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Home My WebLink AboutFAB IS MEALS @ FRATERNAL LODGE - FOOD Cem- Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. RAWNW UM F.P.(Thomas)Lee a 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D.,Alt. M 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: 1145 Issue Date: 04/27/2022 DBA: FABI'S MEALS @ FRATERNAL LODGE OWNER: FABIANO DE MATTOS Location of Establishment: 1989 FALMOUTH ROAD CENTERVILLE MA 02632 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: I `$ Iw 00 00 For Offic.-IT.. �.tMETpN, Town of Barnstable • Initials:~Q` Date Paid 3 Z--�Amt_Pd$ + 1ARNSTABLE, ` Inspectional Services MASS. 21 � 11 1659.iOlEpMp.�A Public Health Division Thomas McKean, Director 200 plain Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 p APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE ,��lei-2-- NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: VA13 i �S M OLS `M�l��ivG `/Ov2 tirc e6i'aw" / \ ADDRESS OF FOOD ESTABLISHMENT: /989 FwA106I1/ gxq - L?ewfoyille 1. Frc,4nrtQ-Lo�J MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: CHeF,4dj;j y019 [QCMj4- AM TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( 7� TOTAL NUMBER OF BATHROOMS: 2 WELL WATER:YES NO ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: /_/_ TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING 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) t /�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*** REOUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 QAApplication FormsTOODAPP 2020.doc I i OWNER INFORMATION: FULL NAME OF APPLICANT F/-1[3)fA1VO Q• VC rOATfDS SOLE OWNER: (YE /NO D.O.B 17-23.-19TV OWNER PHONE# 3t( 3 3,04Jo ADDRESS 'u j 04m'p SjI. uml 502- waf y-4'2Moj919, M11 026-13 CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: 1-✓�IO 1" 0?- 06 /W HO 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 o2 ` /2tp 2: I� 2074 SI TU E OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.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.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FonnsTOODAPP REV3-2019.doc 1/24/22, 11:56 AM OpenGov Town of Barnstable,MA 01/24/2022 B L-749 Business License Status:Complete Date Created: Dec 15,2021 Applicant Location Fabiano De Mattos 1989 FALMOUTH ROAD/RTE 28 chefabianol9@gmail.com Centerville, MA 02632 345 Camp St unit 502 Owner: West Yarmouth,MA 02673 774-368-3046 FRATERNAL LODGE BLDG CORP PO BOX 595 CENTERVILLE,MA 02632 Business Information Business Name DBA Fabi's Meals Chef Fabiano Business Structure Type of Business Service Individual Food Service Phone Number Is this a New or Existing Business 774-368-3046 Existing If existing is it at the same location Is this a Home Occupation Yes No EIN# A Home Occupation permit is required by the Building Division Restrictions NAICS Title Code Applicant Signature Applicant Signature I hereby certify that all of the details and information I have Fabiano Ribeiro de Mattos submitted or entered regarding this app ication are true and 12/15/2021 accurate to the best of my knowledge. ......... Attachments No attachments ......... ........ ... ........ ... ... ......... .... History https:Hbarnstablema.viewpointcloud.io/#/explore/records/249111/printable?act=true&app=true&att=true&emp=true&int=true&loc=true&sec=1011289°/`... 1/2 f zy Monday Grilled Salmon Couscous Lentil Asparagus Tue dw Ground beef Brown Rice Black Beans Cauliflower Wednesday Chicken Breast Quinoa Lentil. Brocolis Thursday Steak. .Brown Rice Black beans Mixed Veggies • Friday Tilapia GF Spaghetti Marinara Sauce Mixed Veggies LJ CENTERVILLE BUILDING CORPORATION COMMISSARY KITCHEN RENTAL AGREEMENT Organ ization/D BA: ResponsibleParty: A�q � Address: City: 4—ajr(�( //C State: ' Zip: Email: 0 6 07h Phone.-77"1 The Renter shall have access to the kitchen and equipment every Monday from 8 am to 4pm. Terms •The renter shall pay to Centerville Building Corporation the rental amount of$ 125.00 (One hundred and twenty-five dollars per day of use), which will be due on the 1 st of every prior month for the duration of this contract. This rental amount includes basic kitchen rental, utilities and equipment usage. This is a at will agreement that shall be renewed every month upon payment. • The kitchen is a shared use facility, equipped with commercial stoves, ovens, sinks, refrigerators, tables, dry and cold storage and other food preparation equipment. The Centerville Building Corporation shall maintain the kitchen in a sanitary and orderly state and ensure that all equipment available to the renter operates to all applicable health and safety standards. It is the renter's responsibility to furnish all small wares needed for their food process. It is also the renter's responsibility to ensure that the kitchen is left in a sanitary and orderly state at the end of the rental period. •There is a ZERO TOLERANCE policy regarding signed commissary agreements with our kitchen. If a renter is found to be cooking from home or in any other kitchen while claiming to any entity to be working from the CBC Kitchen, they will immediately be banned from further kitchen use and any health department that holds a signed commissary agreement from us will be notified. No refunds will be given. •The renter shall furnish their own food, spices, bowls, utensils, towels, pots and pans necessary for their process. When processing is completed for the day, renter must remove their equipment from the kitchen or store it in a rented storage space in the kitchen. All stored items must be properly washed and sanitized. • Renter shall procure and maintain the appropriate food service licensing from the Barnstable Town Health Department.A copy of the license must be provided to The Centerville Building Corporation prior to your first rental date. The renter shall be solely responsible for any fines or fees levied by the County Health Department or the State of Massachusetts related to their activities in the kitchen. jy� o Renter shall report any personal injuries or property damage arising at any time during and/or arising out of or in any way connected with the renter's use or occupancy of the kitchen. • Renter is solely responsible for supervising all individuals in the kitchen during your rental time related to your rental time.The Centerville Building Corporation reserves the right to evict individuals from the facility at any time if their conduct is deemed to be destructive or detrimental in any way. Under no circumstances shall the renter allow any other organization or individual to use the kitchen for the period which the renter has contracted. • Renter agrees to abide by the following rules, and agrees that upon violation of said rules, The Centerville Building Corporation has the option to terminate this rental and demand that the tenant vacate the premises. 1. No furniture or equipment shall be removed from the premises unless it has been rented. 2. Renter shall not admit a larger number of individuals that can lawfully, safely and freely move about the facility. 3. Smoking is not permitted in the facility. 4. Drugs and alcohol are not permitted in the facility. 5.Animals are not permitted in the facility. 6.All trash in and about the facility must be removed on a daily basis and placed in trash receptacles located outside the building. 7. If you are storing products or ingredients for products in the facility, you must check your stock for current dates. NO EXPIRED DATES allowed on premises. 8. Rental time begins at the scheduled start time and ends at the scheduled stop time. All set up and clean up must be completed within this time frame. You must be vacated from the rental space by the scheduled end time. Indemnification and Liability Renters shall indemnify, defend and hold harmless the Centerville Building Corporation from any and all losses, costs, expenses, claims, liabilities, actions, or damages, including liability for injury to any person or persons or damage to property arising out of or in any way connected with renter's use of occupancy of the kitchen. i 4w III ner ignature odrigo Sena--CRC President Owner Print Name Date