HomeMy WebLinkAboutLOBDOG-MOBILE - FOOD - CLOSED Lobdog-MOBILE
1081 River Rd — C
Marstons Mills
f
Town of Barnstable BOARD OF HEALTH
John T. Norman
Board of Health Donald A.Gaudagnoli,M.D.
"• aaR.NSrABLE. F.P.(Thomas)Lee
MASA, + Daniel Luczkow,M.D. Alt.
'
$ ►�xg. 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: 1137 Issue Date: 01/01/2022
DBA: LOBDOG MOBILE TRUCK
OWNER: THOMAS DAVERN
Location of Establishment: 1081 RIVER ROAD MARSTONS MILLS MA 02648
Type of Business Permit: MOBILE FOOD
Annual: Seasonal: YES
IncloorSeating: 0 OutcloorSeating: 0 Total Seating: 0
FEES_
FOOD SERVICE ESTABLISHMENT: YEAR. 2022
RETAIL FOOD:
COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022
B&B- FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBILE- FOOD: $50.00
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:
'O Town of Barnstable BOARD OF HEALTH
John T. Norman
Board of Health Donald A.Gaudagnoli, M.D.
Ai ME)��1 F.P.(Thomas)Lee
ASS\
200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt.
ra ° Phone: (508) 862-4644 Fax: (508)790-6304
www.towndbarnstable.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: 1137 Issue Date: 01/01/2022
DBA: LOBDOG MOBILE TRUCK
OWNER: THOMAS DAVERN
Location of Establishment: 1081 RIVER ROAD MARSTONS MILLS MA 02648
Type of Business Permit: MOBILE FOOD
Annual: Seasonal: YES
IncloorSeating: 0 OutcloorSeating: 0 Total Seating: 0
FEES
FOOD SERVICE ESTABLISHMENT: YEAR. 2022
RETAIL FOOD:
COTTAGE FOOD.OPERATION: Permit Expires: 12/31/2022
B&B- FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBILE-FOOD: $50.00
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:
Town of Barnstable BOARD OF HEALTH
John T.Norman
y
Board of Health Donald A.Gaudagnoli,M.D.
RAWNRrtBLF. Paul J.Canniff,D.M.D. .
a 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: 1137 Issue Date: 05/18/2021
DBA: LOBDOG MOBILE TRUCK
OWNER: THOMAS DAVERN
Location of Establishment: 1081 RIVER ROAD MARSTONS MILLS MA 02648
Type of Business Permit: MOBILE FOOD
Annual: Seasonal: YES
IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0
FEES
FOOD SERVICE ESTABLISHMENT YEAR. 2021
RETAIL FOOD:
COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021
B&B-FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBILE-FOOD: $50.00
MOBILE-ICE CREAM: a
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:
McKenzie, Marybeth
From: McKenzie, Marybeth
Sent: Tuesday, May 18, 20214:10 PM
To: 'thomas davern'
Cc: Soto, Kathryn
Subject: Selling product in your Mobile food truck
Tom,
It was nice to meet you today. I just wanted to send you an email regarding the info that you submitted stating that you
will be selling"Morning Glory Cafe product".You may not sell their product UNLESS they have a wholesale license.A
business can only sell their product to consumers directly, it they sell or give their product to another company for resale
then a wholesale permit from the State would be required. If you or Morning Glory Cafe have any questions please feel
free to contact the Health Department.
Regards,
Marybeth McKenzie R. S.
Health Inspector
Town of Barnstable
(508) 862-4644
1
f
Hi Marybeth:
In this folder please find documentation related to my application to operate a mobile food
operation in preparation for an eventual health inspection by your department.
Documents included are in the following order:
✓ Application fee (check for$150.00 made out to the Town of Barnstable)
✓ Completed Town of Barnstable application for permit
✓ Completed Town of Barnstable Hawking/Peddler Permit signed by Chief of Police
✓ Copy of my Certificate of Registration for Concession Trailer w/scan of official
Hawker/Peddler License
✓ Menu
✓ Floor Plan
✓ Allergen and Certified Food Manager certificates (2)
✓ Letter (MOU) stating that I will be allowed to use a permitted commercial kitchen as a
base of operation. Letter is actually the MOU contract with my permitted commercial
kitchen, Morning Glory Cafe in Marstons Mills, signed by myself and the two owners of
Morning Glory Cafe.
✓ And below is my equipment list with type of self-closing screen per your request.
Please let me know if I've missed anything.You have my email (tdavern44@gmail.com) and my
direct line is 774-361-8908. Many thanks in advance!
--Tom Davern
-----------------------------------------------------------------------------------------
Equipment list:
• Stainless steel commercial mini-refrigerator
• Magic Mesh screen fully affixed to concession window for passing food to customers
• 1 Electric griddle for hot dog buns
• 1 Electric hot dog roller
• 1 Electric hot dog and bun steamer
0 2 Fire extinguishers approved by the Town of Barnstable fire department
• DuroMax XP5500EH portable generator unit to supply electricity to concession trailer
• 1 Propane tank to run generator
0 2018 Chevy Silverado pickup truck that will tow the concession trailer
TOWN OF BARNSTABLE
Permit Issued by the Chief of Police PERMITTING AUTHORITY USE ONLY
1200 Phinney's Lane Permit Number
Hyannis,Massachusetts 02601 Date Issued
Records Div PH(508)775-5466 Expiration Date
Records Div FAX(508)790-0062 ,E
*************************PERMIT'TING AUTHORITY USE ONLY*************************
It is the responsibility of the permitting authority to ensure that the identity of the new/renewal applicant is true and accurate and in the
case of a renewal, that the applicant is linked-to the original tracking number. The permitting authority shall only issue permits after
conducting a criminal background investigation into the criminal history of an applicant to determine eligibility for a new permit or a
renewal.All applications must be .app accompanied by a copy of an applicant's fmgerprinfs and applicable fees.
APPLICATION FOR PERMIT TO ENGAGE IN
HAWKING/PEDDLING/DOOR-TO-DOOR SALES
Pursuant to M.G.L. Chapter 101 & TOB Ordinance Chapter 150
**THIS APPLICATION MUST BE COMPLETED FULLY**
Name: 1;1���li(�i 5 P '� hone:
Cell:
Street Address: f t�-1 ve r' R ee Email.
City/Town: ZIP:
:
Please Check One:
NEW APPLICANT
_ RENEWAL MOST RECENT HAWKER/PEDDLER/DOOR-TO-DOORPERMIT NUMBER
ISSUED FROM WHICH CITY/TOWN? MA
EXPIRATION DATE:
PLEASE ANSWER THE FOLLOWING QUESTIONS COMPLETELY ANDACCURATELY.
1. Have you ever used or been known by another name?DYES NANO If YES,provide name and explanation:
2. Are you a sex offender,as defined by Section 178(c)of Chapter 6 of the General Laws? DYES X1,NO
3. Are there currently any sex offense charges pending against you?(All sex offenses are identified in Section 178(c)
of Chapter 6 of the General Laws) OYES XNO
4. If you answered YES to Questions 2 and/or 3,please provideexplanation:
PLEASE ATTACH A COPY OF THE APPLICANT'S FINGERPRINTS TO THIS APPLICATION. UPON RECEIPT OF
THIS APPLICATION, THE PERMITTING AUTHORITY (LOCAL MUNICIPALITY) SHALL CONDUCT AN
INVESTIGATION INTO THE CRIMINAL HISTORY OF THE APPLICANT TO DETERAMEELIGIBILITY.
Signature: Date:
****OFFICE USE ONLY****
License AP roved.( ES O
{ SiPRlure I3,,:...:. _Authori
Date
�¢ The permit shall be furnished immediately upon request.
Fdt\adCdHWonal information please visit the Department of Public Safety's website at Nvww.mass.z,ov/dps
i
iC
ent lobster rolls.
rmet hot dogs.
APE COD,01
2021 Spring/Summer Menu
2 Lobster Roll Choices
Classic Cape Cod Lobster Roll:
Five ounces of succulent lobster meat with just a hint of mayo, chopped chives, lettuce, lemon wedge. $19.00
Cajun Classic Lobster Roll: Five ounces of succulent lobster meat with just a hint of mayo,
Old Bay Cajun Seasoning, lettuce, lemon wedge. $19.00
----------------------------------------------------------------------------------------------------------------
2 Dog Choices
➢ All-Beef Hot Dog: $2.50 each, two for$4.00
➢ Sweet Italian Sausage: $3.50 each, two for$6.00
-- Complimentary condiments: Ketchup, relish, yellow mustard, honey mustard, spicey brown mustard, onions.
-- Each order includes choice of Cape Cod Potato Chips, BBQ chips, or Fritos.
-- Served on a traditional New England hot dog roll. Choice of steamed roll or grilled & buttered roll.
Drinks: Ice-Cold Coke,.Diet Coke, Lemonade, Bottled Water: $2.00
5 Specialty Dogs
✓ The Fenway: $4.00 each, two for$7.00
Sweet Italian Sausage, chopped onions, cheddar cheese, yellow mustard.
✓ Buffalo Hottie: $3.00 each, two for$5.00
All-Beef Hot Dog, chunky blue cheese, buffalo-wing hot sauce, lettuce.
✓ Goodfella: $4.00 each, two for$7.00
Sweet Italian Sausage, marinara sauce, mozzarella cheese, oregano sprinkles.
✓ The Smokeshow: $3.00 each, two for$5.00
All-Beef Hot Dog, smokey-sweet BBQ sauce, cheddar cheese, onions.
✓ The Stowe: $4.00 each, two for$7.00
Sweet Italian Sausage, Vermont cheddar cheese, drizzle of Vermont maple-aioli sauce.
- - LobDog is also proud to serve homemade
k muffins and fresh baked cookies courtesy
of our friends at the Morning Glory Cafe.
—6bro-bbdee
MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding(MOU) is entered into between Tom Davern (sole proprietor,
business name: LobDog) residing at 1081 River Road, Marstons Mills, MA,and Joshua Sodekson and
Callie Sodekson (co-owners, business name: Morning Glory Cafe')with an address of 211 Cotuit Road,
Marstons Mills, MA 02648.
The purpose of this MOU is to establish the distribution and sale of Morning Glory Cafe'food products to
the general public,which will be sold from the LobDog mobile food concession trailer, in exchange for
Tom Davern being able to store food items on site at the Morning Glory Cafe'.
OBJECTIVES
1.Tom Davern will sell an assortment of Morning Glory Cafe'food items(cookies,veggie burgers, etc.)
to be purchased at a retail price totaling$40.00 from Joshua and/or Callie Sodekson.This$40.00
purchase will take place each time Tom Davern visits the Morning Glory Cafe'to pick up LobDog food
items.The LobDog mobile concession trailer will be the means by which Morning Glory Cafe'food items
are sold to the general public by Tom Davern. No food will be returned to the Morning Glory Cafe' after
it is purchased by Tom Davern.
2. In exchange for the$40.00 purchase of Morning Glory Cafe'food items by Tom Davern each day he
visits the Morning Glory Cafe',Joshua and Callie Sodekson shall allow for ongoing on-premise cold
storage of LobDog food products,which will mainly consist of hot dogs,sausages, lobster meat, bacon,
pasta and related condiments.This direction is per the Massachusetts Food Code 105 CMR 590.000 for
Mobile Food Operations,which states that a mobile food business must operate from a 'fixed, licensed
food establishment" per the aforementioned 105 CMR 590.000 food code.The refrigerator/freezer for
this food storage shall be purchased and delivered by Tom Davern to Morning Glory Cafe'for placement
in basement.
In short,this MOU agreement establishes a collaborative effort for the sale of Morning Glory Cafe'food
in return for cold storage of the LobDog food products at the Morning Glory Cafe'.
Signature:Tom D_aver Date:
Sign osh ddekson Date:
Signatu a ie Sode Date:
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For Office Use Initials:
Town of Barnstable
Date Paid
t659.
659 : Inspectional Services
�6 �` L-*1
Public Health Division Check#
dpL04-j
Thomas McKean,Director 0 D-(30
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT
DATE 2Q Z NEW OWNERSHIP RENEWAL
NAME OF FOOD ESTABLISHMENT: 116 Fbm
ADDRESS OF FOOD ESTABLISHMENT:
MAILING ADDRESS(IF DIFFERENT FROM yABOVE): f
E-MAIL ADDRESS: tjCkVe-�'� L .�1 Md i l , LWVI
TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 7 { 36 -
TOTAL NUMBER OF BATHROOMS:
WELL WATER:YES NO A ...(ANNUAL WATER ANALYSIS REQUIRED)
ANNUAL: SEASONAL: DATES OF OPERATION:J lwlc(TO 12 l fy l2—
NUMBER OF SEATS: INSIDE: O OUTSIDE: 6) TOTAL: 0
SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV.
***OUTSIDE DINING REMINDER***
OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING
REQUIREMENTS.
IS WAIT STAFF PROVIDED FOR OUTSIDE DINING?
IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)9 /a
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)
:X:MOBI.,E FOOD
FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED)
CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2)
*** SEASONAL,MOBILE &NEW FOOD ONLY***
REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED
PLEASE CALL 508-862-4644
Q\Application FormsTOODAPP REV3-2019.doc
OWNER INFORMATION••FULL NAME OF APPLICANT ����5 AA
SOLE OWNER: e/NO / OWNER PHONE# ���" �6 6 d U`®�
ADDRESS_ �O I veil P�d1 r�IR rs` Ord /'`J��`S i 1YA 60l1
CORPORATE OWNER: N�
CORPORATE ADDRESS:
a .
PERSON IN CHARGE OF DAILY OPERATIONS: �1�aLs 1 `� V e
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
A / M /XS 1. tyyu N(m /0 / ,!:E-J /! o2S
2.
SIGNATURE OF APPLICANT DATE
***FOOD POLICY INFORMATION***
SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div.
prior to ovenina!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance.
FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter,
with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert
Permit until the above terms are met.
CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering
event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp.
OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited.
NOTICE: Permits run annually from January 1 st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN
THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st.
Q\Application Forms\F00DAPP REV3-2019.doc
Lb dt
Bellaire, Dianna Rio-
From: thomas davern <tdavern44@gmail.com>
Sent: Thursday,January 28, 2021 10:28 AM Rtl L
To: Bellaire, Dianna
Subject: Re: New Mobile Truck- Lobdog L �1
Hi Dianna,just a uick update as I realize I kind of left you hanging from our last email exchange last October.
I passed the fire inspection for my LobDog concession trailer a few weeks back but I'm holding off on the health
inspection with you until spring, as I don't see a lot of people wanting to buy hot dogs and lobster rolls in this type of
weather. Plus I had to drain all the water from the trailer so it wouldn't freeze and damage pipes and I know your
inspectors will want to see hot&cold running water for the sinks.
Anyway,thinking more like March or certainly April when I'll get back to you and arrange for the health inspection.Just
wanted to touch base. Hope your winter is going well.
Best Tom Davern
.-
?
,u32?aY33
ava�
..::Decodent lobster rolls.'
Gourmet.hot dogs.
On Mon, Oct 26, 2020 at 1:18 PM Bellaire, Dianna<Dianna.Bellaireptown.barnstable.ma.us>wrote:
Please read answers below:
Dianna Bellaire
Permit Technician
Town of Barnstable
Health Division
200 Main Street
1
LobDog Mobile Floor Plan/Overhead View
Front of
Concession
Trailer
Fire Extinguisher#1
3-Sink Washing Station Single Sink for Hand Washing
Hot&Cold Water Hot&Cold Water
Wash—Rinse—Sanitize
Fire
Stainless Steel Table
Extinguisher#2
---------------------------------
Table Holds 1 Hot Dog& Bun
Steamer Unit here
Table Holds 1 Hot Dog Roller Fully
Unit here
Screened
Customer
Ordering
Window
Table Holds 1 Griddle
here
L--------------------------------
Side Refrigerator
Access
Door.
Back of Concession Trailer with 2 Access Doors
INE rqr� TOWN OF BARNSTABLE _ _ :- HEATH INSPECTOR,s Establishment Name: Date: Page: of '
OFFICE HOURS
+"��'�� PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
BARNSTABLE. ' 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
�b M 39. ,•� HYANNIS,MA 02601 MON"-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY
pFFD MPS° 508-862-4644
FOOD ESTABLISHMENT INSPECTION REPORT
Name Dat De of Type of Inspection
Routine
Address L isk Re-inspection
Level ail Previous Inspection Cl
Telephone I"al Kitchen DEiiniess
i Owner HACCP Y/N orary
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP
Other
In:
Inspector Out:
Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated.
Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑
Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F)
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
d/
❑ 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
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 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations
Critical(C)violations marked must be corrected immediately. (blue&red items) 3Corrective 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
Y Y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other:
checked indicate violations of 105 CMR 590.000/Federal Food Code.
23.Management and Personnel. (FC-2)(590.003) This.report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F.
25.Equipment and Utensils B=One critical violation and less than 4Hon-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 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 9Hon-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of
28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration.
within 10 days of receipt of this order. violation,4 to Brion-critical violations=C.
29.Special Requirements (590.009) y p
30.Other DATE OF RE-INSPECTION: Inspector's Siggatu a Print:
31.Dumpster screened from public view YAP/
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N
Dumpster Screen? Y N +
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) 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•frotn Unapproved Additives
Contamination from Raw Ingredients 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
_ _ _ _ 15 Poisonous or Yoxic`Substarices *
590.004(F)- -
EMPLOYEE HEALTH - � 3-302.11(A)(2) Raw Animal.Foods Separated from Each 7-101.11 Identifying Information,-Original Containers* *
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F
2 590.003(C) Responsibility of the Person-in-Charge to _ 7-102.11 Common Name-WorkinklContainers* - - -
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* � - --j - - - - * P g 20 Time as a Public Health Control
3=302.11(A) Food Protection 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* g g 7.202.12 Conditions of Use*
PP P3-304.11 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* 7-204.11 Sanitizers,Criteria-Chemicals* - - REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions 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 * 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
3-701.11 Discarding or Reconditioning Unsafe Food
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 * 3-801.11(D) Raw or Partially Cooked Animal Food and
-4-501.d 11- 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* 4-501.112 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. r 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of
3-202.16 Ice Made From Potable Drinking Water* - 3-401.I IA(1)(2) Eggs-155°F 15 sec
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
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*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* - - 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
3-201.15 Molluscan Shellfish from NSSP Listed Chemical*
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.
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 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 3403.11(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
* 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F
3-202.12 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
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. 1 Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009
3-502.11 Specialized Processing Methods* 130. 1 Other
3-502.12 Reduced-Oxygen Packaging Criteria* -
8-103.12 Conformance with Approved Procedures* S: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 596.000.
i
Bellaire, Dianna Lao bo
From: McKenzie, Marybeth
Sent: Thursday, May 20, 20218:16 AM
To: 'thomas davern'
Cc: Bellaire, Dianna
Subject: RE: Selling product in your Mobile food truck
Thanks Tom and I hope you have a great season!
From: thomas davern [mailto:tdavern44Ccbgmail.com]
Sent: Wednesday, May 19, 2021 10:50 AM
To: McKenzie, Marybeth
Subject: Re: Selling product in your Mobile food truck
Totally understand Marybeth, I won't be selling Morning Glory Cafe' product without a wholesale license, not a
problem.
Attached is a picture of my window that you asked for as a friendly FYI. Thanks again for yesterday, have a
great summer. -- Tom
On Tue, May 18, 2021 at 4:10 PM McKenzie, Marybeth<Marybeth.McKenzie@town.barnstable.ma.us> wrote:
Tom,
It was nice to meet you today. I just wanted to send you an email regarding the info that you submitted.stating
that you will be selling"Morning Glory Cafe product". You may not sell their product UNLESS they have a
wholesale License. A business can only sell.their product to consumers directly, it they sell or give their product
to another company for resale then.a wholesale permit from.the State would be required. If you or Morning
Glory Cafe have any questions please feel free to contact the Health Department.
Regards,
I
Marybeth McKenzie R. S.
Health Inspector
Town of Barnstable
i
(508) 862-4644
i
!
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