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HomeMy WebLinkAboutHYANNIS HARBOR HOTEL - FOOD - CLOSED y2n n Is Hambor Ao-feI boo 91 tt t Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. T' RAn,.; ABLE, : F.P.(Thomas)Lee,. MAS& Daniel Luczkow,M.D. Alt. 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1054 Issue Date: 01/01/2022 DBA: HARBORVIEW RESTAURANT at HYANNIS HARBOR HOTEL OWNER: OCEANSIDE RESTAURANT GROUP LLC. Location of Establishment: 235 OCEAN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 128 OutdoorSeating: 74 Total Seating: 202 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit i Ex 12 2022 Expires: /31/ B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: G�� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. aAWNSTABM -' F.P.(Thomas)Lee,. bx 200 Main Street, Hyannis, MA 02601 Daniel Luczkow.M.D. Alt. Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1054 Issue Date: 01/01/2022 DBA: HARBORVIEW RESTAURANT at HYANNIS HARBOR HOTEL OWNER: OCEANSIDE RESTAURANT GROUP LLC. Location of Establishment: 23S OCEAN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 128 OutdoorSeating: 74 Total Seating: 202 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B- FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: j Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. Paul J.Canniff,D.M.D. A F.P. Thomas Lee Alternate s � 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1054 Issue Date: 01/01/2021 DBA: HARBORVIEW RESTAURANT at HYANNIS HARBOR HOTEL OWNER: MICHAEL GUSTAFSON Location of Establishment: 235 OCEAN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: U IndoorSeating: 128 OutdoorSeating: 74 Total Seating: 202 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: G � FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: I � I • �ZMETp,�, Town of Barnstable Initials: ti Q` Date Paid ApltI'd$ BARNSTABLE, : Inspectional Services MASS. ss' Check# q, 1639. ,• Public Health Division ArfD MPS 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 1 / NEW OWNERSHIP RENEWAL `V NAME OF FOOD ESTABLISHMENT: Aa440'a4p) ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM J/ABOVE): 1 E-MAIL ADDRESS: I; Pl T es 10 j TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO_IL-"'... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: Vlo� SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: L22_ 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? eS IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S). TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) ZFOOD 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 QAApplication FormsTOODAPP 2020.doc OWNER INFORMATION: A FULL NAME OF APPLICANT Q 1 SOLE OWNER: YE /NO OWNER PHONE# f62 (f�Z 6 ADDRESS CORPORATE OWNER: CORPORATE ADDRESS: 2.3 ke PERSON IN CHARGE OF DAILY OPERATIONS: G,1 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 i. � S�/ Z / 22 1. " & � �'/P /Z�' O �1 O i 2—Z3 2. 20 SIGNAT RE OF PPLICANT 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/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.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.doc r 6 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. t HARNSTABM PaulJ.Canniff,D.M.D. MAS& F.P. Thomas Lee Alternate s� 200 Main Street, Hyannis, MA 02601 ° Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1054 Issue Date: 12/10/2019 DBA: HARBORVIEW RESTAURANT at HYANNIS HARBOR HOTEL OWNER: Michael Gustafson Location of Establishment: 235 OCEAN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 128 OutdoorSeating: 74 Total Seating: 202 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: C?n��t FROZEN DESSERT: Thomas A. McKean, IRS, CHO,Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: s For Office Use Only: Initials: K'J Town of Barnstable fir: Date Paid 30 �'Amt Pd$ 3JD f, &UMSPABLB. ; Inspectional Services CA- MASS o Public Health Division 1eC&# 13mH � ` s.t. Thomas McKean, DirectorR, 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 t7,} l APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE I1 /10 /9 NEW OWNERSHIP // RENEWAL NAME OF FOOD ESTABLISHMENT:aeaA4i!/� eed"s , A,,4 (9l 146L d eQ -#a 60rVi' ADDRESS OF FOOD ESTABLISHMENT: /7 441(1 ipS� Arg D2601 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: V- WELL WATER: YES NO V' ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V' SEASONAL: DATES OF OPERATION:_/ / TO NUMBER OF SEATS: INSIDE: dl/ 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? Zr IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? f"o 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 l�'r�icLaed 6ue4q qo SOLE OWNER: YE /NO &� OWl( / /NER PHONE #y�,,A9Z 4')Z 41Lp(o I ADDRESS Z�— l C�CGei[�.� S-� ykc n of a tl CORPORATE OWNER: CORPORATE ADDRESS: S�Q PERSON IN CHARGE OF DAILY OPERATIONS: ;E61"ad 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. [ lifJOJA. l l 0 Z. I / 26X 2. / SIGNATU OF PP CANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openine!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/apolications.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. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc i - BOARD OF HEALTH Town of Barnstable Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. 11,, ,B John T.Norman a 4 200 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: 1054 Issue Date: 12/20/18 DBA: HARBORVIEW RESTAURANT at HYANNIS HARBOR HOTEL OWNER: Michael Gustafson Location of Establishment: 235 OCEAN STREET HYANNIS MA 02601 Type of Business Permit: RESTAURANT Annual: YES Seasonal: IndoorSeating: 128 OutdoorSeating: 74 Total Seating: 202 FEES (� FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: — --- --- -- --- — - MOBILE-FOOD: MOBILE-ICE CREAM: GQ� 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: T A tl �pTNE Initials: Town of Barnstable Am s 3 ,Date Paid t Pd MARIL Inspectional Services �. �— AIFo �s Public Health Division Check# Thomas McKean, Director M t:1 200 Main Street, Hyannis, A 02601 1� l O Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE %/ Zo NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: law Ah�441-&� '� ✓ ADDRESS OF FOOD ESTABLISHMENT: 9M MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: Zal P ., Ayitij GLaCp TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( ?W) V-70 - TOTAL NUMBER OF BATHROOMS: t WELL WATER:YES NO �... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V SEASONAL: DATES OF OPERATION: / / TO Col NUMBER OF SEATS: INSIDE: 12-? OUTSIDE: 4_TOTAL: 208. 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) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FormsTOODAPPREV2018.doc . .---- _- ...__. . : ... - .R PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT l"L'1 C^�(•Q�� �t'efJ c¢r-� SOLE OWNER: YES NO OWNER PHONE # efy2 — ?5P3'JT410 ADDRESS_ CORPORATE OWNER: FEDERAL ID NO. : ? CORPORATE ADDRESS: Q�yl PERSON IN CHARGE OF DAILY OPERATIONS: (�v List (2) Certified Food Protection Managers AND at least (1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have I 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 ller en Awareness Expiration Date 2�221. 1.2- 2. t&ok�-�tu t Z / Jc 122m o/ Vf SIGRAT4 OF AP ICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to openintz!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.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 1st to Dec.30 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q\Application FormsT00DAPPREV2018.doc �IME rq TOWN OF BARNSTABLE HEALTH INSPECTOR s Establishment Name: Date: Page: of o OFFlCE HOURS PUBLIC HEALTH DIVISION 800=9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS �+ MON.-FRI. +639• .e HYANNIS, MA 02601 508-862-4644 No Reference •R .Red Item ;, PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Name Date hype of Type of Inspection iperationfal Routine Address Risk F Service pection Level coon Telephone a Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 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) ❑ ZAda Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑.12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control }• r ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSR ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) �j � Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating ry P Employee ❑ a y y � ❑ Voluntary Compliance Em to ee 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: 23.Management and Personnel (FC-2)(590.003 checked indicate violations of 105 CMR 590.000/Federal Food Code.) This report when signed below b a Board of Health member or its agent 24.Food and Food Preparation (FC-3)(590.004) p 9 y 9 A=Zero critical violations and no more than anon-critical violations. F=3 or more critical violations.9 or more non-critical violations, constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than'4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.o08) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8nonscritical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's ignature Print: Self Service Wait Service Provided Grease Trap Size. Variance Letter Posted Y N Dumpster Screen? Y N i I - �--�..--��-.w-.r�,, {..r-r+w •.✓.S _....V_i+ .. .-vti :'�+r�...,,...4. �� .,,,. -' . r ..- r try .n .�..-+....F.--�f fir .. _...:5�CJ ..��.}:'^�."-ac.Z�. --.�.�:.N.�.---.-�. F?-y.r._'.'.-'w�r.'::i,: F:..'�•�''°^°"." i 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) i Assignment of Responsibility* 6 Cross-contamination 14 Food or ColorAddlUves 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.* Protection - '1 -- 19 _____ _PHF Hotand_Cotd Holding. _ 2-103.11 Person-in-Charge Duties- - - - '-- - - -- '• ' 3-302.14_ -fr"om'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 3-362.11(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) Ho[PHFs Maintained At or Above 140°F* 7-102_ti• 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-Storagc Time as a Public Health Control Applicants 3-302.11(A) Food Protection* 20 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 3-30215 Washing Fruits and Vegetables Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) q 590.003(G)- Reporting by Person in Charge* - -_ - 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) I 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.Washin Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g Disposition of Adulterated or Contaminated -- - - -- - - - - -- Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* 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 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products 4-501.112 Mechanical Warewashing-Hot Water Monitoring 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk-Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of 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* Equipment* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* effea"°°11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency r f ces Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 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* foodbome illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )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* 3-20211 HF's Received at Proper Temperatures* 2 401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3 403.11(C) Commercial) Processed RTE Food-140°F* Blue Items 23-30) 3-202.15 Package Integrity Y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining UnslicW 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* E 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashing Facilities 3-202.18 Shellstock Identification* 3-501.14(A) 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* i 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008.. HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the,federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. pTNE r HEALTH INSPECTOR'S Establishment Name: Date: Page: . TOWN OF BARNSTABLE _ _ 9 of OFFICE HOURS PUBLIC HEALTH DIVISION 6-00-9:30A.M. BARNSfABLE.O' 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified mAss. MON.-FRI. 'gyp 1639• .0� HYANNIS,MA 02601 No Reference .R-;Red Item.;; PLEASE PRINT CLEARLY tE0 MPy° 508-862-4644 - FOOD ESTABLISHMENT INSPECTION REPORT (C Name Date Type of T fDe of Inspection 012 Ro ' Address Risk ood Service eKeinspectio Level ion Telephone Residential Kitchen Date: Mobile- Pre-operation Owner HACCP Y/N Temporary • Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 11 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) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities I) EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ' ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding i ` 4 PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control \\ IN ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(4 ) - ❑ 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 LZ JAW Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ���✓VJJrn Critical(C)violations marked must be corrected immediately. (blue&red items) ll„ q fired. Yes ❑ No ❑ Non-critical(N)violations must be corrected immediately or Overall Rating i3Gjai' Correctivtion Re within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an.inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Sign a Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N .... ,_:r.T�•-•�.,......_.•-�,....:..-....�....,�.�,r•-„•.. ..••_. _,,,,.�.�•.,(.-:.�..-*..+..•-.,,_..+_.r1e...��.. - ,�.:-....." _ ..�-r ...-.-. .-. .�..--.+.. -......,..-...-.,,,.:...-..�.�,:-Y.:..��. ..r-,..-....,..... .-r. .-.:� t _.-• .•-� ... r�s .- _ .�--ti..-� .. ,... ---..-ti.•�._s•�.v,- _ ... -...,.-•. 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 Additive's. Law Cooled to 41°F/45°F Within 4 Hours* 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* "= ' 19 PHF Hot and Cold Holding - 2-103.11 Person=in-Charge Duties- - - - - - Cooked and RTE Foods. 3-30214 Protection I from Unapproved Additives* - Contamination from Raw Ingredients 15 _ Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F - - - 590.004(F) * - EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information.-Original Containers* Other* g g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility in the Person-m Charge to_ 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage*- - - - - = Applicants* - -- -- - - "` - 3=302Z1(A) 'Food Protection* P g .. 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An _ _ _ _ 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 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 3-3-06.14(A)(B-)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 590.003(E) Removal of Exclusions and Restrictions g Disposition of Adulterated or Contaminated � .Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* 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 - 4-501.11-1 --- -Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed S routs Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and P 3-201.13 Fluid Milk-and Milk Products* - 4-501.1 f2 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* - - Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* - 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Tce Made From Potable Drinking Water* _ 3-401.11A(1)(2) Eggs-I55°F 15 sec Animal Foods That are Raw,Undercooked or 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* 5-101.11 Drinking Water from an Approved System* __ _ gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg crrvc mnooi 4-602.11 Cleaning Frequency of Utensils and Food. .. Animals-155°F 15 sec* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 590A06(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * gg Shellfish and Fish From�n}lpprovgd Squrc@_.._ 3-401.11(B)(1)(2) Pork and Beef Roast-130"N 111 min Eggs* - _' 4-702-11-' 'Frequency of Sanitization of Utensils-and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* - - 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical*. I g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* 1 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 andWild Mushrooms Approved-By 2-301.1 f Clean Condition-Hands and Arms* the appropriate sections above if related to Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave 3-202.18 Shellstook Identification Present* - - - - 2-301.12 _ _ Cleaning Procedure* t 165°F* foodborne illness interventions and risk factors. 590.004(C)_ Wild Mushroo * 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( * - 11 - ---- - GdodHygienic Practicei 17 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 Game Animals 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* 3A03.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 PreventingContamination When Tasfin * * (Blue Items 23-30) 3-202.15 Package Integrity* g 3-403.f1(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:Shellstook 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 3-203.12 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301. 22 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000' *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. OF tHE Tp� TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. RARNSTARLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified Y ,679. ae HYANNIS, MA 02601 MON.-FRi. No. Reference R-Red Item PLEASE PRINT CLEARLY Py s, 508-862-4644 M FOOD ESTABLISHMENT INSPECTION REPORT Name t Tyoe of Type of Inspection a io Ro -' Address Risk Food Service e-inspection Level e Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other n zgi _L Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. i f CA— Violations Related to Foodborne Illness Interventions and Risk Factors(Red Itemsl Anti-Choking 590.009(E) ® l Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ / FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY❑ W 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories y ✓� Violations Related to Good Retail Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations !VI Critical(C)violations marked must be corrected immediately. (blue&red items) �1 f{ 1 Corrective Action Required: ❑ o �/ `- > ❑ Yes Non-critical(N)violations must be corrected immediately or Overall RatingQI ` 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=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your;request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of violations observed,7 to 8npn-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 29.Special Requirements (590.009) receipt within 10 days of recei t of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view ' Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's at 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* F 8 Cross-contamination F14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(I) 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.* 99 PHF Hot and Cold Holding g 3-302.t4 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 * 590.004(F) 7-101.1 1 Identifying Information-Original Containers 2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * 3-302.15 Washing Fruits and Vegetables 3-501-19 Time as a Public Health Control Applicant To Report To The Person In Charge* 3-304.11 7.202.12 Conditions of Use*Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Tem erasures* Raw Seed Sprouts Not Served* p 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(I)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.I 1(A) Clean Utensils and Food Contact Surfaces of Eggs s Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.1 I Drinking Water from an Approved System* * Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Fl-^'e uirzna 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 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009 A Chemical ( )-(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 Game and IMIdMushroomsApproved By ( )O Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 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* 3-403.1 t(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-I01.l l 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 Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. `Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oFt Toy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page of WP \ OFFICE HOURS M 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 � MASS639• p HYANNIS, MA 02601 M-8 -464FRI No Reference R-Red Item PLEASE PRINT CLEARLY 3,TFp Mp+> 508-862-0644 FOOD ES ABLISHMENT INSPECTION REPORT � L Name D Arvoe of Tyne of Inspection 2=�_ Rout' 1 Address Risk inspecti Level us Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP ' - In: Other Inspector Out: 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 ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: TO 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 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 9 ( )( ) 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,sews 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must sewage back-up,infestation of rodents or insects,or lack of violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's a r Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N .�.rw..'""�-r-..�--.►"-`"; ;;,,'^�.ai�.* -•e�i_.. -s.---..-.. w^,4..�s,,,,''�"�"'�xs^a`""^`^,r^'�'"`w%�-y,i. _ _ T _ - r .• -"y'- �.�+'ir'wr-.�... ,.-..s.-�ti!-v c 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* 3-302.1 l(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHN 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 * 590.004(F) Information-Original Containers 2 r 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.1 I C 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment ommon Name-Working Containers* 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 7-201.11 Separation-Storage* PP 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* PP P g Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.1 I Food Contact with Equipment and Utensils* C o .. 590.004(l I) Variance Requirements 590.003 G Re ortin b Person m Charge* 7-203.11 Toxic Containers-Prohibitions* 9 ( ) P g Y g Contamination from the Consumer 590.003 D Exclusions and Restrictions* 4 LI o s 7 20 .I I Sanitizers Criteria Chemicals ( ) 3-306.14(A)(B)Returned Food and Reservice of Food* REQUIREMENTS FOR 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdulterated 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 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-80 1 11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12• Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11 A(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or u Eq P i ment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game * rry cove uu2na 4602.11 Cleaning Frequency of Utensils and Food Pathogens 590.006(B) Water Meets Standards in 310 CMR 22.0* Animals-155°F I5 sec* n* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Contact Surfaces of Equipment* Shellfish and Fish From an Approved Source 3-401.11(13)(I)(2) Pork and Beef Roast-I30°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- Sources* Ratites-165°F 15 sec* in mobile food,temporary and residential 10 Proper,Adequate Handwashing g• P Y Game and Wild Mushrooms Approved By 3-40 1.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. g g 3-403.11(A)&(D) PHFs 165°F IS 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* 16 Proper Cooling of PHFs P 9 following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 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 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.1 I Handwashing Cleanser,Availability . Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 228. Special Requirements .00 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF.NE r� TOWN OF BARNSTABLE HEATH INSPECTOR,s Establishment Name: Date:. _ Page: of f ti OFFICE HOURS PUBLIC HEALTH DIVISION - 8:00-9:30 A.M. BARNSfABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MA55. 0g HYANNIS, MA 02601 MON.-FRI. No Reference R,:Red Item PLEASE PRINT CLEARLY i63v ♦ 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT c Name Dat Tvoe of T ectionVa. ' Op era IA JAAll Address Risk Se. " e-inspection Level % ai Previous Inspection Telephone Residential Kitchen Date: Ci Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) ( Time Bed&Breakfast HACCP 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 590.0091(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ 4/s 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 r �• ° -%t ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals 1 FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) c �e ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ',� _ 1 ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling V F ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding 5` PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control J V" n ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) - ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP 9, ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices-. ❑22.Posting of Consumer AdvisoriesLD ' Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �` Critical(C)violations marked must be corrected immediately. (blue&red items) �rVa Corrective Action Required: 16, _ e , Non-critical(N)violations must be corrected immediately or FAN Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension Official Order for Correction:Based on an inspection tod a items C N ❑ Embargo ❑ Emergency Closure r ❑ 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_ B-One critical violation and less thanregardless Health. Failure to correct violations 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 non-critical violations if no critical violations.observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establis&ent 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 violation observed,7 to anon-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address s tical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. w 29.Special Requirements. _ (590.009) y p _ - 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's ISignature Print: Self Service Wait Service Provided Grease Trap Size_ Variance Letter.Posted Y N tp / Dumpster Screen? Y N ,V µ Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions 4. Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* * * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.*. 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F. 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* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* ( ) P y7-102.11 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 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 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* 590.003(E) I Removal of Exclusions and Restrictions 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 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* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equiment 5-101.11 Drinking Water from an Approved S stem* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* - � - 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* ej/cnvc inrzooi 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* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* faces 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* Mushrooms Approved By ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec* Authority 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23-30) 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45'F r5. Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 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 Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours* Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. r aFiMWE r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of 4 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-a:3o P.M. I Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. g MON.-FRI. F.639. • HYANNIS, MA 02601 -s62-4644 No Reference; R-Red Item PLEASE PRINT CLEARLY - FOOD ESTABLISHMENT INSPECTION REPORT f Z - "� Name / D Tyne of T Ins ec ion �p outine Address - Risk n Level Retal revious.Inspection zo Telephone �� Residential Kitchen Date: AA Mobile Pre-operation I Of Owner HACCP YIN Temporary, Suspect Illness of L t Caterer General Complaint ple Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: e-- 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) ❑ �v� l Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ .41 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 FacilitiesIN EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling If j ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ANA- ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) 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 regardless of the number of critical,results in an F. - 25.Equipment and Utensils 6=One critical violation and less than Orion-critical violations 9 (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B" Seriously Critical Violation=F is scored automatically if: no hot 26.water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food-establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation;4 to 8 violations observed,rio 7 to 8 non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. n-critical violations=C. w 29.Special Requirements (590.009) y p 30"Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view V Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's ignature 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 15 590.004(F) Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 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* Applicants* * 7-201.11 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 7-202.11 Restriction-Presence and Use* * O P y3-302.15 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* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) I 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 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 Raw Seed S routs Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and P 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 * 4-501.114 Chemical Sanitization-Temp., H. Proper CONSUMER ADVISORY 3-202.14 Eggs Milk Products,Pasteurized P P 16 Poe Cooking Temperatures for PHFs gg P 9 P Concentration and Hardness* 22 3-603.11 Consumer AdvisoryPosted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec 5-101.11 Drinking Water from an Approved System* k 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 - Egmpmerit* Not Otherwise Processed to Eliminate * J- _ 3-401.11 A 2 Comminuted Fish Meats&Game * e-ti-11112001 590.006(A) Bottled Drinking Water ( )O Pathogens � 4-602.11 CleaningFrequency of Utensils and Food * 590.006 B Water Meets Standards in 310 CMR 22.0* q y Animals-155°F 15 sec 3-302.13 Pasteurized Eggs Substitute for Raw Shell Contact Surfaces of Equipment 3-401.11 B 1 2 Pork and Beef Roast-130°F 121 min* gg Shellfish and Fish From an Approved Source ( )()O)( ) Eggs* PP 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* ( J 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 _ g g � hY A - D Violations f Section 590.009 A - Din cater- * 590.009 0 0 - 3 201.15 Molluscan Shellfish from NSSP Listed ( ) ( ) ( ) ( ) Chemical*l 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* ( )( ) 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* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 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 Tastin * * (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 12 Prevention of Contamination from Hands (E) g illness interventions and risk factors listed above,can be found in the 3-101.11 Food Safe and Unadulterated* 3-403.11 Remaining Unsliced Portions of Beef Roasts* 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Ln Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45'F Item Good Retail Practices FC 590.000 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' I Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1 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:590Forrnback6-2doc *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 IKE r,,y _ TOWN OF BARNSTABLE HEALTH INSPECTOR•s Establishment Name: Date: Page: of y OFFICE HOURS P ` PUBLIC HEALTH DIVISION 8:00-9:30 A.M. RARNSrABLE. 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item 'DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified a39. HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY p' 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT r Name - Date f V j T e of T e of I s ec ion 1 I n ine Address Risk Foo Re-inspection Level s nspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: 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 ❑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 HAP ❑ 10.Proper Adequate Handwashing - CONSUMER ADVISORY) Lon ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good,Retail Practices(Blue Items), Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating ❑ 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 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N 'PI 's Si In 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* 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.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chazge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 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 3-501.19 Time as a Public Health Control* 3-302.15 Washing Fruits and Vegetables * 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 Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated. g ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served y * Pe 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products 4-501.112 Mechanical Wazewashing-Hot Water Monitoring 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Lit Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155'F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* egcnve rnrzoor 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* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590:009(A)-.(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g� P �' 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* 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 shouldpractices 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requiremen 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* 3403.11(B) Microwave-165*F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 PreventingContamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne 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 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling 3-202.18 Shellstock Identification ( ) g Cooked PHFs from 140°F[0 70°17 r5. 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 5-203.11 Numbers and Capacities* Within 4 Hours* Management and Personnel FC-2 .003 Tags/Records:Fish Products P 3-402.11 Parasite Destruction * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient Food and Food Protection FC-3 .004 • * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability Poisonous or Toxic Materials FC-7 .008 HACCP Plans 1 16-301.12 1 Hand Drying Provision 129. 1 Special Requirements 1 1.009 3-502.11 Specialized Processing Methods* 130. 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. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF.K�E ror TOWN OF BARNS.TABLE HEALTH INSPECTOR'S Establishment Name: Date:l Page: of ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:001.6:30•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 167q: �•� HYANNIS,MA 02601 sos-s2 FRI. No Reference R--Red"Item PLEASE PRINT CLEARLY A'FON1P�a FOOD ESTABLISHMENT INSPECTION REPORT Name Date TXpe of Type of Inspection Routine Address Risk ood Servic inspection Level a al coon ' Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: 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) ❑ 6 Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ G r FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands t ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities W V/� 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 L ;.¢ 04 ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding o 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 WP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories 7 T Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations CAI 14N Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: o 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/Ex sion Re-inspection c eduled 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 6=One critical violation and less than 4non-critical violations g (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical " water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. - within 10 days of receipt of this order. violation,4 to 8von-critical violations=C. 29.Special Requirements (590.009) nature Print:Signature Inspector's 30.Other DATE OF RE-INSPECTION: Ins p 9 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter.Posted 'Y N /I A/��j l Dumpster Screen? Y N `'�'�,, Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003 A +Demonstration Assignment of Responsibility* 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) g14 Food or Color Additives 590.003(B) of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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* 3-302.11(A) Food Protection** 7-201.11 Separation-Storage* 20 Time as a Public Health Control � Responsibility 590.003 Res of A Food Employee 7-202.11 Restriction-Presence and Use* * n' pto yee 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* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Resumed Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 590.003(E) I 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 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-40 1.11(A)(2) Comminuted Fish,Meats&Game Pathogens* effe cmc uuzom 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 rf cesSanitizationEquipment* of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-20L14 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 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165*F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* . 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140'F* Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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 Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70'F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 L 3-402.11 Parasite Destruction* 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 1 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 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. t a �F THE ram, TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of P. 1 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BAR.K.STABLE. • '� 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS.679 `0$ HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT 508-862A644 - Name Date , e of T ns ecti n O era ' utin '� S ✓t- �- Address Risk F Servic ns ion Level Retai Previous Inspection Telephone Residential Kitchen Date: S Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) - Time Bed&Breakfast HACCP In: Other _ t� Inspector Out: yv:�S S \ G3/ L l��fy 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 ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.0 (F) ❑ G'-, aN� Action as determined by the Board of Health. Allergen Awareness 59 . 09(G) ❑ J FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS IN ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives_ ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Ha ardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures P ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling L9 ❑ 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 C ❑ 10.ProperAdequate Handwashing CONSUMER ADVISORY rr'�� ❑ 11.Good Hygienic Practices ❑22.Posting of ConsumerAdvisoriesLv s tf� usf.N1�'' �A Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations -I V+ V- IA` Critical(C)violations marked must be corrected immediately. (blue&red items) jl Corrective Action Required: 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 e-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 B=One critical violation and less than 4 non-critical violations if no critical violations observed,4 to boon-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter.Posted Y NVC,t' 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 A%cording 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)(I) 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 15 590.004(F) Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers P g 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 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) I 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 Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 17.206.12 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 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* Eggs 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 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. h*W 2-301.14 When to as * Other 590.009 violations relating to good retail ' S90.004(C) Wild Mushrooms* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding 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 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 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 U3-502.11 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 Labeling of Ingredients" Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7Conformance 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 Specialized Processing Methods* 30. OtherReduced-Oxygen Packaging Criteria* 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. FIME ro TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of Pao by OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BABN/TABLE. ' 200 MAIN STREET 3:30-a:3o P.na. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e;v, .o$ HYANNIS, MA 02601 08-8MON -FRI. No Reference R. -Red Item PLEASE PRINT CLEARLY sos-as2-asaa "lF°M FOOD ESTABLISHMENT INSPECTION REPORT - L Name Date a of sec io Operatkugs) utine l Address Risk ood Service Re=rrrsp=on Level a Previous Inspection Telephone Residential Kitchen Date: r Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness VA p Caterer General Complaint Alk Person in Charge(PIC) Time Bed&Breakfast HACCP 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) ❑ 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 WKS FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures I ❑5.Receiving/Condition ❑ 17.Reheating C ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY _ ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&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. FR ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ® Embargo ❑ Emergency Closure ❑Voluntary Disposal Other: ❑ 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent 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 8non-critical violations=C. w 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease 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 e f v /CGS 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.* Additives* 19 PHF Hot and Cold Holding -i 2=103.11_�� Person-in-Ctiazge Duties 3-302.14 Protection from Unapproved i 3 15 Poisonous or Toxic Substances ) Contamination from Raw Ingredients 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH_ 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C)- Responsibility of the Person'in-Charge toV 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 \ _ *.- ,l 7-201.11 Separation-Storage* Applicants f 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An' 7-202.11 Restriction-Presence and Use*� �� 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* j 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(P)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g � ) / W Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE `. 31701.11 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* ` 1 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* * Raw Seed Sprouts Not Served � Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* 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.I1A(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 * Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* gg mme ery sec * _ Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effe c"°e 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell 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 * 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 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#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 13 Handwashing Facilities 3-202.18 Shellstock Identification* 3-501.14(A) Cooling Cooked Fr from 140°F to item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours anndd From 70°F to 41°F/45 45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* - * 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 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* '` -j 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* ^it 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. p IKE r'r TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: �� Page of .� q OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. ennNs'rasLe. - 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified mass. MON.-FRI. v�ArEDM ".� HYANNIS,MA02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Name DateMob, a of TyQ0.2LnsRection O utine Address Risk od Servic inspection Level Re Previous Inspection ci Telephone Residential Kitchen Date: Mobile Pre-operation caw Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 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) ❑ 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 ,i ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals L �y� 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 y_ ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories r 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 E] 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. B=One critical violation and less than 4non-critical violations re g 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically la hot C=2 critical violations and less than non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-cri 28.Poisonous or Toxic Materials (FC-7)(590.008 be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8 non critical violations=C. w 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view YV\O\ nNLN�i6�� a_�_ 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 "1 Dumpster Screen? Y N .I - GS 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 15 590.004(F) Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45°F EMPLOYEE HEALTH_ 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140'F* 7-102.11 Common Name-Working Containers 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 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* 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(11) Variance Requirements 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 Rated or 7-204.12 Chemicals for Washing of Food* Produce,Criteria* HSP HIGHLY SUSCEPTIBLE POPULATIONS 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* [7-206 1-3 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 Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145F 15 sec*' Animal Foods That are Raw,Undercooked or Equipment 5-]01.11 Drinking Water from an Approved System* * 8g Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective///rzoo/ 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 r f ces Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Ho[Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' S90.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*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#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (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 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140'F to 70'F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70'17 to 41'F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 1 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. 00. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF.Me rok TOWN OF BARNSTABLE HEALTH INSPECTOR's Establishment Name: U Ir%w Vt'e►✓ s v�4 Date: / Page:._of q OFFICE HOURS r 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 .A-- HYANNIS,MA 02601 MON.-FRI. No Reference R Red Item PLEASE PRINT CLEARLY 508-862-4644 �'FDN1P�' FOOD ESTABLISHMENT INSPECTION REPORT Name Date Tvaeofof T e of Inspection rVi e w F wJ/bvr C1 fFocre, Routine G' Address ^� ,``` Risk i spection ems"3,5 V '^ - �" �` Level Previj.1,j pe on oo i t Telephone Residential Kitchen Date: S fi �` I Lot �J v,JMobile Pre-on Q Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast HACCP d ^E' , In: Other Inspector C,V �, ^ f� Out: g r1eA / 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 ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP , ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C).violations marked must be corrected immediately. (blue&red items) 111 Corrective Action Required: o ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ 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 automaticallytion of rodents or insects,or lack of if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to.a hearing. Your request must C=2 critical violations and less than 9nonvcritical. If no critical water,sewage back-up,infestation 28.Poisonous or Toxic Materials FC-7 590.008 be in writing and submitted to the Board of Health at the above address violations ed,7 to 8nonvcritical violations. If 1 critical refrigeration. ( )( ) violatio ,4 to 8 n I ical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. DATE OF RE-INSPECTION: Inspector Signature Pri 3 .Other i 31.Dumpster screened from public view i N fi Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N I�+ #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's ature Pnnt: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted- Y N f- Dumpster Screen? Y N V Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19. PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*7-102.11 Common Name-Working 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 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 7-201.11 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-Presence and Use** 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 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 Reared or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual 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* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. F 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of Eggs 5-101.11 thinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg c i-11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency 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. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* en 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 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* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F. Item Good Retail Practices FC 590.000 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 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ( .t �'f • �pFSHE Tp� Barnstable y�P Town of Barnstable AMmmicac" Sa BAR MA TA NSTA � BLE. Board of Health Q � '9 pPTf1639-MA't A 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Donald A.Guadagnoli,M.D. Junichi Sawayanagi Jeffrey M. Ford, Esq. December 4, 2017 Ford & Ford Attorneys At law 72 Main Street, PO 'Box 485 West Harwich, MA 02671 RE: Variance to Operate with Two Restroom Facilities — 235 Ocean St, Hyannis Map / Parcel 326-034 Dear Mr. Ford, You are granted temporary variances until March 1, 2018, to operate food establishment(s) at 235 Ocean Street Hyannis with four restrooms (two restrooms on the lower level and two restrooms at the second floor level) shared by patrons and employees at 235 Ocean Street, Hyannis. The variances granted are as follows: • Section 322-4 Toilet Facilities To maintain two restrooms at the lower level 99 seat restaurant to be shared by both patrons and employees, in lieu of the requirement to provide separate employees' male and female toilet facilities and separate patrons' male and female toilet facilities whenever more than 50 seats are provided. • Section 322-4 Toilet Facilities To maintain two restrooms at the upper level 109 seat Hyannis Angler's Club to be shared by patrons and employees, in lieu of the requirement to provide separate employees' male and female toilet facilities and separate patrons' male and female toilet facilities whenever more than 50 seats are provided. These temporary variances are granted with the following conditions: • No more than 109 seats total are authorized on the second level. • No more than 99 seats total are authorized on the lower level. Due to the limited number of restrooms provided, employees shall have access to restrooms on both the lower and second levels, regardless of whether the workers are employed by the lower level restaurant or the upper level club. • These temporary variances are not transferable to another owner or lessee. Q:\WPFILES\ThirstyTunaATtorneyFordVariances2Ol7.docx • Copies of this variance decision letter shall be posted on the wall adjacent to the food service permit of each food establishment in an easily accessible location for viewing by a health inspector anytime inspections are conducted. These variances are temporary until March 1, 2018. The first floor restaurant, the Thirsty Tuna, will be commencing operations under new ownership and management. It is the new owner's intent to convert the current building to a single license with the tenant occupying both floors, at which time these variances will no longer be necessary. Sincerely yours,0� Pau J. a- i , I�.AA.D. Chairman Q:\WPFILES\ThirstyTunaATtomeyFordVariances2Ol7.doex FORD & FORD ATTORNEYS AT LAW o20 r 72 MAIN STREET, P.O. BOX 485 WEST HARWICH, MA 02671 TEL. (508)430-1900 FAX(508)430-9979 MICHAEL D.FORD ' office ,fordandfordattorneys.com JEFFREY M.FORD Attention: Town of Barnstable Board of Health Attention: Thomas McKean, Director 200 Main Street Hyannis, MA 02601 November 15, 2017 RE: Variance to Operate with Two Restroom Facilities—230 Ocean Street, Hyannis Temporary Extension Request Dear Mr. McKean, Please accept this letter as a request for the temporary continuance of the variances currently in place at 230 Ocean Street, Hyannis,MA(see attached copy). As discussed,the Hyannis Anglers, who occupy the second floor of the building have ceased operations and will not be renewing their license. In the meantime, the first-floor restaurant,the Thirsty Tuna will be commencing operations under new ownership and management. It is agreed that the Thirsty Tuna, their staff and employees, will have full access to the two second floor bathrooms to be used as separate employee bathrooms facilities. It is the new owner's intent to convert the current building to a single license and tenant occupying both floors, at which time the variances will no longer be necessary. In terms of timing, it is anticipated that this change will be taking place over the next few months. As a result,the owners respectfully request a temporary continuance of the variances, as needed, until March 1 st, 2018. Please let us know if you will need any additional information in support of this request. , Very truly yours, Jeffre M. ord, Esq. Att e or 235 Ocean Street LLC CC: Clients. i DATE: I / snt . MASS. t►tnes , t639. 1 MR(� h• REC.BY: 1404v,-i Town of Barnstable SC> ED•DATE: Board of Health Office; 508-862-4644 200 Main Street, Hyannis MA 02601 FAX: 508-790-6304 Paul J.Conniff D.M.D, Junichi Sawayanagi Donald A.Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN GOTOIY VARIANCE REQUEST FORM C--. -- Property Address: 5 U r k� ` r C Assessor's Map and Parcel Number: 34 6 /0 314 Size of Lot: Q ciu-C Wetlannd§Within 300 Ft. Yes Business Flame: 3� C 1`P No -�s`"°`' n"'4 -�,�. weer Q1 s�,a„ Subdivision Narne.— q � APPLICANT'S NAME: �35 Oce-o-4 rtc 4 W— Phone Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON n �) Name:Q 35 Gcnn� 54ruzz] LLJI Name _ Fird ��� �d/ t'J1��� s' �� Lgt*j Address: J-L C,e W1A Address: �I �i �" �4xLj 2S (Y4 �,~�o•w s U�itz1� Was Pw 9 d Phone: —ab a�. rc���-a 0 1 Phone: VARIANCE EMAIL: G ;G � •� ®�_•,Ud i FROM REt ULATIrOIY t,List Reg) REA N FOR VARIANCE(May attach if more space needed) �J �n i I ^� J"h C�1 P�D C� novation NATURE OF WORK: House Addition House Re Repair of Failed Septic System Check ist (10 be completed by office stag`-person receiving variance request application) Please submit copies its 5 separate,collated packels. 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 t/A septic systems only. Five(5)copies of labeled dimensional floor plans submitted(e.&house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarion Signed letter stating that the property or business owner authorized you to represent him/tter 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—give(5)copies of full menu submitted(forgrease trip variance requests only). $95.00 variance request application fee collected (No fee for lifeguard modification renewals , grease trup variance renewals [same owner/lessee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal syst expansion to the building proposed]) ems[only if no Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED NO'r APPItOVl.D Paul J.Conniff,Chairman REASON FOR DISAPPROVAL Junichi Sawaynnagi C:\User®\Decollik\AppData\Local\Microsoft\Windows\Temporary Donald A.Uuadagnoli,M.D. !Files\Content.Outlook\8MQD49H2\VARIREQ Rev APR2017.DOC Internet w�F wH - N Town of Barnstable sar[Is tablc I,I �o.mvs~rne3�e,,�� AI-AmateaC'� Board of Health 1 O t639 Ar�O MAC 200 Main Street, Hyawlis MA 02601 Y 2007 Office: 508•862.4644 Wayne Miller,M.D. FAA. 508-790•ti�Ja Paul Canniff,D.M.D. Junichi Sawayanagi Mr. Anthony J. Folino Jr,, ':Trustee June 30, 2015 Hyannis Anglers Club 235 Ocean Street Hyannis, MA 02601 RE: Variance to Operate with Two Re t p s room Facilitie s — Hyannis Anglers Club _. 230 Ocean St, Hyannis Dear Mr. Folino, You are granted variances to continue to provide only four restrooms (two restrooms on the lower level and two restrooms at the second floor level) for two separate businesses to be shared by both patrons and employees at 235 Ocean Street, Hyannis. The variances granted are;as follows: Section 322-4 Toilet: Facilities To maintain two restrooms at the lowe r level 99 seat restaurant to ibe shared by both patrons and employees, in lieu of the requirement to provide separate employees' male and female toilet facilities and separate patrons' male and female toilet facilities whenever more than 50 seats are provided. • Section 322-4 Toilet Facilities To maintain two restrooms at the upper level 109 seat Hyannis Angler's Club to be shared by patrons and employees, in lieu of the requirements to provide separate employees' male and female toilet facilities and separate patrons' male and female toilet facilities whenever more than 50 seats are provided. This variance is granted with the following conditions: • No more than 109 seats total are authorized on the second level. • No more than 99 seats total are authorized on the lower level. • Due to the limited number of restrooms provided, employees shall have access to restrooms on both the lower and second levels, regardless of whether the workers are employdd by the lower level restaurant or the upper level club. Q:'.WFFILES'\Resu00m Variance -fyannis.Anglers Club 735 Ocean Street 2015 doc • This variance is not transferable to another owner or lessee. • Copies of this variance decision letter shall be posted on the wall adjacent to the food service permit of each food establishment in an easily accessible location for viewing by a health inspector anytime inspections are conducted. These variances may be revoked anytime unsanitary conditions are � Yn e observed. ry Sinc rely yours, W tyne iller, .D.Chirm n i I Q WP(-*I!_ES',.Restroom Van nce Hyannis Anglers Club 235 Ocew Street 2015 doc 5 322-4 Toilet facilities. [Amended 11-15-2005; 2-28-2006] All food-service establishments shall provide adequate, conveniently located toilet facilities for their employees. All food-service establishments shall provide adequate, conveniently located ;toilet facilities for their patrons at any locations where seating is provided. Each food-service establishment with a seating or standing capacity of over 50 patrons shall provide; toilet facilities for employees that are separate from the toilet facilities provided for patrons. Separate facilities must be provided for male and female employees and male; and female patrons. All restroom sinks shall be equipped with touchless sensor-operated plumbing fixtures. Each food-service establishment shall be provided with adequate, conveniently located hand-washing facilities for its employees equipped with touchless sensor-operated plumbing fixtures, hot and cold or tempered running water, hand cleansing soap or detergent from a dispensing unit, and sanitary towels or other hand-drying devices. Common towels are prohibited. This handwashing facility shall be located in the food preparation area. I i r Fimic -".......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF. HEALTH-! C'W ...................OF....... ................................................................................. : rfiration for Dhipoott1 Works Tonitrurtion Wrmff Application is hereby made for a Permit to Construct ( ) or Repair (*) an Individual Sewage Disposal System at: ....:. 3S..C3cear._S t -+... >ecA!XiA................... ............................••--........--------..._.....---------.........._..................--- c� 1 Location-Address o Lot -----MGc6K 7�F r�e....orb. • 0c Ica s............................ -•-a35_Q-----ctr_S R'' Owner Address Q b /hW ........v s nto r.. Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons....._...................... Showers ( ) — Cafeteria ( ) a' Other fixtures __________________________________ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length________________ Width................ Diameter................ Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by••----•-•----•---••---•-----••---•-••--•••••-...--•-•--.......•-••-•----- Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 -•••---••-••••----•••••••-••-•••--••---••--••----•-•-----•--•--.... ..........................................•••-----•----......----•--••--...---_...•- 0 Description of Soil.....:...............................•-•-----•------••---•---.......-----•----------•------------------.-..------------.........------------...•--••••••---.._......._.. V -•------------- ------------------•-•-•------------•---•------------•---•----------------•----------___-- _ .__..._..--•--- U Nature of Repairs or Alterations—Answer when applicable... ¢.___l® R.+QgL- a._: ��jP__4 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITU 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is ed//by the board of health. Si ned..... -•' fil. 0 6'-/8' 0 Application Approved By---------------'-------�. ...............---------•- ............................ .......------.� . Date Application Disapproved for the following reasons-------------------------------------- ---•-•---------._...-------------------•-•••--••-•---•-••...._-------- ..............•----......:__...•--------------•------._..._._........_........---•-............._..-.-...._......_...._.....••-•--•..... •-••..__._._....-------•------___ -•--•-------- Date_._ Permit No.-....... -. Issued__......:-� - ..........------------------------- -- ------______________�._.___------------------------ ------------ -- - 4 - --------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH rJW rt.....................OF....�= rtl.� r,b�_......................................................... Appliratiun for Dispnstt1 Works ToustrWiun rrrmit Application is hereby made for a Permit to Construct ( ) or Repair (,hG.) an Individual Sewage Disposal System at: .....!2.3 "? �crn« 1.eca 4ci n n 15..................... ............................................ ......-----............................... Location-Addresst n p !/ ppr Lot ••o. ...w(k(.% r�e_c� (2c, UC2CC)IS /8far 4�r(I`_..- ................................................._6 (3AZ J`'h-1ea.1• �]F4�c�r»/�;......._...«......«........ • - n /y n Owner 7 n Address / t IWa / �`} lJCC�ttCrt .256 /�trl,? ....� ........... Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) U Other—T e of Building No. of persons............................ Showers — Cafeteria W Other fixtures ................................................... . Design Flow..........:.............................. .'gallons per person per day. Total daily flow............................................gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No............:........ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by•-•-•--•-•••••••....•.--•--.....•••.....................•••---•......... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -----------------------•...... .... ........•--••--------..................... ....•---------..... ........ ......-------------------------------------- 0 Description of Soil.........................................................•.............................................................................................................. W V ------------- ------••-----•-•----..-•----------- ---------- .-- ._...------------- --------- •------- ---. --• ......------------- - .------ ..---.---- ------.-----••••-•----•-----------•-- W ...................••-••-....._..•••............-••••-....... • •••......-------•-•-..._••- U Nature of Repairs or Alterations—Answer when applicable.keni -:_.1 ..... ..:............................................................. .......--------..............................•.............. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT11- 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i§sued by the board of health. - �-, C'7 . Application Approved By..... •-- .......e.7........................................ ......(Irl .`.Dj..'�.�.. Date Application Disapproved for the following reasons:..........................................................................................................«..« .............................................•-•-----......................------•----......-•------•--............................-•----......................----•------•-••••...._........._...----- __._. _ Date Permit No.� ......... ...... ...... Issued........................................................ Date � ( ,n THE COMMONWEALTH OF MASSACHUSETTS BOARD�QOF HEALTH ......�....�'�G':!77...................O F........FJ,C%A-Vt ....414.............................................. ................. fgrrtif irtttr of Tamphana THIS IS TO_�R.�IFY, That the Individual Sewage Disposal System constructed ( ) or Repaired� ) by......................... -W..:..............Pnaf.........0................... .................---.............................------.............................. C��11 at . ---•---•-----•------------------•-••-••--•••••---• \ - .. ... .................. .......... has been installed in accordance with the provisions of TIT:Z;,,j of The State Sanitary Code described in the application for Disposal Works Construction Permit No..... ,c.:.. dated___.__ ?.. r.�'/f3 ............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A dated--,, NTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE .......... .............. ..... ...... -.......... Inspector :. ..................................... THE.COMMONWEALTH OF MASSACHUSETTS BOARD OF HE LTH No ..... .1_ r' ....................OF... ? --••-----------•----................................... Fss.! .:":........... 13ispod Works Tunstrnrtiun f amit Permission is hereby granted........... Lf.n-A)......................................................................................._.... to Construct._(_ ) or Repair ( ) an Individual Sewage Dis osal S stem atNo.............. .:�?..._-�....A..�r C r �................ _..................... Q.h L�_l ................................................................. treet _� �� as shown on the application for Disposal Works Construction Permit_N_ �?__ 1__�_�.�-ated... ..fil - ............... 9\ . } Board of Health _DATE.......... .............._... .....-------==--=:..--------- FORM 1255 A. M. SULKIN. INC.. BOSTON 1 n FERN, ANDERSON, DONAHUE, JONES & SABATT, P_ A_ ATTORNEYS AT LAW DANIEL J. FERN P. O. Box SIB RICHARD C. ANDERSON 436 MAIN STREET ROBERT J. DONAHUE HYANNIS, MASSACHUSETTS 02BOI STEPHEN C. JONES C HARLES M. SABATT AREA CODE 617 77S-S625 May 22., 1986 Board of Health Town of Barnstable. Town Hall Hyannis, MA 02601 Re: Main St. Corporation d/b./a Oceans 235 Ocean Street, Hyannis Dear Members of the Board of Health: By letter dated May 22, 1985 your Board granted to Oceans a condi- tional variance from Regulation 14, Supplement to Minimum Sanitation Standards for Food Service Establishments upon condition that Oceans install a grease interceptor prior to its next licensing period. A copy of said letter is annexed hereto. Request is hereby made that an extension of this variance be granted until fall for the reason that Oceans finds that it has no money with which to comply at this time. Unexpected expenses caused by the. need to re- place a hot water heater, a hot water booster, and a new roof, have left Oceans' coffers bare. If an extension for this season is granted, Oceans will agree to have the grease trap pumped monthly, or more frequently if you deem it necessary and will install the requisite grease trap in the fall. If you would wish for me and a representative of Oceans to appear at one of your meetings, I will be more than pleased to 'oblige upon being so advised. Sincerel , R'ch C. Anderson RCA:esj Enc. IQ�pFTME.p� TOWN OF BARNSTABLE ?„ OFFICE OF BnsasTesL>i :0 BOARD OF HEALTH q ItA66. p p 1639. `00 iDTFa uAR k• 367 MAIN STREET HYANNIS, MASS. o26ot May 22, 1985 Mr. Joe Callahan Main St. Corporation d/b/a Oceans 235 Ocean Street Hyannis, MA. 02601 Dear Mr. Callahan: You are granted a conditional variance from Regulation 14, Supplement to Minimum Sanitation Standards for Food Service Establishments, for outside dining at Ocean's, 235 Ocean Street, Hyannis, with the following conditions: (1) Only 32 outside dining seats are authorized. (2) Your 1000 gallon grease interceptor must be pumped on a monthly basis and a record of the pumping kept on the premises. (3) You must install a grease interceptor commensurate with your seating capacity prior to your next licensing period. A 2,500 or 3,000 grease interceptor will be required for your total authorized seating of 130 persons.- This total includes bar seats. (4) This variance is granted with the stipulation that all conditions listed in our outside dining criteria from A to O must be strictly adhered to. . (5) The Board reserves the right to terminate the variance for sanitary violations or for conditions not specifically outlined in our outside cafe criteria. V r truly yours, /Rober L. Childs Chairman BOARD OF HEALTH TOWN OF BARNSTABLE JMK/mm U i a 'r Y ,'- ,' a„ -.2 ,tr Jt at..yt�•4r t wt v*LC •` ,is 4`+e e 'e { E a � ,! Y •� �`Sr „t *••'±` <,, * ,!,y.�'' a '�' ;,t r,�^ 't A t♦ F.y,' ."t'.j t `�+ 41 '.. , }!��� 1. y ^wt :{.♦' 3»•S n.\ �:� n ♦• t- v Y ! 2' ., u x 14 .. .. ..r e53 �'' r �...5 ����., a .43 .* w, r � . 534 ;�s+tt; �, at' �.x + st e� ,�'. �rY 4 k.. r •-`{ .. r • � - . ., n w9 rt t,a.p" S } i Y+•#dyk y'"1d�i.+ :r i " .;'b- -. '" ,r i� :. t t' t't"� s T >i f 1 °;..v ""' a`' ♦ :s i ;/� �'�M19 'k *S + �• t °d�"t, t�. y*,}s't�' .° r �t,�a .t +, a , •, �_� � . � # r r 'Ka f t 1't L t _1 Y ✓ 1 ,�,Fe F t> Z.:1 � t „P, y,..�:4 � � i r *ix !3r , �" �''.; r.;'�e t�.' �S i! , v. �.` '` _ ✓. l.+' � Lie -.t�,� f 4 4,r,y t ', ,3 .. •.:"s; qf.✓ �' -. ` 5 }., t` U`, ♦S �.., {j-' iµ f °'2. >. `� � � ♦ i' f 3 `i A -•3 4�'> } �,k t .tl �'ti' - t•S»^- 4 Sit' r r ..; ! .:. �+ �' y -` f+ �Ma 22�t198S J Y, Y , ° 4'w i 1 r 9 Y�v t h A t"Yfi +t5 ty a`r 6 .+ 9 •A r 1. y i 3;fx'' N ''ti. *iL .- - L �• ` y ar xr {' `o- •d w s-t, t N„ h; ,? t f i 6 „ t tj..r i ,r '"r +• + `r 'wx"' `tta^ty,° `''4 Yc a "''{* d fir. w C:� a�".. .'F�'S .14 `?Pr , ➢• f'ss>L a .v a e }`Y" '' „P, `°*S f s' c.•# �� t. •'" �. •i 'is 4 +" ,,, r-e •a _..t 4 a. 's w. � , _ ``a ttw,`♦R e �.•,� .#, t4, e s w yr `.k�,;.,,.,y hta i•�'� #,�^.#.�,,i i♦ 5 .•,^�'�' t fix"`.:R Y ��,' _•'{t *s r, '�is r ,...5� ,..t,.:. �� �xt a 3.. �, .: Ltae t'+d 'SS •` ,�} Y t F }t r Y✓ d'�4 r•r A 'r C ,wiz M e*• ,.t "• TS' ,• t i" rnePr•1 ;fir A q n A Y {.5 • r� as ,` �, 5,r. Al E. MT. Joe•�Callattann � e;=,Main St Corporation-:d/b/a Oceans : r t:' �• f ' `235-Ocean Streets Hyannis,rkiA <02b0I ,: ~. r 'Dear br..Callahan ' a y'.L ;,�', . ' ,` d �S� F e�r r 'fit} �•` !tt r „ a r Y 1" � ' 13 � ;.. �- } 4 :You are,*granted `a�-conditional ,variance �froin Regulations 1.4,° 'Supplement to ' Minimum Sanitation Standards for Food' Service; Establishments,-forgo aside dining . ' fat Oceans, 23S Ocean Street; Hy nnis;'with the foltowing,condittons (1) Only 32 outsidi dining seats are authorized. +.%r a.- .,�.; '�, �.� 3 L•;'� } i 2. 3 '� i �_' i >etw{ L e y °,wy :•, }r'4 J•y,e: •'�' .4 -rg •.' 4 ,�,. ,,t }•• + 'h *r(2), Your 1000,gallon grease,interce tors,musti,be"pumped;on a"monthly basis`and P a`record of^the pumpingkept on the premises:, ,5 's _r "�.• t';l r ''t'=g r'.r.�At A ;'_✓S�a 5 rt �. , ,yw• "t You +must tnstall 3!a grease -interceptor. commensurate with our, seatin s z Y z , Y ,F y g; * ; s f capacity prior to ' our,'.next licensing eriod. A 2 500 :oi� .3°Op0 ''grease ► 3> ' f ' t intercept requtred for_ ,your`total,authorized'seating,of 3I30 peisons. t r :This total includes'bar'SeatB. } S.r t:• . .�'..(T) .This..t ariance't. 5,. ;� .Tl �- •Y .t. ..t . ) ♦ i . .y ". • : tr " .A, 'is granted with the stipulation,that aMrconditions listed•,in,our > o'dutside dining,criteria from A'to O must be,strictly adhered`to. M The-Board reserves,'the:right, o terminate>the�variance,for sanitary violations `f oryfor conditio_ns not specifically;outliaedinj our outside cafe criteria.,, z '"L�• •'�+� " L �' +. k �} x...- 4 .[- F', i.,•t;{ r ut,. - t. }.i .e, 9. X t;• d i > ` c a v � V y4 trul ours ,„t 4 + n' t{! , r 74 °.» �, .r,. a••.•.• },., r a- +. ^t `•ai*4 ! tYK 4,. t Y�z.,,wt,�a �4 f�.°�� "�r y d�,r'"��' 'r { �tr � r:,:��,� ra. ,d,,� i k r � t�'' R�Y.:•t. t y A r� ��• � ; obert L y� y .rya♦ i ,.'a' � � t r ."Nst � t'.. k .r,�. o .+�� •q' kph t-t.a irr Y :t.. i �;7 �,c„. ,a� ., • 4 ,..r•t��� jbf.'i�4 'ChairmancYei N`H i fi,. .,� •qr, , ti .is k�Ae ''4;'t`,3}'r'°"r Y,f 3 1 .i ,+ �W ti rk r'{ r.ys h �';. =e �.�; '� a • ,.. 't i rr{}A:.r'h ',, : t _ v t ,p,:. ;5,q� s- .J F; � ,� 1 a'.• 5 ,•BOARD OF 'HEALTH =' :44 °. ,, .� ti. w.Jt.:n � » s �� t` �`,7 •,: ,,..' OVWN,OF BARNST'ABLB ,. ���, , # , _• , aL. j'' ae♦ r - ';t 9 ww t�: rt+l• .R:"k, *y. ;j,;�+, j4. � s Y �� .�;�✓t ri+•d+t.•`'x r+�•�r.4�r`�e~i.,,;e "R .�Y'3 k r .. K r�a..r r` r,, k�r �� 5 i'E L�1 i r + { j t}} k.. @ ,.. �S..t �*yK, d I "°,,s an F.'f�" f{♦ i� `�`.- ';•,� ,• .•' p'tr � �.r)# r °1�,.. J �.'. J i i as 4,rk- { +k i `a ! :• ""3 ,� .+Y' ! I. w{� 3;: I 'e' '.t r 9 °" •y .•'t w. «:k :�} �� o � ,.. ; � .-,r+`rP f, �+'; w.::- ra.R' .� rt*r�.^F �a Aq,f M:• r t •� y„ t r w.a � `°,"�. y '� �* a w ! / JMK r, '"•; y tagY,SFF .i �' �';•n '�•P t ~-, -v , •'' a+y t'4'a 3 v #> ,P t+ Sir ;•afi :,s. A � � � +� S '' t� _�_f � -7� �� `k .>� !! t .~+ • ' d *, 1,. '-.ft • A •:-.� � a,;t..'Y� iY� 4 .y.r y t �e ;.•t •f. 4 y yJ"' 'F* 'Y"3.R }. w �� ri'3'. ,�f 3 et fj,'" t ..3 r" - - `•�/Z { '3• ` '.,r� •`� �' �', ;f; 3 k,'^'A i i y'` a r _ + . [• Ft •'-7 if R. }' { `i l f, . ;•t�. ti1. ,"m a i 3 -li � � -t- t .�y t t .,� a'„ tf„ � ,r g � .i^yw�,�•f# w 'Rt* 's. tt.. '. ., yR`rr� :4 "at r 'p , ,n p 3 ,t -�aA f; •'� ti ;. Yr "°{ ;S ,Y .S >t •t ' s 3 t' iry. x1t ,~ �rati i..-.,.. r ye^',} •°• �.. +Yp L aM.. � t g, .'!'•n a, '` , 4 7 9 !. '� '•. i:R' d k 'k rk . Jf.� ° _�Y r�. ,,+ k¢. y't .k �.x J ^e+ �±,. y - y r•`; 'Ey •'• .'•' �:..� 1 41 a•� ,.rli.! r Y + i 5. L. S . ' v� t Jar •, d° r Ya a r ry 't �r •,�` . �', g'`'. } t t �'" �3"r ; • , T- „ r �, k t a"di. e ,� slf�t�5 � 'y',x ' P. ", 1. •>�r�t� �"g'� Ufa F.;y"� r^ t _ p ..",-k• - .. 7 p..�.,r,i Y ''S"+ t K• P ti •>r t "fir+. + tq�y.. M D Cf THE Tp TOWN OF BARNSTABLE FEE r � P � 0� OFFICE OF BOARD OF HEALTH 1639. `e� 367 MAIN STREET HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variance requests must be submitted five (5) days prior to the scheduled Board of Health meeting. NAME OF APPLICANT l I G 1�� �� CQ 2Q l,�L� C�C��N S TEL. N0. ADDRESS OF APPLICANT �3� OCC-gO-- 4 (S M� NAME OF OWNER OF PROPERTY SUBDIVISION NAME DATE APPROVED LOCATION OF REQUEST VARIANCE.FROM REGULATION (List regulation) �� /0(,U/7 VARIANCE REQUESTED (Specific request) 91 REASON FOR VARIANCE (May attach letter if more space needed) - - PLANS - Two copies of plan must be submitted clearly outlining variance requested. VARIANCE APPROVED NOT APPROVED REASON FOR .DISAPPROVAL Robert L.. Childs, Chairman Ann Jane Eshbaugh Grover C.M.. Farrish, M. D. BOARD OF HEALTH I TOWN OF _BARNSTABLE "` S.;S �!...i' ♦s + Y� d 5 y� t • If Y� i T � r µ� n�.:. � V � � ��s` °{"•y"� J. { Y'." i s� .. '� 9'. � aA ;.r -A .,`� r ¢ .Mt � .•r5.hn;N��' ^N t ..tfs� r ; $ 'f v a R'r �"' r S .�, C r �4-, # .{ro„ "tw„tlet ,, r. •, *�Ar� �.s a '� i^ r k i .� \.a .. Y r a a*� �"`� r,ar 't V �+4.: � ✓E ' r a , s.'' y� �� •., ,`..e ] .^t. wf Jr. � r y tr '�fr, r 1 4 t t 4 r+{ f .r ? f E♦:! r o Y..'�cr y+7• A.. tJ 'Y✓4 f-t .:l$ a{ �+ '` t'�+}':. � "t. bl •....'r ` at; r. '..'F•u ! F r°:`�f.ro4 s"�g4L '. r �' t ;'t r. t ^,;1 ,y✓ - y>s'.y�{rtr J *�}t!a' V} y ^ ', .mot " a� , �. + : ti t. � ry.a .S, � -'✓" '� t � .r i ` ✓ ., f a, = a :,L a ti "` s �! �� s I ,i,. +> .`r 9'a b �:�' � � -i.• sa.'`y * ,. ✓ :� i,,,y,;.i d r a �,� x i:. � _ ;Lx .r arr ',r fR.x f . F h." :c► A v� a '`.a r a ".aL !h - •,.. �, ;� KtS � r G_yr. �✓� At _ r r, r t '� " ,�' t F.= 2: fi+. .t fie a •:p"e 'S•� p ro f `� th:( - ``<r_ - {.. . yY r•h '#.•: t t r , �' "� F - 1 i r a _ '{?>_ s b v t. ti ♦ - _ t' aJune 2, 198V A F ✓ `� gg 1 :.µ4 � t 3 rf .,� ^ r 3 `� '' a •L s r s 7y S ,'�(•. ,� e t ♦' * � a� � t� ✓ .t f• r ? f It lzM.', f« r>. ,;t �zq� r •'x b r; s t.;fit 3 W s ., f' F t •::•Y � Yf ,}} ,�� r•..Y r� ; +� bti� � C` r �. J }} rJ C � , k � � ,• • rr r t t .: �er � +',S r ✓ L ,wJ f.. � .ti r `� tiK i# }:�A,� � a -.�:� r ^ ✓ � "' ,rt,rF �+ � 'q+,t k^'.,y a'�. ,'{ "!✓� r F-`a, t+. ' ''_ " i t y\ tic �f aC f:'. ,rrF, s • q t t LL.r• .,l•, t D. '' V.6 1,7 x • ,lr' t = i Robert McNulty-f r y' H. �s',Chowde ouse r,f H yani vY ti .•, �,' t ♦ ,r.• ?,,. ♦r�• i I�.^�K w� .. t R rye, .r r;y. `2I 5 ;Ocean Street e� �4f ,xf' w. •!t' .�f " :.x57 a.•i' ^,,. t a " "V,�• t ;.?a .r t: t ' Hyannis Ma• w{� � 7•{a�'.Y It i' '+a� JtK'''4' 3 rr:. a .'v t '`,Ty. .6 Y } a _ V �:. r `'�� III '.Dear: . ,McNulty f , is, S ahV •`y.. + .y, f ` c x ry J ° �'~ •� ,y :, 1` Y 1 r. .r� s,n t '� _ r° .you.%Aje `granted; a: *c6hditional •vat snot�trgm Regulation l ; " { ,Supplement td,..Xinii um San tat on°Standards ;for :F©od SQry r . _ E&tab istuments;s' orF'outsidd `d n n at ,the . yanhis Chowd6r , L r t r t t • Y AI. i.rgr ,K "rr {p 1 } • •� • al '.rr ,^... r� ` „ House with Ftie following conditions: , k f,f t • 'S '{ ., ` -a t , >I yv 37:'`• �c � •: ri ^,`rl ly § '4 >sy"` ,• J ,,.>r. t s kv' i ti r e .i : r �.� � i� r -r s.v rrr + 7 t '.::"•' ank .C. r; thin 'y«FItwo additionalseats au�tho :N?ter, i # t,n .#+. ,> � . r ... i - Js r s' , ., ,t i+.. .- _• ! r '$ , J �H h t.�{ fY rl.*r. ,# dK 'YY ,t• rt �� `" {I•. r.,i•,R � 16�d' t• it,: ° ;. S. " ', f 4 t.�� n Y 1 ,•, i.l.,, i tr ;F. t iw 2 •Yr,. _. past w an f a p10 ee to et ►Se �' e s, ?8b �.� � r r r .' • "., :inistal a next r_j s., reby//y(�ojLu ,,out�»., s ids r ng c3. Bont�.n' d.' �*Y ' : " +' r�,y V •t ..f t"$' L '' 4'3 >t t r. v— t .t;,� rf`�':F � �� _' tk A� ''%n.r - '.r r *lo."' S 9 �_..'„ •` #„ � _., r S r + '' . .. � n+` t' This'roarianCe'ti$ f•'grantec with the• t�p� :ation`rthat °�N.jr ,d D J, '. r ar +� `all conditican�a listed` ri our Q i g � . y" .; t ut ids dnin criteria° •• 1.d t •. ;.. .be�•strictly a8here o. r. }, r ✓ 5 k ,dd hf f f . a kt e 4m r. -•:: kj:`�z, a ; t,.L',x i ,kry,i. ` t.a' 2� ,:�A �� :.. ,r �K, �L ,. r k .x" y ... a,. �,:..c •+ �. x t' ,; Y7 �' � •�r > F, « 1 a e..trigl t to, terminate "the° variance ,The-Board''are="serves' th ; K-'� }` far 'sanitaryy .violations or.'.foz';�cond'itions..not specie.= s { '� ✓ Jr _ e; s; c.•.*.. - s,;' 1, rout, Ind in .our ;u�ttside cafe 'criteria. f 7�a'd t �r '`Y�`"t� r°�' �' „- ' .�!.,�y .-:j rr,xw f-.`.'rw sl, �. )yl,: r��' �i�'•''"`s� � 't -;'r' t3 ..q , w if t,�?�'L +. �{ •., a, ��C'• t'ix. rul ours••I .1(,• L.rltr ( y' �r'tgAr4+' ` r ry 4• r f �+a�r ♦yY -.r. ryrtr r27 . {,,¢ t` .' ��' r + '�,' �,_•`"''"'1�t.1:,$��f 'J�F F '�+� s[j} t,' r t.'• - • r �.�. r.w t. y r i f:; ?q '+c d` 7 ` �'' r '�•M Y� '�a x +'•. 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K �'K♦ , I t [`{r r _I II,;N � x, s • Y Ir r .:"f.,-, r �...,5't y ,,r, , 'I _ , r >{4, o f,r r.ty. +`r. r ♦�n r f n+ >{*x .,{ a,,. , v, t ) , # r w'3 ",O ti d, •, A 3,..�. �' '• h ' yv•' f `�, t. s `«t r. s ++. .} 1 r 'i f { y"`r > W I A i Mr:. Rc�ber�t:MCNu3t r t �.. `, ' .f r t.Hyann s Chowder Hpuse°� t ,^ ,'.r,Il N , ��, � F R ;r,_le '��,� fit�r, ��.7-s # w� ,� __ q, - _, a - g `.. �+ r -: s4'_' 't r :. L' r .� t { .' I +,. `Y+, a',�♦` ' ..",p -•v T",t .A``r i p f is��;,i '�2235 c1.Oceant�a}Tt�ee6t�r�, i '.:ems' I. ,r i t.. ,r' ?..,.: iv�,' aS_,,.ter s•r fk ''_ N s'. °`r14",�`' r t k.X' c -, ',.•..Hyannzs; MAi S Vii x.a#t +' ` r l "'i�' '^v,r'a'va,Ty.*l.+,` . '•4' , . ,I 5 •..r t ,,,, �I.••_., + y. .J`d�r _a + k�"•�.; t 'Yn 1 { at i"_. rw :d> ,_t.r.A '!� , •8`+,r 4r ,,. • r 9r n +,l,r} ,:;'� i9 A. 0 `, ! `•�' .I :j ') >• e. ) a ,` ^e*< : r ¢'t.e t>,t 'r' :. ' c 4- 3 s .� :G.,+• +.., 1 r`d, ,[ D4,jp }�7 r y y+�,.�.�t��^r /�],�y *,s.�► �`,�. 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E.Js 's a .p.'r Y '3 a ,. . .�^' `�'r+.'�.? , a tM1•r. x�,1 >': Y;�f-L� , s}" ! ,,.^�1 "r r 2i+e 4 r� >rsr to tf .j n+r' + ,,.:, 4 kti..SYx, Y a rr 1 "'/ ..R ` `r,i+} ..;- ,J ,, r ['4 e• 'k c'..•at ', �� '• Fe<* 0, �♦ ,That you;fr�r meeti :with us pan Tuesday;,MayY 17 ;.39$3, cancer ting" ;` , C r ``� . ,,� '�4 the , ts�de dining,S at'your restaurant, t,he,,Hyannis Chowder kl' se: }.,K v * ._; a+ ` x r r +.. .•„b ,,'r `^ y Eger rf �. i,Y- r r .r.., r'} r. n .:[ irr.'.. , 4 i r GJ �$ �a • 1 1 ft'. r s e ya r fw i N ,;i i�'7♦, .t'a l 1r 1,+s, c`= S :•i*, ;•ti x* ,: a.,t u• P ! at '• - • e y ..a . rr "�_" , Xou ar agrEantedF an eaten ,lbh rof�trF'tirae, to."expirre,>prior..to your `1984` :��. -: > �,", 'censinga�,to `install. separate mad a 'aridt female employee toilets` v�ith _` , ti : 1. yS s, i7�•, .t �'•," r1�f+��, a '. "p� �a . ° � +,t''' S. ti• r . ° l._,�,,0,4 f - _ ,,,., 4• +Yt• �', y yM a -♦ ,*'�,.++r f.���V Rirn�? Ci/1i�.iI ions;i r r ^":tE'"� 1. 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' 1 M *,r,' '.{ til,�,»... , y` t H r' r �.' .'. i y +.•. ,.,tir �.T',, pa' ? ,.> kti {: t w ^f +!'. r %. x t;.f c.:t'S♦ t �, e{ 1 ,^ .' ,r,r Y rr j rs.� , ,+.e. ! C r, r Rt ,' r ,+ t f n� �x ". ,y, �,Z'4^ ."'M 'yey, + .c zr r r ,r'.�• i). .. rFo +r ) ` A ;+,. > ♦ l<-f. f ;?:, t 'r-� r,C¢ s.,kill"i 7 :d- c+cr , _ ....:5 .i<.,+;.. - _ a .tT j _ v.•,." . w . a t• .t: JOHN & BOB INC: DBA Hyannis Chowder House 235 Ocean Street Hyannis,. MA 02601 May' ll, 1983. Town of Barnstable Board of Health 367 Main Street Hyannis, MA 02601. ATTENTION: . John Kelly, Director RE: Employee Facility Board Members: I would like to thank you at this time for the variance granted in regards to Outside Cafe dated May 24,. 1982 As mentioned in the above request, I stated that the success of this deck would permit me to comply to the statutes listed in Regulation 11 Toilet Facilities - adopted February 21, 1975 by your board. After having completed my second year being in business on Cape Cod I have found that you must budget your financial obligation in order to survive the following year. I must admit that a successful season depends upon many underlining causes. I would like to take this time to explain that my second year had not been to my expectations financially. I'm building this deck, I had no foreseeable idea that it would .rain six consecutive weekends in the month of June and that my total business would be off by thirty percent. These monies as well as you know are lost and were depended heavily in complying to the variance you board granted in regards for employee facility. In the winter months I talked with three different plumbing contractors in regards to. the cost of installing said facilities. From the quotes . I received, I reviewed my budget and realized that in order for me to meet my financial obligations, I could not afford such a venture at that time. I would like to express to you at this time that I understand how important it is for that I would not be inconsistent with accepted health practices and have for the past two. years taken great pride -in working to keep my establishment within your sanitary codes. Board of Health Page 2 May 11, 1983 At this time, I assure you that if your board would grant me an extention in regards to Section C of the criterion having to do with "Outside Cafes for this season, I will make it my express concern to having installed the employee facilities by the end of 1983. I am looking forward to this season enthusiastically and completing this project by the end of this calendar year. Thank you for your time and consideration in this matter. espectfully, Robert McMulty V- JOHN & BOB INC. DBA:Hyannis Chowder House 235 Ocean Street Hyannis, MA 02601 May 11, 1983 Town of Barnstable Board of Health 367 Main Street Hyannis, MA 02601 ATTENTION: John Kelly, Director RE: Employee Facility Board Members: I would like to thank you at this time for the variance granted in regards to Outside Cafe dated May 24, 1982 As mentioned in the above request; I stated that the success of this deck would permit me to comply to the statutes listed in Regulation 11 Toilet Facilities - adopted February 21, 1975 by your board. After having completed my second year being in business on Cape Cod I have found that you must budget your financial obligation .in order to survive the following year. I must .admit that a successful season depends upon many underlining causes. I would like to take this time to explain that my second year had not been . to my expectations financially. I'm building this deck, I had no foreseeable idea that it would rain six consecutive weekends in the month of June and that my total business would be off by thirty percent. These monies as well as you know are lost and were depended heavily in complying to the variance you board granted in regards for employee facility. In the winter months I .talked with three different plumbing contractors in regards to the cost of installing said facilities. , From the quotes I received, I reviewed my budget and realized that in order for me to meet . my financial obligations, I could not afford such a venture at that time. I would like to express, to you at this time that I understand how important it is for that I would not be inconsistent with accepted health practices and have for the past two years taken great pride in working to keep my establishment within your sanitary codes. Board of Health Page 2 May 11, 1983 At this time., I assure you that if your board would grant me an extention in regards to Section C of the criterion. having to do with "Outside Cafes" for this season, I will make it my express concern to having installed the employee facilities by the end of 1983. I am looking forward to this season enthusiastically and completing this project by the end of this calendar .year. Thank you for your time and consideration in this matter. Respectfully, Robert McMulty