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HomeMy WebLinkAboutBEACH CLUB, INC - FOOD BEACH CLUB, INC. 47Long, Beach Rd.Cent, i Lo rtKE Town of Barnstable BOARD OF HEALTH John T. Norman -� Board of Health Donald A.Gaudagnoli,M.D. F.P.(Thomas)Lee MASsL Daniel Luczkow,M.D. Alt. 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 302 Issue Date: 01/01/2022 DBA: BEACH CLUB, THE OWNER: THE CRAIGVILLE BEACH TRUST Location of Establishment: 27 LONG BEACH ROAD CENTERVILLE, MA 02632 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: 188 Total Seating: 188 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: MOBILE-ICE CREAM: C,�� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: For Office Us Djft� Initials: s �°FIME T°°y Town of Barnstable� ti °s Date Paid /2,2-AnitMl$ BARN&r B : Inspectional Services 1 H7�A�S�S: 1639.9 AtE �p Public Health Division (heck# 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 4440juaZZ NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT:_•r/ Q� �i��d ADDRESS OF FOOD ESTABLISHMENT: 27 AM &ed 61 , a ALWA B.NA OW 2 tX MAILING ADDRESS(IF DIFFERENT FROM ABOVE): &AX2,17,C & , N d 4gzZ vK E-MAIL ADDRESS: /I191 I O(i�9�7 CD/�l V \ TELEPHONE NUMBER OF FOOD ESTABLISHMENT: LOW)ja- 0711 X TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO—j— ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: ti/ DATES OF OPERATION:k 49 /PTO /0 //✓r/,ZZ ***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)? Na TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT �Q/1f�f P �1f 4,0 SOLE OWNER: YES ``/NO. nn,n,--DII:,O.BnnQJJ.2 ����6yy OW)'NERPHONE# 911• 921' SIb ADDRESS_ 27 444 pW4 lam• rt/��i-W--YL� MA D?/ IA CORPORATE OWNER: N�J� CORPORATE ADDRESS: -T PERSON IN CHARGE OF DAILY OPERATIONS: &", List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. "ATTACH COPIES OF CERTIFICATES" The Health Div.will NOT use past years' records.You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. N�cl� I/Pcc tort b2 i /3 i�p23 1.l�' 1'/P.tc one Obi Ito i�p23 01 //0/� SIG4MME 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: Froz n 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 htty://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 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 FormsTOODAPP REV3-2019.doc �r �t1fT Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli,M.D. t putt ar,�tste Paul J.Canniff, D.M.D. MAS F.P. Thomas Lee Alternate s �• 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 302 Issue Date: 01/01/2021 DBA: BEACH CLUB, THE OWNER: THE CRAIGVILLE BEACH TRUST Location of Establishment: 27 LONG BEACH ROAD CENTERVILLE, MA 02632 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: 188 Total Seating: 188 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: --- - --- -- — - MOBILE-FOOD: MOBILE- ICE CREAM: C�� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: I Vi k oFt r For Office Use Only: Initials• Town of Barnstable Date Paid`��I AmLl'd$ BMW fABM Inspectional Services 9q, `"sy Public Health Division Check# 21 DR , 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 l NEW OWNERSHIP RENEWAL,4 i NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: ] )6t 2 ZA MAILING ADDRESS(IF DIFFERENT FROM ABOVE):. aC 7 < Ze—lef--t 9<Jll" E-MAILADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER:YES N04 ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: ,� DATES OF OPERATIONILF TO )/,31 /, + NUMBER OF SEATS: INSIDE: . .) OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) �(&FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED& BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc 1 R OWNER INFORMATION: FULL NAME OF APPLICANT ��/� ,Sat rj SOLE OWNER: YES/NO D.O.B6711111563 OWNER PHONE# ADDRES n re1�ne Li t CORPORATE OWNER: Al CORPORATE ADDRESS: —r PERSON IN CHARGE OF DAILY OPERATIONS: 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._ / / 0 i SIGNA U APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to oyenine!! 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/healthdivisioit/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 I st to Dec.3 V each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist. Q:\Application FormsTOODAPP REV3-2019.doc BOARD OF HEALTH Town of Barnstable e� John T.Norman Board of Health Donald A.Gaudagnoli,M.D. RAWN AOM 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, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 302 Issue Date: 01/01/2020 DBA: BEACH CLUB, THE OWNER: THE CRAIGVILLE BEACH TRUST Location of Establishment: 27 LONG BEACH ROAD CENTERVILLE, MA 02632 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: 188 Total Seating: 188 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q.� FROZEN DESSERT: $30.00 Thomas A. McKean, RS, CHO, Health Agent l FOR ESTABLISHMENTS WITH SEATING: - PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: f .,r of tp� For Office Initials: Town of Barnstable ? K � Date Paids r�a�o�D �pd$ J 3D BARNb9'ABLE. ; Inspectional Services Public Health Division (neck# 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 2D NEW OWNERSHIP RENEWAL� NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: �� .T T c� T RC'_1%.a�-7— Ct®� aIr A r. TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES_NO__X_ ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: ®S ISldcro Agl X/ .20 NUMBER OF SEATS: INSIDE: v OUTSIDE: )9� TOTAL: JR'6 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*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc f 1 ai OWNER INFORMATION: r f `'�� FULL NAME OF APPLICANT �� f�j7'I I }� c am e&p/c&-2� SOLE OWNER: YES/e)0 DD..O.B ll 21W OWNER PHONE #r ri1 g 77S— (q71r' ADDRESS CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: 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.: SIGNAT F APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD S RVICE: 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 httv://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 1st 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 I Town of Barnstable BOARD OF HEALTH ~ G Paul J Canniff,D.M.D. A.Ga Board of Health Donald A.Gaudagnoli,M.D. • 11ARNsrtiuts, John T. Norman M'39 � F.P. ,bs� ��� 200 Main Street, Hyannis, MA 02601 Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.towndbarnstablems 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: 302 Issue Date: 06/12/2019 DBA: BEACH CLUB, THE OWNER: THE CRAIGVILLE BEACH TRUST Location of Establishment: 27 LONG BEACH ROAD CENTERVILLE MA 02632 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 0 OutdoorSeating: 188 Total Seating: 188 FEES FOOD SERVICE ESTABLISHMENT:: $300.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B- FULL BREAKFAST: i CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: �CQ� FROZEN DESSERT: $30.00 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: �oF�we royyFor Office Use OnLv. Initials: o* Town of Barnstable ` Date Paid "S. IQAmt Pd S 4 BARN6TABLE, : Inspectional Services a q�b �. `�� Gheelc# >f�MAyA Public Health Division Thomas McKean,Directot 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 i APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT i DATE r S I�I NEW OWNERSHIP RENEWAL � r- rr,, NAME OF FOOD ESTABLISHMENT: l Q ADDRESS OF FOOD ESTABLISHMENT; � MAILING ADDRESS(IF DIFFERENT FROM ABOVE): `P (i v�9 yet 1 i II P E-MAIL ADDRESS; TELEPHONE NUMBER OF FOOD ESTABLISHMENT: bF _�ZL- 6 7/I TOTAL NUMBER OF BATHROOMS: G'q �O c t'�}S V P(yt7wl S 3 WELL WATER:YES NO y ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: _ DATES OF OPERATION:a/A/jj TO j' 30 l-q G r NUMBER OF SEATS: INSIDE: Qoo OUTSIDE: I�lo TOTAL: 3 2n 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 y 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) YY 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 I FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE 0) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) ' *** SEASONAL,MOBILE &N-EW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Appfication Fomis\FOODAPPRE;V2018.doc 6 gA Ckk P - - L {€ l PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: YES D.O.B OWNER PHONE#T SQ�- mil`- 0-7 ADDRESS --f T CORPORATE OWNER: k1I(A FEDERAL ID NO. : CORPORATE ADDRESS: 4 PERSON IN CHARGE OF DAILY OPERATIONS: � 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 �L/_ of-aq (!P, SIGNY4 O4APPLJANT DATE i ***FOOD POLICY INFORMATION*** i SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile bucks must be inspected by the Health Div. t Dior 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•/hvww townofbarnstable.as/healtlidivision/agplicRtiorrs.Rsp. 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 k THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC l st. l Q:1Application FormsT00DAPPREV2018.doc E �ptME To,, TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: J Date- LO Zj, Page: =of .. 2 , .' OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p e3 HYANNIS, MA 02601 508 g62�RW No Reference R-Red Item . PLEASE PRINT CLEARLY rFDN1P`� FOOD ESTABLISHMENT INSPECTION REPORT Name Date 2 Tyne of Ins ectio n Routi Address -1 _J Risk ood clsn `�� � o L VI Previous n Level Retail pection Telephone Residential Kitchen Date: Mobile Pre-operation ci Owner HACCP Y/N Temporary Suspect Illness V I lL111 Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP mod- S, CIe� In, Z \'; Other Q lI � Inspector Out: : (rev, 1 C) Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. 11 z Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ 11� Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ W _ �c� - 3 p E .Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ r _ J FOOD PROTECTION MANAGEMENT ❑]revention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties 3.Handwash Facilities /f-- EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ✓M ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives 4S 0-6,).e,, ❑ 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 �!n�C� - ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 1 Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans 19.Hot and Cold Holding -// PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ^`W�,__ 1 � ❑ 8.Se aration/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) AA I i Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY Q l_0 E ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories _ Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 1r (A10t--1 S� 6 1-) a t Critical(C)violations marked must be corrected immediately. (blue&red items) g(r Corrective Action Required: ❑ No Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food 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 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's ignatur Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y IN #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 IN Dumpster Screen? Y N _ _ s'-' ��..:... .�.rJv.- ......r---:,.r..,.^^..u�TY..-....+•..-- _s,�...-_-. ."......-- �. �. _- n_,. ..r .�--, , - .. t -� -,- . �. ..._ .-.- _ .. . ... -�.��....�n.i �_.. �-.... '`�a _-�-.-...-� •--"• ..r+. y--TMr......��. . _- --�.. - . r 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 1q 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 2-103.1-1 Person-in-Charge Duties 3-302.14 Protection.from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F - 590.004(F) * - EMPLOYEE HEALTH J 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 3-501.16(A) Hot PHFs Maintained At or Above 140°Fo _ 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se azation-Storage* Applicants* 3-302.11(A) Food Protection* P g * 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) q 590.003(G) Reporting by Person in Charge*. 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Reate for of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) •'Removal of Exclusions and Restrictions � g ( ) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* Food and Water From Regulated Sources' * 3-801.11(B) Use of Pasteurized Eggs* q 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* gg .9 590.004(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 HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-201.13- Fluid Milk and Milk Products* 4-501.112 Mechanical 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.I IA(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* eg°"ve 11112001 I 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source _ 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4=702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 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 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Chemical Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arens* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 - Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition 2-401.11 __ Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23-30) 3-202.15 Package Integrity ( ) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the 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 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F[0 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 P Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 128. 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 590.000. (HE Tok, TOWN OF BARNSTABLE. HEALTH INSPECTOR'S Establishment Name: �'i(/�•l � Date: _ 12J Page;.. Z- of Z Q o OFFICE HOURS • �' � PUBLIC HEALTH DIVISION s:oo,-ssaA.M. BARNSTABLE. • 200 MAIN STREET 3:3o-a:so P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. 3. �e� HYANNIS, MA 02601 - 508-862-4s44 No Reference R-Red Item - PLEASE PRINT CLEARLY �'FON1P`' FOOD ESTABLISHMENT INSPECTION REPORT Name Dat ,L Tyne of Type of Inspection ��'_ {/ ��Qectii Address /��J_ r�' -�-�i�► Risk Food Service f ►� G S l �-2/ Level ction l Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness _ Caterer General Complaint Person in Charge(PIC) Time Z Bed&Breakfast HACCP I In: f Other Inspector V f0 Out: 3. i Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. 1902 tl- 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 (J� ❑ 1.PIC Assigned/Knowledgeable/Duties Q_1,3-F andwash Facilities `` 1 EMPLOYEE HEALTH PROTECTION FROM CHEMICALS l/!nn t ,-e� ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals I _ _I �� FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) l�I!(itl ,L�..Cl ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures so ❑ 5.Receiving/Condition ❑ 17.Reheating - ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling n ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control fW W 6 f/�`- ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) rN ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY JAW ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories A 9, Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations UL Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No El 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-insp Sc eduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Dispo I ❑ Ot er: 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, or ore non-c it" al violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils 6=One critical violation and less than 4non-critical violations 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 6von-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 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 g violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. - 30.Other DATE OF RE-INSPECTION: Inspector's S" ture Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions Y Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 3-501.15 CoolingMethods for PHFs 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 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 F15 Poisonous or Toxic Substances 590.004(F)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 7-10].11 Identifying Information-Original Containers* * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers 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*- - �•- - - �- * P g 20 Time as a Public Health Control 3-302.11(A) Food Protection 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* * Applicant To Report To The Person In Charge* 3-304.11 Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use 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) I 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 WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* _ 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a 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 Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 _ Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(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° Not Otherwise Processed to Eliminate F 15 sec* 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 11112001 590.006(B) Water Meets Standards in 310 CMR 22.0* 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency r f ces Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A) oaons of . in cater- -Molluscan Shellfish from NSSP Listed Chemical* -(D) Violations f Section 590009A( )-(D) Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By 3-401.I1(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present*' 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms 3 401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition' - 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* I 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* - 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 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 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Forrnback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. OF(NE Tp� TOWN OF BARNSTABLE...., _ _ . HEALTH INSPECTOR'S Establishment Name: Clu 6 Date: Ce l) ..Page:_�of , fo OFFICE HOURS _ t PUBLIC HEALTH DIVISION 8:00-9:30A.M. > E. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified v e3q. .0� HYANNIS,MA 02601 MON.-FRI. No Reference R=Red Item PLEASE PRINT CLEARLY C �A 508-862-4644 TF FOOD ESTABLISHMENT INSPECTION REPORT Name �� Date L Type of Type of Inspection O s Routine �1L vl Address - 1 Risk ood Service Re-inspection �k / Level Previous Inspection �-1 Telephone Residential Kitchen D Mobile re-operati Owner HACCP Y/N Temporary uspect Illness Caterer General Complaint Person in Charge(PIC)- Time Bed&Breakfast HACCP to Sj In: Other Inspector v -gt� Out: I Z;36 p it Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. a 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. revention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties Zandwash Facilities ✓ ���� W EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives W �� ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals _ r I FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures o-- �JQ GtJI G - ❑ 5.Receiving/Condition ❑ 17.Reheating - 'k 6 � ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling �ae ❑ 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) Jim (4,w\ cCJ a Ar • C6^ ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY qq ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories l S I✓I nn �ZP/���� '�1�'n Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ' ly AX, 1X 'I d`^ 7-�L v� ' C t✓/� Critical(C)violations marked must be corrected immediately. (blue&red items) U Corrective Action Required:- No 4- Yes yt ;'^ 1a Non-critical(N)violations must be corrected immediately or Overall Rating ❑ r_` within 90 days as determined by the Board of Health. ( 2� ❑ Voluntary Compliance ❑ Employee Restriction/ xclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an i spection today,the items Embargo Emergency Closure Voluntary Disposal checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ 9 y ❑ ry P ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils 6=One critical violation and less than 4non-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 9non-critical. If no critical water,sewage back-up,27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must g p,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen 7 Y N J 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.) I 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* 6 Cross-contamination 1 q Food or Color Additives Law Cooled[0 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 - - - -- -- - 590.003(C) Responsibility of the Person-in-Charge to Other 7-102.11 Common Name-Working Containers** 3-501.16(A) Hot PHFs Maintained At or Above 140°F 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 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 Repoli To The Person Iri Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 1590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals far Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g ) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and * 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations � 3-201.12 1 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* - 4-501.117--- 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 * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* 5-101.11_ DrinkiOg Water from an Approved System - _ gg Equipment* - -- - - Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* 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 Game and.Wild Mushrooms Approved By 3-40 1.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301:11' Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 19 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 Game Animals Requirements. 5 -Receiving/Condition - 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth*. 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 ( ) 590.000 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 P Tags/Records:Fish Products 5-203.11 Numbers and Ca pacifies* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41'F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. p THE Tok� TOWN OF BARNSTABLE - -. H +�FFI'NseecTOR s Establishment Name: ��( � Date: - - Page:. L! of -. OFFICE HOURS PUBLIC HEALTH DIVISION soo=ssoA.M. BARNSTABLE. ' 200 MAIN STREET 3.30-a:so P.nn. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �A .639. �•� HYANNIS,MA 02601 50e-862-4644 No Reference R-Red Item... PLEASE PRINT CLEARLY rFO MP'�p FOOD ESTABLISHMENT INSPECTION REPORT � �/ in l e vu Name '(X,cJ Date Tyoe of Tvoe of Inspection �/� f� l O Routine �� A,(/w c / Address Risk ood Service Re-inspection ,hC S /� _�y -h) fi / Level Retail Previous Inspection u 1 Glfal✓ p (lv Telephone Residential Kitchen )I P, J d Mobile re-operati Owner HACCP Y/N Temporary Susp ess Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other i l �/-/ Y-'!\ C!r Inspector E Q Out: Each violation Lchhecked 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) ❑ (tea S b 17d (� Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ 2 Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ 2 C�, /L FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities �G�✓ EMPLOYEE HEALTH PROTECTION FROM CHEMICALS C",rh, C ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives �� � l�� r ❑ 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 O ems$ �r "OD ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling bqf/ ,S ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control � - q ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) odh - r�l ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP !r/ t el ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY `� � //� ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories `1J �t"^r - n - 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: ❑ Nod ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating ' within 90 days as determined by the Board of Health. - ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑.Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items' ❑ Embargo Emergency Closure ❑ Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations if no critical violations observed,4 too 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 violation,4 to 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector' S' a re Print: 31.Dumpster screened from public view y� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N �c v #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 �1 Violation related to Foodborne Illness Violation Related to Foodborne Illness Interventions - r • i 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 i 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14. Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - - 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * 2 Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 590.003(C) Responsibility of the Person-in-Charge to - 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees-and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130*F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An _ _ 3-302.1 5 __ 7-202.11 Restriction-Presence and Use*Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 3-304.11 Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use* 590.00411 Requirements 590.003(G) Reporting by Person in Charge* - _ _ 7-203.11 Toxic Containers-Prohibitions* ( ) Variance Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g ) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P _---- .- - -- .* - _- -- 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures Raw Seed Sprouts Not Served*7-206.13 Tracking Powders,Pest Control and - 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13_ Shell Eggs* _ __ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202:16 Ice Made From Potable Drinking Water* - Concentration and Hardness* - 3-401.11A(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 • I 590.006(A) Bottled Drinking Water* - 3-401.11(A)(2) Comminuted Fish,Meals&Game Pathogens* Eg rrme uuzooi 4-602.J 1 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 - 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec Shellfish* - _ 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 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 Authority oms.Approved By - - ' 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 _ Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 2-301.14 When to as * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms_* Wash* � 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* FITGood Hyglenic Practices 17 Reheating for Hot Holding Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition -- - -2-401 J I 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 d03.11 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 Pgrtions of Beef Roasts* illness interventions and risk factors listed abuue,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 3-202.18 Shellstock Identification ( ) Cooling Cooked and Fr from 140°F to /45 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. I SUBURBAN SUPPLY CUSTOMER36453 SERVICE / SURVEY P O, Box 2606 Westwood, MA 02090 (781) 449-1042 ACCOUNT�c-07'zr--,-'� t__ / Time: Date. Address > /�C �/� �o Machine / Modell/�e�(�L Tel#: () Attention: Location: (CHECK ONE) ROUTINE CALL:( )NIGHT CALL:( )WEEKEND CALL:( )EMERGENCY SERVICE:( ) Operating Charts PreScra ing Cleaning Equipment Use of Equipment Racking Silver Presoaking Changing Tank Water Cleaning Scrap Screen ITEMS Good TITRATION OK OK OK I Dishes 81 Pre Wash Temp 115 Fill Valves ✓ 22 Pumps 2 Glasses 9 Wash Temp �'� 16 Wash Tank Arms t✓- 23 Rinse Period lam' 3 Silver (k >Zinse Tank Temp ,117 Rinse Tank Arms 24 Racking 4 Pot/Pan ✓ ,11.5Final Rinse Temp 18 Final Rinse 25 Scraping 5 Sanitation L-� 12 Final Rinse PSI a/'� 19 Rinse Valves 26 •Gurtatm— 6 Floors 13 Machine Sanitizer / 20 Overflow 27 Wa'��ener 7 Meter Read 14 By Pass/Gal Min 21 Drains � 28 Racks CUSTOMER `` ! W i f SIGNATURE: !1,i i � REP.: APPROVED: _ MACHINE RINSE SANITIZER SILIE)UPRE. POTIPAN SA.NYPOT DELIME FLOOR DRAIN Ot'ENIGRILL HANDSOAP LAUNDRY MISC.PROD. 1 PRODUCT: STOCK ON HAND: ORDER: ZZ—ZZZ//,)/Z Z V I z PARTS/EQUIPMENT 01iDERED/IN ALLED QUANTITY QUANTITY t WFSH¢r TOWN OF BARNSTABLE HEALTHwsPEcroRs Establishment Name: ) "✓ Date: Page: of . .° °kq 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 MASS. g. lll..YYY MON.-FRI. �ls, ,esv p.• HYANNIS,MA 02601 No Reference R-Red Item PLEASE PRINT CLEARLY rFo MPS 508-862-0644 F OD ESTABLISHMENT INSP TION REPORT Name Date Type of Type of Inspection Routine Address g /-A'O r Risk Food S Re-inspection Level Retail .Previous Inspection Telephone Residential Kitchen Dat Mobile re-o e Owner HA Y/N Temporary Svspet Illness Caterer General Complaint i Person in Charge(PIC) Bed&Breakfast HACCP 1. Other �.+ Inspector 3ut: L Each violation checked requires an explanation on the*narrtivepages)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) ❑ % Of Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ O A FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands --" I q ❑ 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 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 J ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding i 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 If Z Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 1 Critical(C)violations marked must be corrected immediately. (blue&red items) 12M Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance _ ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal [].Other:- checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report;when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4 non-critical violations if no critical violations observed,4 to 6nnn-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC•7 590.008 9 violation,4 to 8 non-critical viol tions--C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspe is Signature C rint: . 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Sig ture Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen o 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 L14 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) 590.003(C) Responsibility of the Person-in-Charge[0 * 2 Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage** 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* 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* 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 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 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 Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 . Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment Co* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) omminuted Fish,Meats&Game Pathogens* Ed°nee 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) I Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 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 1 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 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 internentinns and risk factors listed above,can be found in the g 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 * Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities 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* 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 I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. � U, oFtHF roh TOWN OF BARNSTABLE EAL.H INSPECTOR s Establishment Name H6,-, ' ) Date: 67 %' age:. of v` o CA OFFICE HOURS E. PUBLIC 0 MAIN STREALTHEET 3:30-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified BARNSTABL3:30-4:30 P.M. �A 63.a�0� HYANNIS,MA 02601 MON.-FRI. No Reference R Red Item PLEASE PRINT CLEARLY. 508-862-4W rFD MP'� FOOPESTABL14PSWENT INSPEICTION REPORT Name Date T e o Type of Inspection o O t'o Routine Address Risk ervi Re-inspection e el et Previous Inspection Telephone Residential Kitchen Date: Mobile a-opera ion Owner HACCP Y/N Temporary ess Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Other Inspector Each violation checked requires an explanation on the narrativelaX 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) ❑ 7 FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) IV❑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 I ❑ 10.Proper Adequate Handwashing. CONSUMER ADVISORY I I t!1 ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories �-. I �i "14/1 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations La4�1 IV I IS C k2;-q Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating ❑ Voluntary Compliance [:],Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items [E] Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils FC-4 590.005 6=One critical violation and less than 4npn-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8 non-criYcal vi lations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violati n,4 to 8 non-critical viola Ens 29.Special Requirements. (590.009) within 10 days of receipt of this order. 30.Other PATE OF RE-INSPECTION: In a 4S,, re 31.Dumpster screened from public view �M Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed IFrozen Dessert Machines: Outside Dining Y N PIC's gna ure Int: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N 'e, Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45'F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods! 19 PHF Hot and Cold Holding 2-]03.11 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 Anima]Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 2 590.003(C) Responsibility of the Person-in-Charge to. Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130'F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* 3-304.11 Food Contact with Equipment and Utensils ii Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.00411) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* ( Contamination from the Consumer 3 1590.003(D) Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions 7-204.11 Sanitizers,Criteria-Chemicals* _ REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Rated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP ' Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-266.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P I 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations * 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served y Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMErfEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. LL6 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an Eggs d Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* EJjemve 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006CB) Water Meats Standards in 310 CMR 22 0* Contact Surfaces of Equipment* * min Eggs 3-302.13 Pasteurized Eggs Substitute for Raw Shell * Shellfish and Fish From an Approved Source - _ 4-702.11 Frequency r f 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,injected Meats-155'F 15 scc* 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 Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* (A) �) Sources*Game and Wild Mushrooms Approved By ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 2-301.11 Clean Condition-Hands and Arms* Ratites-165'F 15 sec*3-401.l l(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under i Regulatory Authority 3401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. * 2-301.14 When to as * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms Wash* 3-401.11(A)(1)(b) Al]Other PHFs-145'F IS sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165*F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting*: 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodbome * 12 Prevention of Contamination from Hands 3-003.11 Remaining Unsliced Poriioi�s of IIccf Roasts* 3-101.11 Food Safe and Unadulterated (E) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 1407 to 70°F rem Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41'F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 ■ 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Crereatioation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. 1 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 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical 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. °F ME r TOWN OF BARNSTABLE _ HEALTH INSPECTORS Establishment Name: Date: < _ Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSrABLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified Me3y. HYANNIS, MA 02601 sos 8s2�saa No Reference R-Red Item PLEASE PRINT CLEARLY .. FOOD ESTABLISHMENT INSPECTION REPORT Nam i Date `� ' T e o section }+' g outine Add, Risk od Servi - Re-in ction _ _ 1 Level Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation ' Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP c Le A In: Other Inspector Out: L. Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. ) d O 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) ❑ Gi,n T .� Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ C t+� FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEfTEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ✓ 0 ❑ 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 4 1A L44, / r ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP / t ❑ 10.PrdperAdequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations L V� t ­r_, C. Critical(C)violations marked must be corrected immediately. (blue&red items) " Corrective Action Required: l Non-critical(N)violations must be corrected Immediately or �d 7 a Overall Rating I within 9 � Compliance .Employee R striction/Exclusion Re-ins a tion Scheduled Emergency Suspension 0 days as determined b the Board of Health. Voluntary Y Y ® ❑ ry ❑ ❑ P ❑ 9 Y P C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils FC-4 590.005 B=One critical violation and less than Orion-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food.establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials, FC-7 590.008 9 violation,4 to 8 non-critical violations L.C. 29.Special quirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dump er screened from public view �I - // 2 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N P #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 PROTECTIOWMANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assigtunent 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* I 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14. Protection from Unapproved Additives* 19--- PHE Hot and Cold Holding _ Contamination from Raw Ingredients 15 Poisonous of Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below-41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to - - Omer* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-101.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* - * 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 7.202.12 Conditions of Use* Applicant To Report To The Person In Charge * 590.004-11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils f ) 9 590.003(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 Foam* 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 i Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 ' 'Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law*_ 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* _ _ 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-561.112 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 4-60L11(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 Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eft°nvc 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(R) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved-Source _ 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Chemical Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Au 3-40 1.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and d Approved By 2-301.11 Cl Condition Hands Arms* Regulatory Authority Wild-Mushrooms y Clean on- ans an 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 - Shellstock'Identification Present* __ 2-30L.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms* _ 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17. Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 - - Receiving/Condition - - 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts * illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F . Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 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. I °p 111E r TOWN OF BARNSTABLE HEALTH iNSPECTOR,s Establishment Name: Date: % .age: of -'4• � - �. PUBLIC HEALTH DIVISION OFFICE HOURS8:00-9:30A.M. BARNSTABLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e3: `0� HYANNIS,MA 02601 M-8 -FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �°rFo MPS° 508-862 4644 FOOD ESTABLISHMENT INSP CTION REPORT Name Date .j e o Tyne of Inspection Routine Address Risk od Service Re-inspection 1' Level Re ai Previous Inspection Telephone Residential Kitchen Date: Mobile re-operatio Owner HACCP Y/N Temporary Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: OL 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 lam+- .,N ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous l) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures �- f ❑ 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) 1 ❑ 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 s .t Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �\ Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within-90 days as determined by the Board of Health. Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more.than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4non-critical violations 26.Water,Plumbing and Waste if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot g (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9non-critical. If no critical water,sewage back-up, t 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have aright to a hearing. Your request must g p,infestation of rodents or insects,or lack of violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. violation,4 to 8 non critical violations=C. 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: �Af� l� Inspector's Signature Print: 31.Dumpster screened from public view RE 'Ile Permit Posted? Y N Grease Trap Previous Pumping Date ' "/��� Gre sS a Rendered Y N Y •` ,( ►` #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 7 Y N MI.A.At ���111 R Violations related to Foodbo.me 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 1q Food or Color Additives Law Cooled to 41*F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(I) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 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) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working 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 7-201.11 Separation-Stora rage* 3-501.16(A) Roasts Held At or Above 130*F* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 3-302.15 Washing Fruits and Vegetables 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* 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* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Reared or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 1590.003(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* q Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Roden[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* TIME/TEMPERATURE CONTROLS 3-202.14 1 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 dness* 22 3-603.11 Consumer Advisory Posted for Consumption of Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved S stem* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef cdw/d/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* 4-702.11 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' S90.009(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* 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 ni 3-201.17 Game Amals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiceRequues should be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A g 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F 5-203.11 Numbers and Ca pacifies* Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products P 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients[0 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 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 1 Conformance with Approved Procedures* S:590Fomrback6-2doc *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. Ef y PLEASE SEE THAT THIS IS FILED CORRECT THIS TIME SO IT E- ,,S NOT GET MISPLACED. t s { 4 STATE MEN T 0 JOSEPH P. MACOMBER & SON, INC. Tanks - Cesspools - Leachfields Pumped & Installed DATE 2/2/87 Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775.3338 775-6412 Beach Club :............................................................................................................................................................................................................................................................... _._Long...._Be ac h....._Road ........................................................---........................................................................................ • Centervil.lea. Mass.. . 02632 .................................................................................-................. ..................................................................................................................................................... TERMS: PLEASE DETACH AND RETURN WITH YOUR REMITTANCE $ DATE I INVOICE NUMBER/DESCRIPTION Ij CHARGES ( CREDITS- I''' BALANCE BALANCE FORWARD ' ) To thE _Board of Health. Town -of Barns _ab_1 ._..---... _.__ ._..___.....-.---.--.--...__..._-.._.._._ Second Notice Wecotracted with... the__._Beach...._._C.l ._b._,_Lo. .�_Beach Rad ..ilt ... summer... ...._ .._.... _ _ ._ . __._ _._ .._ - .._ ..._ ..__..........--- ...---............_...._..._._.....- --............---....._ _-_ ._...._...._...__............................ ............------- JOSEPH P. MACOMBER & SON, INC. �„�Q� ry� Board of Health & John Raffe 09"4W PAN HIS COLUMN T T JJ j 5 ce 6i yy J 5 1 Yi ,,aaee.. {.�' '' t 5 ti 1 ry� ,41•` ^`. _73y 55 May 21, 1986 `^ t°' f# ' ` "'� ��M , kX ! r<ti 'W7,rt` ;t['i$ ,y ty SW f .•7s'y ` ?a�' 4 .� 1•yr91 Mr. Richard C. Anderson Attorney at Law P. O. Box 518 , Hyannis, MA. 02601 Dear Mr. Anderson: The Board voted to grant your client, The Beach Club, a final extension of time to upgrade their on-site sewage disposal rsystem at ip meeting May 20, 1986. This extension of time will expire Api it 1, 1987. The following conditions must be met: I (1) The revised engineering plans for the on-site sewage disposal system must be approved by the Board of Health. (2) Septic system must be installed prior to licensing for 1987. (3) The on-site sewage disposal system must be umped after your fourth (4th) week of operation and again after your eighth 8th week of operation. Written certification of the pumping by a licensed septage hauler must be submitted to the Board. (4) You must receive an Order of Conditions from the Conservation Commission prior to the issuance of a Disposal Works Construction Permit. This final variance is granted because your letter, dated May 13, 1986, explained the unforeseen difficulty you have encountered in attempting to accomplish this upgrading prior to opening this season. Very•tr�ly y 3, R/bbert L. Childs, Chairman An u-- �� n L ; 1 f,,{ .1 �T �! ;L .•Y; ! .y r � r Grover C.M. Parrish, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE a JMK/mm cc: Conservation Commission s b4 P V, O m Commonwealth = jMU'TAM rAsIL of Massachusetts moo 1639. \�®� D Determination of Applicability Massachusetts Wetlands Protection Act, G.L.c. 131, §40 TOWN OF BARNSTABLE BY-LAWS, CH. 3, ARTICLE XXVII From Town of Barnstable Conservation Commission Issuing Authority To The Beach Club Richard C. Anderson (Name of person making request) (Name of property owner) P.O. Box 297 P.O. Box 297 Address Centerville, MA 02632 Address Centerville MA 02639 This determination is issued and delivered as follows:__ ❑ by hand delivery to person making request on (date) j by certified mail, return receipt requested on April 8, 1986 (date) the authority of G.L. c. 131, 40 and Chap. 3 Article XXVII of the Town of Barnstable By-Laws, Pursuant to - § P the Barnstable Conservation Commission has considered your-request for a Determination of Applicability and its supporting documentation, and has made the following determination (check whichever is applicable): This Determination is positive: 1. 71 The area described below,which includes all+part of the area described in your request,is an Area Subject to Protection Under the.Act.Therefore,any removing,filling,or dredging or altering of that area requires the filing of a Notice of Intent. 2. ! The work described below,whichin�ludes all/part of the work described in.your_request,is within an Area Subiect to Protection Under the Act and will remove, fill,dredge or alter that area.Therefore, said work requires the filing of a Notice of Intent. 3. 0 The work described below, which includes all/part of the work described in your request, is within the Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under the Act. Therefore, said work requires the filing of a Notice of Intent. -- - - This Determination is negative: 1. O The area described in your request is not an Area Subject to Protection Under the Act. 2. ❑ The work described in your request is within an Area Subject to Protection Under the Act, but will not remove,fill,dredge,or alter that area.Therefore, said work does not require the filing of a Notice of Intent provided that the following conditions are met; 3. EX The work described in your request is within the Buffer Zone, as defined in the regulations, but will not alter an Area Subject to Protection Under the Act. Therefore, said work does not require the filing of a Notice of Intent provided that the following conditions are met; approval is contingent upon approval b the Board of Health of 1•. This app g P P_ Y the septic system. ' 2 A revised plan shall be submitted indicating that h _� � m shall be moved away from the existing dune to 10' from the road_ 3. The mound shall be stabili_zed_with__vegetation 4. D The area described in your request is Subject to Protection Under the Act, but since the work described therein meets _he requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Issued by the To Nm of Barnstable Conservation Commission Signature(s) _ This Determination must be signed by a majority of the Conservation Commission. On this 8th day of April 1986 before me personally appeared Lindsey Counsell to me knob-,m to he the _er a _t`d T ,7 •l . z fo.7 the fnronr)ino inctnti?1]eilt. andar knntrlPdeeri that.hp..'-.hp.exrruL^d the sanie as his: r fr a act and deed. November 28, 1991 L \ot,ary Pub c �� My commission expires `) �J This Determination does nit reL'eve the appicant from complying with ail other applicable federal state or focal statues.nrci.;antes.bviaws or rE-gu'atioas.This Detern r Iv n shall be gelid for three years from the date of issuance. The ap.icant.the owner,any person aggrieved by this Dr..ermination.any owner of land abutting the land upon which the proposed work is to be dere,or any test residents of the ci:v or tc�-n in.thigh sort la-td is loca:cd,are hereby notified of u1neir right to request ti,<Departmert of En%i onrnen:ai Quality Er.t.ntprng to issue a Superseding Determination of Applicability,prodd ng the request is made by certified maO or hand delivery to the Department within ten days and t the date of issuance of this Determination.A copy of the request shall at the same time be sent by cerified mail or hand delivery to the Consen•a:ton Commission and the appiicartt_ ., + , t - •! 4. j,.t :ja >, _ 1n :r_.,i ° w. i 4 It w ,"r rf .. .� �_ „' a { M 4{ { �� fta�• € �, ,j k r � t ."�'f� . ; .( L r �L .. J,'1 ,1.a e..�" ✓'. �'.a � ,�-�' t`- •t .JI �: W t'£rf � •"y � ,a.r ��` F t .,r��,r o v _ .- yr �,lr ri -.(• '1 #. w f�l.> , t�2, '. 4'- .�' a'Lt •�9. •r..jr, ` �.µ w t i ]] , }: t .ta irk � � ;; = i - +;ti ., � �" "f p5i�' t• � y ty.- �i •l ` � Y, � y S t L> s�A' :.• Y ,✓ - ! . '�h 's• l �` ` '�. � 9i t 1 . G °J..•.. ' .• . .y .� „ ~ r ^,., \p "Y., y ,. 'Z'.r i ! t K .; t i�'- t °•�L ,." *� 1,�.• v 1 �j, f; L S 1 r ,y � •�'. • ry ' � a � `� c ��,'e'SK �,. t z t ..ay \. a r'!-, a' ✓�_. ... ��4. .r s ? .. , � ,� :t 1. fry t '.e 7 , - t t [* '.T. ( Y 1 i r s y'•,Kj a .. l ♦ Mi 1• y 198Y y't /{, • // �' .t r t A� 1, 5 1�F ,rays T aYr t • •' s ♦.r ,t,.. •,^ , t 7 y h " ' t >i ;.,1 t" , Sr. � R '� .Y R j rs`i fW{ }G sAM .` x t t r, '' � Y s ;• t r r", °r ✓ro T.-` +'' _ - `, '� `' +.. ~ y ". Sa "' t,• P f, �_ r T:3. s ✓• ;, a. i y y: 1 ✓„! �'.�P a } r e 2 4 a :w ! t'r + � '.�r r}.. .sS L, �> t .r •y •S � F .i;ti, , tr..r t ♦� �.. `! r >v.:t r.- l > r 1.• f a:F' t r•'h, v t '-.. t- ° r. John' The' Ra f€a t , w The Beach Club .-1 (•� _ qr� .t. R 'kf.. e Y . Y rT 5r'• �J F r,4.. s �- � F}�0•"`✓Box l 9 .I3 r '• -•' *+ '� '' Y{ y r ° t t ��.• •^ _� r:': > , "° e , 'r, a Cihteyrville,.Mat;.-02632 kV .: Dear Mr. Raffae >� r ' * • - , 1 rr}�r �` • + 4- .���' ,. r� . �r *�s .i y ff t�Y w ,p a .iy a ti '•r - k 3} t r •} Y i c You,are.�'granted-an extension of Circe to expiree bviie ber. 1, 1984y rt ;{ -- 'to upgrade your;onsite sewage diepoaal `sy temm at'`The.Beach',Clnb,. ��+1 n •gong,Beach Road,' Centervil3e. a` Y This extension of time'�ia,;gisiited;because, of, your,' •season. peration. in? ',addition; ;we haves no knowledge'of any nuisances s t t '.'t caused-:by your present'-system > ;t 1. #i ✓ ti• ^ ` "3 9♦ • S v '►1 i t..,:. S ",(J s d cr1 ery ,. tr 3►aSa 0. 77" T '� ten '> ..,♦ t : r. , '�'. t ° _ .t ? S - ' i - R + "{'`. - Robertr<L lds�a Chi 1rm8n :S � ♦ •Lt 4�3.'kA 3 � rt� f r r , i.,, i'`$ I t � l 4+ rf L i .t YJ •t,'.3 { , ^.f t:,.Sr n a ti~ .. Ann 'Jane s Baugh" �t b. .,� y1 ¢y •. rg S�s F." ,{ nge,`t��!'1��Z.rn� D.,, BOARD,OFa'ii "TN -[ . y,7` R x•.< � ^t '. ° J rr l� r,•n. 4 .� .aM ... r 8! ! "�}'13il.TS� '� •,•• ✓ `;a 0} 4 t i �_ - r- rt :, TOWN OF ,- "�' y F r �•� y a -` �K. /m®- ax�r �' r�t f { 4.:.� • *. . a 4 Fr � �, v � ,�" F> T; #{ •n+�y• . , ,. R+ ' _ ..` i s.•2r .r. i t r`t<.'.-qt. l ,R 4r- � i �i'"t rt! y.,s f 3rT3 ` �'.: � i_4 ✓ r L{ .•t, � r yr. •...F�f f ; w - sj'r ._r ya .rt� �.. ' r.�j 'i r !3. Y,,d T- a' J 1y t�T `. rc: 4 N •4'd AL t ,H-'� rMM #� _ - ,..5 ,y tt �'y 3�., .+ h t �S`� .::.>' t i 1 t,. �. 3`yr ti, 'y. `••{�Y f/ '!�y. � 7 +. � . [ F r. r► t.r r -15 - y t+1 4 i'• x�t. -sS �'1 ,yr g +. .': s.'k 4 " y`r "{'f ° �. .{t �,•. R r` _ {• _ •.r 9 1M A ' + t a a l # n L r { � z x.$` • �,. A 4 't. a ✓" . � ` 'R N -L. .1'+}.a. ♦ !� ^t 5 fir. * 4 , �` t 9.rs•�• } t,n .%t Y,�,.y j .i ♦••7'R .,. ,gyp ^ 30,A � ty r > ��� ( ; . ,t- > r,r„y;n r, t. w t ♦ •�v ? � r .'.,.i .,. y > a,.+'t ... �,. r F r 't 'r � 'i� '. .•� ..� !�''�4S t f i °', � t't Y t ' ; ,+ y.,'- � _ r' + ' i�1 r,.l ,e Cy t\,�" t tPT�,i* a ea kh� i'�+ c ra E" ti., _ Sr"�` y • , 4. �.. N 1,,Sa t t 4F a wy• K t ,L.M y s;� •dt, J _♦ '�{` ,� 4• - •-w r ri7r "� Y fi. 'Sr t tR t s.r� 1'~a< � £° ia. � e R+' H .,N .1{ '�t .v A �. • 4 . .. t AI • • P.O. Box 297 Centerville, MA 02632 May 18, 1984 Mr. John Kelly Barnstable Health Dept. 367 Main Street Hyannis, MA 02601 Dear Mr. Kelly: During a recent conversation with Chef Carl Davis, I learned that The Beach Club is not up to date concerning the Town of Barnstable' s septic system code. Due to the fact that The Beach Club operates from late June to Labor Day, approximately ten weeks, I am asking you to consider our request to postpone the immediate need to up-grade the septic system. It is our intention to bring the system into compliance after the club closes. Sincerely, John Raffa Manager The Beach Club r • FERN, ANDERSON, DONAHUE, JONES & SABATT, P_ A_ ATTORNEYS AT LAW DANIEL J. FERN P. O. BOX SIB RICHARD C. ANDERSON 436 MAIN STREET ROBERT J. DONAHUE HYANNIS. MASSACHUSETTS 02SOI STEPHEN C. JONES AREA CODE S17 77S-S62S CHARLES M. SABATT May 13, 1986 John Kelly, Health Agent Barnstable Board of Health Town Hall Hyannis, MA 02601 Dear Mr. Kelly: The purpose of this letter is to request, on behalf of The Beach Club, one further extension of the time to upgrade the on-site sewage dis- posal system to conform to Title. 5 of the State Environmental Code and the Town of Barnstable health regulations. The reason for this request is that although The Beach Club has, since the close of the premises last fall, vigorously pursued this project, delays caused by design work, changes in design work mandated by the Barn- stable Conservation Commission, inability to obtain satisfactory bids and inability to find any company who would agree to install the system prior to this summer, have made it impossible to comply with the terms of the last extension a copy of which is annexed hereto. I would bring to your attention that the club operates for approximately 10 weeks in the summer, is open for lunch only, other than for five dinner dances during the season, and there have been no visible signs of any problem with the existing system. If you so advise, I will be more than pleased to appear before the Board of Health and plead my case. You are well aware of the fact that the club has been progressing in good faith and with all due diligence to get the system in and you have my assurance as a trustee of the Craigville Beach Trust that if one further extension is granted, the system will be installed after the club closes on or about Labor Day. Your, anticipated cooperation and courtesy in this matter is greatly. appreciated. Sincer , is r C. nderson RCA:esj �QypFTHE T TOWN OF BARNSTABLE VVI OFFICE OF BaaasTsaL>w :MAB� BOARD OF HEALTH 9 ppA 16;q. 0 �Dypg d\ 367 MAIN STREET HYANNIS, MASS. 02601 May 8, 1985 Mr. Richard C. Anderson Attorney at Law Fern Anderson Donahue Jones Sab att P. O. Box 518 Hyannis, MA. 02601 Dear Mr. Anderson: You are granted an extension of time for the second time to expire November 1, 1985, to upgrade the on-site sewage disposal system to conform to Title 5, of the State Environmental Code, and the Town of Barnstable Health Regulations at the Beach Club, Long Beach Road, Centerville. You agreed to hire a professional engineer to prepare plans for the upgrading. This final extension of time is granted because of your short ten week operating season. In addition, there have been no visible signs of any problems with the present system; however, we are concerned with on-going cont ination of the Centerville River during the summer season. V ry t ul yours, R l "it '. Chi ds J hairman BOARD OF HEALTH TOWN OF BARNSTABLE JMK/mm FERN, ANDERSON, DONAHUE, JONES & SASATT, P_ A_ ATTORNEYS AT LAW DANIEL J. FERN P. O. BOX SIB RICHARD C. ANDERSON 435 MAIN STREET ROBERT J. DONAHUE HYANNIS, MASSACHUSETTS 02601 STEPHEN C. JONES CHARLES M_ SABATT AREA CODE 617 77S-5525 May 10, 1985 John Kelly, Health Agent Barnstable. Board of Health Town Hall Hyannis, MA 02601 Dear John: Thank you for your cooperation in connection with the extension granted this past Tuesday relative to the septic system at The Beach Club. As I indicated to. you, The Beach Club will engage the services of a sanitation engineer to investigate the septic system situation at The Beach Club and to design a proposed system that will meet with your approval. Once approved, the system will be installed after the club closes in the fall. At the aforementioned meeting of the Board of Health it was recog- nized by all that such a system cannot feasibly meet the requirements of Title V of the State Sanitary Code. Sincere y., ich C. Anderson RCA:e s j cc: Mr. John Raffa !t ` j � h� j •.. .y� .',� ;r .. ," � 1 a�• �x ¢¢.,yi � «,•�� 4t,_{r F T • �} �i. ( .+,4 +1 • , 9 �' a.� r: p9 yY`i-.. .!,. �?�7c r f sf Y ,�"'. t�f` r, .s'•. 1 �.7'ii �,�, 1 �^ sir- '.a, a .= E l ; t iai�% c.. ', t s�, 3 t-� .; * [ -ry .•�"\-, g? y S?. Y +. t'`H = ✓ _ A- ^7 tlt y g t +. ipti.t r a a", ' i ., r Xs +t.t p- a., �' - ,r F •- „+r„ i rt' 4 ,t� ^. ' . .4 x :a .•, t ... G w'aS t. .'w ¢ i:�,,°,¢ i '.._ti N i " f x !`i r •..'.. raT'.. t '` ,L tr 4';'t ,ti � _::." s..M `<i` � 3'�k i+ * r • lviay,8, 1985 i 5. t t a `' #` s '',N# r> 47 r' y, "1 7^ t t #' y \ t u•.G - r ! sA #1.- 4 r! „:wwx r `?f11' a r,•, , y. 7 +S i a t 7«. Y , { ,iX', .Y Yiv ! ,,•' : 'fit }� y 3 'R 9~ :5.� ♦ -r{ t, tw � fG7�..{t � •,( "S. t s`�"," ..�. � G '�*•» a s r •s .«' v;,. �y'`"� Z`.'��` .''�'.^ r f,. •'� a r+ R.� f'� ,t.,,..� f•� , 01 �ir..ltichard?C Anderson ++3� ..y Y�r � .S `'Attorney 8t'tiawr'.4r.` t Ma Y ¢�t r. �4,° ;c # 4cy„�Fr. :'€#d W ��• .. . '�� w� ;F� � � ` ', 5�'Ixe ''.j� A ;M1*, !t F Fern Anderson Donahue <- e•s•r ,. ( rw r t ,, =p , x+ r= °` '� _ , Jones Sz Sabatt •P�•O.:BD%'SRy.. > F r... . Gy ` 5,` ,iY r it annis, MA.•02601} ....y •• '� J„ 1 t` ar 4 t -* ;94 q r�+# _. a w� • a INN x/�(�; r a �,� ;s K / rw � ?e �.� p/,' it,)rat •*, 4F`s ;S':.+� Dear Mr. Anderson: , ' 4 eat M M" ` . ## a. � ,'S,. Y t r, � t a i� ��+. y � .�..+ s* �_ ,t r .9 t `y y +. f- `;! '' � .y 'f F, * t`•� do � r '.'! y` �. a p You rare..,-granted: an extension of; time.: for the 'second timed to !expire t t •.'� t'' / 'Tw '`y 3., .. r. y' i ;'.' . `• f 5�� '~�'Y 1' w i Novemtier'1,,1985 , o'upgrade<the'on-site sewage dispoeal'system`to conform'' k 'to Title .5,I-of-the State•Environmental''Code,�and•,the,Townf oPh Barnstable; ;• ' r i,Health Regulations at the Beach Club,Lon 'Beach Road;Centerville t,. You agreed4 to'-hire a,,professionalt� engineer to prepare plans for ,> 1 7 ? '�7 e• t•., ,pt* z 7 ,! ,upgrading % . ` �. `� d R li �, - 5 ,�. a "a a i�r' t A� a tx L .. �7. r' ap'' ` \• _ 1' :.'� .: •a}?�;4#tt # ,� , !Ina1 'extension of time�ls,,grantedrbecaase of your short; ten `week` t y r # ;operating season., In addition, Ftliere+)have, been_nogvisitile signs of any ;,s , problems with�the.present*system,however, we are concerned with on-going. liy e+"",J .«. r { : rt ;, ' # y l y¢;,•1 S 9 a- 4, L;; �t• contamination:of the Centerville+River`duing the summer°season. .� - '� .r C` .` �'; t ^Er x ` M1 •. ft Wa " Ya '�•-.a•� .,:i F .,.Very-, ` i_ � 3" R i' � "��,5`, �5na; � '' .� w •1 x��' 3 t .. .., Very, 1 rs, "•r .a "',zx , . „ x �y # } w S ,`I t • .jai /'. .t'-'!. {ra,y 4 • �, ♦ _� € 7 >s ..t } ,l: S: Yt, - {` rr t.. - ':,e1 1 � �` �,1', �, � ,•�f �� � �.�YI'r ,?t `w• Y ` � t a �;. # '- «i 4 ! �' �.- Y�;- t� t 'Childs,' .,J F^�.^ # :R a ,•C' a r 77 g (�_'S. k `. •, t 'f' a :w ,hair .'=,BOARD OF HEALTH TOWN OF BARNSTABLE .4 t � 1. ..'t 1 .;r w-,' &pie.,'+. ..� � � �r.. tit N§ ( r a.'.a ` ..:y •,tw ..Y ,§. 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'J� # �� ''� �.fi'/Y• l i .. .1. t ,Y v 7 t '3"c Yk s�✓ .j3�.�, t:• � a �� ♦ 'cta ry• 'S1 ' ' - "+' t J :." , . +i:q � �,y Aa&I37 .�:n ��/'+ ,y 3' ° •e57 r ` .A` t�•� "..•. • r str a s u-,�„ a 3 .. a ,ti w vhi, ,t« �`� � r r; .•r '.' `.. � aJr• 9.W ttti�S ���, d' '``- ,� j,r3 , �r i 3 f r, t• �...a...'. r �- .:'t '1 rq , •.1 J! r} .a� ;s',r : t`j, � .a'?�yls fr �, a j t �•t �rl •� sf s t,.. _ . . { �. ta"ft' 'r. , a '� �',� � s� x« t K: ,. x ..fi .. '�ti �i •. L, �a ..t � ' vI r � � Y4f .'�, "'�¢• � Y' '..( 6++ .4 .-a l f' .. 3 A«�. f r",Ty� c .t a< { t fi i a P i'4' 4 t. S d' ,, f�` • r.+`t � y�;n q .�• .f`r W'' �#t r..-. 7..KwF...* 's R ti, - .r'•' .� `t�, J ,. <. L° 1P �` e�4.. + �•a� �.+ �? • „SP ,'" ,�""i. y -;�'x} ��n. a .�,'#t. Is t'r •t ♦ Or 1 -4'Ct r- ., ,4 � { !"' t ;c. �X,. �-•,y Y w.},.a r �." k .d l+'1 i 'tm .�' µ� r` ,ra .> + n• ' er. -,.yrs ,.. i iR'f ya ass' :ti ,� L r0. .�'" ti •S 4>1.,�.. r,i 'IV , F i ,r_••r "° ;.L«'t t a:.' ' r r r' r'Y tr a ,( 'y`'s' f,$•' + -.+ 1•. F�. February 19;,4986- Y't -y � e Eyz� S .r Y ,'.r 4 �. }�. 3 tii }r a ' t• 'r r i �# ,e,.r.# �'s � . 4a `�rhT�' ''i' .♦ 6 ,. � ,e� iff t -, � �"*h.,}Mjr � }�..a�Ir s 'G - a 4 +a y.. *� � fyk -a f ti �'sF �,i y. ..', t• {rr F, Est I .i . „�9f•f- S•#, xy �, ? . ` > �' rJ ry.• `. +•P V' S1. { t s j. 1 tr � 1 t �'•.» i 4:btr George=Mason�••'y ♦ •�` `{'.a' _ / `1 yr1 `.`.*° H• , f 1� ,Y ."t�dir4 t. - J P} ttt 9, t f ail ....• s..T z P:�O. Box 573._ z,Osterpille, MA.`02655" '}'' ,1 va Stt yr..# s 4 �t(i.' Tr{Z._' w.t • err E K �'i} 77' 139 Sa, n rid• �. 4Y ;'lam _AM1 z.1rr •.� ,,j '`Y- ;r t _ r aM 7� P � ' ;Dear Mi D'las�n gym.} }I`"� +�,r,, •-.d� r r,��r h y _.. � 7 . y {ttj µ �*,� �T�C`'�, ,yixy �• i•--i a{y ti rk ,'� I S lewt. r 4 �' i Sx`' ♦ -�i' f � ,� -r" .r-.•, :''' r ..." a 1' " v ��' • ' 'r` .',°,. JSt3•r 3 �'. ,You arergranted variances from'Title 5,;of,,the.,State•Environmental Cade; <toyupgrade, , • '' : .�; -:the 'on-site sewage disposal sy'stem_.at ,The Beach"C10, _l:ong±Beach.Road,_'Centerville:,: The-variances"granted are: r F "r _ a,. ,�qr •� ,4 ''1� •.,yv. � .", 3 w str t (,w•�' '' �...�F ''f`•'7 ° �a�T+ Y -jY:.,� '"r�'srs �� , a�z+r u� ,''�ky k.'E ,.:. Al, � ,A�:, RegulationY l'S.12(2)r Maximum-,ground;water elevation,�of �3 feet beneath•the'.Bottom �. ea htn of•the 1 g"galleys, in lieu of the r' ui , feet. r+ r i ,y y ,` t 1 _ eq red�4. , F •+y;,' it y fr .r a y 'r x ' i ,�'., "` r e s . * t .�, b is:. �� � � �i:r -y - a -:•^ ct• ^ M C`•� ,F7 ',r` , F a :�4° . 1,,a r �' Ttegulation'15`02(5) 8iid (13),=,System not designed in+stiict accordance with flow''rates } -of Title t w. F,r v�'1 . Sr •i.try ti e a e.r. is° ♦r i ^L+ Y. 5. hit •G4 L > t ♦ir,�l ♦* 4� h.• t,+,r `y�. �.1T h ,4r ,,.1. The following'tonditions,a I PP Y!. ..y. 7 ��ek ,;'�}:'.� f �t4c.:S r4.'k 4 + , h8a,'r F. .� i�' y-SC. r .y )'y �.t , �" Y�•,, rY �' �.,.,,';. �,..., - ,y;♦,'.. >`'�,� Y -.. 1•�{ }`'•f' +" '`L'•' 4 Y4�..r.rye •�. '!� �'�•s'i .,L: s , ." �°y 3 . `System-"must.be installedgpriot'to;}1986,1icensure:A t r ,< r .4 -.e z ., .r-r.; �•.•.w a • -.' .fr L ....� •}y.n�° y a � e' 1fi'''r �St .-,�-*r 5.+t a i'" �,,* y,r,�, b ` :� .,+ u1 rr ;wK !4 ,.'; t ��i 'P•S f �.e: y ••1" ,� *.}' 's,`.yr. (2) The designing ,engineer ;mustr-:be'on site 'and supervise construction of the"septic` q �� 1", _ system'andy�certify-ini writing' to the Board+of Health: that his-'design-has. been strictlp adheied,to prior to the issuapnce of-,a Certificate ofr;Compliance-` a "'Sra.. 3'i++«- `r't:1r 'f. #x��! ). .r,�; :.z s, .+,� :��" ��' { 't` �'' M+.f > mod' 1 , s,�•I f', t.• r/ y,y a. q - r., ,r, Y �M � -i a #a ,.•'� � 4 3i �'.,"� ? ,�- ' i'r e. .k,. " ,r aryx,,+r=arT'his variance,i8tgranted`;bcuse the �BeachTC.lub"is seasonal only open ten weeks 1t 1s'notlocatedina zone of contribution l : t , 1 k k, j :The sizing .of this systerri wasbased�on wafer;deter r"eadings+x 2009f�,and ieLfar superior � '• to,the existing,system ,, f = a: r i"1 ,; y r' < K , er trul pours -t(r. .t `^` P .LS.i �`Y f.: -Uf •', j�r't`1, '.5'�.#"ry Y• t r+ a,. yt., ab�a 1 t ". s t » 7� f t y G yy 5 1 it 3 ;r,[ ,.t _! r .,rx Y_ �> .t+ M, +' q ,`k Xw '{ -i �',y �,r �r r'l:.a s •` 4, ? t '.a �{ S r'4• ,�� k ',ii t.T'_._ ..Y w r;<' '.1•r ° i +' , tr t •°'� �$ obe • ilds y '� � r yh M• !:-' � "'�, a, t"- Y•-; ♦ 'S` ..i.A r. .-]." e °,u• �"`yi,w3a-iG ' •i+" 1 a A Chairman, �S4z Q'y.�•'^ ,, �'n4" BOA D ♦� � �' .r.:: ,'^ ""' � )' .., ' j 3 - _.•++a a7,.5.S-. �''+ `k'cr �•r ; ) + �y ,� it OF HBALTI3 tOWN OF�BARNS.TABLB, f� ♦ ' r .r �, +t �.� , �� ..1 • �� . > �- r =} , s • - r. �� ! iY +. a y _ .A;ro. 't, _. �fr •.Lt r �Y� ♦"� �JMK/mm - ).. y{ { ri, :`° tit..�r r - t .,v *L ,L.'4 j fir•+ 'S 1' :..Y f •l'd 'yi ',. cc: `Peter Sullivan, Baxter IV� - '` ' � ` r ` > • : "' At a ar 1. t, •sy _ t,r r } � • t, �r i t.. t '' (,r ''� f _.•« �'-.t!, +.0 S 1 fir'' `Y 5' t .' ,. l . ! �'� 1 •'P�.` t,�r�- .f y -. 'r ..y, � �•:r„21'rvr . ''`' a �' a� ia."� z s. ,., :�',{ `�: a, ;¢' •• r: ar •�, •a : t '° �Sa t S.Iy a.. �Y 3 t ' ,}� • - ,4 .. it`� 'w. t. ai "'t r.: ♦ 4 -,` +-w.�,, a t •f. h a :(yi , x z t r �,r iy" ':*+ �A .� i .: , ..x � a � 3 � x .°-ti;� F •�.`x -si• r,� '7c 5" :.'k•• �t� �'�tr � , � '+'- •nL M -✓ - 11 I ; Z��' ti L t .iy e e 't r� e.•.f `Ys T; s,+ s .„° in s ..:�► 'Y �"1' }, ' { r'X d�t. t h t - wF , 'YA.r ,•.�' t Fy q-• 1- r # «.l f��♦i 3g"�7 � + r. Jrs �... t iZcw � 4a irk '"! - � - � '" +r r r .kEx 'i. ��! :F• � ;#�M,�,,,11� � �y 4+�- R° •1 t i rf 1 t r } r F ,, + - t f , #..a >.• .rti y.d 4 ' r :�, a ., t h •�,,: '�' '">� ' ..- rw s +� ,a-t'' �r r- k �k. c.r t.e 1•F: � `ice- �`�. '7+ "," h'• ,' e i a ' �. ,'r e r 7, r< x :Lt r't1 - rt -� !�'>'4 .`"i �•; )-r rifh '� tr �.1 .,r. x.r § w F � i t ". �.s '{,t�dw*'�`.�..,.�� ,re. ,.t eE.k"� r�#+,r4�e#'S.+ y } N�'�• ��J w 7,Y d. cid #' 'i d '^. ":`" ,;.r4�'�r '::'��d<�'t+, rI'»' t � ti ^ � j?..x + � ,r } * ' • ! � s t '.` r t f`'�a 'x" �``}I' � ,tr 1 •i .w�t s, r. r� ,. April 23;1:985E . i: r - S, rS+ .,, 1 S'.. .t'_' �" t '` i.i'' r'•'°'i :� { T 1 i� e r r k .1,;. t �:, i .. •; > t at r '` . r«i xt! f .�t � � �. Y• f• a ) a 'tk' + �v o..ti -a y.l; es _ 't` { ,.'t, �,.• •�,,�c .^^f+w"k�f., .v � x 4 _ '� '`4 � � ") ,�i `r �`;t.s f rr! .�. '7 ir; <p tc-r* ,, i'„i. > F � t , � �E � ref � � � •r �. i, + -s •. `: t ,• r i « F � sz +;, t > p'' .:� � �" r ; � ,i E it t r.� r .. r 1,.- �� �{r +` r- na e7,siL 5.+ y i � 1•Y , !•', !,a •, T •tit~j � ►' •J. � �t , } !; !"i Y V� � �•.f, #+; r •'<- F .3.�1"•rf'r�,•:r, t �,! ,� t , , `- °`,+, ^ 'Ri s Ri chard,C Anderson !' ` � • ttOTney'at"Law ' i r< r d r 7 a '• .x Pern, Anderson Donahue Jon"es d� Sab "" �` � r> g - d „P. Q. Box 5fgr, 5 ! .F i*,< ,a�• #! '7 Hyannis MA 260'ri0 �1'b tsx}♦ti a Craw ;.7 .,+ aik`•f''Y E <,� *•"� cK r k , 7_ + .,sr. 1 :. fi ;r j r .. i µ S j t •7 a *..^' ! 3 r-a• , ; r, a = e s r a� .i MYt ;r t 1 Fbear 14ir. Anderson: • ; • ,� � J t 'cy r s t1 .. ! v:4 � . 94 r }f.. 1 r 2•�'>ry tf �.� xf fi> '°�# ,,. try..� � ,. •i _ 't t 7g � '(1:#�, G , } :.'.+ •�_ � '.�',.'' rt.. z +`,,i ,. Est..- '1..a y ,We are.in receipt of,you �16ttec,,irequesting"a hearing in•regard to The Beach C1uli Long Beach Road,,`Centetville.� x�'r- k ` ., , ,,::_ �� ,� � ` ' • , �{ " ti. v '1• ' Y t p-� s k ... � x � � � +v-_���pp `.. ti a, �", r _ t , � s .e a ,;. f '�.+ •.q + .' ` :.�`. _ 4 r f +•. 7 � � rr ��.' 'Y'?'E v '`.'.J f•a�'cM�^�4 fi •�° " � � � •�-,'+ �`#.„f' -',,�, t+,ft" ���� ,.. e t ;E'- " ' ♦ The hearing has,been scheduled fo, ,, 30 P. M on May 7 1985 in the �h. y, f` Ei,.{ a �'f I Z i.l r t � [ _ tBoard�of 1~iealth,office,�.367 Main Street,�iyar r�s.„ ,s r•Rt w s ti� r5 t ,str ...r '.t#. 3 t.+44 ft •8 t t -• ��.? ;=?x P, •..'`r }t ., f -ty ` "•. s_` �{ t o irrn they'Whetand date 4w , J � i� ��• ,•"� ; Please�c of a {wit_h this office 775 1120,E extension, `182^ �}f �._ G52�♦-r ;.�•,r �',k.• !f•;. ..�+;��'� t t, rY.�� r,r. � '�,-�pM.L t:rJ t`� �..r� 1 �X.. .r , �F' ,.< �''.y��e � {: _r '_ °rr. v k"E�" .5a •� rk a- }J Ver y ♦`i ,,lyt�ya. .urfs,•t -,`YID s �, �/ y .t5 4..",�_,.3' '+� .y*�l }+ f. i_a•' r •Fp I't �'ar•.r� fv1^ 4 r+''�4 I'�'+. Ht .y 1 r ,t r rll�++. r, � ti-� ♦ �� �' x a�t♦ '�' t �� t } tr! �,,.• tE� .y�r r* '! V'Dh ti ��s tl ': ! { r �" ' 4gYa 9% '� }� "r•� �' +>s. 8 k x..�`�" ..,` r•h...i �s b k,,, X, r., ���.} �,� tiM r rr.+r �Y..1-" � * a', t ix• ..r! 1' , ♦ ,� r t"i t ., �,.�,y e` 'y ,te:.,/� s�4: ..Yt tip.� 16 John Mrs Kelly r lic F :wf ! s tr -:XNEI t f. _ ,f `2'g'• +.. k- rJ. {:r � ,Directot of Pub ,Healtfi �; ► 4� E<"..h+ >• � N o �' 7`l",'# J'33 !r r a i id„ r :•7 91,3 r! x rr ' ',r a .• , ♦ � � y �• b s "t� i ,�� 4 7.0 r -tx:-. i�a �} `ti: �- a xn -'S•.F t ! < x «� ! ff ^4. R F 4sj YF ! JMK/fnm t .H. x � r�. , Y 4'w ,,,� � 4 i •'7 w. � � . ,w i `� ',✓i t t� FEE. , .`t'� ,!, - ' ! f �> t i slv cetr. r �.,„'F ;" ., .��nY '§y}1 A� :t tf .-�.,r• A f"?' „ r r,;, ,•; rl ,,rr-^r t t ae '+:�, ;.r+,+.' �f x- ey 1e, r ¢i 3•` L f •f�.� .� � y r . . " �. f j. � 1 i,;y k,•% "� # I,.,t. J. > ,i'4 e `j +-' �, }1-. f rt• _". S' t �s �. ,;�::i- t.,,fir,t `,r<'! h :' 15'' .;5 f"5S e `74 f A'jo`r t j'� „�` yat•Tl �' :Ew i ";. nl - i !x r �� T ;,. 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'` r+Ae - � E.1i��_v i j •�J t S . r ..k ,.y w. ti w: r 'E l' ," , t .,r �t ,` i a!. � � a '7j•+ >�-,rr a .�`• v-, / s � ; f 7: a�y[T ' - �- 1 �r�a: ,ar ' a ; Z.rti.x t l.'* t {•�.'. r r�. xr ' .t ?r ''«�. r 'z' ''r �� K ...'7J, �`f"E � •, a•k-rM �� i+F ,�t �c�}i'}�.2 a +�.. •� ,, r r:'E.Y rr t �s�a� � ft- .;a � '�• N � �z; .� ; i. + �' � `' �c Y:,�f 4�.� � ��( `°" '!m i';^ .�,. ! �'i":, d"' 'y. rs i,� � -..i u'`2+ry y �)�:Y � �..r � > tit+9 �,}+ �4 ` i #!, ••'K� fi +:.� r # 1f• i � 'r++:,F+r' a^r_; .4}a r + ...•,1 a 'r">� '° -. r a {�� ,r ''s, • c^ �,• 4 + + �`r 't #. } !rs sP `r, . '�"- t r r rr ^E ' ; : 1 y ;; '�:5+�'2- .. .: .r r f� t�t u� L+r• y�$� f � +K ('�a .E,Stb d t i� �' f, .r"' 7 r L' T ••i -If tJj r ♦ad'j•5„4" 'W A' I•' ,S.r.r4,. at +. 1 r s i tt; 7 - K Or FERN, ANDERSON, DONAHUE, JONES & SABATT, P. A. ATTORNEYS AT LAW DANIEL J. FERN P. 0. BOX SIB RICHARD C. ANDERSON 435 MAIN STREET ROBERT J. DONAHUE HYANNIS, MASSACHUSETTS 02601 STEPHEN C. JONES CHARLES M. SABATT AREA CODE 617 77S-S62S April 19, 1985 John Kelly, Health Agent Barnstable Board of Health Town Hall Hyannis, MA 02601 Dear Mr. Kelly: On behalf of The Beach Club, I would request that you schedule a.hearing with the Board of Health to enable The Beach Club to present evidence in support of a request for an extension of time to upgrade the existing on-site sewage disposal system. I shall await further word from you. Sincerely, /�I,�cGtQ�L G Richard C. Anderson RCA:esj i OFFICE OF THE BOARD OF HEALTH OF THE o 13ABH3TABLE, o TOWN OF BARNSTABLE, MASS. 940AMASS. ��� -- -------- 19- ---y----------- - --------- MAY SEWAGE SEWAGE DISPOSAL PERMIT WAIL Permission is granted to 4_—_Z' 1�.. _ __-____ to construct Upon the Premises of Sketch — ---- ------ -- �~R------------ — ----------------------- In the village of 1 75 or more feet from any source of water supply 20 feet from building 10 feet from property line Health Officer. -- — ---- _ _. k NA THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 71 w M..................OF. ...................... Aliptiration for Disposal Works Tons rnrtiun Prrmit u--Cc.V e 4 N; & Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ... !?! ►_ . -v3.--------. !J► ...t���il� i?_..C±er1.1 � !:-.. �-=e---------------- . / Location-Address Owner Address WMlil•I a¢ 1...................................... ••----•---•--------------_....................•--......•-----•-----.............--•--------...---- a .... t � ]ek Address Type of Building Size Lot............................Sq. feet U Dwelling No. of Bedrooms.................................. .Ex Expansion Attic a g— ...__.__. p ( ) G rbage Grinder ( ) aOther—Type of Building 0, k+���. of persons............................ Showers ( �s Cafeteria (Y ther fixtures . ........................................ Design Flow-ALt,ly1&TCtt_ >!wLlons per person per day. Total daily flow...' ._. ......................gallons. WSeptic Tank—Liquid ca.pacity5#000Kallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. ......I............ Width....IT*.......... Total Length-_1&0....... Total leaching area'.� sq. ft. Seepage Pit No---------------------- Diameter.................... Depth below inlet._..._........_...__ Total leaching area..................sq. ft. Z Other Distribution box (�( Dosin ank (Ljj'p ' 1 Percolation Test Results Performed by.. "1. 1M4.4..- y,l.«_. ............... Date..: /��, a ..._Test Pit No. 1... At....minutes per inch Depth of Test Pit-----............ Depth to ground water....& .............. 44 Test Pit No. 2...AL.....minutes per inch Depth of Test Pit.._6.......... Depth to ground water._'"................. a -•---••-----••-•••--•-----•....................................... ........................... ---- - D Description of Soil...'M...A.........�"'�w---�wk1h.�.�.L'I�SQti-�2'~'-�--------�'.�----! -�-�►•u-----••-•--------------- U ----•-Ta4:-`--� ....O-.Q�S >J-Sc�-. Q•� "' �� rC�..r�'141 7-----------•................ W x ^- -----------•---.. U Nature of Repairs or Alterations—Answer when applicable......AS7D�.._ ,R. S I.r,. if (�_ .__� �� .......................................................................................................................... .u�.._______...__.___.__.__.._...: :4............................. Agreement:. ���altat�9pi��• � �� - 11� ��. ";Tql I_ATION AND CERTIFY The undersigned agrees to install'the aforedescribed-.Individual•1 Sewage IDisposal S stem in accordance with the provisions of TITIE 5 of the State Sanitary Code—The undersigned further a o to place the system in operation until a Certificate of Compliance has b sued by the bo of hSign ea / 7 ----•..... ----------------------- - ----•.-- ..... .. . ... -- Date Application Approved B -Q:. I/ - /_ -- Date Application Disapproved for the following reasons:-------•------••---------------------------------------------•-•----------------------------------------------- -•-------------------------------------------------------••••------------•--•---------•......-----•....--.......................................................-....................................... Date PermitNo-------------. ........... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. T�!A�.t:-?..OF........... 'SZ. tl�!..5..................................... At wntiffrate of wilutptiFatta T CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by----------------------------------- .......... ��.!>� �ice•-----•--•-•---•••---•----•----•--•-•-••------•-•-•-•-------.............._..__......_.........-•--•-•--.--- Installer at ©''P --� 1-(•-----......tea-.......----•-... .. has been installed in accordance with the provisions of TIXU 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.... --— ....... dated...... _.2�.�_ '7............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... �..�' is �;i �'�� � ( • THE COMMONWEALTH OF MASSACHUSETTS _ BOAR® OF HEALTH : .- ................1.. J.-....-.. :.....OF..... Applirtttfun for %gpostt1 Workii Tonstrnrtinn rruti Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......-.. `...._.t , .1. :. `�.a ........................C�f�.........;E3E H.. ... - tit` L \ i::!::L-............... .Location-Address - - t r ... ..C..L Owner r Address a _ 1�... C .�..r --••----•-•- ---------•----------------------- ..._____________ .. I ai Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms____!____________________________ _____Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building �..-a� L�.4 a Other—Type g __.___ �___________________ Nei, of persons............................ Showers (� = Cafeteria d Other fixtures - W Design Flow.f=:1'..s_'� .a C_.1 :=: uig4alions per person per day. Total daily flow... js -......................gallons. 1:4 Septic Tank—Liquid capacity:2-:{;f�>_4allons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No........l............ Width____ !_.......... Total Length.__1' ...___. Total leaching area_ j ..........sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (�r)'; Dosing tank Percolation Test Results Performed by-: _L-....."1L-_______________ Date___ ------------ + > Test Pit No. I.... _.._.:minutespermch Depth of Test Pit..... ........... Depth to,ground water....G.'...__________. f3, Test Pit No. 2... _ _.....minutes per inch Depth of Test Pit_____ ___________ Depth to ground water___................. --------------------------------------------------------------------------------.. __----------•-----• -----•----------__----------•------•----------- O Description of Soil••- =_�---------v::_ l_c�:,:: s� -�a.35c�-`-c--- � � �......................` � I'\ r..... ---_-•••. W UNature of Repairs or Alterations—Answer when applicable____.!_ .__: %�i7,4_rS- --•_- -_l1 _i?_•--?_ ?GC��s � ----------------•------•-------•---------------------------------...-------------•.._...__......_...--------...-----------------------------•..------------------------------- •-•-•...•-•------••-. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System-in accordance with. the provisions of TITLE: 5 of the State Sanitary Code— The undersigned further ag to place the system in operation until a Certificate of Compliance has b > ued by the b of hea Z, --� " e� Date r . Application Approved By------------ ........................ f r ti --------- -•--••- Date Application Disapproved for the.following reasons:.............................................................................----------------------------•-••- .......-••-••••-•••--•-•••-•-•-••-•-•-•••.._.._....--•-••••--...••-•-•••••••-••---•--........••---_.._....--••-•••--•-••---•--•••-•--------•••--•••-------•••••=-•-=••••--•-----••••-••--••--•---•------- Date PermitNo................. •••••• .......... Issued---------•-----------------------=•-•-• •-••••••---- Date THE COMMONWEALTH OF MASSACHUSETTS -- ,s, ,,.__BOARD OF HEALTH ..........f.,.. La,�,..... OF............ �rr#ifB.rtt�r of f�unt�r�ittnr�e TH CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by.................... mac: - —_�n�r:: � �.Z ._ ............................... Installer has been installed in accordance with the provisions of TI� 5 of The State Sanitary Cod as described in the -, `, y application for Disposal Works Construction Permit No.__.____.__'7_:"'.. _:__/:._____ dated-_-..._f__ ._Z______ __ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUI RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..........................-------------------------------•--•-------------------- Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH / J � - ! Zb - l No......................... FEE-----`- ........... Dispuuttt uu � T-9 ion rrnti� Permission is hereby granted............ ......... `� to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No........L L- --•••-----=�' ..f �_._1 ................. �. Street j .............. as shown on the application for Disposal Works Construction �?_.�.t_ Dated__-.___C_�_�_Z�.`5;:.............C.. -------- ----------------- DATE................................................................................- -•• Board of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS 6 DATE -f Pyoj'rKr yy TOWN OF BARNSTABLE FEE S" 0 !! OFFICE OF BAfi7]T1BZ 7 ' y Yu[ BOARD OF HEALTH o SAY k��� 367 MAIN STREET HYANNIS, MASS. 02601 VARIANCE REQUEST FORM All variance requests must be submitted five (5) days prior to the scheduled Board of Health meeting. ' o.0 u ea._s hP�„vr�p NAME OF APPLICANT Mr .. George Mason TEL. NO. 428-5114 ADDRESS OF APPLICANT P•0. Box 573 - Osterville NAME OF OWNER OF PROPERTY The Beach Club ?G?�Gri 297 C�hA�FZY��c..6 M� SUBDIVISION .NAME ' DATE APPROVED LOCATION OF REQUEST . Asses so r ' s Map 206 - ParcP.l 16-Lon . cLBearh Road VARIANCE FROM REGULATION (List 'regulation) See Attachment VARIANCE._REQUESTED• (Specific••request) See Attachment REASON FOR VARIANCE':(May attach :letter if more space needed) S PLANS - Two copies of plan must be submitted clearly outlining variance requested: VARIANCE APPROVED NOT APPROVED REASON FOR DISAPPROVAL Robert L. Childs, Chairman Ann Jane Eshbaugh Grover C.M.. Farrish, M. D. BOARD . ARD OF HEALTH II The Beach Club Long Beach Road Centerville Board of Health Variance Request Variance From Regulation: 15 . 12 . ( 2 ) Ground Water Variance Requested: Maximum ground water elevation of 3 feet below the bottom of the ex- cavation in lieu of the required 4 feet. Reason for Variance: Based upon existing regulation the present system is underdesigned, the proposed upgrade will provide an adequately sized leaching field, septic tank and grease trap. Additionally, there will be 3 feet of dry suitable material below the bottom of the leach field. The Beach Club is seasonal and is not located within a Zone of Contribution to a public water supply. A large portion of the water usage is for rinsing salt water off bathers ( similar to the adjacent Town Beach) . AdL BAXTER & NYE, INC. Registered Land Surveyors and Civil Engineers i 7 Parker Road/Osterville,Massachusetts 02655/Tel, (617)428-9131 W JI M C.NYE,ILLS.-President CFiAFtD A BAXTER,R.L.S.-Vice President PETER SULLIVAN,P.E.-Vice President-Engineering April 29 , 1987 -Town of Barnstable Board of Health P.O. Box 534 Hyannis, MA 02601 RE: The Beach Club Long Beach RD - Craigville ,r t r Dear Board: aj Per your request, I have provided inspection during the course of installing the septic system at the Beach Club, The system has been installed as per the approved plan with respect . to size, location and elevation of all components . Very .truly yours, i ., Peter Sullivan, P .E. Baxter & Nye, Inc. I"t, ik i I PS/fmj " tti OF A,� PETER na �+ B� S ILLIVAN r' -No.2 9,73 33) .o ? t ��U�• �0NA L.. `: R. MEMBERS OF { CAPE OLD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS I AMERICAN CONGRESS ON SURVEYING AND MAPPING n MASSACHUSEITS ASSOCIATION OF LAND SURVEYORS AND ciVIL ENGINEERS - Bellaire, Dianna From: Bellaire, Dianna Sent: Wednesday, March 03, 2021 1:56 PM To: Scott Smith Cc: Bellaire, Dianna Subject: RE:The Beach Club-Alterations Okay,just checking. Thank you for the response. Have a great rest of the Spring. I've adjusted the bill and I am mailing out applications for 2021 Season tomorrow. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire @town.barnstable.ma.us 1 he information contained in this electronic transmission("e-mail."),including any attachment(the"Information"),may be confidential.or otherwise exempt from disclosure.It:is for the addressee only.This Information may be privileged and confidential work-product or a privileged and confidential commturication.The Information may also be deliberative and pre-decisional in nature..1s such,it is for internal use only.The Information may not be disclosed without the prior written consent of the Director of Public Health and,lor the Town Attorney's Office of the Town of Barnstable. If you have received this e-mail by mistake,please noti.ft-the sender and delete it from your system.Please do not copy or forward it.1'hank you for your.cooperation. From: Scott Smith [ma i Ito:scott@tbc1927.com] Sent: Wednesday, March 03, 2021 1:53 PM To: Bellaire, Dianna Subject: Re: The Beach Club-Alterations Hello again. I just got confirmation from Scott F. about the soft serve machine; he said TBC had one, but got rid of it five years ago. Regarding the pizza oven; as much as I could see a financial benefit the Board didn't believe Covid summer#2 was the year to install it so no,TBC is not installing a Pizza oven. Thanks again for your detail tracking. S Apologies, it's a tiny keyboard. On Mar 3, 2021, at 1:03 PM, Bellaire, Dianna <Dianna.Bellaire@town.ba rnstable.ma.us>wrote: Hi, i I just reviewed my notes about the email below. Are you still moving forward with the outdoor pizza oven? Alterations? Did you speak with a health inspector regarding this matter? I just want to make sure nothing gets missed when we get to renewal time. Thank you for the compliment. I am trying very hard to keep everyone up-to-date and get everything in order. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us The information contained in this electronic transmission("e-mail"),including any attachment(the"Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only.This Information may be privileged and.confidential work-product or a privileged and.confidential communication.'flee Information may also be deliberative and pre-decisional in nature.As such,it is for internal use only.The.Information may not be disclosed without the prior written consennt of the Director.of Public.1lealth and/or the'.Town.:�ttorrrey's Off.ce of the'Town of Barnstable.If you have received this e-mail by mistake,please notify the sender and delete it from your system.Please do not copy or forward it. Thank you for your cooperation. From: Bellaire, Dianna Sent: Wednesday, November 18, 2020 8:46 AM To: Parvin, Lindsay Cc: Bellaire, Dianna; McKenzie, Marybeth Subject: RE: The Beach Club-Alterations Hi Lindsay, This is normally Donna's territory. Marybeth is covering for Donna. Marybeth, can you get in contact with the Beach Club regarding these premise changes? The email is Scott@tbc1927.com. This is seasonal restaurant. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bella ire @town.barnstable.ma.us The information contained in this electronic transmission("e-mail"),including any attachment(the"Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only.'Thus Information may be privileged and.confidential work-product or a privileged and confidential commimication.The.Information may also be deliberative and pre-decisional.in nature As such,it is for internal use only.':1.'Ine Information.may not be disclosed without the prior written consent of the Director of Public Health and/or the Town Attorneys Office of the Town of Barnstable.I.£you have received this e-ina.il by mistake,please notify the sender and delete.it from your system.Please do not copy or forward it.Thank you for your cooperation. 2 From: Parvin, Lindsay Sent: Tuesday, November 17, 2020 12:10 PM To: Bellaire, Dianna Subject: The Beach Club-Alterations Hi Dianna, The Beach Club would like to move forward with an Alteration of Premises. I want to make sure that the Health Department reviews any seating changes as well as the proposed outdoor pizza oven before he moves forward with this application. I don't want to get into another situation where the Licensing Board approves something that Health is not okay with. Thanks, Lindsay CAUTION:This email'originated from outside of the Town of Barnstablel``Do not click links, open attachments or reply, unless you recognize the sender's email address and>know the content°is safel 3 ::' �,.e% "ya — 3� J :'1..� "" `3'C ►to A. }-fti .' � Ad(� M; _i P I_�/a..i t`v; �' i-�"` lE / ►V.b T F I_1_ t r i F 5 tAC:w M. t-N E 2 E:CO -1 A.'Q APr 2��.E*.A AT'. �t_ 11 jl t_1 T}t:. � <,y.}JL1 f,� 4 r l 1 1 P ..J C✓ �. ..� i ��"�1��3�....�..:� — �"J'' S �► (�ram'�' U;�. .�j JC�C� � ._a,._,r��►....Q ,�s,�,� --�\cam:�a.�-�, c: i•Q,o o - 3 Zz -.4 t5 a q ! ►, ' - ►Mt.._T3 -}►S�. 1.���L� `( "T'�'Z. roc. t-1 2Q,t4 — � Ae.� - (1z© t�� 2 x q �. ion. � � C �►.�� � J 1'1'-J. All. 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