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MI PUEBLO - FOOD - CLOSED
MI PUEBLO CLOSE 459-B Main St. _.HYA^14hs� pg�ag,3 i Town of Barnstable Board of Health BMWSTABM mma 200 Main Street, Hyannis MA 02601 , 039. & Office: 508-862-4644 John Norman,Chairrman FAX: 508-790-6304 Donald A.Guadagnoli,M.D. F.P.(Thomas)Lee,P.E. Daniel Luczkow,M.D.Alt. March 9, 2022 Mr. Mr. Osvaldo Valdovinos 3 Quartermaster Road Yarmouth, MA 02664 .c"d ,i; 4i.xa4 r3. �o d b� �,. RED,. ,``MiPulo; 59°BM1;,7ntre `Hyar�� , Creaserap Dear Mr. Valdovinos, On March 5, 2021, you requested a variance from the Board of Health Regulation which requires a minimum 1,000 gallon capacity grease trap at 459 B Main Street Hyannis d.b.a. Mi Pueblo. Currently, there is a mechanical grease recovery device (GRD) at this location. During the public meeting of the Board of Health held on March 30, 2021, the Board voted to grant you a temporary variance, for twelve months. This temporary variance will expire on March 30, 2022. Please provide the Board of Health with an update regarding grease trap installation plans and schedule. If more time will be needed, the applicant will be required to submit a written request to the Board of Health before March 30, 2022. Sincerely, n Norman hairman Q:\WPFILES\Grease Trap Variance Mi PuebloMarch Temporary March 2021.docx OFFV�2<J = . titre DATE: 3 s $95.00 FEE*:. Q) BARNSTABM Town of Barnstable 1 6 q.. REC.BY: C �� g 1 � �a w Board of Health SCHED.DATE: I ti . ® 200 Main Street,Hyannis MA 02601 Office: 508462-4644 John T.Norman FAX: 508-790-6304 Donald A.Guadagnoli,M.D. ;+ F.P.(Thomas)Lee Daniel Luckowz,D.M:,Alternate GREASE TRAP VARIANCE REQUEST FORM LOCATION Property Address: S`1 % a I v� 5 - ��-yG ►�►�� S W� 0 2 9 I Assessor's Map and Parce I Number: A � 3 Business Name: 1"1 1 .�J ��.l:b I A-(-- CONTACT PERSON ATTENDING MEETING: BUSINESS OWNER'S NAME: 14yoffWre n"�te owner,did owner ofbusiness authorizer �l ,/n yau�'eirpresent him/her? Yes No NameAl0C MuVh St ��C : yVL(A 0010 Name: -OSVQ� 0 U u� �� v I A6 I l 0117� Address: l u)GLI�CINI�+ Vl il� ( w ck 1a y�14 Andress: 3 Quc�r�OMcsI w y Ym wt o L66 y Phone: ` _.6 q D- 63 J b. Phone: - Z 1 9 g- q 7 Z . EMAIL:. : EMAIL: CtY�eO.to, Ci(so . �c �ti!t�li(� .CON✓1 VARIANCE FROM REGULATION (Incl.Rej code#) REASON FOR ARIANCE (May attach separate sheet if more space needed) 61Y-euCe ye Co L-Vkl f1106v NIaV? 1(�UI(. v1e4.v On Town Sewer LJ On-Side Septic System. Li Checklist:(to be completedby office staff-person receiving variance request application) Please submit five packets,each containing A-D(below) 2/ A. Five(5)copies of the completed variance request form. B...Five(5)copies.oflabeled.diniensional restaurant floor plans submitted t/ .C. Full menu-Five(5)copies.of full menu submitted.(for grease.trap variance requests only). T D. Signed letter stating that the business owner authorized you to represent the owner for this request if applicable. IMPORTANT: If on Town Sewer,applicant MUST submit package of all documents on this list to:Griffin Beaudoin,Town Engineer, 382_Falmouth Road, Hyannis,MA 02601 508-790-6400 within a day of this submittal. . i Fee Submitted*$95.00 for the grease trap variance. Variance request submitted at least 15 days prior to meeting date. Board of Health meets once a month. VARIANCE.APPROVED John T.Norn►an. MAIL-IN REQUESTS NOT APPROVED: Donald A.Guadagnoli;M.D. REASON FOR DISAPPROVAL i F.P.(Thomas)Lee Daniel Luckowz,M.D.,Altemate 4:\Application Forms\VARIREQ Grease Trap 2021 3-1-2021.docx y Crocker, Sharon From: McKean, Thomas Sent: Monday, March 29, 2021 9:40 AM To: Crocker, Sharon Cc: Daniel Lucskow, M.D.; Donald Guadagnoli, M.D.;fplee@horsleywitten.com; johnnorman12@comcast.net Subject: FW: Mi Pueblo, 559B Main Street, Hyannis Attachments: S KM_C45821030513380.pdf From: Beaudoin, Griffin Sent: Friday, March 05, 2021 12:48 PM To: McKenzie, Marybeth; McKean, Thomas Cc: Boule, Andrew Subject: RE: Mi Pueblo, 559B Main Street, Hyannis Hello Tom, Today we received the attached grease trap variance request form for this property. As you will recall, about a month ago I sent the below email outlining our position on this property. Summarizing the below email: • It is our opinion that a grease trap is required for this establishment. • Given the circumstances, it is our recommendation that the owner be required to present plans and a schedule for the installation of a grease trap for the establishment before the end of the calendar year, with installation of a grease trap within one year of the variance hearing. We feel that this is a fair and reasonable compromise given the circumstances. Please let me know if you have any questions. Thank you, Griffin Griffin Beaudoin, P.E. Town Engineer Barnstable Department of Public Works 382 Falmouth Road - Hyannis, MA 02601 P: 508-790-6400—C: 774-487-9663 griffin.beaudoin@town.barnstable.ma.us From: Beaudoin, Griffin Sent: Tuesday, February 09, 2021 12:55 PM To: McKenzie, Marybeth Cc: McKean, Thomas; Boule, Andrew Subject: RE: Mi Pueblo, 55913 Main Street, Hyannis Hello Marybeth, Thank you for reaching out on this matter. I had heard about this last week, this is a very sad situation. That being said,the Mi Pueblo grease trap discussion is a long standing issue that ultimately needs to be resolved. In 2013,the BOH granted temporary permission, until August 20, 2013,to operate the establishment without a grease trap. The variance further states that a grease trap was to be installed on or before August 20, 2013. This was never done. Again in 2018, a grease trap variance request for the establishment came before the BOH. The Health Dept sought DPW's input at this time, where the DPW recommended installation of a grease trap within 60 days. Ultimately,the BOH voted to grant the variance. Given the circumstances we are willing to allow the establishment to continue to operate in the short term. However, we feel very strongly that a grease trap needs to be installed at this establishment. Given that this will technically be a change of ownership, does that establishment need to reapply for a grease trap variance? If so, it is our recommendation that the owner of the establishment be required to present plans and a schedule for the installation of a grease trap for the establishment before the end of the calendar year, with installation required within one year of the hearing. We feel that this is a fair and reasonable compromise given the circumstances. Thank you, Griffin Griffin Beaudoin, P.E. Town Engineer Barnstable Department of Public Works 382 Falmouth Road - Hyannis, MA 02601 P: 508-790-6400—C: 774-487-9663 griffin.beaudoin@town.barnstable.ma.us From: McKenzie, Marybeth Sent: Tuesday, February 9, 2021 9:32 AM To: Beaudoin, Griffin Cc: McKean, Thomas Subject: Mi Pueblo, 559E Main Street, Hyannis Hello Griffin, This is a sad story. The owner of Mi Pueblo has died from COVID and so has their other brother. Arreola Valdo called the Health Department because he is the one brother left and he is trying to take over the business. There had been some concerns because of the variance for the GRD in the past because they are on sewer. He has been directed to other depts., but he is trying to work as fast as possible. He is taking over the raising of Enrique's 3 children left behind too. If you want to speak with Mr.Valdo, his phone number is 972-998-9425. Please let us know if he can continue being open and change his license information and apply for a variance at a later date. If you have any questions I can help you with please feel free to contact me too.Thank you for your attention to this matter. Regards, Marybeth McKenzie R. S. Health Inspector Town of Barnstable (508) 862-4644 2 LO Cci tic � ; + -,,� � � � � - � (;, � - —' � � •'b� aj IAO. Ise 0260l r goo a O,,r" S eat S � ell (YAplay �c� � � S f t� t ra E vi- a y - ni " l t .r Or t ' t fnAQ .d T' T 1E _j 0 . , 'O � z} .� i so- T zu t _ )W dul 9191VBNGv J0 NMOI 1 71 77 GUACAMOLE G prepared-avocado,tom.ato,onio-n> 1antro,chile serrano,bme QUESO FUNDIDO f melted chibuabua and monterrey cbeese mfx 1vitb chile pobl.aal-O" peppfrs, sewed w ith tortillas Chips 949 add chorixo Co `I III PUEBLO 'NACHOS fresh corn tortilla ch ps,topped raouterrev cbeese,guacamole,blaek beans,tomato, scallions,jalape]aos,pico de galld,crema £re.sca add chicken or steak. MM qq - CaTICHE DE CAMAROI*t shrimp c;eviche,cit-rus tommato hrotb,diced onjon2c lant_ro,serrano pepperst r tc�rnatfl,avpcad .sc cd with cbip's 9, TANIALES vp 5tcamcd cooked chic4xi And park tamalc5 topped W' itb tounatiUo 5aucc, crema fresca,pickled onion VwW C." . Tostadas 2 shrimp and octopus Cevicbe tostadas,citrus tomato broth,diced onion,"cilantro,cilan /�, ser-rano.FePFers,to aro:a;ocado SSM�- 10 ' �) :a ONG _ r u "-,, s� . a p F TACOS DURRITOS `. .: soft �e�►xn tc+rt4lla,scrvC+ With diced onign, stuff d with ' "'Can, ice,bla l�c�nsx. eiltt trt� eh4ieQ stC k, cher zo, len0a pi de gallo,monterrey chess- a t�Pped r Rl . al pa-tor, enrnitas, alam 50kyith tomatillo Sunce grad Crema,fresca, C°A0,C 170 i CY\ r 60�6 sIdC of guacata ole FrACQ Fv chickens cnrne.aso A S9.0)9 i - Catch of the day camtas 9 ;rillod vac ie- ;j soft dour tort ilb Copp d with shred- ded tided Icttucc in a picw do llo,chapot6 aioli saUcc UESADILLAS I r4 TORTA anClt d 0 C€r C Me gUCsadilla P tine de res (ShrCdd d beef x . Brcadca chicken or ISteuk,lcttncC,orlapn, r tomato, ny4,jala ..tin a de poll ShrCd led chicken pelos,ati ado ( `� r CARNITAS TORT. % ith jalapolos-� ehorlzo att d Oi Xaca cheese SW" y PUEBLO TORTtI F�UTAS .', I s dCd bt€�tk. d C1�iCl�Cta,lti �ru c d�` 4 rolled crispy corn,to fi a v m�nye,blacl£ bCaraS paare�,chips�tic union, ,��ith Chicken topped with lettuce, t mato W.99 naQn,cretna fresco J om-ata11� CA Ck 105 r r v , - I _ r _fir s1',ni';��,�FN�'� :h.,y71�.¢...�.�- ,.�.�k-mil✓. 1- -�F`*� �. < -. n aF »'�'S"' cS...,�Y� t `� "s' � } � C Yv1 .. :.. v. _.�. .. .\3• a_.. '� a .�+. .: a'ly .rova-r j rn:..�..'_�:L._ �..f•...� ...'ix..ti .F_ c+5... ':.ri. ._ '?. iY S �,< #' .� l r s CHICKEN MOLE POBLANO chicken breast topped 'wxith II:mle FobLzno,accompanied witb m-nchero pinta beanzt ' r►a��isan rirfi,c►inl>e is mad; Qf,�enar�xc ss�r,�tralsaut;drop.-° ch;nis�tc}�ocai3tc CHILE RELLEN J; lightly c.R l?att�ercd ehiic pDbJano R ufffied vdth coti"a chavic or tcadi€ic ffcand kncf, x atch r inrfl bgOns,raerican ricettc►r+m sauce z ... .. MCT�II.:�T]r�� thrcc soft C%.r_n tortiases filled+with chicl toppcd with tomatillo ssio,oa-m-.c-a chcp-s a Ocfompa icd velth B'ancbero pinto bcNns mcxkan rice crema fscsce CHICKEN "WOLE E-NCHILAUA } }' three soft•, eom tbitillP.s Red with chickca toppcd with molc se,occ,®ccampanisd V h rancJtero pinto beai&mexican r1ce,d1ced onion,creina fresctxotija cheese PORK C/M11TAS Q101e xien favroriCe) S C{� stew roasted pork sbo alder,accompaaied with Cora Qortgttas,rancbere, Pinto beans, V. m xican rice,tomatillo sauce CAR1 E ASADA € - i rilled-atkirt oteak,with -crapev of chile peblaao and grilled anion tapped with ®erica amazcc _ and crc enca,accompanied with mochcra pirate beans,meximn rice. -ml PLF-BLO PLATE$ - ' `- - enchilada suiza,pork tamalAbde rctleno a:uqed with Comm cheesesccomF anied with 1 � rancharo pineo bo- no^-exican rice 1£ sauteed snarinaecd shrimp g€l. garlic&a s .accompanied wlti ecial;s ice rice and salod COC�'I'�€,>�1; C�rt:�ftO N WSi5�7.';a _ l< t sba* p cocktail c6tturs lime tom,4to broth,gnjo-%to mnto;cits_muo f - sCTro-no pop&rs.,fiaisbod vhth fresh afoc.-, €cu do smod with saes crackc_s e'16`lr S CHICKEN i sty; tl l"7j -�Ct sauced shaskvn or steak with chile oblano,onion, set and red �I9 .a► er sc 1' [ ,p s, Cmps�asc� satacbe,o piniv bean.-,Mexican rice 00 HUARACHE OfqP- corn aria l3atbread,tipped wlib griped rikirt d ak blank beoa pta ee,ddiced onion attd c �tro,ciUja chaesc,eboose of morita-;ace w teat Lmu sauce i } +rA k i.v—.:.?i# jc- •Y t .>YT �..<'. �x. A a _..J. R ,y.,., _ G 1 i Y ' .Y ..�.es.�.-e.•' M+u+.+re+Y �e+,} :".P�^�e+_tr: ._t i ,:+�M'�'._ +e. DRINKS S LAVS pepsi,coke.sprite $1.75 chop iceberg lettuce,nopales(caetus),tomato, f jarritos $ 1.75 red onion,avocado,mandarin,cotija cheese $6.99 tarnarijndo add chicken $7.99 or shrimp $8.99 t Yv r lime chop iceberg lettuce,jicama,cucumber,onion, naranja olives $6:99 -add chicken $7.99 shrimp $8.99 r: } sangria KIDS TVIE U A,GUA FR SCA $1.75 cheeseburger w/fries $6.99 -horchata chicken finger w/fries $5.99 jamaica grill cheese w/fries $4.99 �-- ti ... SIDE ORDERS chesse gnesadilla $4.99 frijoles(_ran.chero beans) $2,00 DESSERTS - E` arrox (rice) $2.00 flan $2.99 rice pudding $1.99 4 guacamole $2.99 cake tres leches slice $2.99 F: ' french fries $2.00 z When placing your Qrder,plense inform your server if o per9en in your party less a focod a lergyY �. eonovining €aw or undercooked foods may Increase your risk of feud Lorne ,llneaF. s? - .�.f �. �:..�i _ .v: 4 :.:{tJ x�,t 3. --.� F�. - �„xd .� .}i'`�'�" .'3`��-b sv'.sr-1�* 'y¢"�„ i F: IN 5 evil °'.. ,'' s"�4Tr' PK Fes^ { 7ij}' ��--.• ,'e--� sCs"�t ..N" r: s, P f �s> ,s v'5 �t�,�. —'Sfi�i i e s f 22 s i IAz19 •�s-�.- _.�,y 'fin- �r� d rs r ysle�, �.y aV�S` 7S'-- "'- >++...i.�» �} �s ..i' +_ i Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. aARNSTABLE. Paul J.Canniff,D.M.D. lMAK'S& F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems 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: 899 Issue Date: 04/15/2021 DBA: MI PUEBLO OWNER: OSVALDO VALDOVINOS Location of Establishment: 459-B MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 22 OutdoorSeating: 0 Total Seating: 22 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - - - - --- - ------ MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE j Restrictions: On 03-30-21 granted 12 month extension on grease trap variance until 04-01-22 may operate with existing GRD system as long as it is properly maintained on a monthly basis with maintenance receipts onsite for viewing. This is establishment is required to use paper plates and plastic utensils-DISHWASHING IS NOT AUTHORIZED. • ca For Office Use Only: Initials: Town of Barnstable Date Paid QS Amt Pd$_� WWSMBLE. : Inspectional Services '059. `0� Public Health Division Check# each s �fD MA't Thomas McKean, Director 200 Main Street,Hyannis,N A 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP X RENEWAL NAME OF FOOD ESTABLISHMENT: e , 10 ly\C ADDRESS OF FOOD ESTABLISHMENT: 5 1—1 lY l AIn S�_ O YDii Y S M G o Z6© 1 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAILADDRESS: ��Ye��a—.�G1��C �� IM(��1 C�►`� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: S( o�)1_3_1- 15757 �( TOTAL NUMBER OF BATHROOMS: WELL WATER: YES_NOX ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL:_ SEASONAL: DATES OF OPERATION: I / / AW TO J.Z./3) /21 NUMBER OF SEATS: INSIDE: ;?ol, 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)? g D 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 OTiN�TER]INFORMATION. i FIZL NAME OF APPLIG���I C �f' c(LA 0 !� 1 �0\1 I V) SOLE 6UNI ER: I'ES!NO D.O.B OXVNER PHONE.# l 7 Z- q ! ADDREss J. QyC�y YV'1uS ✓ S�� 0,r/oIau �� vj'1 pZ� 6U CORPORATE ON'VNER: CORPORATEADDRESS: CAtA Vi 15 a 0Z6 O PERSON I1 CH_ARGE OF DAILY OPERATIOfiS: �0 V Q l jV 1VLZ>S List(2) Certified Food Protection titan -e-rs A1N-D at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISIVNIUNITS must have Y Certified Tood Protection Manager PF:R STIIFT. "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. O Vi COY 5 / Z Z I. �UY� r` r z. CQd��s lYe s Z fj 3 z s 2 i SIGNATLrRE OF APPLICANT DATE ***FOOD POLICY INFORIIIATIONT*� SEASONAL FOOD SERVICE:All seasonal food. establishiiients.including mobile trucks nnist be inspected by the Health Dior. prior to otienm��9 Tiease call tlealfll lily.at z11�- +r�'1-1b to sctlecttile yotu'lnspectlon. 3'iease cast�itteast(1)c►a}=s"uict�allcz. FROZEN D.AIRY'DESSERTS: Frozen desserts iniust be tested.by a State Certified lab prior to openili2 and monthly thereafter. vvith sample results submitted to the Health D' Fak'i111ti�it-,ib i'�%mi1`ill iYll ai15 St31J�U1P61''iCi`uiiil Ull'Sl£}Tvlll''a�iU2C92 L�3 �3'i Permit 1111til the above terills;are Illet_ CATERI\:G POLICY: Anyone who caters vithin the Town of Barrislable must notify theTo1Vt71 by fax or Iuail prior to catering, event. Yoti must complete a catering notice fotuld alt http:/Iis?Ni�1v.townofbai-nstable:us/'he;ilthdii isiour' pphcations.»5p. OUTDOOR COOKING: Outdoor coo".papa ation;or display of any food product by a food establisluuelit.is prohibited. NOTICE: Permits 11111 aru'ivally from Jallllary,1 st to Dec. 31''t each calendar year. IT IS YOUR RESPONSIBILITY TO RETU;R i THE CONIPLETED:IAPPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:.Applicat ion ForihsTOODAPPREVS-0iMoc ' (V� Bellaire, Dianna From: Crocker, Sharon Sent: Wednesday, March 31, 2021 5:47 PM To: Bellaire, Dianna Subject: RE: Board of Health Agenda -Tuesday March 30, 2021 meeting Attachments: FOODAPP 2020.doc *** Dianna, we have waiving the fees for this (as done with Kara Quinn-septic) Thus, no new establishment fee (just new paperwork, and if his brother paid for YR 2021, we will apply that. I DID NOT send email below,wanted to check w/you on payments first. Please send him the application attached and let him know whether the annual payment is due. Feel free to send your own wording/email O thanks. Sharon Hello Ozzo, Attached is the food application. Please fill out. I will let Dianna know the New Establishment Fee (for new owner) will be waived. The annual fee for Year 2021 would be due. You can drop off the application in the Health box at 200 Main St or mail it in. If you have any questions regarding the food permit, please email Dianne Bellaire at: Dianna.bellaire@town.barnstable.ma.us or call her at 508-862-4643. r I lJ Thank you. Sharon Sharon Crocker Office Manager Town of Barnstable—Health 508-862-4739 '11.1e information.contained.in this electronic transmission ("e-mail"),.i.nchtdi.ng any attachment(the"Info.rniation"),may be confidential or otherwise exenxpt from disclosure.It is for the addressee,only.This Information may be privileged and confidential work-product or a privileged and confidential communication.`Fbe Information may also be deliberative and pre-decisional in nature.As such,it is for internal use only.The Information may not be disclosed\vithout the prior written consent of the Director of Public health anti/or the Town.Attorney's Office of the Town of Barnstable.If you have received this e-mail by mistake,please notify the sender and delete it from your system.Please do not copy or forward_it.'I'lian.k you for your cooperation. From: ozzy arreola [mailto:arreola valdo@hotmail.com] Sent: Wednesday, March 31, 2021 1:47 PM To: Crocker, Sharon Subject: Re: Board of Health Agenda -Tuesday March 30, 2021 meeting 1 Hello, how are you, Mrs. Crocker Sharon, now what happens next? Who I need contact to get the permits? Sent from Outlook From: Crocker,Sharon<sharon.crocker@town.barnstable.ma.us> Sent:Saturday, March 27, 20214:04 PM To: 'ozzy arreola' <arreola valdo@hotmail.com> Subject: Board of Health Agenda -Tuesday March 30, 2021 meeting Hello Osvaldo, Attached is the agenda for the Board of Health's Tuesday meeting. You'll see meeting ID at top of agenda. Please sign into Zoom by 2:50 pm so our I.T. people will be able to sign everyone In prior to video-taping. Please let me know if you have any questions on attending it through Zoom. Thank you. Sharon Sharon Crocker Office Manager Town of Barnstable—Health 508-862-4739 The information contained in this electronic transmission("e-mail"),including any attachment(the"Information"),maybe confidential or other,ise exempt from disclosure.It is for the addressee only.This Information may be privileged and confidential work-product or a privileged and confidential communication.The Information may also be deliberative and pre-decisional in nature.As such,it is for internal.use only.'.['he;lnfoi rnatioia may not be disclosed.without the prior written consent of the Director of Public Health and/or the Town:�ttorney's Office of the Town of Barnstable.If you have received this e-mail by mistake,please notify the sender and delete it from your system.Please do not copy or forward it.Thank you for your cooperation. CAUTIONThis email originated from outside of the Town of Barnstable! Do not click Links, open attachments or reply, unless you recognize'the sender's emailaddressi and know the content is safe! 2 Town of Barnstable BOARD OF HEALTH t John T.Norman _ Board o1 Health Donald A.Gaudagnoli,M.D. WiRNSTAUM . Paul J.Canniff,D.M.D. MA 02601 F.P. Thomas Lee Alternate � 200 Main Street, Hyannis, �- 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: 899 Issue Date: 01/01/2021 DBA: MI PUEBLO j OWNER: ENRIQUE VALDOVINOS Location of Establishment: 459-B MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 22 OutdoorSeating: 0 Total Seating: 22 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q.� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Approved-09-25-18 to operate with existing GIRD system as long as it is properly maintained on a monthly basis with maintenance receipts onsite for viewing. This is establishment is required to use paper plates and plastic utensils-DISHWASHING IS NOT AUTHORIZED. f ,H i �TNE t� Town of Barnstable� For Office Use Only: Initials:� Date Paid ro Amt Pd$ � BARNSfABLE Inspectional Services p Check# s '�I' Cur i639 `e� Public Health Division AtfD MA'S�` 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 & Z0ZO NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: M f Po e, b 10 ADDRESS OF FOOD ESTABLISHMENT: "l 5 C( "6 M ct t r, 54 P y ct n 4 i,$ Met o.2601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): }� E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( 0_1- 15 75 TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: OUTSIDE: © TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? 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 T OWNER INFORMATION: FULL NAME OF APPLICANT tf�)"y/live, 01 SOLE OWNER: ®E /NO D.O.B OWNER PHONE# 508 Z 9•Z �C 2, F3 X ADDRESS-3�10 DQ 1<14 f?Gl Roca I�1/C//11 dl [$ �i 02 ,601 �C CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: y! l./ ��QiJ I n dS List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. 1`I CCLYJe.) 6146uinos 3 l / 1 1 I. L 1, ay , LV Akle SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.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 1 st. Q:\Application FormsTOODAPP REV3-2019.doc l_ f Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARNSTABIZ Paul J.Canniff,D.M.D. i 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 899 Issue Date: 12/10/2019 DBA: MI PUEBLO OWNER: ENRIQUE VALDOVINOS Location of Establishment: 459-B MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 22 OutdoorSeating: 0 Total Seating: 22 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Approved-09-25-18 to operate with existing GIRD system as long as it is properly maintained on a monthly basis with maintenance receipts onsite for viewing. This is establishment is required to use paper plates and plastic utensils-DISHWASHING IS NOT AUTHORIZED. For Office Use Onj& Initials: ,TNEE Town of Barnstable Date Paid Amt Pd s G a:._ : Inspectional Services KAM 16 • `�� Public Health Division Check# Thomas McKean, Director Iq 200 Main Street,Hyannis,MA 02601 l ra; Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE l NEW OWNERSHIP RENEWAL tl NAME OF FOOD ESTABLISHMENT: 4polC Poe 6 Jo ADDRESS OF FOOD ESTABLISHMENT: 759— 6 Mom S1 /(L'�i�n l S MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( ZZI -1,52S TOTAL NUMBER OF BATHROOMS: 2 WELL WATER: YES NO V.. (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: 2 O OUTSIDE: 0 TOTAL: Z SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING_ REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? N IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? NO TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) J/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 REQUIIRED) 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 QAApplication Forms\FOODAPP 2020.doc i r � k . OWNER INFORMATION: FULL NAME OF APPLICANT , SOLE OWNER:EY5 /NO D.O.B ® OWNER PHONE # ® ZQ Z, e ADDRESS 3�10 6*&1Q, C! 7, 60 ���-�Ar.e g dKr, 02XO ^V CORPORATE OWNER: , /4 CORPORATE ADDRESS: /V ( 4 PERSON IN CHARGE OF DAILY OPERATIONS: j !e, /cam 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. at,l;ell c Lohy/c 5L- i1 izQZZ1 i ia 3 2.)ZIPS%ate L QIY1(Y � >/ 12o�`f SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/heaIthdivision/apylications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Wpplication FormsTOODAPP REV3-2019.doc r s ' Of iM6E? Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. rARNSTABLE, John T.Norman g 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 899 Issue Date: 12/20/18 DBA: MI PUEBLO OWNER: ENRIQUE VALDOVINOS Location of Establishment: 459-B MAIN STREET HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 22 OutdoorSeating: 0 Total Seating: 22 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - --- - MOBILE-FOOD: MOBILE-ICE CREAM: �� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Approved-09-25-18 to operate with existing GRD system as long as it is properly maintained on a monthly basis with maintenance receipts onsite for viewing. This is establishment is required to use paper plates and plastic utensils-DISHWASHING IS NOT AUTHORIZED. r For 0 1, �k F roy, I nitials: Town of Barnstable Date Paid Amt Pd$ &uwffrABLE. Inspectional Services vQ i6J9. 4eTFp►�'s Public Health Division Check# Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 l•-� l Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE•A/FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL (/ NAME OF FOOD ESTABLISHMENT: /M I /0 y5/3 L d ADDRESS OF FOOD ESTABLISHMENT: L/5 q ,8 �v►G in 57� �Vc�n✓1 is �� 0-7 dD/ MAILING ADDRESS(IF DIFFERENT FROM ABOVE): Sd3ry1 E-MAIL ADDRESS: eAri9j.rz#88&8!S1-taj i C0,14 TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (5-0-a)7-7—/ - IX�.5 TOTAL NUMBER OF BATHROOMS: .21— WELL WATER:YES NO_)L ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: Zv OUTSIDE: TOTAL: QPQ 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)9 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 'U 0/dn U I✓!OS SOLE OWNER: ES/NO D.O.B AlIZZ119 Z5-OWNER PHONE # 50eg 0 9? y/-Ztq ADDRESS3 y0 OQA Zoj1d —Ioe?d h1 yoA11 fS mo O?f b1 CORPORATE OWNER: FEDERAL ID NO. : XM fo�f D CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: &—y r,(/feyt oS List (2) Certified Food Protection Managers AND at least (1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Aller en Awareness Expiration Date 1. 61(-717CG I hoyiq bQ9n6s,-3 l Z l l;3 /201. 1. 67,Y/Qur, kyld ,i ,,S C) L2 023 2. Wh 85 / 15 /ZOZZ �22C�kf(f, '�/y2oS l l�� l ZOO SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/apl)lications.asy. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec. 315`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Application FormsTOODAPPREV2018.doc j, I�UuJoLc) Bellaire, Dianna From: Stanton, David Sent: Tuesday, December 04, 2018 4:17 PM To: Bellaire, Dianna Subject: RE: Mi Pueblo Yes the are ok with the inspections. The did get a variance for no grease trap recently, so that should be listed on the Y p Y permit. Thanks, Dave From: Bellaire, Dianna Sent: Tuesday, December 04, 2018 4:01 PM To: Stanton, David Cc: Bellaire, Dianna Subject: Mi Pueblo Hi Dave; Just want to confirm if you are okay with Mi Pueblo for 2019 permit? Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us 1 pp IKE T� TOWN OF BARNSTABLE _ HEALTH INSPECTORS Establishment Name: Date: l / Page of 4 OFFICE HOURS �P PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. .200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 9 �0� HYANNIS,MA 02601 MON.-FRI. ,679• No Reference R Red Item PLEASE PRINT CLEARLY 410 -"""�� FOOD ESTABLISHMENT INSP CTION REPORT 508-862-0644 L Name Date T e o T o ns ction Oo ation(sl outine V\A- 64"o, 5�; 'o" Address Risk ood Servic Re-i ion Level revious Inspection Telephone ✓ Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness AA A4,q- Caterer General Complaint Person in Charge(PIC) Uvv- i Bed 8 Breakfast HACCP I Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) / FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands L - ❑ 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 ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations L Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: II kor Yes Non-critical(N)violations must be corrected immediately or 01 within 90 days as determined b the Board of Health. Overall Rating 1 y y � ® Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ® Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils FC-4 590.005 B=One critical violation and less than 4non-critical violations g ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 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. s violation,4 to 8non-critical violations within 10 days of receipt of this order. =C. 29.Special.Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster scre ed fr=publicew Permit Posted? YN as�Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Sign ture Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives. Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7-101.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130'F* Applicants* 7-20 .11 Separation-Storage* LIP_ 0 Time as a Public Health Control 3-302.11(A) Food Protection* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and 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* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* 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 Equipment 5-101.11 Drinking Water from an Approved System* * 88 Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Epecnve mnoo/ 4-602.11 Cleaning Frequency of Utensils and Food Animals-155'F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-40111(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* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )O 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-203.18 Shellstock Identification ( ) Item Good Retail practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients[0 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures 1 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 1 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S.590Formback6-2doc 'Denotes crifical.item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date, Page of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3 • .0 HYANNIS, MA 02601 sos-s-FRI. No Reference R-Red_Item PLEASE PRINT CLEARLY 'FO1A�`� FOOD ESTABLISHMENT INSPECTION REPORT lI I Name G Date Type of ectio p utine Address Risk Food S Re-m Level Tatail Previous Inspection Telephone �rorl i �5 Residential Kitchen Date: L 1 1 Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) YL ime Bed&Breakfast Other CP / Inspector V Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) - FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives en ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals L 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 i ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY. ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories (] }�h -� Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 1-06 �v Critical(C)violations marked must be corrected immediately. (blue&red items) I� Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating G/ within 90 days as determined by the Board of Health. ® Voluntary Compliance Employee Restriction/Exclusion ❑ Re-inspection Scheduled Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,'when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food'and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than Orion-critical violations 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 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 8rion-critical violations=C. 29.Special Requirements (590.009 Y P 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumps r screened from public view , Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures Accorm":g:. 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding, 2-103.11 Person-in-Chazge Duties 3-302.14. Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage*Applicants* 3-302.11(A) Food Protection* 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 3-304.11 Food Contact with Equipment and Utensils* * 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � � Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical 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 Pntahle.Prinking 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 Lrmiediate Seiviuc 145°F 15 see* 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* Ef°five 11112001 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 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 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under 929-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* * (Blue Items 23-30) 3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°17 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41"F/45'F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. . Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food.and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. i *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. op�ME r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of v` L 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 � ,e39. HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item - PLEASE PRINT CLEARLY prFo Mr+�p, -862-4644 FOOD ESTABLISHMENT INSPECTION REPORT. 508 Name Da f Tye of T Inspection O ation s .outin Address Risk d S Re-inspection Level Retail Previous Inspection Telephone (, Residential Kitchen Date: L Mobile Pre-operation Owner Loe HACCP Y/N Temporary Suspect Illness t Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP (4 Aulkloo'- In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items, Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ t[1 Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands i ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities /�r� U, EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives �Y ❑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 01� ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Lo 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. 26.Water,Plumbing and Waste_ (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically o la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of 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 t3 non critical violations=C: w 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.��N ed from public view V . V _ Permit Posted? Grease Trap Previous Pumping Date Grease Rendered Y N V��W #Seats Observed Frozen Dessert Machines: Outside Dining Y N IC's Signat Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding g 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH. 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(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 I 3-304.11 Food Contact with Equipment ment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* I 7-204.11 Sanitizers,Criteria-Chemicals* 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* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and * � 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 9-401.1 l A(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* Ef cli a 1112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency 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 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Chemical Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.l l(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and AutWildhority Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A g 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) 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 .003 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3- * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41'F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.00�. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF11 E rok TOWN OF BARNSTABLE . HEALTH INSPECTOR'S Establishment Name: V e- u Date: 2 `� Page:._of / p 'Lam OFFICE HOURS PUBLIC HEALTH DIVISION s:oo=saoA.nn. BARNSTABLE. • 200 MAIN STREET 3:30-4:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 63q: HYANNIS, MA 02601 MON.-I Ri. No Reference R-Red Item PLEASE PRINT CLEARLY . o 508-862-4644 - 'FON1P�a FOOD ESTABLISHMENT,INSPECTION REPORT 1 Name �� .O Date / T e o ?t I s ection / O e S ou. uy Address Risk ood Servi Re-inspection Level Re Previous Insp tion Telephone Residential Kitchen trelh Date: �� Mobile Pre-o tio�i ° Owner HACCP Y/N Temporary Suspect Illness v _ Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP In: Other Inspector v _ Out: Each violation checked requires an�explanation on the narrative page(s)and a citation of specific provision(s)violated. u Violations Related to Foodborne Illness Interventions and Risk Factors Red Items �' L - OG� ( ) 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 Asa 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 O ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories (^ Dh Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue$red items) a'I I O) ® Corrective Action Required: [ lo Yes Non-critical(N)violations must be corrected immediately or Overall Rating I 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 todaWheitems ❑ 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 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations.observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violat' n,4 8 ori-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspect is Sign r Pr' 31.Dumpster screened from public view �V?- Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Desseit Machines: Outside Dining Y N PIC's ignatu 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 Law Cooled to 41`F/45'F Within 4 Hours* ( ) g14 Food or Color Additives 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* . - 19 PHF Hot and Cold Holding g 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 Informat ion-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* Require Reporting by Food Employees and Contamination from the Environment 7-101.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 7-2011 Separation-Storage* 20 Time as a Public Health Control 3-302.11(A) - Food Protection* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-P 3-501.19 Time as a Public Health Control* * Presence and Use* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements Contamination from the Consumer 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR- - 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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 3-20LU Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 1 g Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 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 E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective uuzooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-155`F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11 C 3 Whale-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and AutWINhority Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* ( )( ) P Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140'F* Blue Items 23-30) 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identifica[on Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004 J Labeling of Ingredients* Supplied with Soap and hand Drying Devices () 9 9 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. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S.,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. f W 3e-,r DATE: $95.00 FEE*: ' MAW' $ Town of Barnstable c 7 1639. �0 REC.BY: d4A_.� Board of Health SCHED.DATE mac) : 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 John T.Norman FAX: 508-790-6304 Donald A.Guadagnoli,M.D. F.P.(Thomas)Lee Daniel Luckowz,D.M.,Alternate GREASE TRAP VARIANCE REQUEST FORM LOCATION _Property Address: 5��_ 3 da(i t, 4 )A-yG a yy S �I/L--1 C Z6%0 1 Assessor's Map and Parcel Number: '- _ BusinessName: ft pet b1p I VLL CONTACT PERSON ATTENDING MEETING: tvYV�� BUSINESS OWNER'S NAME I€ycT a owner,did owner ofbusiness authorize ,l /� ` you edit him`/her? Yes ` No Name:� ti i'( �L�QV r1 �� « YV1W1 G NY 0'4 6 I Name: LS VCt' Cu Cl I (' U f✓l�i + l �)71 SS Address: IL, w c',lJQ vt� y� ) (4 ,; C:U Jet V� V114 Address: ' @0C, A Q11' S-1 Qy- Ct e,' yU.V lt`IO cal t< t , O z61 y Phone: 64 U` U ? �c Phone: C( Z 9 g'" C1 7 2_ S EMAIL: EMAIL: Cl Y�(e 0�Q A G(j e' cL 1U 4{ixj . [0 a j VARIANCE FROM REGULATION Uncl.Reg.Code#) REASO FOR VARIANCE (May attach separate sheet if more space needed) clr-ease V On Town Sewer LJ On-Side Septic System LLJJ Checklist (to be completed by office staff-person receiving variance request application) Please submit five packets,each containing A-D(below) A. Five(5)copies of the completed variance request form. v B. Five(5)copies of labeled dimensional restaurant floor plans submitted ��t�r C. Full menu—Five(5)copies of full menu submitted (for grease trap variance requests only). T D. Signed letter stating that the business owner authorized you to represent the owner for this request, if applicable. ✓ IMPORTANT: If on Town Sewer,applicant MUST submit package of all documents on this list to:Griffin Beaudoin, Town Engineer, 382 Falmouth Road,Hyannis,MA 02601 508-790-6400 within a day of this submittal. Fee Submitted*$95.00 for the grease trap variance. Variance request submitted at least 15 days prior to meeting date. Board of Health meets once a month. VARIANCE APPROVED John T.Norman MAIL-IN REQUESTS NOT APPROVED Donald A.Guadagaoli,MD. REASON FOR DISAPPROVAL F.P.(Thomas) Lee Daniel Luckowz,M.D.,Alternate Q:\Application Forms\VARIREQ Grease Trap 2021 3-1-2021.docx v s kz goo S1 o d ;t y s fly °i — Ir '.! S:ti: a a z". .g�",0.° oft. .u' _ - ''"$. 3 *!4*x •�Xr t to YU F� 3< XtS—.� ::�$ - d;•=�.E-may._ �.d:..S3 _y A t Y h r'P f4 C � T � �, ,y "`r-Vz;. r YrF _ ,✓ r .,� R 4 �� L r < z dd en l kv 'tea Ja -rs 5 fr f �M3- �/f Y.z �F K36-417, ` Y+ 1.vir Y sY y c• Y �99 • L ,$y r'Sia �, > r sSc�' `-,c+-3 ..Ms•' v.r• 1 - 10- t - ON M U,=A gr -. ,ggm-, .Y- Nfll Elie 319blsUV2 Jo NMOI GUACAMOLE Prepared-a�•ocad�►_toato,gniom> 1antr4,chile serrano,lime �� c\ _ PESO FUNDIDO I melted cbihnabu3 and montc_r_rey cbeese mi_x with cbxle pobl_ano peppers, served with tortillas chips 9w9Y add chorizo --RL-- n i4II PUEBLO NACHOS fresh corn tortilla chips,tepped % ith monLerrev cheese, guaeamole,blark beaas,t ffiato, scallions,jalapej!os,pico de gallo,cremaa fresca &AM add chicken -or stems CEO;ICHE DE CANL: RON shrimp ce icb-C-4truk tomato brotb,diced onion,cilantro,ser-ran.o peppersr tQmato,avncado,sccvcd with chips �� .CA CA TANIALES t3vo Ocamcd cookcd chickcrt and pork tamalc5 toppcd With tomakiUQ 5ancc; _ crerm.a fresca,pickled union S&W (a Tostadas = 2 shrimp and"octopus ceviche tostadas,citrus tomato broth,diced onionxilantro, serrano peppers,tomato,avocado io '911 . at1Qs Y_y..rt.�.Np.��.rr �r.-s�•.r-g++r ..t-"'r P•":_� -•� �rwr+.'rxv...rr-�•.�s•'.u-sn`.v+'V-..+..''fit '^.T"!""T^ - �'s'Y�c..�.�}�aa.��rF ry :. TA soft corn tortilla,scmd % ith diced onion, stuffed with r_r�exican rice,black bcans, cilantro chorces= steak, chorizo, lengua pica de gallo,monterrey cheese topped ; r al pwitor, carn i 3.5c vith tomatillo suace and cream fresca, C' ,rk��L c,5, � side of guacamole { FISH TACO _l chieken� cache a3ada s9owU,� � I jh: catch of the day ; f earnitas :'�9 grilled �veggie9, IC . R` soft flour tort illa,topped with shredded lettuce in a Pico de pllo'chipotttte/moll mucc r !� tQ QC ! R ,uES�1D1LIiS TORTAS mcltccl on-mca- chm. c- quesadilla KFM - ,�nila'neta, .5" ! t tinga de res (shrcddcd hecf) Breads chicken or steal�,lettuceoonxoa�, tinga de polio (shreddcd chicken) � � tomato,annyo,jai�,pc�os,a�o�do r . CARNITAS TORTA with )aIapc�loq 9 chosazo.and oamaca cheese a � PUEBLO TORTA FLAuTA,S 4 rolled crispy corn tortilla Breaded steak and chicket�,ham,Qyocado, p}' mnyo,blac& 6ea,n5 puree,chipotie onion, Pilled with chicken topped with lettuce, 5 tomato $10.99 oniou,cretr�a 1res ,tozna.til.lo since, \� cotija cheese L� Hs 1 %M a. �r •�3x,�.�s-�F•''�c 'a+ -,''_ f Fes':a.. � ,�� � - �"� - �'� r--1 r n�. �'�y J.y�y �z'��"'y &"v._��s'• .'�`,� :. iikk AA/✓�A J 4.e��3'.•,• 3_. '-"".-� _ f__ .e. �:sr-ii.�'��. '^'. - _'�._ rfi"c:'`_�-..__ u tw .___u __.-�;:: '`{ s..-.T,� z z -«c x -':z.. CHICKEK MOLE POB © \� chiclsca breast tnppcd tritx%W016 Foblano,aecumpanied a,itb ranchero pinto brans= t t ° rraea7san rlcfi�fi1�41C iF made 4{,seharxt e;sed'a��!iInut,dried chiGic&chacolptc 1 . ('.I-.TLf RELT,T No t*ft •, 3 ��` li hzl r e1=S haitersd chile poblano gtu: ed vrith rotija checic or picadiiic(grn4nd a ': r cl�ern pinto b ns,ira ican ritc,t4 a:n s2ucc E`JCHILADAS SUIZAS e three soft corn tortillas filled with chickca toppcd with tomatillo squcc.oe-Tac--n checsc =3. #cco anicd*math Mcherc± into bcans,mexican ris fresce E,.._ p P� �crc�a _:. three soft corn tortillas filled with chicken topped with mole saucc,acwmpanicd vat! t , 7� .:' rar ebero pinto bextia,t exic=rjce,dieed onien,Cr£ms fr�esca,cotija cbeese r ' FORK VkRNITAS(ble k-an favorita) sil@-qy ��.4C� j slaw roarud pork sbotalder,accomp 1L�d with corn Qor0as,n;wcberos ploto beans, wexican r1Cc2WMatW* saucc CARP:E ASADA g grilled-akirt ateal:,with -;tripes of chiltz peblano and grin ed anion topped wRh morita amucc and crcmu frenca,accvmpanird with raochcro pinto bczas.McxiC=a rice tail PUEBLO PLATE$ �- 4:n i1ada suiza,pork tamal,chile rel6no a:u$Qd wiah cotija e6cese,aecompanicd with ranchero Q inzo beanA,rnesisan i7cQ r ' ! winced marinazed shiirnp in garlic &Puccmpani Wit z"oed g g7 t white rice and sa,ad t (:f3l;6T 7. 1€,DF C NIARt.N T,t=Sij ' �ecla F to 1 citurs lime.to—mmo b_roth,oDjon,tontato;ciis�trs� F t' ;.sc_rraao peppera,fnisbcd v4th fresh avoc-ado scn,cA with saltines crackers.! kJ i �e 16`l fi CHICKEN ►st,:.af, r� � 1"?j �� � i`�""i Ci 1 1 sauteed chicken or stcgk with chile poblanoronton,grcca and red b�cli p-ppers,acw panicd t i T _ �-Nillt rancbere pinto beans,mextean rice HLIARACH l coda masa flatbread,topped with sgrill_d skirt slEak,blank bean Furmdiced onion and i::. c 3an2r�,c:tlja chaeuxboase •ef murita--vuce el tern LMo sauce �f Nil P., i 'r b, DRINKS StALAD$ ;..: pepsi,coke.sprite $1.75 chop iceberg lettuce,nopales(caetus),tomato, �- jarritos $ 1,75 red onion,avocado,mandarin,cotija cheese $6.99 t;a arindo add chicken $7.99 or shrimp $S.99 s.. �. iz lime chop iceberg lettuce,jicama,cucumber,onion, ouranja olives a6.99 -add chicken $7.99 shrimp $8.99 F: �r..: sangria ACIDS tviENU ai AGUA FRESCA $1.75 ,cheeseburger w/fries $6.99 f` hoarchata chicken finger w/friees $5.99 T grill cheese W/fries $4,99 jarnaica SIDE ORDERS cheese quesadilla $4.99 f� f-rijoles(ran.chero beans) $2,00 DESSERTS s arroz (rice) $2.00 flan $2.99 race pudding $1,99 {z uaearnole $2.99 cake tires leches slice $2.99 E Y french fries $2.00 wIien pin�in yc��ar order,plcaoc inform your Berm if o perBOA iD YDUr party Jim a fowl Aergy. conouining rawer undercooked foods may increase your risk of food borne illnetb. F..'.v, MR, tayx� �X.-". -3t t-fa"L - ',xf � �'`'rn ,as. a. �Sc 9 Jt' 'i'ee•�F d :+-�g { i)f}Via{j�F i E^�-�•'� a ..a n K ' • r 1 re s a .1'� r '�` t.cygr s �',ate �{ - ✓ i.xi.'r-�'�-` �µ "''k' �r Ct sl 41, s•. ���� s,,ni�-` y p, zL• - r� +ref st rn� sJ t. � :,F '� �K�4 � ts.,r 4 �^i' P � � _.,� ..xa� a- : x .if•7'� i._ -'�- � ��qj.:?3 e"- t�"t;wj - -3 \�i'rs '3�Yi^w�,a 1 na A TIMELINE-459 Main Street Hyannis,Grease Trap Issue • August 29, 2002-A variance was granted to Chandler Bosworth to utilize a grease recovery device(GRD) menu limited to chicken dumplings, hamburgers,appetizers,sandwiches, etc.. • May 30, 2013-Enrique Valdovinos applied for a variance to continue to utilize the GIRD. • June 18, 2013-The variance request was withdrawn by the applicant • — permission was ranted b the Board of Health to use the GIRD until August 20 July 1, 2013 Temporary g y g , 2013 - within sixty days. • I vinos was ordered to connect install a grease trap w t s s February 12, 2018 Enrique Va do / g p V Y • June 28, 2018-The Board of Health granted the applicant an extension until September 22, 2018 to connect/install a grease trap. • September 19, 2018-Dan Santos. Griffin (Phillip) Beaudoin and Thomas McKean met with Chandler Bosworth and Enrique Valdovinos. Mr. Bosworth stated the existing GIRD is functioning properly and is maintained each month (receipts were provided showing$90 is paid each month for this service). Mr. Bosworth stated it would cost$15,000 to install an inground grease trap. Mr.Valdovinas inquired if the Town would allow the installation of a Trapzilla, as an alternative to an inground grease trap. After consideration, Mr.Santos stated the DPW continues to recommend installation/connection into an inground grease trap; understanding that the Board of Health makes the final decision. Staff suggested Mr. Bosworth and/or Mr.Valdovinas should make another attempt to negotiate with the owner of the property next door(Embargos)to connect into the existing grease trap there. McKean stated that the restaurant is required to be closed on Saturday September 22, 2018 if this food establishment is not connected into an inground grease trap per the Board of Health extension deadline order. [NOTE: After the meeting ended, Mr. Bosworth requested to be heard at the next Board of Health meeting,on Tuesday September 25`h . Mr. McKean informed Mr. Bosworth this item is already on the agenda and he is welcome to attend. Sharon Crocker provided him a copy of the agenda..] Town of Barnstable + BAFtN57'ASLE, +' ��9- Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. August 29, 2002 Mr. Chandler Bosworth P.O. Box 685 Centerville, MA 02632 ARE ``I nterconfinental Enterr�se4591W'NV MainkStreet Hj%annis, Grease Trap r �„>�,/laaiG.f✓ii� :,�. ,r. Dear Mr. Bosworth, You are granted a conditional variance from the Board of Health Regulation, PART II SECTION 1.00, which requires minimum 1,000 gallon capacity grease traps at all food establishments. This variance will allow you to operate a food establishment, utilizing a grease recovery device at Intercontinental Enterprises, 459 Main Street Hyannis with the following conditions: (1) The menu is restricted to the submitted one page listing of foods (dated June 25, 2002) which includes sandwiches, appetizers, chicken dumplings, hamburgers, etc. (2) The grease recovery device shall be installed in accordance with the State Plumbing Code. (3) This variance is not transferable to another owner or leasee of this establishment. This variance is granted because it has been demonstrated that a grease recovery device (G.R.D.) would be effective in removing grease, fats, and oils. S"Iyyou Chai an GRDVariance i CeyP 4 -vb `f`.Q'` * Town of Barnstable Su� PG oZ t�t Barns able Board of Health OftWnCft IARN$rASLL 200 Main Street, Hyannis MA 02601 , r Mass. 1639. 39. p��� 2007 Paul J.Canniff,D.M.D. Office:508-862-4644 Donald A.Guadagnoli,M.D FAX: 508-790-6304 John T.Norman F.P.(Tom)Lee,P.E.,Alternate BOARD OF HEALTH MEETING RESULTS Tuesday, September 25, 2018 at 3:00 PM Town Hall, Hearing Room 367 Main Street, 2nd Floor, Hyannis, MA I. Public Comment: A. Mark Ells, Town Manager, spoke to the Board to reiterate the programs already in place and his goal to reduce or remove the Interim Estuary. B. Steven Seymour urged the Board to make sure the Fire Training Academy's pollution is cleaned up thoroughly. II. Monitoring Reduction Request: Winston Steadman, All Cape Environmental Services, representing Carol Bergenheim, owner— 11 Nyes Point Way, Centerville, seasonal occupancy, requesting reduction. MONITORING CHANGED WITH CONDITION. The Board voted to amend the monitoring to two times a year with the following condition: 1) the contractor (i.e., Winston Steadman) must notify the Board if the property is used "year-round" vs "seasonal" and at that time the testing will revert back to four times a year. III. Hearing — Order Issued to Remove Underground Fuel Storage Tank (Cont.): Attorney Mark Boudreau representing Robert and Maureen Vanasse, owners - 514 Grand Island Drive, Osterville, existing 3,000 gallon underground tank used for heating oil, constructed of single-walled steel, more than 30 years of age, owner was ordered by certified mail to remove the tank (item postponed from July 19, 2018 meeting). GRANTED 60-DAY EXTENSION - for Abandonment Work. A letter from COMM stated an abandonment permit will be allowed. A licensed professional would take out the permit, drain the tank, sanitize it, drill holes in bottom, test soil underneath the tank (to ensure it hadn't leaked) and once that certification is granted; they will fill it with the proper solution. The Board voted to grant a 60-day extension to allow time. IV. Food — Temporary: Betsy Davis representing Cape Cod Doxie Day, to be held on September 29 at Barnstable County Court Complex, 3195 Main Street, Barnstable with one vendor, The Local Juice, with the following menu items: pre-bottled juices/smoothies, prepackaged salads and grain bowl. Page 1 of 3 BOH 9/25/18 GRANTED. The Board voted to grant the Cape Cod Doxie Day as an annual temporary food event. V. Hearing — Food: Ms. Hye Suk Olden, owner—Annie's Frozen Yogurt at Cape Cod Mall — 793 lyannough Road, Hyannis, continues to operate without a certified food protection manager on site at follow-up inspection. No one was present. ACTION: The Board determined Mr. McKean will send a letter stating she has three more days, in accordance to the Board determination last month, and if not in compliance, her license will be suspended. VI. Food — Grease Trap Chandler Bosworth, building owner, and Enrique Valdovinos, owner of Mi Pueblo —459-B Main Street, Hyannis, Map/Parcel 308-083, extension to install exterior grease trap expired September 21. GRANTED WITH CONDITIONS. The Board voted to grant the grease trap variance with the following conditions: 1) they will kept the invoices of company who cleans the Big Dipper for the record, and 2) they will continue using paper plates and plastic silverware. VII. Minutes: Minutes — May 22, 2018 and Aug 28, 2018. ADOPTED The Board voted to adopt the minutes for May 22, 2018 and August 28, 2018. VIII. Informal Discussion: Dan Ojala, Down Cape Engineering, representing Osterville Pines Condominium Association — 3040 Falmouth Road, Marstons Mills, Map/Parcel 099-030, replacement of multiple septic systems to one shared pressure-dosed system. Mr. Ojala believes the wording is very clear in the Town code that this would not require an I/A septic system. Action: Mr. Ojala will speak with Brian at MA DEP and see whether he would require the complex to have an I/A installed. IX. Old / New Business: A. Wimpy's Restaurant— 752 Main Street, Osterville, requesting food variance for outside dining for six tables with no screen door. Page 2 of 3 BOH 9/25/18 6/'x ti Town of Barnstable Board of Health j"e`c a Cfty BARNSTABM MASS. 200 Main Street,Hyannis MA 02601 ok 2007 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi June 28, 2018 Mr. Enrique Valdovinos I Quartermaster Road South Yarmouth, MA 02664 RE MUPRIUM -'xte ',G,- -r- sueet, MEE nsioig,, r,, badR� gcj m;0, n mo N g, 030 X- 0 Dear Mr. Valdovinos, During the public meeting of the Board of Health held on June 26, 2108,the Board voted to grant you an extension until the end of the summer, until September 21,2018,to continue to operate your food establishment at 459-B Main Street Hyannis without an inground grease trap. This extension is granted with the following conditions: 1. This extension approval is contingent upon you receiving written approval for an extension from the Department of Public Works. 2. A minimum 1,000 gallon capacity grease trap shall be installed on or before September 22, 2018. During the hearing,you testified that the very high cost to install a new grease trap, estimated at $15,000, will leave you with no options, other than to close your business. Previously a grease recovery device was approved at this business location and it continues to operate properly today. The Board members became concerned about closing this business in the height of the tourist season. It is hoped that you will have additional finances available at the end of the summer season to install the required inground grease trap. Sincerely yours, 4au' . Camif, D.O�D.a/VV Chairman Cc: Griffin Beaudoin, RE, DPW Chandler Bosworth, Bosworth Associates, PO Box 685, Centerville,MA 02632 Q:\WPFILES\MiPueb]oGreaseTrapExtensionJune 2018.docx The Town of Barnstable Department of Public Works A 382 Falmouth Road,Hyannis,MA 02601 Y r • RARNSICAUM BARNSTABLE NAB& wwwtowii.barnstable.ina.us W0-204 575 4659.h C* Daniel W. Santos, P.E. Office 508.790.640.0 ffil*ectol- Fax 508.790.6343 May 8, 2018 Town ol.'Barnstable Board of Health 200 Main Street Hyannis, Massachusetts 02601 RE: Mi Pueblo, 459-B Main Street, Hyannis DPW Recommendation for Grease Trap R.equirernent Dear Board Members, In response to the Health Department's request for DPW input on this matter, it is our reconunendation that a grease trap shall be installed for the above referenced restaurant use within 60 days. It is our understanding that this matter has been continued until the May 22 nd Board.of Health hearing, so we would recommend that the 60 days be effective from the date of that bearing, Since,L rely, Daniel W. Santos, P.E. cc: David W. Stanton, RS, Barnstable Health Division Amanda Ruggiero, P.E., Barnstable DPW Andrew Boule,.Barnstable DPW, Water Pollution Control Division Crocker, Sharon Al From: McKean, Thomas 'Sent: Tuesday, May 01, 2018 8:55 AM To: Beaudoin, Griffin (Philip); 'Paul Canniff' Cc: Boule, Andrew; Ruggiero,Amanda; Stanton, David; Crocker, Sharon o Subject: RE: Fw:459-9 Main St Hy'Mi Pueblo Grease Trap Variance Req Hello Griffin, This e-mail will suffice. I agree with allowing them 60 days to install a grease trap. We will forward this information to the entire Board for the next Board meeting. From: Beaudoin, Griffin (Philip) Sent: Tuesday, May 01, 2018 8:51 AM To: 'Paul Canniff; McKean, Thomas Cc: Boule, Andrew; Ruggiero, Amanda; Stanton, David Subject: RE: Fw: 459-B Main St Hy - Mi Pueblo Grease Trap Variance Req Tom and Paul, We would be comfortable with allowing up to 60 days for them to install the grease trap, which would give them sufficient time to hire a contractor. Ideally, the grease trap would be installed prior to the 4th of July. Would you like a formal letter from us regarding this or does this email suffice? Let me know if you would like to discuss further. Thanks, Griffin Griffin Beaudoin, P.E. Senior Project Manager—Water&Sewer Barnstable Department of Public Works 382 Falmouth Road-Hyannis, MA 02601 Cell: 774-487-9663 griffin.beaudoin town.ba Instable.ma.us From: Paul Canniff [mailto:canniff.paul gmail.com] Sent: Monday, April 30, 2018 6:51 PM To: McKean, Thomas Cc: Beaudoin, Griffin (Philip); Boule, Andrew; Ruggiero, Amanda Subject: Re: Fw: 459-B Main St Hy - Mi Pueblo Grease Trap Variance Req Thomas. It would be my opinion that the DPW people involved should determine the time frame for a grease trap installation at this restaurant. As I recall, somehow the owner(s) have operated for approx four years without a functionong grease trap. PJC On Mon, Apr 30, 2018 at 4:23 PM McKean, Thomas <Thomas.McKean@town.barnstable.ma.us>wrote: 1 McKean, Thomas From: Ruggiero, Amanda Sent: Tuesday, April 24, 2018 12:30 PM To: Crocker, Sharon; canniff.paul@gmail.com; McKean, Thomas; Stanton, David Cc: Boule, Andrew; Beaudoin, Griffin (Philip) Subject: RE: Board of Health meeting - Tuesday Apr 24 Hi all, Regarding the three comments for the grease trap variances, here are the DPW's recommendations: ,� • Chandler Bosworth and Enrique Valdovinos, owner of Mi Pueblo—459-B Main Street, Hyannis, Map/Parcel 308-083, requesting grease trap variance with Big Dipper Grease Recovery Device (GRD). o DPW: Based on the information provided, it doesn't appear there is documentation supporting a grease trap variance. DPW does not recommend approving this grease trap variance. It appears there may be sufficient room to install an exterior grease trap. • Kevin Dellarciprete, new owner of both the Compass Caf6 and the Four Points Tavern in the Hyannis Inn —473 Main Street, Hyannis, requesting variance for seating with existing 1,000 gallon grease trap and air curtain variance for outside seating. o DPW: DPW's recommendation would be to require this grease trap to be pumped every two months during peak months and then every three months during the off peak season. If not already installed, DPW would also recommend under sink grease traps as well, which would need to be approved by the plumbing inspector and DPW staff. During these inspections of the exterior grease trap, the accumulated grease should be noted and discussed with WPCD staff. If the frequency can be adjusted, it will be at the WPCD supervisor's written discretion. • Russell Smith, Island Twelve Restaurant and Bar- 16 Barnstable Road, Hyannis, space previously part of KKatie's Burger Bar, Main/Barnstable Rd, Hyannis, requesting toilet facility variance and grease trap variance. o It is unclear how the buildings (16 Barnstable Road and 334 Main Street) are tied in by sewer together. It appears that 16 Barnstable may be able to utilize the fenced in space northwest of the building for installation of a grease trap. Based on the lack of information, DPW does not recommend a grease trap variance at this location (16 Barnstable Road). Thank you ! Amanda Amanda Ruggiero, PE Barnstable DPW-Assistant Town Engineer Office: 508-790-6400- Cell: 774-487-2834 Amanda.Ruggiero(cDtown.bamstable.ma.us From: Crocker, Sharon Sent: Friday, April 20, 2018 5:26 PM To: Ruggiero, Amanda Subject: Board of Health meeting -Tuesday Apr 24 Amanda, / fTHE t� Town of Barnstable Banistable / IY,Y 04maicacay �r) 11 Board of Health IN if nn s. 0 ' 200 Main Street,Hyannis MA 02601 039. 6�0� ArEO MA_'t� 2007 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi Certified Mail# 7006 0810 0000 3525 3749 February 12, 2018 ORDER TO INSTALL A GREASE TRAP Mr. Enrique Valdovinos 1 Quartermaster Road South Yarmouth, MA 02664 RE: Mi Pueblo, 459-B Main Street Hyannis Order To Install A Grease Trap Dear Mr. Valdovinos, Back on July 9, 2013, more than four years ago, you were granted temporary permission, until August 20, 2013, to operate a food establishment at 459- B Main Street Hyannis.This was granted to provide you some additional time to install a grease trap or to connect into an existing grease trap. However, you failed to connect into an existing grease trap or install a new grease trap. The Town of Barnstable Code specifically reads as follows: "grease traps must be provided at restaurants, nursing homes, schools, hospitals, bakeries, or similar establishments as determined by the Board of Health. The capacity of the grease trap shall be calculated by the kitchen flow rate of 15 gallons per seat or chair, per day, but in no case shall be less than 1,000 gallons. This applies to establishments connecting to Town sewer, or establishments with on-site sewage systems." You are hereby ordered to install a grease trap or connect into an existing grease trap within 60 days on, or before,April 15, 2018. FAILURE TO COMPLY WITH THIS ORDER WILL AUTOMATICALLY RESULT IN A SHOW- CAUSE HEARING BEFORE THE BOARD OF HEALTH ON APRIL 24, 2018. Sincerely yours, omas McKean Director Cc:Chandler Bosworth,Bosworth Associates,PO Box 685,Centerville,MA 02632 Q:\Order letters\Food Violations\MiPueblo GreaseTrap2013 REV 2-12-18 Order to comply.doc BOH 4/24/18 EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES ON AUGUST 20,2013: B. Chandler Bosworth, Bosworth Associates, representing Enrique Valdovinas, owner of Mi Pueblo, 459-B Main Street, Hyannis, grease trap variance (continued). Chandler Bosworth said he has had a couple meetings with Roger Parsons and has spoken with Tom McKean. He has his grease trap installer secured along with a plumber. The grease trap installer is handling the engineering. He spoke with Roger Parsons and the installation will take place in early October so it won't disrupt Embargo's parking or his own during the busy season. He is close to deciding which of his two options he will take: tying into an existing grease trap at Embargo's or doing an independent one but either way, it'll be done in the beginning of October. Upon a motion duly made by Dr. Miller, seconded by Dr. Canniff, the Board voted to grant an extension to October. If the digging for the grease trap has not commenced by the October 8t" meeting, the applicant is to return to the Board with the status. (Unanimously, voted in favor.) EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES ON OCTOBER 8, 2013: A. Chandler Bosworth, Bosworth Associates, representing Enrique Valdovinas, owner of Mi Pueblo, 459-B Main Street, Hyannis, status on grease trap (continued from August 2013). Mr. Bosworth was present. He is working on hooking into the grease trap at Embargo, next door. He has approval from the business owner but the property owner has been ill and he was just able to reach him yesterday. Mr. Bosworth asked him to contact Tom McKean and Mr. Anderson, DPW to answer any questions the property owner may have. Mr. McKean has already done the calculations and there is more than enough room available in Embargo's grease trap to service both facilities. Mr. Bosworth said he told the owner of the property that he will need an answer within five days; otherwise, he will have to install a grease trap independently. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board granted an extension until November 12, 2013 to connect the grease trap. Q:\MINUTES\EXCERPT-MULTIPLE Hearings\459-B Main St Hy Mi Pueblo 2013 apr2018.doc , 4 ' �OFSHEtp� DATE: FEE: + BARNSTABLE, • ;.sa: MASS. 9� REC.BY: Town of Barnstable S CHED.DATE: Board of Health ; 200 Main Street, Hyannis MA 02601 Office: 508-862-4644' Paul J.Canniff D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald A Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION nn Property Address: lJ MQ;�, f,'T �(•�/If1 is iM1'�G � G[ Assessor's Map and Parcel Number: 30A — OP-3 Size of Lot: gad F Wetlands Within 300 Ft. Yes Business Name:, U No Subdivision Name: L3 APPLICANT'S NAME:���� �� �- ICInV lO'Q1� Phone �d� Z917— 7 1 Z6 Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON / Name: c)i W07A Name: rf'441 U� Address: ���clt>[//ee oniq 6�Et�Z Address:/# 6L)Q V� �1=41 7� 66' lC�,4�t6c2 Phone: 7 6 R 03 Z Z9 Phone: L508 7—l Z' 9 t 2-9 EMAIL: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) Sze F/0 -"I P/4 n Fv// At.&4u _ NATURE OF WORK: House Addition LJ House Renovation LJ Repair of Failed Septic System LJ Checklist (to be completed by office staff-person receiving variance'request application) Please submit copies in 5 separate,collated packets. Five(5)copies of the completed variance request form _ Five(5)copies of engineered plan submitted(e.g.septic system plans) Five(5)copies of MA DEP approval letter for I/A septic systems only. Five(5)copies of labeled dimensional floor plans submitted(e.g,house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). $95,00 variance request application fee collected (No fee for lifeguard modification renewals , grease trap variance renewals [same owner/lessee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A Guadagnoli,M.D. Q:\Application Forms\VARIREQ Rev APR2017.DOC Y , >v vf WPM Akm o: kk aticuarp _':'e''t� L`��. zA�r� F'. 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GUACAMOLE j prep ared-av+ocadQ:toto,olon> Intro>ehile sgrran4,ho-e $5.49 QUESO FUNDIDQ f melted chihwahua :and monter_rey cheese mtx witb chile pobl.ano peppers, P served w it:h tortillas chips 5.99 .add chorixo or mushrooms $6.99 kl� - MI PUEBLO NACHOS fresh corn tortilla chips,topped whh monterrev eheese,guacamole,black beans,tormato, scallions,jalapeaos,pico die gallo,crema fresca s7.99 add chicken $8.99 or steak S9.99 CEVICHE DE CAMAR.ON shrimp w,�-ich-xitrus tomnato'hroth,diced onion,cllant_ro,serrano peppers, t0MAto,avpca4o. crvcd with chips $7-99 TANIALES t►44 steamed cooked chickan Azad pork ta_rnalc5 topped vilith tQmatWo Sauce, crema fresca pickled onion $5.99 Tostadas 2 shrimp and-octopus ceviche tostadas,citrus tomato broth,diced onion,cilantro, Serrano peppers,tomato,avocado $5,99 r~: C f y L. I t • 7" r : TACOS BURRITOS J; soft corn tortilla,oervcd with diced onion, stuffed with mexican rice,black beans, cilantro choices- steak, chorizo, longua pica de gallo,monterrey cheese topped a Ny+t al pastor, carnitais, alambre $22.00cas Ivith tomatillo scam and crema ffresca, side of. guacamole <. FISH TACO chicken S5.99 carat asada S9.99 .0 b catch of the day ca.rnitds $0.99 willed willed veggie M99 soft flour tortilla,topped with shredded ti lettuce to a Pico de gallo,shagotle moll sauce SE ,UESADILIAS TORTAS 4: aneltgd oaxvea-ehmc— quesadilln $6.99 3, -milanlezaa 56.99 $9.99 tina de res (.shreddcd becf) $9,99 N,,N Breaded chicken or steak,lettuce,onion, r i txnSa de pollo (shredded chicken) $8.99 � J -. tc�m,ato,n�axya,falape�ios�atio�dQ (aAltNITAS TORTA'with jalapefim $9•19 cherizo.and oaxaca cheese $7.99 < PUEBLO TORTA FL #,LiTAS Breaded steak and chicken,ham,avocado, 4 rolled crispy corn tortilla mayo,black beams purec,chipotle onion, filled wiLb chicken topped with lettuce, �: vt tomato $10.99 onron,crema fresca,tomatibe suave, r cetija chew $8.95 hrt" L ` ^wr t: c(� -- +Mir bR ....a...: �z { i 4 �+5`�-c�-x' ,�±--.-. ,r^y:-;w ter.. 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F. t+cc9 6mpanied-with ranchero pinta beans,mc kau rice,crewe hresca CHICKEN ZMOLE ENCHILADAS$9.99 three soft corn tortillas filled with chicken topped with mole se►acc,ecoompatlicd with rane-hero pinto beaJi&mexican rlce,dlced onion,crema freact,cntija cheese ' FORK CAVOTAS Qvlexkan favotite)$10.99 i sdow roasted pork s),otilder,$ecampariled 1kyAb corn t,orti lawancl Bros pinata buns, rate dean rkv,LQmalillu sauce fit.. CA-RUE ASADA 111.99 'x i riBarl-skirt steak-,with t;Wpan of chile publanQ and oltvd. union topped with morita souCm and creme fresca,accompanied neigh macharo pinto 6eans,mez 5cMn rice. r F -3 Dill PUEBLO PLATE$12.99 Y 1 c nchila& suiza,pork t,amalAdc rclleno s:u.qed with cat e6cese,accumpanied wide ranchero pinta beano Mexican rice ,f C:AMAROWS AIMOjO D8 AJO SM99 r sautced marinated sh7imp in garlic €auccAcrompanicd with special white rice and salad i COCkTE1:,DE C:�;t,�R.C?T�1 l,(lSt2.9A�,iVi£7.9d3 t. '' shr}mp �coc tail citurs lime.tomiltri bToth,o�io�,to�nate,s9lentrs� TTODOpepp�e_r,faais_�d a._th fresh avocedo scr;•cA with saltines crackers 11Tt sled. _�77 .......S sfimecd clickea or steak with chile poblano,onion,brccn and red bell peppers,accompanied 'W:t7t eancliere pinto beans,mextraat rice MARACHE 8.99 Cora mesa fatbread toFP:d with SAM skirt etcaktblank bmapuree-Aced s d cilant,ro,cotsja checsc,eboose of marita wuce of 1pn3 UMo sauce =f : "o..yc,,.,.r ,�-..3.�. �_•,arr e. •e..r. ._. .Y..Y : sn 1 s_�'t _.3"" .,.�ttu.. :L..T 4 ��.:?rL ti-,.,7r..�Curi t �.k S^ �sf-. .,._..i•,,�}9 T3 DRINKS SALAD'S pepsi,cok,-sprite $1.75 chop iceberg lettuce,nopales(cactus),tomato, t' . , ,.jarritos $ 175 red onionavocadomandarin,cotij,a cheese $6.99 E � ; tarnariudo add chicken $7999 or shrimp $8.99 } lime chop iceberg lettuce,ji cam a,cucumber,onion, z naranja olives S6.99 add chicken $7.99 shrimp $8.99 w Y sangria KIDS TV1ENTJ } ,�,GUA FR C,� $1.75 cheeseburger %,Ifries 6.99 a -h or-chata chicken finger- w/fries $5,99 Jamaica grill cheese w/fries $4,99 -- SIDE ORDERS cheese quesadilla $4.99 frijoles(ranchero beans) $2.00 DESSERTS e axr��� (rice) $2,00 nan $2.99 rice.pudding $1.99 LyLi guacamole $2.99 cake tres leches slice $2.99 french fries $2.00 �-1ien placing your order picasc irrfaryn your saver if a iperson in your party }res� � f�a� �l_l�r�y. senFr��nin € �} or t�nd�er� a�-ed fesndg may iiasrease your risk- of food borne MaerF. r `-' � .-..t ,a;. �a '•"a - -ar. -x-'` -t t A?AEI .k .�� uu � 'r -:x". ?.� �f,=�ws�s.+-' ``> .`� ' g y�-� i ,*R,�s s - as �-i� t } �''�fyi.,S�F r• #z"'-re�� W '�=:a-"$+ $.yea 'irk � .� z e �r +� s..,r - m i e iw an!Wo �. �1/�/f/� �S /'f'11��. C�.Z � �� rye � Cove-�•�.t-�oP. S-�� � � j--\ Aff l3 j t f•U „� � o i ? - Ji �drnIq- s INV -d -4L� _ t ---------------------- -..... ,� ::. M.-: _. ...... ..:..:. ..• V--..` w�...'y.. � - l.— �^','.�iw4' _ - '�.. .-.... r-.l� i'JLsi.,^ .....,ems .:1.,...:.-..4cd.N.....Y,�`�' s. m-u McKean, Thomas From: Ruggiero, Amanda Sent: Tuesday, April 24, 2018 12:30 PM To: Crocker, Sharon; canniff.paul@gmail.com; McKean, Thomas; Stanton, David Cc: Boule, Andrew; Beaudoin, Griffin (Philip) Subject: RE: Board of Health meeting - Tuesday Apr 24 � 9 Y p Hi all, Regarding the three comments for the grease trap variances, here are the DPW's recommendations: • Chandler Bosworth and Enrique Valdovinos, owner of Mi Pueblo—459-8 Main Street, Hyannis, Map/Parcel 308-083, requesting grease trap variance with Big Dipper Grease Recovery Device (GRID). o DPW: Based on the information provided, it doesn't appear there is documentation supporting a grease trap variance. DPW does not recommend approving this grease trap variance. It appears there may be sufficient room to install an exterior grease trap. • Kevin Dellarciprete, new owner of both the Compass Cafe and the Four Points Tavern in the Hyannis Inn —473 Main Street, Hyannis, requesting variance for seating with existing 1,000 gallon grease trap and air curtain variance for outside seating. o DPW: DPW's recommendation would be to require this grease trap to be pumped every two months during peak months and then every three months during the off peak season. If not already installed, DPW would also recommend under sink grease traps as well, which would need to be approved by the plumbing inspector and DPW staff. During these inspections of the exterior grease trap, the accumulated grease should be noted and discussed with WPCD staff. If the frequency can be adjusted, it will be at the WPCD supervisor's written discretion. • Russell Smith, Island Twelve Restaurant and Bar— 16 Barnstable Road, Hyannis, space previously part of KKatie's Burger Bar, Main/Barnstable Rd, Hyannis, requesting toilet facility variance and grease trap variance. o It is unclear how the buildings (16 Barnstable Road and 334 Main Street) are tied in by sewer together. It appears that 16 Barnstable may be able to utilize the fenced in space northwest of the building for installation of a grease trap. Based on the lack of information, DPW does not recommend a grease trap variance at this location (16 Barnstable Road). Thank you ! Amanda Amanda Ruggiero, PIE Barnstable DPW-Assistant Town Engineer Office: 508-790-6400- Cell: 774-487-2834 Amanda.RuggieroCcD town.barnstable.ma.us From: Crocker, Sharon Sent: Friday, April 20, 2018 5:26 PM To: Ruggiero, Amanda Subject: Board of Health meeting -Tuesday Apr 24 Amanda, EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES ON MARCH 30, 2020 1. Variance—Grease Trap: Osvaldo (Ozzy) Valdovimos, owner— Mi Pueblo, 459-B Main Street, Hyannis, requesting grease trap variance to continue with his brother's business. The Board acknowledged his loss and inquired whether one year would be sufficient amount of time. Osvaldo said he is working on finding a new location and he hopes it will be enough time. A motion to grant an extension for twelve months until April 1, 2022. The Board would like him to return at that time to give a status and a plan for connection, if possible, or may come before the Board to consider an extension at that time. I Q:\MINUTES\EXCERPT Of MINUTES\EXCERPTS\Excerpt BOH March 30 2021 Mi Pueblo 459 Main St Hy.docx t -- a�r�,stau€� Town of Barnstable of SHE row m�rac�v ��� Board of Health '9 un na S,BLE'tea I 200 Main Street,Hyannis MA 02601 TfD MA� Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi Certified Mail# 7006 0810 0000 3525 3749 February 12, 2018 ORDER TO INSTALL A GREASE TRAP Mr. Enrique Valdovinos 1 Quartermaster Road South Yarmouth, MA 02664 RE: Mi Pueblo, 459-B Main Street Hyannis Order To Install A Grease Trap Dear Mr. Valdovinos, Back on July 9, 2013, more than four years ago, you were granted temporary permission, until August 20, 2013, to operate a food establishment at 459- B Main Street Hyannis. This was granted to provide you some additional time to install a grease trap or to connect into an existing grease trap. However, you failed to connect into an existing grease trap or install a new grease trap. The Town of Barnstable Code specifically reads as follows: "grease traps must be provided at restaurants, nursing homes, schools, hospitals, bakeries, or similar establishments as determined by the Board of Health. The capacity of the grease trap shall be calculated by the kitchen flow rate of 15 gallons per seat or chair, per day, but in no case shall be less than 1,000 gallons. This applies to establishments connecting to Town sewer, or establishments with on-site sewage systems." You are hereby ordered to install a grease trap or connect into an existing grease trap within 60 days on, or before, April 15, 2018. FAILURE TO COMPLY WITH THIS ORDER WILL AUTOMATICALLY RESULT IN A SHOW- CAUSE HEARING BEFORE THE BOARD OF HEALTH ON APRIL 24, 2018. Sincerely yours, omas McKean Director Cc: Chandler Bosworth,Bosworth Associates,PO Box 685,Centerville,MA 02632 Q:\Order lettersTood Violations\MiPueblo GreaseTrap2013 REV 2-12-18 Order to comply.doc Ir m . Ln ru z . L-n m Postage $y p / � , 9 p certified Fee t/ p Return Receipt Fee Pnostmr�azk (Endorsement Required) ! p He ON p Restricted Delivery Fee � (Endorsement Required) c p Total Postage&Fees $ g o e"`To Enrique Valdovinos, Mi Pueblos orPOBc 1 Quartermaster Fed CRY, i So. Yarmouth, MA 02664 #--- -Certified Mall Provides: .p A mailing receipt (asraney)zooz aunr'cm avod Sd ® A unique identifier for your mailpiece a A record of delivery kept by the Postal Service for two years Important Reminders: ® Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. ■ Certified Mail is not available for any class of international mail. a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. to For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". Ji If a postmark on the Certified Mail receipt is desired,please present the and cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. ■ Completwiba 1,2•and 3. A. Signature ■ Print your rliMe antf'address on the reverse ❑Agent ©Addressee so that we can return the card to you. ■ Attach this card to the back of the mailpiece, B• ReceiVed by(Printe Name) C. Date of Delivery or on the front if space permits. pr. C 1. Article Addressed to: D. Is delivery addres if(MenAtbro erp 1 i ❑Yes r - - ---- — If YES,enter del�vQ`.a dress a lo'lcv. ❑No Enrique Valdovinos, >? Mi Pueblos � �;1 Quartermaster ���'`� f So. Yarmouth, MA 02664 II I'III'I I'll liI l I i I l lI l Ill i Ii l Il I lI ll Il lI I III 3. Service Type ❑Priority Mail Expresso ❑Adult Signature I]Registered MaiITM ❑ dult Signature Restricted Delivery El Registered Mail Restricted 9590 9403 0521 5173 2825 55 Certified Mailo Delivery ❑Certified Mail Restricted Delivery M Return Receipt for ❑Collect on Delivery erchandise 2. Article Number(Transfer from service_lab e/---❑Collect on Delivery Restricted Delivery ❑Signature ConfinnationTM �1 ❑Insured Mail ❑Signature Confirmation 7006 0 810 0000. 3525 37491 El Insured Mail Restricted Delivery Restricted Delivery�e 4 - (over$500) n PS Form 3811,April 2015 PSN 7530-02-000-9053 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4®in this box* Public Health Division ( Town of Barnstable 200 Main Street Hyannis, MA 02601 USPS TRACKING# Fiite I {I�lil ae}i ill jEi i iit�7}i EEjli;i�il��t j•°t •.i I'ilFi' .f— 1 L•.:,.... «... ii i 11 �F}I f of'THE r� Town of Barnstable Barnstable Board of Health j e'�j IAEtNSTABM .Mass. -g 200 Main Street,Hyannis MA 02601 ►634 b~� 2007 AtfA�� Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi July 1, 2013 Mr. Enrique Valdovinas 1 Quartermaster Road South Yarmouth, MA 02664 r , y d fi -^Z t Mw '� 3R' 4a - 5xass RE N11 RPuebto 459_B,Maln Street'Hyannis n � $t tyWE Grease�Trap VananceI, equestr Dear Mr. Valdovinas, You are granted temporary permission, until August 20, 2013, to operate a food establishment at 459- B Main Street Hyannis. On or before August 20th, you have the options to (a) install an inground grease trap at 459 Main Street Hyannis, or(b) connect into an existing grease trap of sufficient capacity, or (c) present plans and a timeline for the installation of a grease trap to the Board of Health at the regular meeting of the Board of Health scheduled for August 20, 2013 at 3:00 p.m. Back on May 30, 2013, you submitted a variance request application, along with the required $95.00 fee to the Public Health Division Office. The variance request was relative to a proposal to operate a food establishment at 459-B Main Street Hyannis. Specifically, the request was for a variance from Section 322-3 of the Town of Barnstable Code which requires grease traps at all food establishments. The Town of Barnstable Code specifically reads as follows: "grease traps must be provided at restaurants, nursing homes, schools, hospitals, bakeries, or similar establishments as determined by the Board of Health. The capacity of the grease trap shall be calculated by the kitchen flow rate of 15 gallons per seat or chair, per day, but in no case shall be less than 1,000 gallons. This applies to establishments connecting to Town sewer, or establishments with on-site sewage systems." On June 18, 2013, you withdrew your request for a variance. Then during the public meeting of the Board of Health held on July 9, 2013, you requested permission to operate temporarily until the grease'trap is installed. This request was approved. This permission is temporary until August 20, 2013. Sinc ely yours ayne Miller, M.D. l Chair an Cc: Chandler Bosworth f Q:\W PF I LES\Temp Perm iss iontoOPerateGreaseTrap2013.doc I y J t. J ► w my OWN 11 MAN w1 f + ow i� QQ i r BOSWORTH ASSOCIATES P.O. Box 685 - 1645 Falmouth Rd. Unit C - Second Floor ����j)j3 Centerville, MA 02632 I/ r!A (p OCA low. Xg -O UAL LjIV-. l 41AJ0� BUILDERS - DEVELOPERS - PROPERTY MANAGEMENT Phone: 508-790-2422 - Fax 508-790-5982 DATE: SHE FEE 4 , ; + $aRNSTaam ; y Mass �° REC. BY 47�i6 3�9., �0 Town of Barnstable SCHED. DATE: CP/10 l3 Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne A. Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul J.Canniff,D.M.D. �o�f VARIANCE REQUEST FORM LOCATION t( - Property Address: q ' Assessor's Map and Parcel Number. 3 .9 -. 0 13 S Size of Lot: Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: W e q u e L l0 /dOi 9 A 0S Phone ,50 q2 Ll� Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: �`�nd]d Le x CJ-ilk/()-f Name:e Y cj, i ��o LiyG� 1 . a Address:.P (.I L P,_5—/6 Zj,5 FO Address: ® k.(,tr3f't Phone: O f LJ�.2 Phone: (5 �� 1// `3 VARIANCE FROM REGULATION(ust Reg.) RpEA�jS�3ON{] FOR{gVJAyRIyyAN�ClE(May attach if more'space /n9eededd� o k .c o .7 y l - f I(; 011 �� P/crvr a r-� NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System ❑ Checklist (to be completed by office staff person receiving variance request,application) Please submit copies in 4 separate completed sets. _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian _ Four(4)copies of labeled dimensional floor plans submitted(e.g,house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be 'notified by certified mail at least ten darts prior to meeting date at applicants expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance-requests only) _ Variance request application fee collected(no fee for lifeguard modification renewals,.grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) _ Variance request.submitted at least 15 days prior to meeting date a VARIANCE APPROVED - Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL_ A 1C`""` Paul].Canniff D.M.D. lor � l� C:.\cache\Temporary Internet. Files\A \V IREQ.DOC I Town of Barnstable Barnstable Board of Health KS&A 200 Main Street,Hyannis MA 02601 �m i639. '��� ATf��b 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi July 1, 2013 Mr. Enrique Valdovinas 1# Quartermaster Road South Yarmouth, MA 02664 ,' r r' 2 kw r t c 4 y 3v^x F t'ew- R'E � {MI PuebloG,459 B``Mpaln'S,�treetHyannis = �.-�,� r�� � �.����� �"� tJ :uyl , A.. ' ;ti.Grease TrapUariance;n,Requesth rrRN ,k „ rx . 5 ryr W � f Dear Mr. Valdovinas, On May 30, 2013, you submitted a variance request application, along with the required $95.00 fee to the Public Health Division Office. The variance request was relative to a proposal to operate a food establishment at 459-B Main Street Hyannis. Specifically, the request was for a variance from Section 322-3 of the Town of Barnstable Code which requires grease traps at all food establishments. The Town of Barnstable Code specifically reads as follows: "grease traps must be provided at restaurants, nursing homes, schools, hospitals, bakeries, or similar establishments as determined by the Board of Health. The capacity of the grease trap shall be calculated by the kitchen flow rate of 15 gallons per seat or chair, per day, but in no case shall be less than 1,000 gallons. This applies to establishments connecting to Town sewer, or establishments with on-site sewage systems." During the public meeting of the Board of Health held on June 18, 2013, you requested permission to withdraw your application for a variance. Therefore, your variance request is hereby withdrawn. Sinc ly your , Way4 Miller, M.D. Chairman Q:\WPFILES\MiPuebloGReaseTrapVariance2Ol3.doc Bellaire, Dianna From: Logan, Erin Sent: Monday, December 20, 2021 1:53 PM To: Bellaire, Dianna Cc: Hartsgrove, Elizabeth; Coyle, Brenda Subject: RE: Mi Pueblo I just called and confirmed with the current manager that they are in fact closing for good. I will email him and ask for confirmation back for our files. Dianna—they lost several members of the family due to COVID. So sad-So much so that the CC Times ran a story about them last year. Best regards, Erin Logan Licensing Assistant I Licensing Division Town of Barnstable 1 367 Main Street I Hyannis, MA 02601 Erin.logan town.barnstable.ma.us P 508.862.4774 it and hone Monday through Friday,8:30am to 4:30pm! Available via email a p Y 9 Y In office Monday, Wednesday& Thursday 8:30am to 4:30pm.Available Tuesday and Friday by appointment! From. Bellaire, Dianna Sent: Monday, December 20, 2021 1:29 PM To: Logan, Erin Cc: Hartsgrove, Elizabeth; Coyle, Brenda Subject: RE: Mi Pueblo Hi Erin, I am not surprised. They were on a BOH extension due to the death in the family and they are required to put in a grease trap. I am assuming it is too much of a cost for them. Thank you for letting me know. They didn't need to renew yet because their BOH extension was good until 03-31-2022. They probably didn't want to pay rent again and closing early. Thanks. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us 1 i The information contained in this electronic transmission("e-mail"),including any attachment(die"Information"),may be confidential or othenvise exempt from disclosure.It is for the addressee only-.This Information may be privileged and confidential work-product or a privileged and confidential communication.The Information may also be deliberative arid pre.-decisional in nature,As such,it is for internal use only.The Information may not be disclosed without the prior written consent of the Director.of Public Health and/or the Town At:torne:y's Office of the Town of Barnstable.If you have received this e-mail by mistake,please notify the sender and delete it from Your system.Please do not copy or forward it.Thank you for your cooperation. From: Logan, Erin Sent: Monday, December 20, 2021 11:56 AM To: Bellaire, Dianna Cc: Hartsgrove, Elizabeth; Coyle, Brenda Subject: Mi Pueblo Hi Dianna, Not sure if you have had any contact from Mi Pueblo but my husband is friendly with the owners. He went there for lunch on Friday and they told him that as of January 15t they are closing for good. Of course I will confirm this directly with them but thought I would pass this information along. Best regards, Erin Logan Licensing Assistant I Licensing Division Town of Barnstable 1 367 Main Street I Hyannis, MA 02601 Erin.logan@town.barnstable.ma.us P 508.862.4774 Available via email and phone Monday through Friday, 8:30am to 4:30pm! In office Monday, Wednesday& Thursday 8:30om to 4:30pm.Available Tuesday and Friday by appointment! Barnstable Mission:Protect the Towns quality of life and unique character,Engage our citizens,Enact policies that respond to and anticipate the needs of our community. For updated information on the Town of Barnstable's response and resources related to COVID-19 visit www.BarnstableHealth.com. Thank you for your patience and support as we continue adjusting to the COVID-19 outbreak. 2