .• , }'� is# a�."s*��!,�i {�~ _.•. . . .._ U • � ♦'fit#*. , rr ► l�l. r "1T` ?, •�11 I1 a'�I r;r�r ae:• .'aF# 1 rr # rs, rrer +r. y. . � ,e� alb .' a1� � ,_: '{ L+�1�f1 ...i 4f � .F` T1 f, �- ; ,��', tf"C l,.�1- Y1 tf - 1'i !' T :�1t. • Rl:; tvr..lr .. -: ,.r •,, �"�. #���._r+*r �� ' ` , ,�'�'��� r e .'� .4�. . � � .��� � '� ��►:�a�,+� r-,_: �u+.: '� S,-:«�,.� : j:t� r� ►r!"fi��t . �a r :al :, •!a 1 ,«." ��� .a�K +••s t : i;.�s�+►*y a► '•r,�#.� .1`a,�4�i '�'� �'����`' ��'t�r t �., +� l��'i�4� $�r � �� �� ,�:�1 � b�t l�„rt �•r�, ,.�-+,� a��/A,••!►+�: .°► �i,;•k!„k.a'.o�,..�'1ar,;l: e� _t tr, i•�y." ♦ .,� ,:!• . .w'}' 4..y 1"RY��f;►�:"�t,w''k��,'M.{� fJ14�S a ,,::4°'• 'hG .d,:�i � ab"�..��� y. ,�:�,. !1t,fw'is"�'- sir .•# ,►.. ♦}�"°s'ps.., •Y��.P v."'e •ISM '. w,rta'-v"�r•#.Ni .� i, * rLa}..wt k .w. i:J•►A ur,i. t�M `., +w`!�'►'.r,,e+• ttq� �g: �y....,�0,�, i, ,..1.. �1[ t-�-}! _y.•M}R a•!�,Y..'�, A\.,..y.y :...�Y•►, ,#•#-w- #+�Ylw wF er:-+a.�4+-"Red�Ya•#� �„+r,*�SY't�l�i Wri..,yy�,�;�1� �.R��e,�M ,iR, '�' v.y��..�9r s{'"«.�`�at'1..AA "� rc •, w:: �...'t•"' y� . � .°�R�•!�•t.y a t'"P^► !"- �•�'►���at+4 �A�*=�'i,�'�ili'p#i.-;�i�"�.K� r""� �1�*�0.•�e`, s 1i 'i�t� 'y,'""��i R�. y +v y .s�. . i ,,/, �.�.y, �,y,���� a-t- +.*�. pa2p��11�t�lr.t}.Rr���,�'°ti'yA+1-..�'L'p..p.w•,i � � �� It,,�. .. .. ,�•� �\�y �;I �7y�• � 7i�'��* i� � � ��li —��". tipyR��l;���''iA�i�{� rt������ �#f. •F.�a.�"Ii+�.. ,�.i`���.ry�., . .. i tits 3-1 CERTIFICATE OF ALLERGEN AWARENESS TRAINING . Name of Recipient: Susannah Locketti - ttz Date of Completion::April 13, 2017' Date of,Expiration: April 13, 2022 Issued By: 5 The above-named person is hereby issued this cert ficato for completing an allergen awareness training orgram recogni zed by the tl assadmsettsDepartmentofPublicHealth, Berkkshire WAHEC ,in accordance with 105 CAIR 590.009(G)(3)(a). Area health Education Center Pittsfield,Massachusetts This cert ficate Will he valid for five(5)years from date of completion. x���e.maCondaller�•trainina.orb ��. .rya noLQo Barnstable Public Health Division APPLICATION FOR TEMPORARY FOOD SERVIIjCE1PERMIT DATE ` l 1 �`"` NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay `Road `VILLAGE Osterville NAME OF ORGANIZATION C'1 Ck e_ `VYY-rl ` OYN­Le- CONTACT PERSON \�+r'"� C-\ U" �` TELEPHONE 33V� �I 1p ADDRESS �t\Cx{'l�iL "�!e_e— . rr)yf1 0 FOOD TO BE SERVED(LIST EXACT FOODS) 1 X e_oAS `MV��1r1S � G�C G.�C��C• � �c�����5 ,1GSC,lA\�S \pr�l?�h�C.S�� � NAMES OF TRAINED FOOD HANPLERS(TO BE ONSITE DURING EVENT): (A'YI'ACH COPIESOF SERVSAFE&ALLERGEN C R IF I'1; ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,Osterville MA 02655 DATE TO BE SERVED June 21-Sept 13 TIME 9 am.to 1 p.m. WHAT TIME WELL ALL EQUIPMENT BE SET-UP&READY FORINSPECTION? `� r HOW WILL FOOD BE KEPT BELOW 41 DEGREES F CO3\e-C HOW WILL FOOD BE HELD AT 140 DEGREES F k�V-\ 0,e HOW IS FOOD COVERED C-(�J 2I c.CA C(V _A 4A HOW IS FOOD SERVED)(7)Ce— ��� TYPE OF HAND-WASHING FACILITY� � SIGNATURE ' a THE COMMONWEALTH OF MASSACHUSETTS TOWN OF PLYMOUTH PUBLIC HEALTH DEPARTMENT 2019 BUSINESS LICENSE TIMOTHY&LISA CLELAND CLELAND, LISA 8 ATLANTIC ST PLYMOUTH, MA 02360-4302 CID #: 46029 BL ID#: 101186 _.__DBA.MONEY rM HOME _ ---V- Your 2019 Business License for A LICENSE TO OPERATE A CATERING ESTABLISHMENT is printed below. Please retain a copy for your records. If you have any questions,please call the Public Health Department at 508-747-1620 ext. 10118. THE COMMONWEALTH OF MASSACHUSETTS FEE PAID 4- ' TOWN OF PLYMOUTH $ 150 =m PUBLIC HEALTH DEPARTMENT y 2019 This is to certify that: TIMOTHY& LISA CLELAND HONEY I'M HOME RESIDENTIAL KITCHEN Doing Business In: PLYMOUTH, MA 02360 Has been granted- A LICENSE TO OPERATE A CATERING ESTABLISHMENT In accordance with Regulations promulgated under authority of Chapter 94,Section 305A and Chapter 111,Section 5 ofthe General Laws and 105 CMR 590.000 Expiration date: December 31,2019 Signature ��rT LICENSES ARE NOT TRANSFERABLE r T • � 'n ` r'.�/' `i1�w > i �: `, c�.i/r:'U�,s � n ` r'.'< lw�s i n r�_r� :t��. s i Il � r ill was � n' � r�s ��-'s i _ : � -�Y ' ��✓�`'c�-e��`c�=ei��c�:e��`'cam:�.�%�'�`'c�=�i-�`'c'� �.✓j c`��� l CERTIFICATE OF yy ALLERGEN ''� `�. �, I�° � '� �' � � [ ,E ''� � � � � t Name of Recipient: Timothy G Cleland DateNovember 1 Date of Expiration: November 15, 2021 ��S< r �` h � 7 fol,completing ♦ rec h IDepartmentI Public Health ]AHEC Berkshire ^ pArea Health EduCation Centerr .s. HPittsfield.Massachusetts %�� r. :G'�7 C/r-c�:6'\7�;.C�7c '6-\�C../�c '-G��C/-�'G�7 C/�c7• ;G-��C '-c�'G\�Cr/'�.. } ���' HONEIMH-01 DCHRISTIE AOCoREV CERTIFICATE OF LIABILITY INSURANCE °A���°D� 4/312019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER FACT WM.F.Borhek Insurance Agency PHONE FAX 311 Plymouth St AJC,No.Ext:(781)293-6331 1 A/C,No):(781)293-2171 Halifax,MA 02338 NSURER S AFFORDING COVERAGE NAIC# INSURER A:Ohio Security Insurance Co. 24082 INSURED INSURE : Honey I'm Home INSURER C dba Tim&Lisa Cleland 8 Atlantic ST INSU ER D: Plymouth,MA 02360 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI. ADDL SUBR L TYPE OF INSURANCE i POLICY NUMBER POL(MMIICY EFF POLtDr EXPrml LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR BLS(20)59724989 413/2019 4/3/2020 DAMAGE TOREoNTED ccunnoal $ 300,000 MED EXP(Any one n $ 16,000 PERSONAL BADVINJURY S 1,000,000 MX L AGGREGATE LIMIT APPLIES PER: GENERAL A REGATE $ 2,000,000 POLICY❑JECT LOC 210009000 PRODUCTS-COMP/OP AG OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ri $ ANY AUTO -' OWNED SCHEDULED BODILY INJURY Petperson) S _ AUTOS ONLY AUTOS EE BODILY INJURY Per accident $ AUTOS ONLY AUOTNOS ONL� .OaPER Y DAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTION$ WORKERS COMPENSATION PER OTH AND EMPLOYERS'LIABILITY Y l N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑(R E.L.EA H ACCIDE $ A ndeo ry 3n NNf EXCLUDED? N I A I es,desdribe under E.L.DISEASE•EA EMPLOYE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Evidence of Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE UTTHHORIIZEDREPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.. The ACORD name and logo are registered marks of ACORD ery ER C TIFICATION TIMOTHY CLELAND for successfully,completing the standards set forth for the S,,Saf o Food Protection Mangger Ceitification Examination, which is accredited by the American National Standards Institute(ANSI)Conference for-Food Protection(CFP). 381376 10�518 CR7lx( A, UMBER EXAM FORM NUMBER 11/1 '16x 11/17/2021 DATE OF E AF DATE OF EXPIRA 1ON Local laws apply.C envy for recertification requirements. 94 Q"!_ ;t IC ACCRE01TED PROGRAM She rti��bwgt ri v ,: ari�ltiS>) 1Iil � isltiort #0655 In accordance with Maritime lo�ou 2006,Ratuhan�i51htITaA �atiaa 83, eyt3Md Aid, ; 02015 National L� ArIIU r 9 logo are trademarks of the NRAEF. I►raaMcdd,r rrc dr �tn mydsrpdxtCt�#tl+i ltoWdnd ttiiit ` docultnrMAoiiihaYl'ss,�ipredas''alArrss� ''` , . i�If129Gt Y.� 1' Canted us with questions at 175 w Jod wn BW.Ste 1500,Chicago,R.60604 or ServSafe@restauranl.org. e*r Barnstable Public Health Division APPLICATION FOR TEMPORARY FOOD SERVICEPERMIT DATE 3I9Gf�2 , NAME OF SPECIAL EVENT Osterville Farmers' Market 2018 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT Jennifer Williams,Market Manager TELEPHONE# 508.428.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road y� i,,,, �y—VILLAGE Osterville NAME OF ORGANIZATION 2LI II,eOl Y y f7"f/ LU V 0 �CONTACT PERSON hill Ch, n-P 9-1 l f 0I TELEPHONE M 7�9 75 1y ADDRESS- 3 �Y/ .JT` ► V `�O{��c%/J-(�wZit�Y /7/�( 4.21-7 2 FOOD TO BE SERVED(LIST EXACT FOODS)� � i�itij�c���l ktichw-, r�l�sh, �4Licer) NAMES OF WED FOOD HANDLERS(TO BE ONSITE DURING EVENT): i'I Stll'�P �lll t l�'Yl (ATTACH COPIES OF SERVSAFE&ALLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,Osterville,MA02655 DATE TO BE SERVED June 22-Sent 14&Oct,6 TIME 9 a.m.to 1 p.m. WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECTION? �U HOW WILL FOOD BE KEPT BELOW 41 DEGREES F 1114 HOW WILL FOOD BE HELD A,,T11i�140 DEGREES F. AJI,4 /"Vdh HOW IS FOOD COVERED hell` HOW IS FOOD SERVED OA S//7 f �b'� 1�dS17I . CV�L IC eII W A !YI 4 l TYPE OF HAND-WASHING FACILITY Handwashine stations on site SIGNATURE CERTIFICATE OF ALLERGEN AWARENESS TRAINING 1 t`i OF `L Name of Recipient: CHRISTINE ALLISONt3 Certificate Number•y33e6013 +{ d i Date of Com 5/8/2018 pletion Date of Expiration:'5ie/2023: 44 ` � !t 0 Issued By: ! The above-named person is hereby issued this certificate NATIONAL < for completing an allergen awareness training program v fin RESTAURANTrecognized by the Massachusetts Department of Public Health .. .� ASSOCIATION® in accordance with 105 CMR 590 009(G)(3)(a). Massachusetts Restaurant Association 800.765.2122 333'Iurnpike Road,Suite 102 www.restaurant.org Southborough,MA 01772 This certificate will be valid forfive(5)years from date ofcompletion. 508-303-9905 www.macestaurantassoc.oag low € ' ' II I The Commonwealth of Massachusetts IM RICK Town of west Bridgewater West Bridgewater Board Of Health License Number FEE $75.00 2019/64 e This is to Certify that: Jammed with Love 43 High Street West Bridgewater, Ma 02379 Is Hereby Granted A Permit By The West Bridgewater Board of Health u FOR THE OPERATION OF A : Manufacturing of Jam In - Home Base Establishment , i This permit is granted in conformity with the Statues and ordinances relating thereto and expires on: December 31, 2019, Unless sooner suspelided or revoked. kA 4 Date Issued January 1, 2019 o - C aisperson a Bo of Health Cl This license shall not be sold, assigned or transferred,and it must be Hosted in a Board of Health Member conspicuous plane e t/'r 'mil•i/ ��r f/- ���+'/%��`I r�A�l t/�/"�.1�� / 1 f�/.O \i'1'fy "'1k"M1,;.�I'�►`� +!: a+•+�, r,►:Tj�'�►�.al, .+��`.�-..l .r�► ►r,�_ � ♦•�f►.•�r a•� • •?i+:;tom• /_ • .w • rt •� ,II�w••_ •+w••+a,. _}twq._, r�� •_ ;}•I+q+._ •�wq•��rr.w► •� _rSw�1_ ! �R citr r} ..'�s. •� �'.:• ,� •�!•�•�' iy'O�r11+.�. !}�71�,'+`�It-�,.R�.y��a. r t �.,*��.1.•.���V.'+i�• "��a -il:♦ O'\ " +'M � s. r_► ,•.+�,.+� {.F Ofw s+r,}.. �'` s f s t e 1�e•t q i# l� •+1+- a R..�!"l/ ♦1. q, ..(• a 1.s •r�♦•R♦It • 1•- •}+`�•f,"t 1+.!�+i" ,♦�S/.'' ..• +� 1'+..i seeq w +� ♦1'f♦ ••., #�♦ .�r•!t•/� r!t!•y,rc},.*/+?•�..f.�lljR�l�a. •�t}/�l�a}tr1�5�4.1} 7,1}rSf.ti .,��'�1�1♦f r;'1?t•1..5}.L}�*I'lf;���•�f•t!}T.Y11�•*t+/lfr,Rll+y4S1s�/♦ ,�.Tift►f/s 4,1�►}r� ��t�tft �r�.�tlt t �1 �t��,+i �1lttir 4rl,lttt� :•�����11rv��4+M41t��r'�+�11t►t rf14+�11f+�� �4? ����♦ .y!lfffr`� ra►►:LI'lL.L:I��ia011111•aL.,•l►► 'l.l�dr..aal,/11�i,ytLrif�•►t11.111./s.�•��IkiJl�♦��•�1.11111.Qi,NiUi,1/ia.•Id1l111r;owa,►1,lIU11��.•01ldf.abr.�►►Llfil�l�.�•�1/11,1 1a,.1 ♦•�1 IIO� rrfT`fT:raf:t Jaf O ..I• %6LT1010 M IrfT V U s1 •� ol 20 • �� n1�1 1`1 s r • Two attva!6 That Christine Allison V; nfunbrb f4rts arfifirnfe for Learn2Serve Food Handler Training Course Credit Hours: 2.00 • ,.cam � i'••► i'+r„ ate:•' yy' t��-tip. •r�`��� ate: i ,ANSI ��1�. 04/24/2021 Certificate #: • #0975 - •Certificate Issuer qr Food Handler •+,�s� rr�"a _� ....� ., yJ!� � Y•y aJi O• �s _ r •1-y,1 • • • • • course is designed • prepare in• •uals in the Safe Handling of Food. +�. •1 • • •:1 .• / ' i • •• •/ • • �♦�+fir;% •1 `� s For • •yer verification of - validity, please send your requestto Food Hand lerProgramAdmin@360trai iing.corn . .�;r : .. .: , . ♦r. �... .. .v a.. ,, Sri :, :..,;. ��-► ...,. - _'... �� , '1 , r� ,•ayn ', ..;. •., .,..- , '�•+ f:. 'r�ira,. c. r - ,c?. •. c c • ♦ l c c r 1 ♦ c •-s'q urti!f .`t11a. ►r1 _R rl R1,� c. )?I r. , , : •,`t . . t{{Ly►r ►►}. . Ri,,, 77ddl1 . -, t[ .:tf1. r/Rt r l/fR,R r►.fi� Y? !r' '��l, 1d 1 �..�a, 11RR . ,.�: s 1_,�7,+ 1?1 ����= 111'1 ,1 .�:� :. a�. 41 y.�s J , .,. L�il�. .1} . ,.,n,y,♦ ,! : : .1�f.J �� : . ,•�IiJJ l4A,�c�, �:41� a:d ,j. .�� . . 14,L,. , ►� �.i, , : .l'h :, :l.y, ,, .ati . .11, �,'+: . ��1: ��� � I�,. :1,11: t. ): :i. d/,L.i � r. �,��1 r' 1:1, �,1. �i,1 l i,�� . • • �l T: ./: ! ?� `1f' 1.���:w'. �� A. /�� ♦ ��.��. �i ,r. � . :.! t .,U. .,�.,: �, O.. �. �: ..::♦ T t� :A � � `i l„ ., M. 1r, -• «. t,•. /. ,•_ ,�,�+a� •.q.• ,S Sa { e. ,• � + .1.Y.r r ►� ♦t/ ,► /. � >. 1 t� � .•.•,� 1.�.a. 'I,.,q .e Y 1��!•+'! ••}!5 1J./.�,•.y•i J e•r.I,.r:•a�1'A,+, 4• }q.•� 1 . `.' • .•.+¢��1� .. i., .:..•f�.�.. ,• ,•I .r•'... :1 ♦ + •w• �3 'R}l'l�:►b�...ai O.. y,. ,,..,f.+:.,. A. }�.s�•+:.W. O •...r•,,.�i • t:�f•`•-4:`-► •. � ..�• !„..�.r-a''•: ♦ /.<�.,•..,�0.. •:�,.s.-+ Rl.� •r1'w��,f�lfr♦+}. -•�t r���11{�.r s��,r.C��s�'a y �+..►�r�shy� �^t q' •y f.•��la �,1 wry l�+ ,f,r ♦y k} •,) +.••1• ♦,y.^.n� •} �� s_ i�� �,+.•. �•,♦a•�•�Ir �,•.+Y.♦,+J'y w.q a .�.ai,w�.f 1:-►:al,t,r,q..y,.+r•2+��,F 1,, ':+}}.. ,�..,4.q. +1 .►T,•.�.as•► -�-�:;F.q.�►�:1r+:,;.,-ai►r*�i a-+aw•►+ ,�i}q. •. .• .: �..•:#,. .., • •. .;. •. `',.+ , ..+,�� ,�'fi•}ram• 4>,.y.,- ' +e�, •.y+� <�:•.i� s .,,.. •.'•�►+'�.�.. ►.�•r+.**• •,�i1•: O\�• �.n • - • +•• r-•V r e� h•'�/►�+•�+ !. Off•►'t }V T 4iRv\��/'1►1"'`ifj��`\'��i'yl,.'���"J►R-1`k�`����t�//►+ 411�\�r/j{/���•,t+�I/i►11,�`��Jr 1�f Ly�.j;Ir 2 ,e ms r (Ike& Lo �-- APPLICATION FOR TEMPORARY FOOD SERVICEPERiVIIT DATE ILI 12-o Y NAME OF SPECIAL EVENT Osterville Farmers' Market 2019 Season WAS THIS EVENT APPROVED BY THE BOARD AT APUBLIC MEETING? X Y N NAME OF PERSON(S)REQUESTING PERMIT JENNIFER WILLIAMS,EXECUTIVE DIRECTOR TELEPHONE# 508A28.5861 CELL# 508-280-8882 HOME ADDRESS 155 West Bay Road VILLAGE Osterville NAME OF ORGANIZATION CONTACT PERSON k StiA W 1 k TELEPHONE 'i )S-a 3 L cD ADDRESS FOOD TO BE SERVED(LIST EXACT FOODS) (A 'AV inn s NAMES OF TRAINED FOOD HANDLERS(TO BE ONSITE DURING EVENT): f (ATTACH COPIES OF SERVSAFE&ALLERGEN CERTIFICATES) ADDRESS WHERE TO BE SERVED Osterville Historical Museum,155 West Bay Road,Osterville,MA 02655 DATE TO BE SERVED June 21-Seat 13 TIME 9 am.to 1 p.m. ' WHAT TIME WILL ALL EQUIPMENT BE SET-UP&READY FORINSPECT��IO(N? HOW WILL FOOD BE KEPT BELOW 41 DEGREES F if) L uui a l w1 HOW WILL FOOD BE HELD AT 140 DEGREES F. t -0 VA I t 7-e-n HOW IS FOOD COVERED--&,(iOSIC Cl IVC h kv) C al t"Guru,'S -tha,�t&--p— (J o5tA HOW IS FOOD SERVED C U tit I fie/1 TYPE OF HAND-WASHING FACILITY n hVl'dU- SIGNATURE U r COMMONWEALTH OF MASSACHUSETTS CITY OF LYNN Board of Health Food Permit License f.,. PERMIT NO.BOHF_19-1724 FEE:$0.00 ISSUED:5/1/2018 The Board of Health of the City of Lynn,in accordance with all laws,ordinances and regulations pertaining thereto,hereby grants a/an Food Permit License to: Name:CASEY WHITE Address:271 WESTERN AVE,LYNN,MA Establishment:JAJU PIEROGI w , This permit shall expire on 4/30/2019,unless sooner suspended or revoked,and is subject to the following restrictions: �-- MILK&DAIRY$10.00,RETAIL FOR FARMER'S MARKET AND ONLINE ONLY Michele Desmarais Director of Public Health,City of Lynn f . �,.- . u,1�2.r► �-� s rec env c� CASEY WHITE for successfully completing the standards set Earth for the ServSafe®Food Protection Monoge�r Cer1i(ication Examination, which is accredited by the American National Standards Institute{ANSI}-Con�erenae,for Food Protection{CEP). 747253 10439 Cf RTIFICA UMBER E X A F6,RM• NUMBtR . 9/13 15 9/13/2020 s DATE OF E AMINATION DATE OF EXPIRATIGN, w Loeol,laws opply.,C k with your"Rgukeory enty For recertification requirements. S Brown National Redourant Assaciotion Solutions #0655 tnaocortlmcewilhManlime Inbou nlllt T'.4.l..::�.fL:'..ttQ/+°c)I r 1Rr 4:*1A 1..t x 4.•4A1 It � 0 ®2015 Nm oral r 4r r cl E A•„{+r RAE11 tit rt w rns' 11 5Rs-' 'fit•art iu" are kademai6 of the NRAff. _ N ' ....rn-.rt 4ennM-` rct+h x�+a�n 4xn len�:,wine!Flu l+kta.�d Nc.^Auarf A rse+ 1yg y�•ar.H^M :wni,t ba r-P*�++-d.•a;k.e*3 . 11tiir UI r 1401 contad us with quWima at 175 w koc m 8W.St.1500'CAimpo,IL 60604 or SeivSate@restauraM.oi r ----------------- CERTIFICATE OF ALLERGEN 'RAINING , w ; Name of Recipient: Casey White ; Date of Completion: 11/9/2015 Date of Expiration: 1i/9/2o20 r , i v � Issued By: The above-named person is hereby issued this certificate / for completing an allergen awareness training program recognized by the Massachusetts Department of Public Health Berkshire in accordance with 105 CMR 590.009(G)(3)(a). ��AHEC ' Area Health Education Center ' Pittsfield,Massachusetts ?his certificate will be valid for five(5)years from date of completion. ; "vww.mafoodallergytraining.org ------------------- Jaju Pierogi 4 Osterville Farmers' Market Dates Only: X; 7/19; 8/16; and 9/13 1. Frozen labeled boxes of pierogi to sell. 2. Heat refrigerated pierogi's on-site using electric griddle — Done at Ashland Farmers Market, SOWA in Boston, Somerville, etc. CURRENT FLAVOR OFFERINGS POTATO AND CHEESE CABBAGE AND MUSHROOM** BUTTERNUT SQUASH, APPLE & SAGE** SWEET POTATO & CARAMELIZED ONION** JALAPENO CHEDDAR SPINACH & FETA Vanessa & Casey White 41 3-219-63 48 1 413-221-5328 jaiupierogi.com facebook.com/iaiupierogi I instagram.com/jaiupierog RM'S Menu We make handmade polish dumplings called pierogi. Pierogi are dumplings made by wrapping dough around a filling which include potato and cheese, sweet potato and caramelized onion, butternut squash, apple & sage, cabbage & mushroom, spinach & feta, kielbasa & red pepper, and jalapeno cheddar fillings. Please find the ingredients lists here: Flavor varieties: - Potato & cheese o Ingredients: Potato, Farmers Cheese (Cultured Pasteurized Grade A Low Fat Milk, Salt), All Purpose Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin), Onion, Butter ( Cream, Natural Flavoring), Eggs, Water, Extra Virgin Olive Oil, Salt, Pepper, Sugar. Contains: Wheat, Milk, Egg Sweet potato & caramelized onion o Ingredients: Sweet Potato, All Purpose Flour ( Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin), Onion, Extra Virgin Olive Oil, Butter (Cream, Natural Flavoring), Eggs, Water, Cinnamon, Nutmeg, Salt, Sugar. Contains: Wheat, Milk, Egg Cabbage & mushroom o Ingredients: Sauerkraut (Cabbage, Water, Salt), Mushroom, All Purpose Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin), Onion, Breadcrumbs (Wheat Flour, Cane Sugar, Yeast, Salt), Greek Yogurt (Cultured Pasteurized Skim Milk, five live active cultures including s. thermophilus, I. bulgaricus, I. acidophilus, bifidus, and I. casei), Extra Virgin Olive Oil, Butter (Cream, Natural Flavoring), Eggs, Water, Salt, Pepper. Contains: Wheat, Milk, Egg Butternut squash, apple & sage o Ingredients: Butternut Squash, All Purpose Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin), Apples, Onion, Bread Crumbs (Wheat Flour, Cane Sugar, Yeast, Salt), Butter (Cream, Natural Flavoring), Eggs, Water, Extra Virgin Olive Oil, Salt, Sugar. Contains: Wheat, Milk, Egg - Kielbasa & Red Pepper o Ingredients: Kielbasa (Pork, Water, Salt, Spices, Dextrose, Garlic Powder, Spice Extracts, Sodium Nitrite), All Purpose Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin), Red Bell Pepper, Onion, Bread Crumbs (Wheat Flour, I Cane Sugar, Yeast, Salt), Butter (Cream, Natural Flavoring), Eggs, Water, Salt, Pepper Contains: Wheat, Milk, Egg Jalapeno Cheddar o Ingredients: Potato, All Purpose Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin), Jalapenos (sliced jalapeno peppers, water, vinegar, salt, lactic acid), Cheddar Cheese (Pasteurized Milk, Cheese Culture, Salt, Enzymes), Eggs, Butter (Cream, Natural Flavoring), Water, Sour Cream (Cultured Cream), Salt. Contains: Wheat, Milk, Egg. Spinach &feta o Ingredients: Spinach, All Purpose Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin), Feta Cheese (Pasteurized Part- Skim Milk, Salt, Cheese Culture, Salt, Enzymes), Farmers Cheese (Cultured Pasteurized Grade A Low Fat Milk, Salt), Onion, Butter (Cream, Natural Flavoring), Water, Eggs, Minced Garlic (Garlic, Water, Phosphoric Acid), Salt. Consumer advisory &food allergen statement: Please be aware that all food contain wheat, milk and egg. This product is produced in a shared facility that processes soy, dairy, wheat, tree nuts, peanuts, and eggs. Before placing your order, please inform Jaju Pierogi LLC if a person in your party has a food allergy. Thank you. Cooking and preparation process: First we make all the stuffing's. The flavors vary depending on our production schedule. Once the stuffings are prepared, we start on the dough. While the dough is being made we place all stuffings in the refrigerators and start boiling water on the stove. We then get all our pierogi making materials out on the prep tables. Once the dough is made, the dough person puts the dough through the dough sheeter. Once flat on the prep table, we start cutting the dough into circles and filling those circles with ice cream scoop sized balls of stuffing. We take one bowl of stuffing out of the refrigerator at a time. The stuffing is typically potato and cheese, sweet potato & caramelized onion, butternut squash, apple & sage,jalapeno cheddar, spinach &feta, cabbage & mushroom or kielbasa & red pepper. Once the stuffing is placed in the circle, we fold the circle and seal the pierogi with a cut and seal. Once closed, we move the pierogi to the boiler where the pierogi boils for 1-1.5 minutes. Once boiled, we move to a sheet tray covered with a baking sheet. We coat the baking sheet with butter and place the pierogi down on the sheet. Once the sheet is full, we move the pierogi to the refrigerator and continue with the next tray. Each tray is placed in the refrigerator for two to four hours to cool down. The pierogi are then moved to the freezer to freeze for an additional 2-4 hours. Once frozen, the pierogi are packaged in sealed hinge containers and labeled. The pierogi are then placed back in the freezer until they are sold at farmers markets, events or to our wholesale retail locations.