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Home My WebLink About3 WIANNO - FOOD - CLOSED 3 ianno l!'7- + 1(aka 3) Wianno Ave Osterville ®pD Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. WA NhUM Paul J.Canniff,D.M,D. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1102 Issue Date: 01/01/2021 DBA: 3 WIANNO j OWNER: BETH.IVIELCHIONO Location of Establishment: 1 (aka 3) Wianno Ave OSTERVILLE„ MA 02655 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 9 OutdoorSeating: 0 Total Seating: 9 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 202 1 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: 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 Board of Health Donald A.Gaudagnoli,M.D. B' M' Paul J.Canniff,D.M.D. 200 Main Street Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30513, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby;ranted to: Permit No: 1102 Issue Date: 01/01/2021 DBA: 3 WIANNO OWNER: BETH MELCHIONO Location of Establishment: 1 (aka 3)Wianno Ave OSTERVILLE„ MA 02655 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 9 Outdoor5eating: 0 Total Seating: 9 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: 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. nanrisr�BM _ Paul J.Canniff,D.M.D. MAM 116596 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate R Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 3056, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 1102 Issue Date: 12/10/2019 DBA: 3 WIANNO OWNER: BETH MELCHIONO Location of Establishment: 1 (aka 3) Wianno Ave OSTERVILLE, MA 02655 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 9 OutdoorSeating: 0 Total Seating: 9 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: For Office Use Oplys Town of Barnstable _ Initials: p�• ti �T Q` Date Paid' Amt Pd$ BARNSfABLE, : Inspectional Services .MASS. Public p Public Health Division Check# �. Eo�� Thomas McKean,Director ] (Z rr 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 . APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE �2�- -7f NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: 1 ti--47r1® ADDRESS OF FOOD ESTABLISHMENT: ��Ct--7/7 0 ^e_ h1 19" OL-91,g MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 50 �- oOv TOTAL NUMBER OF BATHROOMS:_ WELL WATER: YES A'� ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: OUTSIDE: C) TOTAL: r'!' SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD ' FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpplication FormsTOODAPP 2020.doc OWNER INFORMATION: �^FULL NAME OF APPLICANT l C�1' 4'0-n 0 SOLE OWNER/NO D.O.B OWNER PHONE # �`tp75�r ADDRESS -75 4Cv W j 03 f'yl-. QZ41 S/ CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: S � dj'►7 List(2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2. �a l '- il40r6 o ,� 12- 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 openinE!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http•//www townofbarnstable.us/healthdivision/applications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run.annually from January Ist to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsWOODAPP REV3-2019.doc r Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. ! � Board of Health Donald A.Gaudagnoli,M.D. tRAWN AB John T. Norman MA- �. / 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 1102 Issue Date: 04/01/2019 DBA: 3 WIANNO OWNER: BETH MELCHIONO Location of Establishment: 1 (aka 3) Wianno Ave OSTERVILLE MA 02655 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 9 OutdoorSeating: 0 Total Seating: 9 FEES . FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: �� FROZEN DESSERT: , Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES FOR ESTABLISHMENTS WITH SEATING: i PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE } Restrictions: Town of Barnstable For Office s Only Initials: * anrnvsrABLE, + Date Paid � t�"t Inspectional Services �.-}-.L,.L_„1 1 M0� 1 Public Health Division ____ , ; b2 Thomas McKean,Director P 11,p2— Cnet,-)) 200 Main Stacet, Hyannis,MA 02601 ( qV� �p,�� Office: 508-862-4644 Fax: 508-790-6304 Po� V— l —(iek.1 ( ,i APPLICATION FOR PERMIT TO OPERATE A FOOD ` OD ESTABLISHMENT DATE /'5- , NEW OWNERS ✓ RENEWAL NAME OF FOOD ESTABLISHMENT: � & � CL n h ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO w/- ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL."/ SEASONAL: DATES OF OPERATION:�/ / TO FE=SEATING: ATS: INSIDE; OUTSIDE: C� TOTAL: - �t 1 , T OBTAIN A COMMON VICTUALLER'S LICENSE FROM LI SING 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?_t) ,r3 _ 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/fi-eezer) 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*plication FormsTOODAPPRLW2018.doc g . OWNER INFORMATION: PLEASE CALL 508-862-4644 � FULL NAME.OF APPLICANT 3 Pit��. n1 Q,/ n r�D SOLE OWNER-�lNO D.O.B y li OWNER PHONE# SIOS ADDRESS yt, ' 1>4 ►�.� S--fl M-M� 0 s CORPORATE OWNER: kn l 0 FEDERAL ID NO. • I CORPORATE ADDRESS: P Gt]la v�h0 ��t .3 OPERATIONS: �lano�� PERSON IN CHARGE OF DAILY OPERA 4' � O��S .c��Q�/X, /��/�G�OY)r� s 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 NO - must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date C6 2. o9oa,3 Lys SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div, prior to opening!1 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 httn:/hvww.tovvnoibarnstable.us/Itealthdivision/al)nlications asp. 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 I st to Dec.31'each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC I st. Q:1Application i'ormsTOODAPPREV2018.doc 3114 oF�toyy Town of Barnstable For Office Use Only: Initials: Date Paid Amt Pd$ 9s^r�'"& Inspectional Services i639 �� ach Public Health Division Check# 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 I m1 y' NEW OWNERSHIP V RENEWAL i NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: m q-fit- b44. 61 r-1 op Q.oL• .Coln TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (�c f 7q)o - 0004 TOTAL NUMBER OF BATHROOMS: j WELL WATER: Y ES NO /... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V ' SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: _7 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. A� IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? /1 U ,n,// IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? AV6 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 3 f PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT 456x /31 e/C-6/a7,0 i SOLE OWNER: YE /NO D.O.B 6OWNER PHONE ADDRESS CORPORATE OWNER: �CJC.J1d�FEDERAL ID NO. CORPORATE ADDRESS: S �� 5 r� / )-4/,�S/ PERSON IN CHARGE OF DAILY OPERATIONS: 6&t 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 ller en Awareness Expiration Date 1. beth 061MI 12 v �.; ie 5' i CPU 1. C;?:3 i as d 2. d �?e�lca�v I b- SIGNATURE OF APPLICANT DATE I *** *** FOOD POLICY INFORMATION SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. 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.31s`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q:1Application FormsTOODAPPREV2018.doc �o F.ME r TOWN OF BARNSTABLE HEALTH INSPECTOR•s Establishment Name: /,/U Date: ' Iq Page: of ws - v P OFFICE HOURS / PUBLIC HEALTH DIVISION s:oo-ssoA.M. RARNSTASLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � M679• `0'� HYANNIS, MA 02601 508-8 08-8 -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY MPS'len ° FOOD ESTABLISHMENT INSPE TI N REPORT Name Date yoe of InsDection 1 p ` Routine Address Risk' �� ctio /rod Servi Level t t Previous I t J ' Telephone Residential Kitchen Date: C �t Mobile Pre-opera�I Owner HACCP Y/N Temporary Suspect I(Ine s Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP ^ 4 A _ Other Inspector, c r Each violation checked requires an explanation on the narrative pa-e(s)and a citation of specific provision(s)violated. / v Violations Related to Foodborne Illness Interventions and Ris�/ Factors(Red Items) Anti-Choking 590.009(E) ❑ m _ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ sh Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands u 1.PIC Assigned/Knowledgeable/Duties ® g g ❑ 13.Handwash Facilities u EMPLOYEE HEALTH PROTECTION FROM CHEMICALS A I A A P ❑ 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) o ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating -1,1 ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling �. ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding r r j y y 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 ILti1f 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 i ems ❑ 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 (FC73)(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 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)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critic aP violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. viol 4 to 8 non-critical violations/-C. 30.Other DATE OF RE-INSPECTION: Ins pe is Si na r �./Rn- -a 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N v` #Seats Observed Frozen Dessert Machines: Outside Dining Y N A'w PIC s S' ature �v /v 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.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 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 1307-102.11 Common Name-Working Containers* Applicants* 7-201.11 Separation-Storage* 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 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Reated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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. 18 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective t/uzoa 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 3-401.1l(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g� P arY 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 17 Reheating for Hot Holding 11 Good Hygienic Practices 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 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products P 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 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* 1 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1 1.009 3-502.11 Specialized Processing Methods* 30. 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 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. r Qp THE r TOWN OF BARNSTABLE - HEALTH INSPECTOR'S Establishment Name: Date'` Page:. of � " Yo PUBLIC OFFICE HOURS BARNSTABLE. 2 0 MAN STREEETSION 3:30:30--4:30 P.M.:30 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 7 MASS. g. MON.-FRI. - .aa9• .0 HYANNIS, MA 02601 sos-es2 asaa No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPEICTION REPORT Name Dat Tvoeofof Tvoe of Inspection Routine Address- � 25 F Risk Foo ery Re-inspecti n Level a ai Previous p tio� Telephone Residential Kitchen Date: Mobile Pre-oper Owner HACCP YIN Temporary Suspect II ess Caterer General Complaint Person in Charge(PIC) Time Bed 8 Breakfast o eCP - In L'Inspector n�. i Each violate n checked requires an explanati non the narrativ page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ f Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ yo Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ �l7 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands D G ❑ 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: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or n within 90 days as determined by the Board of Health. Overall Rating i� ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the ite s Other: checked Indicate violations of 105 CMR 590.000/Federal Food Code. Embargo Emergency Closure Voluntary Disposal ❑ Ot 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 4npn-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 8 non- itical iolations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. eo a 4 to 8 non critical viol lions C. 30.Other DATE OF RE-INSPECTION: In p is ignature ' 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 P 's Si tur / A Pnn 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.* Additives* 19 PHF Hot and Cold Holding 2-]03.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F') EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F*. 7-102.11 Common Name-Working Containers 3-501.16 A Roasts Held At or Above 130°F* Require Reporting by Food Employees and Contamination from the Environment ( ) 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 11 Restriction-Presence and Use* 3-302.15 Washing Fruits and Vegetables 590;003(F) Responsibility of A Food Employee or An 7-202. 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* uiremen[s 3-304.11 Food Contact with Equipment and Utensils* 590.00411 7-203.11 Toxic Containers-Prohibitions* ( ) Variance Re q 590.003(G) Reporting.by Person in Charge* Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizer§,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 8 ) 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 Wazewashing-Hot Water Monitoring 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 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* Eg give Innool 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Ratites-165°F 15 sec* Sources* Mushrooms Approved By ing,mobile food,temporary and residential Authority Clean an 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and 2-301.11 Cl Condition-Hands an Arms* d A * 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* 3403.11(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 B 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 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* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashin 9 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. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 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. INC r � eTH INSPECTOR'S Establishment Name: Date: 0 ok TOWN OF BARNSTABLE: ( (/�O /Page: of1/0 FFICE HOURS 1� PUBLIC HEALTH DIVISION f6hi6s,508 :00-9:30A.M. BARE. 200 MAIN STREET :3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date erifiede3HYANNIS,MA 02601MON.-FRI. No Reference R-Red Item LEA PRINT-862-4644 prEO MAC Of A4:5- D. FOOD ESTABLISHMENT INSP ION REPORT ' j ._ Name Dat Type of Type of Inspection Routine Address Risk C_=a!I�S � Re-inspectionSLevel Previous Inspection Telephone V V Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP tL Other - / Inspector u Each violation checked requires an ex lanation on the narrative e s and a citation of specific provision(s)s violated. q P P 9 O P P O ' VIAM Violations Related to Foodborne Illness Interventions and Risk Factors Red Items)1 Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ if 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 A Air ❑ 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 ed Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time Asa Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories 179, Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) q Corrective Action Requited: ❑ 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 B=One critical violation and less than 4von-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 violations observed,7 to 8 non- ritical violations. If 1 critical refrigeration.. . 29.Special Requirements (590.009) within 10 days of receipt of this order. vI lion,4 to 8non-critical vio do C.30.Other DATE OF RE-INSPECTION: ecto' ture (/ F : 31.Dumpster screened from public view 14 , -(A - , - 7� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N ' #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature, ® Print: Self Service Wait Service Provided Grease Trap Size Variance Letter,POSted Y N Dumpster Screen? Y N Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According4o 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs - Cooked and RTE Foods.* 19 PHF Hot and Cold Holding, 2-103.11 Person-in-Charge Duties - - 3-302.14 Protection from Unapproved Additives* ' Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers. Ocher* * 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* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 _ Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* - 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* _ . . . - -REQUIREMENTS FOR-- 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 - Food and Water From Regulated-Sources y Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004.(A-B) Compliance with.Eood Law* _ * 3-801.11(D) Raw or Partially Cooked Animal Food and * 4-501.111 Manual Wazewashing--Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* - __ . _ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 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 Not Otherwise Processed to Eliminate * Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* - * gg Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective rrrnoor 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) F Ratites,Injected Meats-155' 15 sec* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 A (D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )- Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Mushrooms Approved By 2-301.11 CleanCondition Hands A * Regulatory Authority on on- ans an 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* foodbome illness interventions and risk factors. 590.004(C) '_ Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS'RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 12 Prevention of.Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashin Facilities 3-501.14 A g 3-202.18 Shellstock Identification* g ( ) 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 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 I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials I FC-7 1.008 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: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. WIA A/r OFTHE Tom TOWN OF BARNSTAB.LE HEALTH.INSPECTOR's Establishment Name: Date. _ Page: OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified AS, HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PL SE PRINT CLEARLY - .� e p 508-862-4644It 0!fZ 'EDN1P` FOOD ESTABLISHMENT INSP -A. REPORT / - Name NWAPIAr) Date LIT of Type of Inspection Operation(s) . Routine Address Risk IfFood Service Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness a Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires faijlexplanation,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 i ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals 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 a 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: 411 o ❑ 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 ardless 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 re g 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessa if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot tion of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of"rodents or,insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. viol 4 to 8 non•critical violations=C. 29.Special Requirements (590.009) Y p 30.Other DATE OF RE-INSPECTION: Insp ctor Si Print: 31.Dumps ter screened from public view Permit Posted? �lt�� 7 ','y Grease Trap Previous Pumping Date Grease Rendered Y N ::D #Seats Observed ` Frozen Dessert Machines: Outside Dining Y N PIC's Si nature Print: ,r ,�y� ,,A r Self Service E�� ait S ice Provided Grease Trap Size Variance Letter Posted Y N �l7 Z4 y "f v"7 Q vy Dumpster Screen? Y IN d 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 my 1 590.003(A) Assignment of Responsibility* ti 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 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties Cooked and RTE Foods. 3-302.14 Protection from Unapproved Additives* - Contamination from Raw Ingredients 7 5 590.004(F) 590.003(C) Responsibility of the Person-in-Charge[0 7-102.11 Common Name-Working Containers*Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-30211(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 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* P g * 20 Time as a Public Health Control (� Responsibility Employee 3_302.15 _ Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use 590.003 Res onsibilit of A Food Em to ee or An 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* - * 7.202.12 Conditions of Use* 590.004(11) Variance Requirements * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reated 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 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 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 Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens*590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game g * eff,dive/11/2001 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* 4-702A1 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* ( )( try,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-401.11 A 3) Poultry,4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and a ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12_ Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004( ) C Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#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 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* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 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 * 5-20 .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 1 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* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S.,590Formback6-2doc *Denotes critical Rem 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. 3 WIANNO BREAKFAST - LUNCH BREAKFAST CONDIMENTS BREAKFAST SANDWICH KETCHUP,MAYO,MUSTARD,RELISH,PICKLES,ONIONS, I Choice of sausage patty,ham,or bacon,.fried eggs and Icheese,on an English muffin BANANA PEPPERS, s STEEL CUT OATMEAL add fruit for an additional charge HOT FOOD WAFFLES 2 CROCK POTS DAILY � fluffy pillows topped with.read butter and whipped cream tell us what you like BEVERAGES COFFEE PASTRIES Irmt;�f�ed: See Beth or "^ l3mdsey for choices jUICI CROISSANT s Plain,chocolate,almond,etc. �w SODA r' MUFFINS SCONES h d Lurch � k SK ABOUT OUR DAILY GLUTEN FREE AND } VEGAN OPTIONS SOUP a hearty bowl of soup,served with a butte re CHOOSE BETWEEN TWO OF OUR DAILY SOUP roll CONSUMING RAW OR UNDERCOOKED OFFERED MEATS, POULTRY, SEAFOOD, SHELLFISH, OR EGGS MAY INCREASE YOUR RISK OF SANDWICHES FOODBORNE ILLNESS served with a pickle and small bag of chips SEAVIEW AVE.SANDWICH Tuna salad served on choice of bread,with tomato and lettuce TOWERHILL SANDWICH Chicken salad served on choice of bread,with tomato and lettuce MAIN STREET SANDWICH Ham served on choice of bread,with tomato and lettuce with Your choice of condiments and cheese SOUTH COUNTY SANDWICH Turkey served on choice of bread,with tomato and lettuce With your choice of condiments and cheese PARKER SANDWICH Roast Beef served an choice.of bread,with tomato and lettuce with your choice of condiments and cheese LITTLE ISLAND VEGGIE SANDWICH lettuce,tomato,cucumber,avocado slices,hummus,carrots, onions served on choice of bread 'before placing your order, please inform your server if a person in your art has alter P y a food 00 F verizon, ' ! amazon.Com BESWoOD 10" Premium Chr glade tiectric Deli meat CheeSm,um- plated Carbon bpi and for Home use 2�40W B,� ; � Food Slicer C®mr�-ierciat - d • 0 f6✓ a itift'y ar 5 • ."$ � <�'M^.aT��+ w,Fnw �' < ��,„.�m�--ram `, u..� ' $298 00 0 0 0 00 'V�"p r* I- & FREE ShiPping Want it ruesday, Feb. 26� Order mins and choose One-® within 7 hrs 57 hipping at cheCk :=n { �v� �: xJ In out:-:: --�- I n Stock• Sold by 13ESVVOOD and Fulfilled by Am wrap available. azon. 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Prices valid through December 2018 sales tax will be added to the STwin Server FS-4 Pius S12 0� List Price: $736.00 Kettle Cuisine Customer Price: $437.00 Net 'includes ground shipping within the Continental US z Tripie Server �S_4 P M . !!_1s 89 ann List Price: $1,068.00 Kettle Cuisine Customer Price: *includes ground shipping within the Continental $634.25 Net Standard Features • All stainless steel construction for durability • NSF-certified as a rethermalization unit • Lid rim returns moisture to the food to retain flavor • Hinged lids stay upright during ladling for easy customer use • Adjustable precalibrated thermostats for accurate heat control ° Temperature marks on knobs with press-in to move feature CROMuL O�usr mm LISTED =._._ . YEARServer Products equipment is backed by a two-year limited warranty against defects in materials and workmanship. For a copy of complete warranty statement and products ;ram �ARRAI�TY specifications, please visit www.server-products.com. � S E R 'v E R a0l verizon LTE 11;37 AM arnazoncom Waring � Waring Commercial WIH400 Hi-power induction Electric 13 Countertop Range Burner I IN $ 0 590 & Free Shipping Want it Friday, March 1 ? Order within ± ~ mina and choose Two- 22 his �2- Day Shipping at checkout. In Stock. Ships from and sold by KaTom Restaurant Supply, Inc. Select a location to see product availability { .00 Verizon LTE 11:37 AM 95% � 6 amazon.com Get unbeatable accuracy temperature p the WIH400 Commercial Induction Range With an e t from Warring Commercial. g Features & details C Easy-touch controls with 12 temperature settings from 120OF to 500°F/790C to qF 2600C k 0 Large 11 " x 11 " Schott ceramic steel construction ry surface & Stainless s glass r ® 10-hour timer 10 Small-article and pan detection � Limited One Year Warranty; Completely NSF and ETL approved p ely Product information Product` Dimensions 14 x 14 x 6 inches Item Weight 7 Pounds Shipping'; 12.95 Weight pounds Manufacturer Waring Commercial Inc. (Kitchen) # AS i N t BO005IJSA Q I ' McKenzie, Marybeth To: Beth Melchiono <mybubbagirl@aol.com> Subject: 3 Wianno Hello Beth, The new establishment floor plan has been approved with the following exceptions: An ice cream chest is noted on the plan. If ice cream is to be served from this case then a dipping well may need to be installed. Please submit specs for approval before purchasing or installing. If you plan on purchasing at a later time,the Waring commercial WIH400 Hi- Power Induction Electric Countertop Range Burner,you must contact the COMM Fire for approval because you do not have a hood system at this time. Due to the hand sink placement, all prep areas must be approx. 16 feet away. On the plan you submitted dry storage is located on the back wall. If the floor plan changes, regarding the preparation of food, another hand sink may have to be installed in the back area.The bathroom hand sink may not be used to accommodate the needs of the food prep area. In the future, if food is going to be stored in the basement then the area will have to meet the approved finish schedule. You will be required to have a pre operational inspection prior to getting food on site. Please refer to the pre op check li t and if you have any questions please contact me. Regards, Marybeth McKenzie R.S. 77� Uniuersaf Food 5ervfce, , R Equeptnent fnc 153 21st Stree Brooklyn, NY 11232 Project Name: Location: a 888-88 7�79 Item: Qty. ' Item# f Designed using the highest " quality materials and components to provide the : _Rw user with colder:product _ v temperatures, lower utility cost and exceptional food. safety. Oversized,, factory balanced, refrigeration system holds for th' e be,st in:rig s" preservation. iQ W R 300 series stainless steel exterror'and interior. The ws '. very finest stainless with higher-tensile st rength for fewer dents.and scratches. t Automatic defrost With:a built in condensate " evtgr system. .., r . Entire cabinet structure is solid foarned-ill-place using a new, innnovative, high density, polyurethane insulation: ... AP OVAL �-® OU! Crated Wei: ht. Ibs Cord. Len th total ft. ov ` 305 NEMA Confi . 9 MODEL Glass Door HP Ca acit,. Dimensi' s Ili hes SDC48SC Volt D 2 1/3 115 48�f H. 31.5" 4311 Un1VORdl SDC48SC -48"Smile Di y D 1 Ease Page i of i < Deli Display Cases (/category/refrigeration/refrigerated-displa cases/deli- ' refrigerators) y display- Universal SD 0 80 gle, Duty. Deli Dace �. r � � ,�'� ns r � .�� ,• a �,. a}.;� my ,. , z*�: .max • 1• a f r'k o � f $2625.00 ------------ Free.Shipping! Contiguous u,s. only i Finance as low as$214.29/month https://www.eliterestaurantequipment.com/product/universal-sdc48sc-48-single-duty-deli-... 2/19/2ot 9 Universal SDC489C 49ii SIngle Duty Deli Case Page 2 of 5 Get Started > (/page/leasing?cost=2,625.00&equiprnent=Universal+SDC48SC+_+48% 22+Single+Duty+Deli+Cas6 Manufacturer: UNIVERSAL RESTAURANT-TIPS.//� FtjTERESTAURANTcoLlI�MENT _ .COM/CATEGORY/UNIVERSAL- EQUIPMENT� , Item: _..... . Universal SDC48SC 48";Sarg6e Cuty be Case a..,... Availability:. In Stock w Shipping: Usually Ships in 7-10 BusCes Oys SKU: SDC40SC _ Condition: New Length: 30.5" Width: 48" . ..... , Height: = 45" verview This Universal Single Duty Glass Refrigerated Deli Display Case 48" [SDC48SC] is a wonderful addition to your commercial kitchen. This deli case includes 2 leve s of display for your guests, phis unit features stainless steel construction and has a storage compartment specifically designed for storing overstock. The storage doors are designed to ease user fatigue This unit,includes internal shelves which can hold and display great quantity of your products: This refri erator holds 32-38 de F for the best in food 9 g preservation. This ifefri.is perfect,to display cold cuts, meats, fishes, and salads. You will be satisfied overall by this unit: Prod U010br-Matior-11 Compressor Location Bottom Depth . 30.51, Display Case Type Refrigerated Door Type Glass Front Type Glass Height 45" https://www.eliterestaurantequipment.com/product/universal-sdc48sc-48-sinLle-duty-df-ii- niversal- DC48SC 48" iiigle Duty Deli Cage Page 3 of 5 Hertz 60 Hz: Horsepower Length :113HP 30. Manufacturer _. Universal Manufacturer Part Number CMPH 4$CI} Model Number sDC48SC Number of Doors 2 Number of Shelves apenihq Style Sliding Phase Service Style Service u Temperature 33-40 Degrees Fahrenheit Voltage .. ........... 115V Weight _ 310 lbs. _... Width 48" Details'- K Sturdy Stainless Steel Floor Works On Environmentally Friend) R9 Y 34A Refrlgrant This Item Includes a 5 Year Warrant on Y the Compressor Biiilf ors Heavy Duty.Stainless Steel Frame Swivel Casters'Are Optional Compressor Performs in Alt`Workn C®`nditro_ns Overs zed Sy' For Consi stem Temperatures Interior Lighting for Optimal DisplayVision n �l Durable and Sturdy Commercial .Grad e Glass .Display Certifications https://WWW.el.iterestaurantequipment.com/product/universal-sdc48sc-4 - '8 single-duty-deli-... 2/14i�n,n UtiiV rsal SDC48SC -48" Slagle Diity Deli Cam Page 4 of 5 5 Year Warranty. rf« : 5 year product warranty. 1 Made in USA. This item was rnanu#actue€ n the'United States of America. � l UL This item has menthe standard$set by Underwriters Laboratories (UL), which tests safety. 4 y � bownloads Specsheet (/media/blfa�files/SDC48SCSPEC—Sheet1.pdf) (� Warran#y Info {Irnedia/blfa files/Um-ersal Warranty_3.pd T�� uvtn Al Related Categori. � Bakery Display Cases (/category/speciali su lies-by business- - Pp type/bakery- oquipmentlbakery-equipmenfbakery-dis)lay-cases) Deli Display Refrigerators (/category/restaurant-equipment/refri erat display-refrigerators) 9 ors/deli- https://www.eliterestaurantequipment.com/product/universal-sdc48sc-48-single-duty-deli-... 2 /19/2019 31r ,�y X 3 Wianno Ave Osterville, MA 1\\\� 1 M1 ode >'✓t�r�o� i3E��` nwyslsx ds� ,' m U]B1B01 WBifiB/ U331fi u � DauEl.Oour RefAp.nior / \ �_ Shelves and Menu aoerd m 0,00 N 9114102 e m Dry OI.pl yG.e - Relrl...-Olepley LG.A Re I.e J— T P 'V /^` /^\ /^` //�\ ✓IC (mac, �� - 01 Sn re�lool elver 51oO1 Olner Sbal Olner SloOl f ner sbW �� ZD Ij OP �i 14-rA c, . � II `-n nt?I vu �o zn�c3j / UP mm Ta I. Zo T.W. 64'Tell Welle 07, 64"Tell Well r � r LdQI'�6/A =Z261,117 lemol a 210fit 0 � TW2446 -+• a.s S! a oFTHE O�y TOWN OF BARNSTABLE 6 0 OFFICE OF i BAH8STABLE, 1639.MOB. BOARD OF oo'fO MAY k�$�9 HEALTH 367 MAIN STREET HYANNIS, MASS.02601 November 10, 2000 Daniel James Leonard Insurance Agency, Inc. 7 Wianno Avenue Osterville, MA 02655 Dear Mr. James: You are granted a variance from the provision contained within the Board of Health Regulation, Part VII, SECTION 1.0 dumpster located behind 7 Wianno Avenue, OOster i ll e.quires screening of the te►v Photographs were provided showing the existing to show a very well maintained and sanitaryrefuse dumpster area which a testimony was provided indicating that the fuse storage appeared would become 9 area. Also partially blocked if fencing is provided around nto the parking lot Therefore, the Board of Health members votedthe dumpsters. variance from the screening requirement cost unanimously to grant you a Regulation, Part VII, SECTION 1.00. contained within the Board of Health Inspector Glen Harrington dated October 18 2 Health The order letter handed to you from 000 is therefore rescinded. Sincerely yours, usan G. Risk, R.S. chairperson Board of Health Town Of Barnstable SGR/bcs v TOWN OF BARNSTABLE LOCATION n 46 /9V s1 SEWAGE # VILLAGE C er-�e_�y .� f__ ASSESSOR'S MAP& LOT INSTALLER'S NAME& PHONE NO. k-*,e - Z SEPTIC TANK CAPACITY F' i LEACHING F4CIL rrY: (type) We ( S (size) I a XY NO. OF BEDROOMS BUILDER O OWNER �� '�X. / I PERMITDATE: f3 U COMPLIANCE DA : I Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) 111000 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachi ;�ac_ility) Feet Furnished by . al/ v tv� i Ca ' 0 j '.� No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE-, MASSACHUSETTS Yes 0(pprication for Migozal *p5tern Construction Permit Application for a Permit to Construct( )Repair( X( Upgrade( )Abandon( ) MComplete System ❑Individual Components Location Address or Lot No. A 1 —13 \f„l t n�r l�a AV-C Owner's Name,Address and Tel.No. Assessor's Map/Parcel. I t_7 j a 9 U 3Z-j v�t eve 1 E 1_A,A-% 1 V,T��j(t L L F_ Installer's Name,Address,and Tel,No. `l D�esi1gner's.Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures I C CO Gv,.��4-0X-t 01 n_�S E •%fL,&,-p Design Flow 604 gallons per day. Calculated daily flow O gallons. Plan Date QL-F If ) ZCbZ Number of sheets I Revision Date �IO&A C. Title s ►'iZ F i l Y2C5 s EeT L L O tTmVikD 9 Size of Septic Tank 1 Type of S.A.S. 1 ZX-4 Description of Soil D _?D 6OU c-ce—W\GQ E116 t k3U-,e ,? 1'T-1 VLA G 100 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue4,4Lthis Board o Health. Sikne - - ----- ------- -Date 1 Q- Application Approved by 17 U4elM, All Date Application Disapproved for the following rea o s v TOWN OF BARNSTABLE LOCATION /9V"R, SEWAGE # -200?— VILLAGE �. 1 ASSESSOR'S MAP & LOT / �0 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING F4CILrIY: (type) W t S� (size) i s XYF l NO. OF BEDROOMS I BUILDER O OWNER �- PERM TDATE: /J o U COMPLIANCE DA U/ Separation Distance Bgtween the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist 1 within 300 feet of leachi acility) Feet Furnished by y 0��`? �L7 fir. 't tJ e