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HomeMy WebLinkAboutGUARANTEED FRESH PRODUCE - RETAIL CLOSED FOOD Guaranteed Fresh Produce 35 1yannough Rd. HYA .3q,3-0&2 I Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. nan.`MBLE. F.P.(Thomas)Lee,. 9 MAS4 Daniel Luczkow,M.D. Alt. 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 776 Issue Date: 01/01/2022 DBA: GUARANTEED FRESH PRODUCE OWNER: GUARANTEED FRESH PRODUCE INC. Location of Establishment: 35 IYANNOUGH ROAD HYANNIS„ MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2O2 2 RETAIL FOOD: $20.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - - - MOBILE- FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: NEEDS FOOD/COLD STORAGE PERMIT/WHOLESALE I IME� For Office Use Initials: D Town of Barnstable � Date Paid � Amt Pd$ BAMMB14 Inspectional Services ,1 16 9. ,0� Check# Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: ✓` - W ` 66 N MAILING ADDRESS(IF DIFFERENT FROM ABOVE): /�,, n n ��(/�__ E-MAIL ADDRESS: Kd� s 1 11 r v[ t " TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( g TOTAL NUMBER OF BATHROO S: 1 WELL WATER: S NO .. ANNUAL WATER ANALYSIS REQUIRED) ( Q ANNUAL: SEASONAL: DATES OF OPERATION: / I /?40 /Z. /31 / 2 Z NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE _->42tETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-8624644 Q:\Application FormsT00DAPP 2020.doc f OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: OWNER PHONE#W- Z�Oat'J-Ar . ADDRESSRAU CORPORATE OWNER: AW&oi CORPORATE ADDRESS: ► PERSON IN CHARGE OF DAILY OPERATIONS: 1 'el ilIV List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. �V / SIGNATU OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q:\Application FormsT00DAPP REV3-2019.doc ti Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. Paul J.Canniff,D.M.D. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 3056, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 776 Issue Date: 01/01/2021 DBA: GUARANTEED FRESH PRODUCE OWNER: GUARANTEED FRESH PRODUCE INC. Location of Establishment: 35 IYANNOUGH ROAD HYANNIS„ MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2021 RETAIL FOOD: $20.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Gi/ •�� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: NEEDS FOOD/COLD STORAGE PERMIT/WHOLESALE ( yti s V Town of Barnstable For Office Use Only: Initials: 719) Date Paid � ��AmLp{j$ �" snxivsrna LEI�* Inspectional Services *h- 0, -� Public Health Division Check# �131 q ArED MA'S A Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATEwbq�d_ NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: 60aA4ntV dXit ADDRESS OF FOOD ESTABLISHMENT: 3� ail n MAILING ADDRESS(IF //DIFFERENT FROM ABOVE): ,, E-MAIL ADDRESS: 1y►I T �� a j 11' TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (� - TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REOUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED& BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc 'r ,l OWNER INFORMATION: n n� FULL NAME OF A LICANT �✓� >� G(/e/I fC� SOLE OWNER: YES NO /' OWNER PHONE# 7 �J ADDRESS & YL P/ AW CORPORATE OWNER: Ktj CORPORATE ADDRESS: 3,r7 PERSON IN CHARGE OF DAILY OPERATIONS: A List(2) Certified Food Protection Managers AND at least(1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date /0/ ? / / SIGNATU E OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.as[). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st. Q:\Apphcation FormsTOODAPP REV3-2019.doc r w 5 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. t uaNWABLK Paul J.Canniff,D.M.D. MAS' F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 776 Issue Date: 12/10/2019 DBA: GUARANTEED FRESH PRODUCE OWNER: GUARANTEED FRESH PRODUCE INC. Location of Establishment: 35 IYANNOUGH ROAD HYANNIS, MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2020 RETAIL FOOD: $20.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: c—�--,�— MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES:: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: NEEDS FOOD/COLD STORAGE PERMIT/WHOLESALE For Office Use Onlv: Initials: °f"'E'�i• Town of Barnstable t 03 Date Paid I� I AmLPsI s U,b BMWSPABLE. : Inspectional Services Public Health Division Check# RFD MAC a , Thomas McKean, Director ' 200 Main Street,Hyannis,MA 02601 i Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATEy�A FOOD ESTABLISHMENT DATE , 19-TIg NEW OWNERSHIP RENEWAL✓ NAME OF FOOD ESTABLISHMENT: 6owaotefd -F - h kdacLjoe. ADDRESS OF FOOD ESTABLISHMENT: :T\ ►' I MAILING ADDRESS(IF DIFFERENT FROM ABOVE): -- E-MAIL ADDRESS: rjI S C11--��I�rq. `-d r" TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ow)T- TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NOC... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/ /_ TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING.AND MEET OUTSIDE DINING REQUIREMENTS. lI� IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? I\I I IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)7 V TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE XRETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) a . *** SEASONAL,MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc t 1 OWNER INFORMATION: FULL NAME OF APPLICANT �lN� �J CAI Vl SOLE OWNER: ES/ O OWNER PHONE# 771�— ADDRESS_ � I� Ve I vlasee, ml� (171a�l CORPORATE OWNER: Sa► Y`.e. CORPORATE ADDRESS: i PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2. SIGNATUdE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Wpphcation FormsTOODAPP REV3-2019.doc w Town of Barnstable rty BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. HAR xBM John T.Norman F' MAC F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 " & Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 776 Issue Date: 12/20/18 DBA: GUARANTEED FRESH PRODUCE OWNER: ADAM WEINER Location of Establishment: 35 IYANNOUGH ROAD HYANNIS MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: YEAR. 2019 RETAIL FOOD: $20.00 COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - --- ---"- --- - — MOBILE-FOOD: MOBILE-ICE CREAM: �� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: NEEDS FOOD/COLD STORAGE PERMIT/WHOLESALE SHE For 0Initials: Town of Barnstable i Date Paid Amt Pd$ MASS.1639. MMB Inspectional Services 3 ,? Public Health Division Check# Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 . 7}}v3vM hyti APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT ++ DATE 1I 0 NEW OWNERSHIP RENEWAL.56 NAME OF FOOD ESTABLISHMENT: ko-ragkt& 1 V) Inc, ADDRESS OF FOOD ESTABLISHMENT: Lj MAILING ADDRESS(IF DIFFERENT FROM ABOVE): ,� n /� E-MAIL ADDRESS: K r l�/�-+� •(?Ja TELEPHONE NUMBER OF FOOD ESTABLISHMENT: LV J A-Uqaq TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO_>C... (ANNUAL WATER ANALYSIS REQUIRED)) ANNUAL: SEASONAL: DATES OF OPERATION: / //7 TO Z /3 //1' NUMBER OF SEATS: INSIDE: OUTSIDE TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV. AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVIC DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FormsTOODAPPREV2018.doc PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT G� 2 / SOLE OWNER: YE /NO OWNER PHONE# 3 ADDRESS CORPORATE OWNER: FEDERAL ID NO. : CORPORATE ADDRESS: 35' -d- Ya / ► PA &hft'� AAk 0 t / PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least (1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2. 11 1�, Za SIGNATURE OF APPLICANT DA E ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openintz!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. E ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and TOBACCO S p pp Employee Signature Form. NOTICE: Permits run annually from January lst to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPPREV2018.doc I OWN OF BARNS I-ABE ISSUE DAT 776 BOARD OF HEALTH. 11106120171 PERMIT TO OPE ESTABLISHMENT In accordance with u� ' ^ & OL , a e er-wthority of Chapter 94, I Section 395A and Ch te•. 51I&A .:. `es,' _ ermit is hereby granted to: - ,.: 2 ° . ADAM WEINER CIO: GUA FhEI PRODUCE air_- r Whose place of business is: S NOUGk AIIS M _ Type of business and.any ro"s iqt.1' BLISHR - To operate a food establisharr nt in he T . , .��a BLE . Y RESTRICTIONS IF ANY: NEED F(0O OCD STOW" AMR-"! - M � F SEATING: ANNUAL: YS� . -= k' r .s SEASONAL: TEMPORAL 3 `. s ` = DES � � �C�`OF HEALTH RETAIL FOOD STORE: .00 ,(Canniff, D.M.D.,Chairperson FOOD SERVICE ESTABLISHMENT: per ° •.' '` s U n' hi Sawayanagi. RESIDENTIAL KITCHEN FOR RETAIL SALE: '. a. d` $ . Wald A. Guadagnoli M.D RESIDENTIAL KITCHEN FOR BED+BREAKFA $ V. 4F MOBILE FOOD UNIT: , - 'z- TOBACCO SALES: �`•��� FROZEN DESSERT: s Thomas A. McKean, RS, CHO CATERER: �' �' Director of Public Health . 1 "WE r Town of Barnstable Regulatory Services ,uo ►)/&IM sn KA Richard V. Scali, Director J� BAMSTABLE 1639. e.ua ueie.ce�vw-mw.wrc s 9� i6'� `�� Public Health Division 1639-2014 °'OtFp�C4 ss3s-ios, Thomas McKean,Director 57 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 F2x: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE: I NAME OF FOOD ESTABLISHMENT: 61 U FKA WTE FD f IIZ A PO DUG E, —Vc. ADDRESS OF FOOD ESTABLISHMENT:O NN O U Q 44 k0 1 D% 'fiIf-y"Nt 15 m 14 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): 0?.601 E-MAIL ADDRESS: APAr I CoL) q F99pi2ya DN u we. a m NUMBER OF FOOD ESTABLISHMENT: 0T - O D 41 TELEPHONE (.7 )�I aI NUMBER OF SEATS*: INSIDE: OUTSIDE: — TOTAL: * Note: If indoor seating provided,see Licensing regarding Common Victuallers License TOTAL NUMBER OF BATHROOMS: I, ANNUAL OR SEASONAL OPERATION: TYPICAL HOURS OF OPERATION MON-FRI: :�_ TO b : D OT DAYS CLOSED EXCLUDING HOLIDAYS (I.E.MONDAYS)_Jyjiolka + IF SEASONAL: APPROXIMATE DATES OF OPERATION: / / TO ***REMINDER*** SEASONAL ESTABLISHMENTS MUST CALL FOR INSPECTION PRIOR TO OPENING TYPE OF ESTABLISHMENT: PLEASE CHECK ALL THAT APPLY FOOD SERVICE ✓ RETAIL FOOD BED & BREAKFAST CONTINENTAL BREAKFAST *IF SEATING: ALSO,MUST OBTAIN RESIDENTL ,L KITCHEN A COMMON VICTUALLER'S LICENSE MOBILE FOOD FROM LICENSING DIVISION. TOBACCO SALES FROZEN DAIRY DESSERT MACHINES CATERING OUTSIDE DINING (OVER) Q:\Application Forms\Foodappldoc r ***REMINDER*** IF OUTSIDE DINING,YOU MUST BE APPROVED BY THE HEALTH DIVISION AND LICENSING,AND MEET ALL OF THE OUTSIDE DINING CRITERIA IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? �I CONTACT INFORMATION: FULL NAME OF LICANT �•V R m W F 10 F.-IZ SOLE OWNER: YES NO ADDRESS O,Z.6 PHONE#(I* - foo,` IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. Off' 32bZ.p�O STATE OF INCORPORATION: M h FOOD SERVICE ESTABLISHMENTS CONDUCTING FOOD PREPARATION (EXCLUDES RETAIL FOOD ESTABLISHMENTS THAT DO NOT PREPARE FOOD AND CONTINENTAL BREAKFAST): EFFECTIVE JANUARY 1, 2004, EACH FOOD SERVICE ESTABLISHMENT IS REQUIRED TO HAVE AT LEAST TWO CERTIFIED FOOD PROTECTION MANAGERS. AT_.LEAST ONE CERTIFIED FOOD PROTECTION MANAGER IS REQUIRED TO BE ONSITE DURING ALL HOURS OF OPERATION.***PLEASE PUT THE NAME OF THE ESTABLISHMENT ON EACH OF THE CERTIFICATES*** LIST THE NAMES OF YOUR CERTIFIED FOOD PROTECTION MANAGERS (I.E.SERVSAFE.) 1._ n a EXPIRATION DATE: 2. n EXPIRATION DATE: EFFECTIVE FEBRUARY 1, 2011 EACH FOOD ESTABLISHMENT THAT COOKS, PREPARES, OR SERVES FOOD INTENDED FOR IMMEDIATE CONSUMPTION EITHER ON OR OFF THE PREMISES SHALL HAVE AT LEAST ONE CERTIFIED FOOD ALLERGEN AWARENESS TRAINED STAFF MEMBER. *** PLEASE PUT THE NAME OF THE ESTABLISHMENT ON THE CERTIFICATE*** LIST THE NAME OF YOUR CERTIFED FOOD ALLERGEN A7DE: TRAINED STAFF. 1. 1� T � � % !� A OF APPLICANT AND DATE Q:Wpplication Fonns\Foodapp3.doc I '(HE TOWN OF BARNSTABLE HEA�rHINSPEcroRs Establishment Name: _Date: 30v v Page:.. of . q OFFICE HOURS AR"„' S ABAB�EOe PUBLIC 2 0 MAN STREET 3:30-4:30 P.M. DIVISION - : 0- :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p ,639, `0� HYANNIS, MA 02601 MON.-FRI. No Reference R:-Red Item, _ PLEASE PRINT CLEARLY . 508-862-4644 rFOMP,a FOOD ESTABLISHMENTINSPECTION REPORT Name.��pi��n Q r�� Date Type of Impa2EInspection ODerationLg) < Routine Address "` Risk Service Re--inspection Level < Re Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Aj Caterer General Complaint AA Person in Charge(PIC) Time Bed&Breakfast HACCP t „ Other In: Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ �: '1 \ �'S� Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands Q�L ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities dnk EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals `^ FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP - ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue 8 red items) )„l r1h EZCorrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected-immediately or Overall Rating to I O(V 4. within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Schedule ❑ Emergency Suspension C N Official Order for Correction:Based on an inspectior),oday,the Items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590..003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. B=One critical violation and less thanre 4non-critical Violations g 25.Equipment and Utensils (FC 4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)( )590.008 be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) y p t t Sig a re +� 30.Other DATE OF RE-INSPECTION: Ins c � . 31.Dum ter screened from public view � F _ Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N PIC's, ttuureel�p Print #Seats Observed Frozen Dessert Machines: Outside Dining Y N .�- Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* * * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(F) Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41`F/45'F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F * 7-102.11 Common Name-Working Containers* 3-501.16 Require Reporting by Food Employees and Contamination from the Environment (A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155`17 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* Eggs 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145'F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate- 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef rn-1112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(I)(2) Pork and Beef Roast-130�F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140`F* (Blue Items non-critical 23-30) 3-202.15 Package Integrity y Critical and non-critical violations,which do not relate to the.foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Lis Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41`F/45`F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Fomtback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. F.HE r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: 'I �"`�'� Page: of PLOq. OFFICE HOURS PUBLIC HEALTH DIVISION 8,00-9:30 A.M. BARNSTABLE. = 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ;'639: `0 HYANNIS,MA 02601 MON.-FRI. No Reference R.-Red Item PLEASE PRINT CLEARLY prFG MP'�a. 508-8624644 FOOD ESTABLISHM T INSPECTION REPORT Name DateC e of sec ion Qeration(s) Routine Address 5 >1 Risk Foo rvice Re-inspection Level C RetaI Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other \ Inspector Out: 424 Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. -1 Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective 'Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP Z' ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: o ® Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating y y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusio ❑ Re-inspection Scheduled ® Emergency Suspension C N Official Order for Correction:Based on an inspection t9 y,the items ® Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Fed al Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. violation,4 to 8non-critical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPECTION: 4inspectr to qPrintt.: 31.Dumpster screened from public viewPermit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered YN#Seats Observed Frozen Dessert Machines: Outside Dining Y N nature Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 1 q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) * EMPLOYEE HEALTH_ 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Se azation-Storage* Applicants* 3-302.11(A) Food Protection* P 8 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rered or of Food*Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* __ Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1 g Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3 401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of F. s Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment* gg' - - Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effe4"°p 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell She/ash and Fish From an Approved Source: 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 8 590.009(A)-(D) Violations of Section temporary and -side tial er- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 Game Animals* Requirements. i 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which dd not relate to the foodborne 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 3-101.11 Food Safe and Unadulterated* �) g 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* L18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification g Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags stocord a Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC.3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC 4 005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5,""" .00 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC.6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11., Specialized Processing Methods* 130. 1 Other 3-502.12 t"' Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S.590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. iftpp 114E►per TOWN OF BARNSTABLE - _ HEALTH INSPECTOR's Establishment Nam crate: Page: of q OFFICE HOURS PUBLIC HEALTH DIVISION 800-9:30A.M. BARNS"I'ARLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item D W RI TION OF VIOLATION/PLAN OF CORRECTION Date Verified 0g HYANNIS MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY p ,639• . , , 508-862-4644 - 1% FOO ESTABLIS ENT INSP CT ON REPORT Name Date; Tvpe of ns ec io f g Routine in PYI, AddressAN Risk ervi ecti n IT 1Level Previou g�ytj rTelephone getal Kitchen Date: 'g,//►J// 11 (J ( ' Mobile Pre-op I Owner HACCP Y/N Temporary Suspect III ess Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Other Inspector Each violation checked'requir s an explanation on the narra ve page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/,Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food'or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating / ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP, ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ®/�^i (� []Ill.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories ` Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations (/ Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating )✓f tq within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number df critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in.suspension or revocation of the food if no critical violations observed;4 to 6von-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility . (FC-6)(590.007) aggrieved by this order,you have a right to hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critic violati ns. If 1 critical refrigeration. within 10 days of receipt of this order. vi Ion, 0 8non-critical violatio =C 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Ins is u rint 31.Dumpster screened from public view.-` Id Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N P�C'sV' tfe Print: Self Service Wait Service Provided Grease,Trap Size. Variance Letter Posted Y N )A,&- Dumpster Screen? Y N 1 Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 7-101.11 Identifying Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41 EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each Information-Original C 590.004(F) Containers* * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 7-201.11 Se 3-501.16(A) Roasts Held At or Above 130°F* Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 590.00411 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR_ _ 3-306.14(A)(B)Returned Food and Reservior of Food* 7.204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Waming Labels* 4 Food and Water From Regulated Sources Fg Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y * P 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products 4-501.112 Mechanical Warewashing-Hot Water Monitoring 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1B Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.I IA(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Eggs Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg-d-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellflsh and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-30f.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsrho ld be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 PreventingContamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11 Remainin Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated �) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30, Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF. roe," TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page:•---(�of � ry OFFICE HOURS ARNsrAa�e.o PUBLIC HE N SH DIVISION 8:00-9:30 A.M. 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �A 3. �0� HYANNIS, MA 02601 - M 508-8 -FRI.62�644 6 No Reference R-Red Item PLEASE PRINT CLEARLY 7FD MPS' FOOD ESTA LISHM T INSPk CT OM REPORT V / C Date / e of Tvoe of Inspection Name er ion s Routine Address Risk ood Service Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Char a(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires ex on on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS i ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals CY FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures r ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ITT ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ElYes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8 non-critical violations. If 1 critical refrigeration.' 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8 non-critic I violations=C. 29.Special Requirements (590.009) Within 10 days of receipt of this order. InspeWe P 30.Other PATE OF RE-INSPECTION:31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y NPIC'sPrint: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted YNON` Dumpster Screen? Y N "� �f Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives _" Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person=in-Charge Duties - 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in Charge to-- Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140'F * 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Se * 3-501.16(A) Roasts Held At or Above 130°F* Separation-Storage Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 590.00411 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.004(11). Variance Requirements 590.003(G) Reporting by Person in Charge Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) - - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* _ Beverages with Warning Labels* 4 Fobd and Water From Regulated Sources _ g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* _ * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* - _ 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 _ Shell Eggs* _ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or gg _ __ Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ep imr,imoa 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an-Approved-Source _ _ 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702:11 ' 'Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* -Shellfish* 4-703.11- Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- - Ratites-165°F 15 sec* • Sources* 70 Proper,Adequate Handwashing ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. * Other 590.009 violations relating to good retail - * g 590.004(C) Wild Mushrooms* 2 301.14 When to Wash 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-001.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23-30) 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.1 A CoolingCooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41'F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. Other. 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. a HE TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: r '/�VPage of �e OFFICE HOURS PUBLIC HEALTH DIVISION 6.00-9i30A.M. % BARNSfABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified p 63 HYANNIS, MA 02601 .. MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY 508-8624644 FOOD ESTABLISHMENT INSP CT ON REPORT Name Date 11 Tvne of o sec io 1 47Ooeration(s) Routine Address Risk f ervice pe ion I ) Level Retail Previou t' Telephone V. ential Kitchen Date: Mobile Pre-o i Owner HACCP Y/N Temporary Suspect 11 ness A Q Caterer General Complaint Person in"Charge(PIC) Time Bed&Breakfast HACCP Other 'W I GG _� A Inspector �[:alfl Z910 ut: IS A�z Each violation checked"requires an explanation on the narrativ page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ _ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating IV- 0 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION - ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) O ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate'Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. . (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23;Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of violations observed,7 to anon-critical violations. If 1 critical refrigeration. ) 28.Poisonous or Toxic Materials FC-7)(590.008 be in writing and submitted to the Board of Health at the above address ( violation,4 to 8non-critical viol lions C. 29.Special Requirements (590.009) within 10 days of receipt of this order. C1' 630.Other DATE OF RE-INSPECTION: Insature 8 rint: Jr, 31.Dumpster screened from public view AM 1 / 3 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N I .s r Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness - - - - - - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red-Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-.202.12-°' Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* __ * ]9 _._ _ PHF Hot and Cold Holding 2-103.11 Person-in--Charge Duties - - 3-302.14 Protection from Unapproved Additives 1 Contamination from Raw Ingredients 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F _ 1,15 Poisonous or Toxic Substances _ 590.004(F) ! EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to - _ _ _ _ Other* 7-102- 3-501.16AI1 Common Name-Working Containers* _ - ( ) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130°F* _ _ - - _ _ - Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(17) Responsibility of A Food Employee or An _ - 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* _ 590.00 11 Variance Requirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ) q -. - Contamination from the Consumer � 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* „ e REQUIREMENTS-FOR. 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 incidental Food Contact,Lubricants* I Beverages with Warning Labels* 4 - Food and Water From Regulated Sources - _9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B)- Compliance with Food Law* 4-501:111- - Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Tem ratures* Raw Seed Sprouts Not Served* y Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Pioducts* - 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* _ Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 ' Ice Made From Potable Drinking Water* - Concentration and Hardness* 3-401.11 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System - 8g Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-40 L11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg cnw urnoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3 401.11(A)(2) Ratites,Injected Meats-155°F IS sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 3-201.15 � Molluscan Shellfish from NSSP Listed _ _ _ _ _ _ _ _ Chemical* (A)-.(D)in cater- Ratites-165°F 15 sec* Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential - Game and Wild Mushrooms Approved By _ _ _ 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to ., 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices _ 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401-11 Eating,Drinking or Tobacco* * Requirements. 5 Receiving/Condltion g. g g � 3-403.11(A)&(D) PHFs 165°F 15 sec 3-202.11 PHF's Received at Proper Temperatures* 2401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Tune* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-101.15 Package Integrity y Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E -Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-50114(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590,004(,l) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* ; S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical items in the federal 1999 Food Code or 105 CMR 590.000. pp SNE rpk, TOWN OF BARNSTABLE - HEALTH INSPECTOR'S Establishment Name: Date: Page: of ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified v 26 Bs. m� HYANNIS,MA 02601 M-8 -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �p + 39• . 508-862-4644 'FDN1P� FOOD ESTABLIS MENT INSPECTION REPORT Name a Tvoe of T section Operation(s) uti Address Risk Fo ervice Re-inspection Level etai Previous Inspection Telephone 'Fresidential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) �� Time Bed&Breakfast HACCP In: Other Inspectors Out: C Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.00 ❑ Action as determined by the Board of Health. Allergen Awareness 59 9(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS Gli4� ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives JA -L" ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals ( , FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazar us Foods) ` ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures (e - ❑ 5.Receiving/Condition ❑ 17.Reheating -a ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling l / ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding �V- u PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP C - ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY 7 l ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Re wired: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. �� ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below b a Board of Health member or its agent 24.Food and Food Preparation ) p g y g A=Zero critical violations and no more than anon-critical violations. F=3 or more critical violations.9 or more non-critical violations, p (FC-3)(590.004 constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically if: la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than non-critical. If no critical water,sewage back-up,infestation of rodents or insects, or lack of 28.Poisonous or Toxic Materials (FC-7)(590.o08) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. violation,4 to 8non-critical violations C. 29.Special Requirements (590.009) within 10 days of receipt of this order. = 30.Other DATE OF RE-INSPE TION• Ins��Jt Print: 31.Dump er screen d from publi�vie �� ,„�{rPermit Posted? ��` N V1X Pre i'<fuuisP11Gm'pi g ate Grease Rendered Y N `. #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Si Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N \� Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* S Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003 C Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F ( ) p Y7-]02.11 Common Name-Working Containers * Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* q Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* I Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of A11601- . Clean Utensils and Food Contact Surfaces of * Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4 ( ) t Eggs-Immediate Service 145°F 15 sec Not Otherwise Processed to Eliminate Equipment* ( )O Pathogens*590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game g * &gecn�uuzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006 B Water Meets Standards in 310 CMR 22.0* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell ( ) Contact Surfaces of Equipment 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* I Shellfish and Fish From an Approved Source gg 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or g trY 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* the appropriate sections above if related to Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* Otherfoodb 90 illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other es should violations relating#to good retail 590.004(C) Wild Mushrooms practices should be debited under#29-Special 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23.30) 3-202.15 Package Integrity* Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail practices FC 590.000 3-203.12 Shellstock Identification Maintained* Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 . 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 5-20411 Location and Placement* 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. • � BAXTP NYE INEE EN G RING & SUR�'�;�7NG Registered Professional Engineers and Land Surveyors 78 North Street,3rd Floor,Hyannis,MA 02601 Tel:(508)771-7502 Fax:(508)771-7622 January 30,2009 Mr.Thomas McKean,RS,CHO Director-Barnstable Health Division 200 Main Street, Hyannis,MA 02601 RE: Septic Design Flow for Existing System 35 Iyannough Rd.,Hyannis—Guaranteed Fresh Produce Dear Mr.McKean: Please accept this letter as follow up to our meeting on January 28,2009 in which we discussed the existing septic system design flow capacity for the system at 35 Iyannough Rd.,Hyannis. As we agreed,the capacity of the system is based on the bottom area of the existing system of 336 sf as recorded by the letter from your files,dated June 10, 1977,by Mr.John M.Kelly,Barnstable Director of Public Health at that time(copy of said letter is attached). The noted letter defines the system as approved for office use and produce warehouse. This is in keeping with the use under which the company,Guaranteed Fresh Produce(GFP),whom currently occupies the site,operates. As we agreed,this bottom area,based on the 1977 design criteria,supports a design flow of 336 gpd. This design flow supports the GFP operation of 532 sf of retail space,6 persons in the warehouse building operation,and up to 14 delivery drivers,or any combination thereof,not to exceed the 336 gpd and within the approved uses. Please see the attached calculations in support of these figures. Please contact me if you have any further questions. Thank you again for your time and consideration on this project. Very truly yours, Baxter Nye Engineering&Surveying Matthew—Eddy,P. Managing Partner i Cc: Mr.David Lawler,Esq. Mr.Adam Weiner,GFP M ,File 0:\2007\2007-071\ADMIId\LETT'ERS\2007-071 L2 TMcKeane septic design flow.doc C) f C CD 3+S a(1 t Land Surveys • Site Design • Subdivisions • Septic Design • Wetland Filings • Planning . .I i s a. 0 Page 1 of 2 McKean, Thomas From: Matthew Eddy [MEddy@Baxter-Nye.com] Sent: Friday, January 30, 2009 2:39 PM To: McKean, Thomas Subject: Guaranteed Fresh Produce -35 lyannough Rd, Hyannis Hi Tom, Attached please find pdf copies of the cover letter and supporting calculations pursuant to our meeting this past Wed. regarding the existing septic capacity at 35 lyannough Rd. for the Guaranteed Fresh Produce operation. I am mailing signed hard copies as well for your files. Thank you for your time on this. It is always appreciated. Matt Matthew Eddy,P.E. Managing Partner BAXTER NYE ENGINEERING&SURVEYING 78 North Street-3rd Floor Hyannis,MA 02601 Ph:508-771-7502x17 Fax:508-771-7622 email:meddvxter-nye.com From: McKean, Thomas [mailto:Thomas,McKean @town.barnstable.ma.us] Sent: Tuesday, January 20, 2009 9:05 AM To: Matthew Eddy Subject: RE: Meeting Re: 45 Quail Rd and Guaranteed Fresh Produce Wed Morning the 28th at 9:00 ? -----Original Message----- From: Matthew Eddy [mailto:MEddy@Baxter-Nye.com] Sent: Tuesday, January 20, 2009 8:58 AM To: McKean, Thomas Subject: Meeting Re: 45 Quail Rd and Guaranteed Fresh Produce Hi Tom, Thanks for calling me back-sorry I missed your call. I thought email might be easier to set time. I will be out of town after today, so if we could schedule meeting for next week that would be great. I am available week of 1/26 on Monday after 1pm, Wed. morning 9 am to 12 noon, or anytime Thurs or Fri. Please let me know what works for you. Thank you very much. Matt Matthew Eddy,P.E. 2/11/2009 BAXTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,3`d Floor,Hyannis,MA 02601 Tel:(508)771-7502 Fax:(508)771-7622 January 30,2009 Mr.Thomas McKean,RS,CHO Director-Barnstable Health Division 200 Main Street, Hyannis,MA 02601. RE: Septic Design Flow for Existing System 35 Iyannough Rd.,Hyannis—Guaranteed Fresh Produce Dear Mr.McKean: Please accept this letter as follow up to our meeting on January 28,2009 in which we discussed the existing septic system design flow capacity for the system at 35 Iyannough Rd.,Hyannis. As we agreed,the capacity of the system is based on the bottom area of the existing system of 336 sf as recorded by the letter from your files,dated June 10, 1977,by Mr.John M.Kelly,Barnstable Director of Public Health at that time(copy of said letter is attached). The noted letter defines the system as approved for office use and produce warehouse. This is in keeping with the use under which the company,Guaranteed Fresh Produce(GFP),whom currently occupies the site,operates. As we agreed,this bottom area,based on the 1977 design criteria,supports a design flow of 336 gpd. This design flow supports the GFP operation of 532 sf of retail space,6 persons in the warehouse building operation,and up to 14 delivery drivers,or any combination thereof,not to exceed the 336 gpd and within the approved uses. Please see the attached calculations in support of these figures. Please contact me if you have any further questions. Thank you again for your time and consideration on this project. Very truly yours, Baxter Nye Engineering&Surveying Matthew Eddy,P.E. Managing Partner Cc: Mr.David Lawler,Esq. Mr.Adam Weiner,GFP File 0:\2007\2007-07MI)MIMLETTERS\2007-071 L2 TMcKeane septic design flow.doc Land Surveys • Site Design • Subdivisions • Septic Design • Wetland Filings • Planning BAXTER NYE ENGINEERING SURVEYING Registered Professional Engineers and Surveyors }� 78 North St., Hyannis, MA ; (508) 771-7502 Project Name Guaranteed Fresh Produce by: MWE Location 35 Iyannough Road/ Route 28 Hyannis, MA Date: 12/10/2008 BN Project# 2007-071 Wastewater Design Flow Calculations Proposed Conditions Using only the bottom area of existing septic system, it supports a 336 gpd design flow This system supports the following combination of proposed use (or other combinations not to exceed 336 gpd) and within the approved uses. Use Area/Unit Design Flow Unit Total Retail Space 532 sf 0.05 gpd 26.6 gpd {from 314 CMR 15.00} Warehouse/Dry Storage 6 person 15 gpd 90.0 gpd {from 314 CMR 15.001 w/o cafetaria 14 person/drivers 15 gpd 210.0 gpd Total Facility Flow 326.6 gpd ( 0.000505 cfs) 2007-071 Sewer Flow Calculations.xls Baxter Nye Engineering Sti Registered Professional Engineers and Land Surveyors Project Name Guaranteed Fresh Produce by: MWE Location 35 Iyannough Road/ Route 28 Hyannis, MA Date: 12/10/2008 BN Project# 2007-071 Verification of Existing Septic System Design Flow Calculations: (Per CMR 15.00- Title 5 1978 Requirements) Existing Septic System Design Area Design Flow SAS area: 6—8 ft. x 4 ft. Chambers in 3x2 configuration with 2 feet of stone surrounding (footprint=28 ft.x 12 ft. Length Width Depth Application Rate (2 min. perc) bottom area: 28 ft 12 ft = 336.0 sf 1 gpd/sf = 336 gpd TOTAL EXISTING DESIGN FLOW: 336 gpd 0.0005 cfs 2007-071 Sewer Flow Calculations.xls r - TOWN OF BARNSTABLE Cf 1HE T� ,OFFICCEtOF )A"ST"L i BOARD OF HEALTH rasa 'woe,i639• � ' 367 MAIN STREET HYANNIS,MASS.02601 November 8, 1990 Bedford Fruit & Produce Company Route 28, Iyanough Road Hyannis MA 02601 Dear Sir: Your food permit will be invalid after December 310 1990. Therefore, we ask that you remit the following amount prior to December 15, 1990: Establishment Fee Seats X Retail100�00 Frozen Dessert Milk Total due $10000 You will be sent, via mailp the food permit(s) upon receipt of your check. Thank you. Sincerely yo"Vs, Thomas A. McKean Director of Public Health TM:cst Enclosure l BAXTER NYE ENGINEERING SURVEYING Registered Professional Engineers and Surveyors 78 North St., Hyannis, MA; (508) 771-7502 Project Name Guaranteed Fresh Produce by: MWE Location 35 Iyannough Road/ Route 28 Hyannis, MA Date: 12/10/2008 BN Project# 2007-071 Wastewater Design Flow Calculations Proposed Conditions Using only the bottom area of existing septic system, it supports a 336 gpd design flow This system supports the following combination of proposed use (or other combinations not to exceed 336 gpd) and within the approved uses. Use Area/Unit Design Flow Unit Total Retail Space 532 sf 0.05 gpd 26.6 gpd {from 314 CMR 15.00) Warehouse/Dry Storage 6 person 15 gpd 90.0 gpd (from 314 CMR 15.00) w/o cafetaria 14 person/drivers 15 gpd 210.0 gpd Total Facility Flow 326.6 gpd ( 0.000505 cfs) 2007-071 Sewer Flow Calculations.xls Baxter Nye Engineering Registered Professional Engineers and Land Surveyors Project Name Guaranteed Fresh Produce by: MWE Location 35 Iyannough Road/ Route 28 Hyannis, MA Date: 12/10/2008 BN Project# 2007-071 Verification of Existing Septic System Design Flow Calculations: (Per CMR 15.00 - Title 5 1978 Requirements) Existing Septic System Design Area Design Flow SAS area: 6—8 ft.x 4 ft. Chambers in 3x2 configuration with 2 feet of stone surrounding (footprint=28 ft.x 12 ft.) Length Width Depth Application Rate (2 min. perc) bottom area: 28 ft 12 ft = 336.0 sf 1 gpd/sf = 336 gpd TOTAL EXISTING DESIGN FLOW: 336 gpd 0.0005 cfs • 2007-071 Sewer Flow Calculations.As ChP Tommonwralt4 of Mass 4usletts DEPARTMENT OF PUBLIC HEALTH,DIVISION OF FOOD AND DRUGS 305 SOUTH STREET,JAMAICA PLAIN,MA.02130 i e License it IN ACCORDANCE WITH MASSACHUSETTS GENERAL LAWS Chapter 94 Section 305C NUMBER ISSUED EXPIRES TYPE 'MA 0165 06/26/89 06/26/90 Process or Distribute food for Sale at Wholesale ISSUED TO Bedford fruit & Prod. Co. , Inc Rte. 28 & Medeiros Way COMMISSIONER OF AUBUCHEALTH Hyannis, MA 02601 POST IN A CONSPICUOUS PLACE 19807 i DEPARTMENT OF PUBLIC HEALTH DIVISION OF FOOD AND .DRUGS SERIAL N° 1 2 3 FEE: $100.00 FOOD PROCESSING REGISTRATION REGISTRATION NO........1.65........................... Date of Registration........FEBg7 ,, ... 19...& .... REGISTERED UNDER THE PROVISIONS OF Section 305CC Chapter 94 OF THE GENERAL LATVS CERTIFICATE OF REGISTRATION NAME OF FIRM ...............BRDFORD.,.FRUIT...AND...PRQi?U!✓R...CQI V.ANX'....LNG...................................................................................................................... L0CATION.......ROUTE. 28..AND MED:IRo. WAY HYMN!,.NI....... �. h.. .N. 8 .................................riASSACIlIISETTS......................... .........026.0.1............. .. STREET CITY OR TOWN "��'""""" STATE ZIP CODE TYPE OF BUSINESS........._j RWARI.NG,.,..1MIRIBUTING,,,•W.IQLESAL..................... .................................................................................................. ....................................................................................................................................:. ommissioner of Public Health THIS REGISTRATION IS NOT TRANSFERABLE ScATINGde(KJ, NUAL f/ SEASONAL afte to TOWN OF.E3ARKISTABLE w TEMPORARY OFFICE OF b DAHIIl � BOARD OF HEALTH r�S&ee. f639. 367 MAIN STREET / am k. HYANNIS, MASS. 02601 DATE 1 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT A IV Te N FULL NAME OF APPLICANT F MeJe- fro� 12/1 NAME OF FOOD ESTABLISHMENT ` /� "V Co O$Y`G ADDRESS OF FOOD ESTABLISHMENT t U4 6,-�Gs b I TEL. NO. TYPE OF ESTABLISHMENT: FOOD SERVICE ESTABLISHMENT: RETAIL FOOD STORE MOBILE FOOD UNIT SOLE OWNER: -XYes No IF APPLICANT IS A PARTNERSHIP, FULL NAME AND HOME ADDRESS OF ALL PARTNERS: ASSESSORS MAP NO: !. { PARCEL NO• Y / --.IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. (, STATE OF INCORPORATION FULL NAME AND HOME DRESS/� OF: //�� PRESIDENT '30`�® r afAtWA EAS U R E R CLERK P SIGNATURE OF APPLICANT Aa� A-J6 HOME ADDRESS O zalt HOME TELEPHONE NO. 3 6 q 9 3'f 4/ 2?,343-V d RESTRICTIONS: June 100 1,979 Mr. 'Edwin F Taylor Selectman Town of Barnstable 13yaninis, Massaobusetts Dear Mr. Taylor ,, . . . our .records indicate that the Bedford Fruit Market has a septic tank of 1250 gallons and six Amerataon chambers with a leaching capacity, of 336 feet. This system was ;.approved for office use and produce warehouse. `` i The., Health Department. has never received pans fog any ad- II ditions or alterations. we do not' know exactly what the owner proposes,, ; There is agreat -difference in septic systems:designe�d `for office and warehouses and those designed for dwellings. It would appear that the :laaching system is inadequate for apartment additions.. Although- the owner apparently has talked to other "people cones cerning whatever he proposes, he has never talked or presented, plans to me concerning this. -.wd would have to` know the maxi mum number of people using the`building now and exactly what he desires to do prior to a final deaision.. The Board has. required a minimum of 400 sNuare� feet of leaching,as ;a minimumr in the past for any we liriq. Please contact -me if .;you. have ,anyquest on>Ra . Very truly yours, John .M, Kelly ' Director of Public Health JMK/mm : THE COMMONWEALTH OF MASSACHUSETTS BOARD. OF HEALTH :r.:.:;-::..,../........OF....:.:....BAR11I STABLE...:......:....:................... No. :_........ FEE..: t Permission is hereby granted. .................... to Construct'' or Repair ................................................... ................... 1 ( ) an Individual Sewage Disposal System atNo.--- ..........:................................................. .. -- -- ---------------•------- t tree! .............. ..... as shown on the application for Disposal Works Construction P it • _-- -•--- -- _._. Dated --- ._.._��-_ .,DATE_ �/ Board of Health • ----------•....:..:........ 111 A FORM 1255 -HOBBs & WARREN, INC.. PUBLISHERS 1 + tMarb Bruit & Froaurt to. fur. ✓lie (/.7eaE ��own =WINTER & SUMMER TERMINAL — RT. 28, HYANNIS, MASS. 02601 CAPE PHONE IS 775-8546 May 11 , 1988 Town of Barnstable Board of Health 307 Main Street Hyannis, Mass. 02601 Mr. Thomas McKean Acting Director of Public Works Dear Mr. McKean, Please refer to your letter of March 219 1988 (attached) , in which it was requested that we obtain the services of a licensed disposal installer to evaluate and upgrade our system. Attached you will also find a letter from Vita-Bac Co. of Pembroke, Mass. in which we have complied with your request. As is stated, we did have a problem with a badly leaking toilet, and some vegetable materials carrying over from the septic tank. Vita-Bac has corrected these problems, we trust to your satis- faction. We are at this time anxiously awaiting our license, and should there be any questions, please do not hesitate to contact US. Ver t yo s, Antone Medeiros, President VITABAC 80 Mountain Ave., Pembroke, MA 02359 00000 CO. 1-800-874.4900 Mr. Tony Mere 1 ros Bedford Fruit Co. Iyanough Road Rt. 28 Hyannis, Ma. 02601 Re: Septic system at above address. To Whom it May Concern: The Vita-Bac co. was recently contracted by Mr. T. Medeiros of the Bedford Fruit Co. to perform pumping, inspection, and cleaning of the septic system at Bedford Fruit Co. Hyannis, Ma. The system consists of a 1200 gal . septic tank, one distribution box and 6 flow diffusers. All covers are built to grade. Upon pumping and Inspection the following was identified: 1 . There was a badly leaking toilet which was loading the septic system with 1 gal . per minute of leakage water. This was overlaoding the system. 2. Vegtable materials from the potato peeling machine had carried over from the septic tank to the flow diffusers. Vita-Bac cleaned the septic tank and the vegtable material from the flow diffusers using cold water ,jets to liquify the material . Under the material was clean dry sand, with no evidence of water table or contamination. After cleaning, the flow diffusers percolated at a rate of approximately 3 min. per inch of water. Vita-Bac feels that this system has been returned to proper order by means of a comprehensive system cleaning. No modifications or alterations to the system were required. Very Truly Yours, .James F. Kelly General Manager Septic Systems Consultants HOME • INDUSTRIAL • SCHOOL • HOSPITALS • NURSING HOMES • RESTAURANTS TOWN OF BAR1491 AU LE OFFICE OF 367 MAIN STREET - • �b agar a 6-0YAh8NJD. MASS. 02601 .Bedford Fruit March 21, 1 988 . Route 28 ` North Hyannis Ma. 02601 Dear The Department of Public Works has notified us that your oiklite sewage disposal system may be Inadequate. Theft recorde Indicate that your system was pumped Dec. 5„Dec. 18, 1987 ,San. 2 and. Feb. 10, 1'988. . We strongly recommend that you obtain the services of aa.licensed disposal works Installer to evaluate and upgrade bona¢• system,. We request your voluntary compliances however, It this is not forthcoming, we will require you to upgrade your system, In accordance with State and local regulations. Enclosed is ar pamphlet explaining the importance of arnaiantaining your on-site sewage disposal system. Please cal 775-1120 extension 182 if you have s M y any questions. Very truly Vows, Thom McKean ° Acting Director of Public Works TM/cet r; enc. I - *�*� lit`• 4 •. ^� ! • t 1�' p��� s��r t ,.. rY) �3 "+ �. :� ���i` 1r r i_•� tS e'f '! .0 it r y�+t`fR(y �, ^�> )� � ''� ,� ' ,. a + r twr�v�x.fa�t•f. R f � �t, .d }."�` .L., u4,r TjjMMvnwrajj4 .of _4jjararl�u�pt � DEPARTMENT OF PUBLIC HEALTH .. _..V - ' - DIVISION OF FOOD AND DRUGS 527 State House e Boston, Massachusetts 2 M us tts 0 133 J APPLICATION FOR -REGISTRATION by RETAIL FOOD ESTABLISHMENT In accordance with the provisions of the Regulation promulgated under authority of Section 305-A of Chapter 94 of the General Laws of the Commonwealth of -Massachusetts application for Registration is hereby MAIL TO made by: Board of Health (Print o: type) Town of Barnstable FIRM NAMEBEDFORD FRUIT & PRODUCE CO INC P.O. Box 534 s 02601 FIRM ADDRESS RTE 28 & MEDEIROS WAY HYANNIS, MASS. 02601 Street City or town Zip Code - SAME STORE ADDRESS �.. Street City or town Zip Code (Each store must be registered individually.) Type of Business (check one) X CORPORATION PARTNERSHIP ' . SOLE .OWNER Date of Application 12-7-1983 City or Town where filed HYANNIS, MASS. Name of Corporate Officers: (to be signed by each) '�..- 4ANT0NE��MEDEIROS ; "� ,,�� ,n.,�,�wr�r President: HUCKIN NECK-ROAD­CENTERVILLE,,r:P'iA.. Name Aaarw Treasurer: ANTONE MEDEIROS Name Address Clerk: KATHLEEN MARSHALL MMVTF ROAT) SO YARM_ OU E., MA, Name Address Name of Partners: (to be signed by each) Name Address fl Name Address Name of S•tE!�si ed) ( `�J(%� Name Address Person Preparing Application Title PRESIDENT/TREASURER STORE SELLS: Meat X Produce Dry Groceries Dairy X_Frozen Foods (Duplicate copies of application should be filed with local Board of Health or Health Department.) Form PH-F-70 30M-7-88-947788 T06TN OF BARNSTABLE APPLICATION FOR REGISTRATION by WHOLESALE FOOD ESTABLISHMENT In accordance with the provisions of the Regulation promulgated under authority of Section 305-A of Chapter 94 of the General Laws of the Commonwealth of Massachusetts application for Registration is hereby made by: (Print or typ FIRr AME f ' Jy m Cr�J r l FIRM ADDRESS Stre City orYt Zip Code STORE ADDRESS Street City or tom Zip Code (each store must be Registered individually) TYPE OF BUSINESS -- (check one) CORPORATION PARTNERSHIP SOLE 011'1NER - Date of Application,/4 / Jq7 City or Town where filed 44217�<24- NAME OF CORPORATE ��,RS : (to be signed by each) President Name address Treasure :' r 010' /V" � Nam Address / Clerk: blame, Address ,':-AME OF PARTNERS : (to be signed by each Name Address Name Address kN ME OF SOLE OWNER: (to be signed) Name Address Per P ep ari "-,pp ication a Title STORE SELLS : Meat Produce _Dry Groceries Dairy Frozen Foods_ i y , -1 �- � poop. r gj OL z STO V, s, A6e -Q0 91- � r Cl 13 --------------- 4 j - o ' s NS A �� 1 -61.7 97 1917 ??q-936; c0q, BARNSTABLE 2009 NOY 26 AN 10: 14 VISION • . i • i 0 0 0 0 0 0 00 G ranteed Fresh Produ e 35 Iyannough 28 � 0 0 0 DHyannis, assachusetts a APPROVED IN ACCORDANCE WITH PLANNING BOARD ■ DATE APPROVED BARNSTABLE PLANNING BOARD Prepared For Weiner Issued for : Planning Board Approval - Permit Set Only (3/27/08) DATE SIGNED Owners: Applicant : Engineer/Surveyor: Martha N. and John Trembley, Jr., trustees Adam Weiner BA= NYE ENGINEERING & SURVEYING Job Number - 2007-071 Raf do Real Trust Guaranteed Fresh Produce Realty Registered Professional I HEREBY CERTIFY THAT THIS PLAN WAS 35 Iyannough Road 85 Yannoutjl Road Engineers and Land Surveyors MADE IN ACCORDANCE WITH THE BARNSTABLE Hyannis, MA 02601 Hyannis, MA 02601 PLANNING BOARD APPROVAL. WITH LAND 78 North Street - 3rd Floor., Hyannis, MA 02601 COURT STANDARDS OF ACCURACY AND THE PERMANENT POINTS SHOWN ON THE PLAN PhOIIe - (5O8) 771-7502 Fax - (SOH) 771-7 2Z ARE IN EXISTENCE ON THE GROUND. AM : Matthew Eddy 0f17i t�lC�F,� No. Drawing Title Date DATE REGISTERED LAND SURVEYOR C-1 Cover Sheet 3/27/08 NOTE: "APPROVAL OF THIS PLAN SUBJECT To COMPLIANCE WITH COVENANT TO BE RECORDED HEREWITH" C-2 Legend and General Notes 3/27/08 THIS LAYOUT PLAN WAS FILED WITH THE TOWN CLERK C-3 Existing Conditions Plan 3/27/08 ON: 10 CLERK OF THE TOWN OF Layout Plan 3/27/08 BARNSTABLE, HEREBY CERTIFY THAT THIS PLAN AS C-4 y APPROVED BY BARNSTABLE ZONING BOARD OF Utlll Plan 3/27/08 APPEALS, HAS BEEN RECEIVED AND RECORDED AT C-5 Drainage and ty THIS OFFICE AND NO NOTICE OF APPEAL WAS RECEIVED DURING THE TWENTY DAYS AFTER SUCH C-6 Detail Sheet 3/�7/Og FlUNG, IN ACCORDANCE WITH THE MAssACHUSETTs GENERAL LAW, CHAPTER 8Z SECTION 23. DATE: TOWN CLERK "OF ENGINEER: VATMEW MATTHEW W. EDDY W. MASSADFIUSEII RED v � 431 PROFESSIONAL ENGINEER REG# 43183 OISTS d�ONA a� 3� by 0 b OF G� 1 SURY VIA: 2W4 JOHN EWS MASSADHUSETTS REt LAND SURVEYOR REGI 29874 1wan Comp 20 @@ffl0@ 00 0 PERMIT PLAN SET - NOT FOR CONSTRUCTION 0 O 6 0 - Conswetion Revision 01) o - Plan Revision O Blank - Submittal Action ao N 3 DATE: 03/27/08 7 U_ n O O ■ O N o REV. BY: DATE: REMARKS DROM NUMBER a / J U 0:\2007\2007-071\CML\PLOT\2007-071 CV.dwg Job 2007-071 I O O N 1� O O N 0 ABBREVIATIONS ORAL CONSTRUCTON NOTES LEGEND * (ALL REFERENCES TO "CONTRACTOR' SHALL MEAN THE GENERAL CONTRACTOR OR HIS SUB-CONTRACTORS.) 24. FINAL LAYOUT AND STAKING OF ALL PROPOSED FEATURES AND GRADING SHALL BE REVIEWED IN THE FIELD AND APPROVED BY THE OWNERS REPRESENTATIVE PRIOR TO ABAN ABAN IM 1. ALL WORK & MATERIALS SHALL BE IN ACCORDANCE WITH MASS HIGHWAY DEPARTMENT STANDARD ANY SITE PREPARATION OR CONSTRUCTION. THE CONTRACTOR SHALL NOT ADJUST OR ET PROP DOWt pf10P ' LOW PONY ADJ ADJUST IN FOR HIGHWAYS AND BRIDGES (MHO-SSHB). AS CURRENTLY AMENDED. UNLESS MODIFY THE LAYOUT AND STAKING OF ANY PROPOSED FEATURES WITHOUT FINAL OTHERWISE NOTED. IF THERE ARE CONFLICTS ANY OF THE SPECIFICATIONS OR PROJECT APPROVAL FROM THE OWNERS REPRESENTATIVE AND ANY GOVERNMENTAL AGENCY WHICH PROPERTY LINE DRAINAGE LINE LP HP HP No PONT APPROI( APPROWIE DOCUMENTS, THE HIGHER STANDARD SHALL APPLY. MAY HAVE JURISDICTION OVER CONTEMPLATED CHANGE. PROJECT LMT LINE 0°- OVEIELAW DRAIN GB GB GRADE BREAK BB BIIUMIKI 1S BERM ALL WORK UNDER THESE DOCUMENTS SHALL ALSO CONFORM TO ALL CODES AND STANDARDS, AS 25. ALL ELECTRICAL. TELEPHONE, DATA/COM AND FIRE DEPARTMENT CONDUITS ARE TO �-� RHT-GF-WAY/PROPERIY LINE -6'Ro -AD - ROOF DRAIN X27.21 c 's eoc � a BOT1i0M ELEVATION BC SMAINDUS CURB CURRENTLY AMENDED, WHICH ARE APPLICABLE TO THIS PROJECT. ALL WORK SHALL FURTHER BE INSTALLED BY THE ELECTRICAL CONTRACTOR. TRENCHING, BACKFlLUNG, EASEMENT - s - -S - SEWER LINE 1525 mc � CUliB CONFORM TO SPECIFIC REQUIREMENTS, SPECIFICATIONS. ORDINANCES AND INTERPRETATIONS OF CONCRETE WORK AND STREET REPAIR SHALL BE PERFORMED BY THE GENERAL - oHw--- -o�w--_ aV�EAD E mim TELoWNE F� K� x/- pFVA w� LOCAL AUTHORITIES HAVING JURISDICTION OVER THE PROJECT. DETERMINATION OF APPLICABLE CONTRACTOR. BUILDING SETBACK r x 25 x aS SPOT ELEYAIKIN Bw 8011 i OF SLOPE CODES AND STANDARDS AND OF THE AUTHORITIES HAVING JURISDICTION. SHALL BE THE STATE H MAY BASELINE — w —" —W - WATER LIE SM E LOCATION � BON BOTTOM OF WALL RESPONSIBILITY OF EACH CONTRACTOR, AS SHALL BE THE ANALYSIS OF ALL SUCH CODES AND 26. RIM ELEVATIONS OF DRAINAGE AND SANITARY SEWER MANHOLES ARE APPROXIMATE. �P- _ FIREMORI STANDARDS IN REGARD TO THEIR APPLICABILITY TO THE PROJECT FOR SECURING ALL APPROVALS FINAL ELEVATIONS ARE TO BE SET FLUSH AND CONSISTENT WITH GRADING PLANS. '- -- --0+00 moo-- BASELINE CC8 CAPE COD MERIT AND PERMITS. ADJUST ALL OTHER RIM ELEVATIONS OF MANHOLES. GAS GATES. WATER GATES AND __._ c - -s - � LINE � � LEST��� OTHER UTILITIES TO FINISHED GRADE WITHIN THE LIMITS OF THE SIZE WORK. ------- LAYOUT BENCH MARK CSE COBILES OW EDGING EXCEPT WHERE THE PROJECT DOCUMENTS INCLUDE MORE STRINGENT REQUIREMENI'05. APPLICABLE �•� ZONING LINE '�E _ _E �t UNOERCRo W MMC� DATA/bOMBRGCAMB LIES �� TIE N TO EXISI CU �y OVA CONSTRUCTION INDUSTRY STANDARDS HAVE THE SAME FORCE AND EFFECT AS IF BOUND HERETO. 27. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE REPLACED N KIND. SURFACES NOT IOwN LIE SUCH STANDARDS ARE MADE A PART OF THE PROJECT DOCUMENTS BY REFERENCE. OTHERWISE TREATED SHALL BE STABILIZED AS LAWNS. ALL LAWN AREAS SHALL HAVE A MODIFIED - ; - -T - UNDERGROUND DATA t COMMUNICATION LINES ow E>aM LOAM BORROW PLACED. SEEDED, FERTILIZED. LIMED AND MULCHED UN71L GRASS STAND IS -- STATE LINE FA---- _FA- FIRE ALARM IL SIWIIP Eq. EQUAL 2. THE CONTRACTOR SHALL BE RESPONSIBLE FOR ALL QUANTITY ESTIMATES AND VERIFYING, TO HIS ESTABUSHED AND SURFACE IS STABILIZED. THE MODIFIED LOAM BORROW SHALL HAVE A MINIMUM WI:1 M BUFFER FDN FOUNDAIKIN OWN SATISFACTION, THAT ALL QUANTITIES ARE ACCURATE FOR ALL CONSTRUCTION MATERIALS, DEPTH OF 6' AND SHALL BE PLACED FLUSH WITH THE TOP OF ADJACENT CURB. EDGING, BERM. OR -Fay— -FOP— FIRE & POLICE CABLE INCLUDING CUT & FILL ESTIMATES WHICH THE CONTRACTOR MAY PREPARE BASED ON OTHER SURFACE. THE CONTRACTOR WWI BE RESPONSIBLE FOR AREAS UNTIL VEGETATION HAS ------- ------- GRAVEL ROAD low WEILANO BUFFER FF FLASHED FILODR ELEVATION INFORMATION CONTAINED WITHIN THESE PLANS. BEEN PERMANENTLY ESTABLISHED. SLOES IN EXCESS OF 3:1 SHALL BE FURTHER STABILIZED WITH - EOP EDGE OF PAVEMENT cnrv- —cn�v�- CABLE 1V EROSION CONTROL BLANKETS (ECB) OF CURLEX OR EQUAL - - - Sa ce � K� BUFFER ® GRADE�� 3. WHERE AN EXISTING UTILITY IS FOUND TO CONFLICT WI1N THE PROPOSED WORK, - eC anitINous CURB �Rce N CATCH BAN OR S BASH) GC GRAMM Cto THE LOCATION, ELEVATION AND SIZE OF THE UTILITY SHALL BE ACCURATELY 28. THE CONTRACTOR SHALL WATER, MOW, FERTILIZE OR OTHERWISE MAINTAIN ALL SODDED AND CCR CAPE COD BERM MOW DOUBLE CATCH BASIN DETERMINED WITHOUT DELAY BY THE CONTRACTOR, AND THE INFORMATION SEEDED OR OTHERWISE STABILIZED AREAS UNTIL GRASS STANDS OR OTHER VEGETATED Fcc PRECAST GONG CUR -r• DRAIN KEt i GE � EO6NG FURNISHED TO THE ENGINEER FOR RESOLUTION OF THE CONFLICT. METHODS ARE ESTABLISHED TO THE SATISFACTION OF THE OWNER OR THEIR REPRESENTATIVE . Vcc VER1: GRAN. CUIO ® �+ DRAIN MANHOLE _52__— _ Np PO 4 THE CONTRACTOR SHALL MAKE ALL ARRANGEMENTS WITH THE APPROPRIATE UTILITY COMPANIES 29. THE CONTRACTOR SHALL RESET ALL MONUMENTA11ON DISTURBED DURING CONSTRUCTION __ 100 YEAR FLOOD PLAN FOR OBTAINING PERMITS AND PERFORMING ALL NEW CONSTRUCTION, RELOCATION, ALTERATION AT NO ADDITIONAL COST TO THE OWNER. THE CONTRACTOR SHALL PROVIDE A SURVEY scc SLOPED �• CURB !� TRENCH DRAM MMGAIION AREA LINE LA LANDSCAPE AREA AND ADJUSTMENT OF GAS, ELECTRIC (INCLUDING UTILITY POLES). TELEPHONE, CABLE. FIRE BY A PLS TO ENSURE THAT THE MONUMENTATION IS RESET TO ITS ORIGINAL LOCATION. UW OF CURB TYPE ` ... EDGE OF IRIR Lp LOW POWT ALARM, WATER, SANITARY SEWER. STORM DRAIN, AND ANY OTHER UTILITIES, BOTH PUBLIC AND MONUMENTS INCLUDE. BUT ARE NOT UM17M TO, TOWN BOUNDS, MASS HIGHWAY BOUNDS. FES� FEg► FLARED END SECI1011 MAX MA>�MM PRIVATE, AS REQUIRED. PROPERTY LINE MONUMENTS, IRON RODS, STAKES, CONCRETE BOUNDS, GRANITE BOUNDS SAICUT ,� HEADWALL a) aD TELEPHONE MANHOLE MIN MAS 5. THE LOCATION OF EXISTING UNDERGROUND SYSTEMS, INFRASTRUCTURE. U71UTIM !CONDUITS, AND AND STONE WALLS WITH DRILL HOLES. SIRUCTUtE 1s �� MARK MCC MONOUITHC OONCREIE CURB RAND HAVE NOT BEEN INDEPENDENTLY ARE SHOWN IN AN APPROXIMATE WAY ONLY, MAY VERIFIED BY THE NOT BE LIMITED TO 7HOSSE SHOWN OU43L THE ENGINEER, ORt THEIR HERON. s`M Sl SOLD MITE LIE � � TRAFFIC SIGNAL s� srl © m sti+ SEVER MANHOLE 0 ® ��Box AND NOT IN1VE CONTRACT REPRESENTAl THE CONTRACTOR SHALL DETERMINE THE EXACT LOCATION. BOTH HORIZONTALLY AND VERTICALLY, OF ALL EXISTING UTILITIES. CONDUITS, LINES. AND OTHER BURIM STOLID LINE FACP FMF NIS NOT TO SCALE INFRASTRUCTURE AND SYSTEMS BEFORE THE START OF ANY WORK. THE CONTRACTOR AGREES TO BROKEN W�1E LIE © ® GREASE TRAP o FIRE ALARM CONM PANEL � ? � CURB BE FULLY RESPONSIBLE FOR ANY AND ALL DAMAGES WHICH MIGHT BE OCCASIONED BY THE CONICREBROKEN M LINE °YE F11E ALARM BON PDRA PREVIOUSLY WR MW RIVER FRONT AREA CONTRACTOR'S FAILURE TO LOCATE THE INFRASTRUCTURE, UTILITIES, CONDUITS AND LINES _ s■a� _ ►+ ® WATER MANHOLE O m TRNlSFORMER PAD EXACTLY. THE CONTRACTOR SHALL PRESERVE ALL UNDERGROUND INFRASTRUCTURE AND U1IUTIES _swcH� SOLD WITE CHANNEL12W TIE PROP PItOP06FD AS REQUIRED. THE CONTRACTOR MUST CALL "DIG SAFE' (AT 1-888-DIG-SAFE) AT LEAST 72 SYCHL SKlI SOLD Yam gHANNtlm TIE pd � WATER GATE ® ® TELEPHONE RISER PWMI PAVED WATER IRY HOURS BEFORE THE START OF CONSTRUCTION. 5V 15Y -°r$L- =-� DOUBLE YELL M►LINE -« -♦► ON� VALVE. � REMODEL, 6. THE CONTRACTOR SHALL BE RESPONSIBLE TO CALL FOR INSPECTION BY THE APPROPRIATE STOP LINE PREssillRE REDUCR REM REMOAIE AUTHORITY IN ACCORDANCE WITH THE TOWN REQUIREMENTS, AS APPLICABLE. 9NESE CON ECIION Rat REMOVE AD RESET 7. THE CONTRACTOR SHALL NOTIFY ALL UTILITY COMPANIES. PUBLIC AND PRIVATE. ' STEEL GUARD RAL 8 FIRE HYDRANT RAS REMOVE AM STACK INCLUDING THOSE IN CONTROL OF UTIU71ES NOT SHOWN ON THIS 1 - - - WOW GUARD RAL PLAN, (SEE CHAPTER 370, ACTS OF 1963, MASSACHUSETTS) PRIOR TO —n--a—o— -�.-.---..- STOCKADE FENCE ® WA10 METER � RETAINCOMMENCING ANY WORK. •PIV POST NDNGITat VALVE SCE SLOPED GRAN E ' PN 8. BOXIER NYE ENGINEERING dt 'SURVEYING ASSUMES NO RESPONSIBILITY FOR DAµIAGES INCURRED PATH ® e W>:tL S®C SLOPED CRANE CURB AS A RESULT OF UTILITIES OMITTED OR INACCURATELY SHOWN. TREE LIE -x--x-X- -x-x-x- T FED MONITORING W� in TE NTO EMSINC GRADE 9. THE TERM "PROPOSED" (PROP.) MEANS WORK TO BE CONSTRUCTED USING NEW } 111MTIDN CONTROL VALVE TOC TOP OF CURB MATERIALS OR, WHERE APPLICABLE; RE-USING EXISTING MATERIALS IDENTIFIED "KDC `� c000000 STONE WALL jl( SPRINKLER HEAD 1pF ICU OF FOlI0A1KIN AS "REMOVE AND RESET-. (R&R) - -- -v--V-. RETAKING WALL ® HAY BALES ° � GAS GAZE Tos la' OF SLOE 10. UPON AWARD OF CONTRACT. CONTRACTOR SHALL MAKE ALL NECESSARY P NOTFICATIO14S AND APPLY FOR AND OBTAIN ALL NECESSARY PERMITS, PAY ALL FEES AND POST K9 ® GAS METER low Tea OF rIN1 ALL BONDS ASSOCIATED WITH SAME, AND COORDINATE WITH THE ENGINEER AS REQUIRED. (E) m ELECTRIC MA HOLE TV TYPDAL 11. THE CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THAT THE PROPOSED --- ----- -4 MOOR CONTOUR CONTOUR FR ® OEMBODE LION UNLESS 01HERSSE NOTED IMPROVEMENTS SHOWN ON THE PLANS DO NOT CONFLICT WITH ANY KNOWN EXISTING MAJOR BOTTOM SLOPEM of SLOPE LIGHT POLE � � INFORMATION OR OTHER PROPOSED IMPROVEMENTS. IF ANY CONFLICTS ARE o"' METERrER�M FEND BY DISCOVERED, THE CONTRACTOR MUST NOTIFY THE OWNER OR DEER IMMECJIATELY cos-- TOP , R� NNcm UPON DISCOVERY AND AT LEAST 72 HOURS PRIOR TO INSTALLA11ON OF ANY IPORTION ---eos— # FLOW LINT OF THE AFFECTED WORK. IL- MLDM LANDSCAPE LIGHT UTILRY ACM T D�� METAL PIPE 12. THE CONTRACTOR SHALL REFER TO ARCHITECTURAL AND STRUCTURAL DRAWINGS FOR ALL BUILDING DIMENSIONS AND CONSTRUCTION. BUILDING DIMENSIONS SHOWN HEFREIN ARE FOR ~° 00 TIGHT POLE (9" COORDINATION WITH OTHER SITE WORK ONLY AND SHOULD NOT BE USED TO :STAKE OUT J4e'T �� ENTRANCE N M SNGLE LIA INNRE CAR S ALUIMIM WE BUILDINGS. SITE CONTRACTOR SHALL STAKE OUT THE EXTERIOR BUILDING CGIRNERS FROM ]C W LOB DOCK �..�. WMINUYRE Cp CAST IRON PIPE THE LATEST ARCHITECTURAL PLANS. THE CONTRACTOR SHALL NOTIFY BAXTER' NYE DOtJBLF ��otio ]40o OVERHEAD DOOR ��. `_•• TRIPLE LUJMIhINRE CR CHANGE IN TYPE ARCHITECENGINTURAL RAL BUILDING PLANS BEFORE PROCEEDING ANY PORTIONG OF ANY DISCREPANCIES BETWEEN SITE PLAN DOFES17EONS WORK BOLLARD -�- .1. QUAD WMINAIRE or CORRUGAIIED METAL WE WHICH MAY BE EFFECTED SO THAT PROPER ADJUSTMENTS TO THE SITE LAYOUT CAN BE D ® DUIMPSTR PAD MADE IF NECESSARY. T so � WALL Pic MADE CODUT 13. PRIOR TO THE START OF CONSTRUCTION THE CONTRACTOR SHALL SUBMIT A SCHEDULE OF SITE LOCUM a = D0W N O O MANHOLE PLASTIC PPE SMODTN INTERIOR COOORDNANS TO THE OWNER AND ITS TE WITH THE OWNER. ITS ENGINEER ORATIVE. THE REPRESENTATIVE.CONTRACTOR SHALL NOTIFY AND GUARANTEED FRESH PRODUCE a►� PM PARKIiG METER35 IYANNOUGI'I ROAD�ROM 28 . -o- C � UTNJIY POLE/M;UY WERE Q PARKING COUNT 0_-o- 0--� UTMJTY POLE/OUY PONE CS CURB STOP FOR WATER LINE 14. CONTRACTOR SHALL BE SOLELY RESPONSIBLE FOR JOB SITE SAFETY AND ALL. CONSTRUCTION ® COMPACT PARING STALLS p ® HAND HOLE DIP DUC11lE IRON PIPE MEANS AND METHODS. BAXTER NYE ENGINEERING & SURVEYING. DOES NOT ,ASSUME ANY PFEPAW FM lIIIIiIIIII Iiillllllll ® PULL BOX DS DOW SM STA�10 LOCOUTY AL. OSHA JOB SITE SAFETY FOR CONSTRUCTION REGULATIONS S USED. �BY ALL. ADAM WEINER SILT FN10E/IIAYBAIE E E ECIRNC PERSONNEL ON'THE JOB SITE AT ALL TIMES. 85 OLD YARMCWM ROAD IIYANNIS, MA 02M 7F AND MAY BA BERM/WALE CHECK DAM 15. THE CONTRACTOR SHALL REMOVE ALL STUMPS, RUBBISH. AND DEBRIS FROM THE (50 177f49W CM PAVEMENIT FAC FRAME AO OOIYER x;. PROJECT SITE. STORAGE OF THESE ITEMS WILL NOT BE PERMITTED ON THE PROJECT -� STANDARD DUTY FLEM E PAVOW A R POW CU NIERSECTION F&C FRAME AND GRAIE SITE. THE CONTRACTOR SHALL LEAVE THE SITE IN A SAFE, CLEAN. AND LEVEL � © WAVY Dun FLEW PAVEMENT —® RAW END SECT � G wa CONDITION AT THE COMPLETION OF THE SITE CLEARANCE WORK. LEGEND AHD GENERAL NOTES La ® HANDICAP RAID WITH STONE PROIEC DON 16. ALL UNSUITABLE MATERIALS ENCOUNTERED WITHIN THE LIMIT OF WEIR SUB GRADES SHALL .�•Pp_ PRMM= RAN � �W BE REMOVED. AS DIRECTED BY THE ENGINEER OR OWNERS REPRESENTATIVE, TO NATURAL & HANDICAP PARING STABLE GROUND BY THE . UNSUITABLE MATERIALS INCLUDE TOPSOIL. LOAM, & VAN-ACCESSIBLE HANDICAP PAR W PAVED WAMMY(PM" ID N1�EPTOR DRAIN STABLE ALL ORGANIC MATERIAL, SNOW, ICE, CONSTRUCTION RUBBLE, TRASH. AMD OTHER BAXTER NYE ENGINEERING SURVEYING vnr, ww � W1H STONEPROlOC110N NV OVERT ELEVATIOND DEBRIS. ® CART CORRAL. INAND THE UM17S OF GRADING SHALLRegistered Professional Engineers a>ad Land Surveyors DOWN no. _ ® AM MAT WALE PD FER�Fmim DRAIN 17. UPON APPROVAL APP SHRUBS _OF THE ENGINEER OR OWNERS REPRESENT REMOVED AND RffSET ONLY ymmj$,�hosetts 02601 78 Narth Street-3nl Floor,H on DETAIL OR SECTION PVC POLYVINYL CHHLORIDE PIPE Phone-(508)771-7502 Fax-(508) 771-7622 Sheet no. Q TREES RCP REINFORCEDWE18. AREAS OUTSIDE THE LIMITS OF PROPOSED WORK DISTURBED BY THE CONTRACTOR'S Q SHALL RESTORED By THE TRACTOR TO TH OPERATION% WITHOUT PRIOR APPROVAL BY THE EIR EH'ORIGINAL CONDITION AT THE �N ,NA + N 9RU8 RD ROOF GRAN CONTRACTOR'S EXPENSE. S SEWER in 19. EXISTING SUBSURFACE ROCK IS NOT SHOWN ON THE PLANS. IT SHALL BE TIME RESPONSIBILITY OF 6 SD STORM DRAIN THE CONTRACTOR TO MAKE THEIR OWN DETERMINATION AS TO THE LOCATION OF SUBSURFACE ROCK. 0 20. THE CONTRACTOR SHALL PROTECT ALL UNDERGROUND DRAINAGE. SEWER. AND UITIUTY 43 t � T FACILITIES FROM EXCESSIVE VEHICULAR LOADS DURING CONSTRUCTION. ANY FACCIt.IT1ES ��pgCApE �Q�$. TSAR TAPPING SLEEVE, VALVE AND BOL DAMAGED BY CONSTRUCTION LOADS SHALL BE REPAIRED BY THE CONTRACTOR AT THE ON AL CONTRACTOR'S EXPENSE. 3 a PLANT SOIL SHALL BE 1/3 SPHAGNUM PEAT MOSS AND 2/3 FERTILE LOWER STORY PLANTINGS: SHRUBS 30-46 INCHES LIP UTILITY POLE 21. ALL EXISTING SIGNS WITHIN THE PROJECT LIMITS SHALL BE RETAINED UNLESS,' NOTED FIELD LOAM BY VOLUME. OTHERWISE' � rtTRlFlm GAY PINE DATA 03127108 o PLANTS SHALL CONFORM TO MOST RECENT STANDARDS OF THE 22. JOINTS BETWEEN NEW BITUMINOUS CONCRETE ROADWAY PAVEMENT AND SAWC'LIT o MULCH SHALL BE HORTICULTURAL QUALITY HEMLOCK BAR. AMERICAN NURSERYMENS ASSOCIATION. w WATER EXISTING PAVEMENT SHALL BE SEALED WITH BITUMEN AND BACKSANDED. ALL JOINTS PROVIDE 6" TOPSOIL do FINE GRADE. SEED, FERTILIZE AND LIME ALL AREAS TO EXISTING PAVEMENT SHALL BE SAWCUT TRUE AND STRAIGHT. ALL CRACKEID OR CN2 0 TREE PLANTINGS SHALL BE COMMON VARIETIES CAPABLE OF INADEQUATE PAVEMENT AND/OR SUBBASE MATERIAL SHALL BE REMOVED AND a NOT OTHERWISE NOTED. REPLACED. REACHING A HEIGHT OF 30' O MATURITY. LNO. BY �� REMARKS ALL PLANTINGS AT DRIVE WAY ENTRANCES WALL BE MAINTAINED TO A 23• ALL PROPOSED WALKWAYS WILL BE HANDICAPPED ACCESSIBLE. ALL PROPOSED DlaAtrNG MAR SHRUB PLANTINGS SHALL BE COMMON VARIETIES CAPABLE OF HEIGHT OF 3' OR LESS AS TO NOT OBSCURE TRAFFIC VISIBILITY. SLOPES WILL WALKWAYS TO BE LESS THAN 57L AND ALL CROSS SLOPES s 2 F- ALL A MINIMUM HEIGHT OF 3' O MATURITY. WORK WILL @E IN ACCORDANCE WITH THE MOST CURRENT REQUIREMENTS OF' THE U.S. 0:\2007\2007-071\CML\PL0112007-071 LG.dwg ACCESS BOARD, AMERICANS WITH DISABILITIES ACT do COMMONWEALTH OF o MASSACHUSETTS, ARCHITECTURAL ACCESS BOARD. 2007-071 O N n O O N .. oy �g LEGEND POLE Tin 50/3 p BOUND a o -0- UnuTY POLE 'h o y I GUY WNW o m MECTRIC METER o� y j S104 � LOCUS oy 0 WYDRANT Go ■ CATCH BASIN co IR Os o e mom, RMG WELL Jy 0 MANHOLE GAS SHUT OFF oy LOCUS MAP ----- --' ® N.T.S. GAS METER 0 \ __�-- U \ 13.86 0 SEPTIC COVER Z %/ � ���♦ , oy -G - GAS LINE J / \ -E - ELECTRIC LINE Gy 13.7-Roople OOA o� Q" 13.76 0 oy 0 FPI 50/>2Z\ 5.7 �O POLE 14.88 'f ! h� ♦ POLE rn � �3.3 . B 15. i 16.46 y>• \`♦ f� y1/ W ♦ `, m o� oy lW.Iffiff.S �`13.98; ® y. 1. 7HE NNi�VN T OF TENS PLAN IS TO DETAIL OEM COMM6. DIII NTAL N M7ION: 4.32 ♦\+ 9 POLE BOUND FND AT TENS SITE SIZE IS NOT Wltt#ii AN A.C.EC. (AREA OF CRiMAL LE Z LOCUS PROPERTY IS SHOWN AS: SM IS�AN CON A OF 8iBIA7ED HABITAT aF RARE ASSESSOR'S AMP 30 - PARCEL 003 WILOW PER NffSP MAP OCTOM 1, 2006 15101ED •� C871IF ITE OF TiRE 163545 ��� � !q„�- ��a � � / A� IN POLE FM�TAi$ OF 1tARE NON DL�E' TOR t1SE wRH 1FE MA PLAN REYERENCE N�Ei m PROiECRON ACT MUMS (310 MR 10). / BOLLARDS q�� �• w; SHE DOES NOT CONTAIN A CERTF�D VERNAL POOL PER NHESP LOTS 1 THRU 4 0 LAND COURT PLAN 11685 C AMP OCR 1, 2006 WI FED VERNAL POOLS'. SUE LS NOT WITHIN A PRIORIIY WFIAT PER W31) MAP 01yWAPPLICANT OCTOBER 1, 2006 'PRIORITY HMBITA7S OF RARE �► /� R IR ARAM NEW FOR SI M UNOER 7W IMSSACHUSETTB ENDNN M 13.7 If, ` O� GIIAYPANIEED FRESH PRODUCE SPECES ACE. REC,�1LAlIONIS (321 CAD 10). \ 85 OLD VARMOM ROAD SITE iS NOT WM0 A STATE APPROVED ZONE N GROUND N UER i// tim p•� HON MS, MA 02601 RECHM M PROTECTION AREA. BOLLARD` 8 �,11w PROJECT LM710N: / b O'r 35 NW10IG 1 ROAD/ROUiE 28 7. Ui>tlTY NrFORIIARON SWORN HEREIN: � 13.53 • HIYANNNS, IN02601 1!f CONiRA= SHMLL COHTACT DIG SAFE (AT 1-888-DIG-SAFE] �/ \\ X, 0 / 1 STORY 3. � ELE11111ON 15' %VD I-FOOT ABOVE IlAST HOURS PRIOR m AM UMff COMRAWS TO i�SIART OONSIRUC.`im AT EXISTNG METAL WAREHOUSE BOLLARD• s• GR X AT UP EM NEAR N CORNER THE tACATION of ExISm tNOmRt>m" INFRASTRUCTURE; POLELOCUS PER 94W SVM 8fA AP JW UrnITt�, CONOINiS, AND I N�E'S ARE S IDON IN AN APPRO)MATE NRY ONLY, ANY NOT BE LAM TO THOSE 81 �1 13.77 WON HEREIN AND HMVE BEEN RE'S ARDIE D WMED ON 7Hf 4. COANMU�NIY PANEL MN$R 250001 0005 C � x lif FLOOD NISWK2: RATE MAP DEFNOS THIS AREA AS CONTMM AGREES 10 BE FULLY RESPONSI�F FOR ANY ZONES 8 AND C, AREAS OF WOKFt00DNdG. AND ALL DAMAGES WHICH IdW BE OCOMO BY 7HE CONIRACiOR'S FAILURE 70 LOME SAD NORGYRUCRK AND i ASSESSORS MAP 343 PARCEL 2 5. ZONING NFORMAIK> U RIES EXACTLY. N' FELD MOMS LIN M FROM PLAN' ' N� NOORMAROK 7Hf CONIfNi M SIKL N07EY THE ENGNW ROBERT A. McLAUGHLJN, ET AL, ZONN�G : AS SERVICES) NIBIEDMTELY FOR PO6'SDLF REDESIGN. TRUSTEES AINM M LOT FRONTAG TAGARE = 10E _ �' SF OEM SOW SYS�M PiEOM97ION OBTANED FROM A 7IiLE 5 G N�iSPECIION PERFOIN�D ON 112601 BY JOHNV RACI FRONT YARD SE79ACK = 20� SEPTIC NSPECIiONS PAL BOX 2119 7EA71CKET, AN MR SIDE YARD sE1BApr = 10 SOW HELD IAG171ONS. REAR YARD SETBACK = 1007ER LK AND APPURTENANT WMKTION IS BASED ON PUN 4806 PROVIDED VIA FAX ON dAWW 4, 2008. 13. % $SEE SUBSECTION 1 240.24.1.4 - DRIVEMYS ON R'OUiE 28 a ] ELECTRIC LNrE NrFORAM710N PER NSTAR ELECTRIC FAIc DATED JANIIARY 2, 2006 *ITCH SHOWS OVERHEAD SERVICE FROM OVERLAY DfSiRICT UTILITY POIF 1150/2 70 POLE /2A 7DUSE HO AT LOCUS GAS LW MORANTNDI PER KEVSPAN ENERGY MAP RECEM VA FAX MARY, 20M FELD SURVEY DATES: APRIL 12, 2006 AND DECEMBER 28, 2007. BOLLARDS , y x12.81 i ' ,- 16.3 6f ' W iyanno"h ROati/ Route Za i '--' Hyannis, Massachusetts x 13.06, � , � 13.99 FREPJiRED FOR 13.27 Adam Weiner HIM Opp r - •' le ung Condifflo Plan \♦ - ------ _ -- - - BAXTER NYE ENGEVEERING & SURVEYING _ _. , -MAP.343 , -PAREEt 003 Registered Professional `\ \`♦\`----------�• * AGS M ��;�� �'� ,' ta- NOF Engineers and Land Surveyors � � -------- -' `♦ ---------- - ,�' 78 Norffi Street,3rd Flout,Hyannis,MA 02601 � MAMEW -----` - -' Phone-(508)771-7502 Fax-(508)771-7622 w � 3 ,-'" a s ` 20 0 20 40 el e� �r4 MAL EN SCALE IN FEET ASSESSORS MAP 342 SCALE 1' = 20' DATE: 3 2 PARCEL 27e � / -7/OS N/F HOUSING ASSISTANCE ASSESSORS MAP 342 ` REV. REMARKS CORPORATION PARCEL 29 -C3 HEN HELD FIND PAUL SAGE ■ aeMrNs M� I 0: 200 2007-071 SU WRKS 2007-071 EC.dw 2007-071 oy ZONING TABLE SIGN SUMMARY ZONING DISTRICT: MS (MEDICAL SERVICES) POLE U.T.C.D. SPECIFICATION OVERLAY DISTRICTS: WP PROPOSED USE: MIXED USE (11,644 SF) #i50/3W NUMBER TEXT QUANTA WIDTH HEIGHT ALLOWED USE: BUSINESS OFFICE RETAIL = 532 SF O� oy R7-8* 12" 18" PN801G 1 EXIST USE: COMMERCIAL OFFICE = 1,816 SF EXIST TOTAL BUILDING AREA = 11,644 SF WAREHOUSE = 9,296 SF 0,-, ALL SIGNAGE MUST BE IN CONFORMANCE Ov oy WITH THE FEDERAL HIGHWAY TOTAL PARCEL AREA: 30,513 t S.F. ADMINISTRATION 'MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES" (MUTCD), PROVIDED 2 O� Oy LATEST , ALL APPLJCABLE CODES, AND LOCAL nREQUIREMENTS. ORDINIA LOT AREA: 10,000 SF 30,513 SF S, a , AND BYLAWS. FRONTAGE: 50 FT 99 + FT Ix \ -- --- - '" 0'y SIGN INSTALLER SHALL COORDINAIIE BUILDING SETBACKS: \ �4 SPECIFIC SIGN WORDING AND COLOR 0 �13.86 '` REQUIREMENTS WITH LOCAL AGENCES AS FRONT SETBACK 20 FT 39.7 FT 2 FT ** c � c oy NECESSARY SPECIAL NOTE TO VERIFY SIDE EAR SETBACK 10 FT 4.6 FT ** Z '���N� 91, ( PARKING SETBACK ** ; Ld� . HANDICAP PARKING SIGN FORMAT)I 10 FT 0 FT Q P e Can ct * ADD "VAN ACCESSIBLE' WHERE MAX. BLDG. HEIGHT(STORIES): 3�GN �13 7Q G� 3 STORIES OR 38 FT 1 STORY XX FT APPROPRIATE / MAX. LOT COVERAGE (IMPERVIOUS AREA): 80X 13.76 c � oy EXIST.=70X (21.358) SF 65X (19,786 SF) 9 5.75�\ POLE PARKING T SOAPING POLE 14.8 m � �16�\\ ^�'� - #150/2 1342 / G' # 3 Oh' 10X INTERIOR PARKING (! 21 SPACES) N/A N/A e o 8 1 o TREES - PARKIN G AREA (1/5 PS) r*0 �\\ �sTq y 14 SPACES/5 = 3 3 XX \\ `13.96 X ® c PARKING TABLE r �` m R7-80 PROP06ED ® q�� D2A 901ND FND o - j I SIGN LANDING 15.98 POLES # COMMERICIAL (RETAIL 1/200 SF) 532/200 3 SPACES BOLLARD � C AM STAIRS � ,.. `o� � / Nc N POL 2A COMMERICIAL - WAREHOUSE, �s # 1 PER 1.3 EMPLOYEES ON MAX SHIFT = 6/1.3 5 SPACES �� �j,,c' ELEV. = 15.0( �V �l BOLLARDS c,�� �-� sy°ot 1YO/ , TOTAL COMMERCIAL PARKING 8 SPACES 14 SPACES �,p HANDICAP PARKING (TOTAL/VAN) 1/1 SPACES 1/1 SPACES i °°tii 14 3 DESIGN VEHICLE SIB r i 4v R co, ** PRE—EXISTING NON—CONFORMING i 13.74 i BOLLARD o0 NOTES. 13.531- ALL CONSTRUCTION SHALL BE}` _ ry0 0� O v .q, o� 1 STORY � ARE, i REQUIREMENTS, AND SPECIFICATIONS.PERFORMED IN E WITH MHDSS, TOWN ORDINANCES, EXISTING METAL WAREHOUSE \\`\ N. WAREHOUSE S' 2• USE HEAVY DUTY PAVEMENT IN TRUCK TRAVEL AISLES SHOWN THUS. (USE HEAVY DUTY POLE � PAVEMENT IN TRAVEL AISLES.) Q i #1342/2 / i 3. STANDARD DUTY PAVEMENT SHOWN THUS. (USE STANDARD DUTY PAVEMENT IN PARKING -4-- ',0ROPOSED ta'�no' , �e STALLS.) r--� FENCED TRASH , ENCLOSURE I ASSESSORS MAP 343 PARCEL 2 46 SALVAGE EXISTING PAVEMENT IN AREA OF PARKING WHEERE ASPHALT IS STRUCTURALLY SOUND, N/F SHOWS NO SIGN OF CRACKING, AND MEETS PROPOSED GRtADES SHOWN ON SHEET C-X. ROBERT A. McLAUGHLIN, ET AL, TRUSTEES 5. EXISTING PAVING EDGE SWILL BE SAWCUT T'O CREATE A CLEAN EDGE WHERE IT IS TO BE TIED INTO NEW PAVING, OR WHERE ASPHALT IS REMOVED ADJACENT TO ASPHALT WHICH IS TO REMAIN. BROKEN OR UNSTABLE PAVEMENT SHALL BE REMOVED ANM SUBBASE REPLACED WITH SUITABLE i COMPACTED MATERIAL PER PAVEMENT SECTION DETAIL HEREIN. LPROPOSED ADING � 6. DIMENSIONS SHOWN ARE TO OUTSIDE FACE OF FOUNDATION OR FACE OF CURB WHERE 13.56 AND STAIRS � h� APPLICABLE. BOLL . �• 1 '� 7. BUILDING AND SITE SIGNAGE SHALL MEET REQUIREMENTS OF TOWN ZONING AND/OR SIGN j N� ' 3► ORDINANCES. J a ' SITE LOGITIOIIt GUARANTEED FRESH PRODUCE � %Ib�,eoLL s , y 851YANNOUGM ROAD/ROUTE 18 FFFIV m FOR ADAM WEINER 16.3 6� / ^~ 85 OLD YARNOM ROAD WAMIS, NA 00001 1 3.99 i�I~ TITLE / 1- 7 �' STIORA LAYOUT AND MATERIALS PLAN G O PARION ,-- ,-- ,-- - ,-, BAX'TER NYE ENGINEERING & SURVEYING Re&wmd Professional Engineers and Land Surveyors 78 North Street-3rd Floor,Hyannis,M1 muchusetts 02601 � '-✓/ \�` �` \�� \�� ASSESSORS MAP 343-" �� .'' ,' �' ,' '/ Phone- (5N) 771-75M Fax -(508) 771-7622 -vA 'k+s 0.70f ACRES- 20 0 20 40 ? N --------------- ",- 3o SCALE IN FEETco G 1"=20' ASSESSORS MAP 342 �t PARCEL 27s9 DATE 03/27/08 rJ/. o HOUSING ASSISTA^ CF I ASSESSORS MAP 342 CORPORATION PARCEL 29 N/Fc 4 HELD FND P A U L SAGE N0. 8Y QAIE REMARKS _J i 0:\2007\2007-071\CML\PLOT\2007-071 DM.dwg O 2007-071 a 0 N r a F