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HomeMy WebLinkAboutVILLAGGIO AT THE REGATTA - FOOD Villaggio at the Regatta �'-cotuit 1 , .Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. A. General Information 1. Inspector: Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 Cityrrown State Zip Code 508.272.6433 Telephone Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the ^' information reported below is true, accurate and complete as of the time of the inspection: The'i'nspe Ition was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of3 Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10/26/12 Inspector's Tignature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. I, ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection,does not address how the system will perform in the future under the same or different conditions of use. GQ ► l �� 4 4631 Falmouth Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4631 Falmouth Rd Property Address Menounos Owners Name Barnstable MA 02635 10/26/12 City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: n/a ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ obstruction is removed 4631 Falmouth Rd•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: n/a ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: n/a C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 4 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 4631 Falmouth Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4631 Falmouth Rd Property Address Menounos Owner's Name , Barnstable MA 02635 10/26/12 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteha indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: n/a D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 4631 Falmouth Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments w 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. 1 have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑, ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is'considered a significant threat, ` or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4631 Falmouth Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)]. , s 4631 Falmouth Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 City1rown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): n/a Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ❑ No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: restaurant Design flow(based on 310 CMR 15.203): 3256 gpdGallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): 93 seats Grease trap present? ® Yes ❑ No Industrial waste holding tank present? - ❑ Yes ® No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ® No Water meter readings, if available: 794 gpd Last date of occupancy/use: September 2012 Date Other(describe): n/a 4631 Falmouth Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: No history given Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 1982 per BOH file Were sewage odors detected when arriving at the site? ❑ Yes ® No 4631 Falmouth Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4631 Falmouth Rd Property Address Menounos Owners Name Barnstable MA 02635 10/26/12 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 18 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: >10'feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2'feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) Steel covers to grade If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 4500g Sludge depth: 6" Distance from top of sludge to bottom of outlet tee or baffle >12 Scum thickness 611 Distance from top of scum to top of outlet tee or baffle >211 - Distance from bottom of scum to bottom of outlet tee or baffle >21' How were dimensions determined? measured 4631 Falmouth Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3 yrs to prolong the life of the system. Owner to pump post inspection 4 Grease Trap(locate on site plan): Depth below grade: 2'feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Steel covers to grade Dimensions: 1500g Scum thickness Excessive Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease trap is full and to be pumped post inspection Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: - Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): n/a 4631 Falmouth Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): n/a *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert level w/the bottom of the pipes Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box has steel cover to grade, no adverse conditions. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 4631 Falmouth Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 4 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): All 4 pits have steel covers to grade, none of the pits exhibit conditions of past backup, at this time Pit "F" has 6"of effluent, Pit"G" has 1'of effluent, Pit"H"is dry, and Pit"I" has 2"of effluent 4631 Falmouth Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M s.•°'�l 4631 Falmouth Rd Property Address Menounos Owner's blame Barnstable MA 02635 10/26/12 Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): n/a 4631 Falmouth Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 dommonwealth of Massachusetts N r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �.' 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 City/Town State Zip Code Date of Inspection D. Sy ',qm Information (66nt.) Sketch Of Sewagebi9posal System:`Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public~water supply enters the building. l � l O G{LEc>9s ' d l A 4631 Falmouth Rd•03/08 Tide 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 15 l Commonwealth of Massachusetts 4 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 4631 Falmouth Rd Property Address Menounos Owner's Name Barnstable MA 02635 10/26/12 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >12 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Per elevation to nearby stream k 4631 Falmouth Rd•03/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 ._ 1 � �e 1� a �qD - - ---- --------- ---------- -- - - -- ---- IKE r, Application Number........ .............................. . ... .. .... ....... 141 MASS. Permit Fee......... ...:..O.P.............Other Fee........................ s639. TotalFee Paid............................................................... ...... TOWN OF BARNSTABLE Permit Approval by.................................On........................... BUILDING PERMIT0 � 1 1-5-7 MV............ ....................................... APPLICATION Section 1 - Owner's Information and Project Location Project Address- Village Owners Name. f, Yq e4 Owners Legal Address City State A / n.4— Zip c� Owners Cell# 5.? P � E-mail JA n:� F- Section 2 -Use of Structure Use Group_ ❑ Commercial Structure over 35,000 cubic feet El Commercial Structure under 35,060 cubic feet ❑ Single/Two Family Dwelling Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate E] Accessory Structure E] Change of use FJ Demo/(entire structure) El Finish Basement El Family/Amnesty 7 Fire Alarm Rebuild El Deck Apartment El Sprinkler System ❑ Addition E] Retaining wall ❑ Solar Renovation ❑ Pool El Insulation Other-Specify, Section 4 - Work Description V G.- oa-P, V0 I 8-,Lk) &16-f C". -4 a re (Z. Last undated: 11/15/2018 4��sr ray Town of Barnstable Regulatory Services ' MAS&` Public Health Division •639• Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 January 6, 2020 John J. Bartolomei,Jr. Villaggio at the Regatta 4631 Falmouth Road Cotuit, MA 02635 Dear Mr. Bartolomei: RE: Villaggio at the Regatta, 4631 Falmouth Road, Cotuit Thank you for calling today and informing us that you have removed the three bedrooms upstairs. This will allow you additional seating in your establishment. In previous years,your permit was permitted for 93 seats. Your food permit for Year 2020 will be revised to allow 100 seats. If you wish to request more than 100 seats,you may file a written request to the Board of Health for multiple variances. Sincerely, c Thomas A. McKean Agent Cc: Licensing Q:\FOOD&FOOD HANDLERS INSTRUCTORS\4631 Falmouth Rd Cotuit Villaggio at the Regatta SEATING Rev Jan 6 2020.docx f �s r Town of Barnstable Regulatory Services � Y BA MA&S.It public Health Division 9�''tFyA10� Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 January 2, 2020 John J. Bartolomei, Jr. Villaggio at the Regatta 4631 Falmouth Road Cotuit, MA 02635 Dear Mr. Bartolomei: RE: Villaggio at the Regatta,4631 Falmouth Road, Cotuit Your application for a Permit to Operate a Food Establishment at the above location from the Board of Health requesting 146 seats for Year 2020 is denied. The seating capacity is limited to the allowable wastewater discharge flow per Chapters 232 and 360 of the Town of Barnstable Code. You are also restricted to the capacity of your septic system components per 310 CMR 15.000,State Environmental Code,Title V. Seating of 146 exceeds the capacity of your septic tank and grease trap. Please be aware that your food permit is renewed for the same number of seats as last year: Year 2020—Limited to 93 seats. You may request a hearing before the Board of Health if written petition requesting same is received by the Board within 10 days. PER ORDER OF T ARD OF HEALTH r� T cKean Agent Cc: Licensing i Q:\FOOD&FOOD HANDLERS INSTRUCTORS\4631 Falmouth Rd Cotuit Villaggio at the Regatta SEATING Jan 2 2020.docx A ' . Town of Barnstable BOARD OF HEALTH GJohn T.Norman Board of Health Donald A.Gaudagnoli,M.D. '�• k1A1LN3TA6LY1- F.P.(Thomas)Lee,. Ma5&5. Daniel Luczkow,M.D. Alt. +�x9� 200 Main Street, Hyannis, MA 02601 o ° 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: 275 Issue Date: 01/01/2022 DBA: VILLAGGIO AT THE REGATTA OWNER: JOHN J. BARTOLOMEI,JR. Location of Establishment: 4631 FALMOUTH ROAD COTUIT„ MA 02635 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IncloorSeating: 77 OutcloorSeatin : 23 Total Seating: 100 g FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: For Office Us Initials: We Town of Barnstable Date Paid Amt M J ELAR,,,ST"LE : Inspectional ServicesMAM 3 '�F1639. Ola�O$ Public Health Division Check# Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 I Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE I I Z� NEW OWNERSHIP RENEWAL_4k NAME OF FOOD ESTABLISHMENT: V) ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT:. TOTAL NUMBER OF BATHROOMS: WELL.WATER:YES NO ..(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/_ TO . 4- a3 I NUMBER OF SEATS: INSIDE: O� OUTSIDE: 2D TOTAL: l 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) - ,' ATERING... (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 Fonns\FOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER:(V)E /NO D.O.B 'b OWNER PHONE # ADDRESS_ '/ C s r j Q,I /" L4 M tt _ /1-1 /r— C-)L6 F� CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: 9 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.L SC -5 / 8 / \SIA M OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/api)lications.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 APPLICATIONS)AND REQUIRED FEES BY DEC Ist. Q:\Application FormsTOODAPP REV3-2019.doc I Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BA, BM :" Paul J.Canniff,D.M.D. iaS F.P. Thomas Lee Alternate 21 9. 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, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 275 Issue Date: 01/01/2021 DBA: VILLAGGIO AT THE REGATTA OWNER: JOHN J. BARTOLOMEI,JR. Location of Establishment: 4631 FALMOUTH ROAD COTUIT„ MA 02635 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 77 OutdoorSeatin : 23 Total Seating: 100 g FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: CQ _ FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Town of Barnstable AWE rq� For Office Use Only: Initials: � Date Paid AmtI'd$�W BARNMBLE, : Inspectional Services v MASS' 1639. Public Health Division Check it— Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 - PLICATION FOR PERMIT TO OPERATE A F OD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: 1 P�1��'J �V� " ` C' t MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: U Ar��/a—�TT'''��� �� M� 1- C J TELEPHONE NUMBER OF FOOD ESTABLISHMENT: - ls� TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO,&_ ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: _ SEASONAL: DATES OF OPERATION:_/ /_ TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: _ SEATING: MUST OBTAIN A COMMON VICT ALLER'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? P— ) r IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) V 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:\Applieation FonnsTOODAPP 2020.doe OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNE DYE /NO D.O.B OWNER PHONE# J ADDRESS—�E J /w— ti. 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 0�, /2- SIGNA UR F APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until,the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at httv://www.townofbarnstable.us/healthdivision/apl)lications.asi). 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:\Apphcation FonnsTOODAPP REV3-2019.doc 't rs�S Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. UARMAntB. + Paul J.Canniff,D.M.D. mma 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate a +` Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 275 Issue Date: 12/10/2019 DBA: VILLAGGIO AT THE REGATTA OWNER: JOHN J. BARTOLOMEI,JR. Location of Establishment: 4631 FALMOUTH ROAD COTUIT, MA 02635 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 70 OutdoorSeating: 23 Total Seating: 93 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: i oFIMMErqk, • Initials• ti Town of Barnstable Date Paid Amt Pd$� a„RNszAa . : Inspectional Services MASS. °•fo9. .>�� Public Health Division Check# ;y Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 ;' Office: 508-862-4644 Fax: 508-790-6304 ' PPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE ' NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: V ��w r, s,rC 14� ADDRESS OF FOOD ESTABLISHMENT: �"�p 1 ���M b MAILING ADDRESS(IF DIFFERENT FROM ABOVE): S�5 tMQ, E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (�—Oym - (0 TOTAL NUMBER OF BATHROOMS: WELL WATER: YES_NOK ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/_/_ TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LIC4NSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? \ TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED& BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpplication FormsTOODAPP 2020.doc s OWNER INFORMATION: ` FULL NAME OF APPLICANT SOLE OWNER: YE /NO D.O.B, `O-\�� OWNER PHONE# Q � ADDRESS A kt'A\6 f'L—e—l� �A�At . M CORPORATE OWNER: \ SfP m L., CORPORATE ADDRESS: `�� \ C pf` D� ' C— !� PERSON IN CHARGE OF DAILY V OPERATIONS: i� "k, P1,O✓-.I 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 SIG TURF OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asy. 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 APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc IKExpk Town of Barnstable BOARD OF HEALTH r Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. BARNgr,►ULL _ John T. Norman MASS" F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 °" a 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: 275 Issue Date: 12/20/18 DBA: VILLAGGIO AT THE REGATTA OWNER: JOHN J. BARTOLOMEI,JR. Location of Establishment: 4631 FALMOUTH ROAD COTUIT MA 02635 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 70 OutdoorSeating: 23 Total Seating: 93 _ FEES - ------ -- --- - - — FOODSERVICEESTABLISHMENT: $300.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - - - - -- - MOBILE- FOOD: MOBILE- ICE CREAM: FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: r FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: w. FIuE ram, For Office Use Only: Initials: Town of Barnstable Date Paid )-A 10IR Amt Pd $ W 9 MAU% Inspectional Services Q . O 16J9 �0 Public Health Division Check# � fir. Thomas McKean,Director f 2� 200 Main Street,Hyannis,MA 02601 1 "� Office: 508-862-4644 Fax:,508-790-6304 APPLCI(CATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE ` D NEW OWNERSHIP RENEWAL Y r NAME OF FOOD ESTABLISHMENT: 4 l T ADDRESS OF FOOD ESTABLISHMENT: 4-� ` �( �rA i/�� , M o del,L l� MAILING ADDRESS(IF DIFFERENT FROM ABOVE): l 0 MA E-MAIL ADDRESS: C�A.`F'7Vt( ' p \® 't�,.� �a�r�1 � " Qn rv� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO :.. (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENS FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ....(CATERING-NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL, MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FonnsTOODAPPREV2018.doc PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT �J V•`^ SOLE OWN:4ftNO D.O.B OWNER PHONE#T_��-�— �n.2� ADDRESS u G" � CORPORATE OWNER: Cq� FEDERAL ID NO. : � CORPORATE ADDRESS: � PERSON IN CHARGE OF DAILY OPERATIONS: `V 0 n I 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 cr,e�� 2. ��� 4 0 / SIG OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. Prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/bealthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation, or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 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:1Application FormsT00DAPPREV2018.doc Bellaire, Dianna From: McKenzie, Marybeth Sent: Tuesday, December 18, 2018 8:16 AM To: Bellaire, Dianna Subject: . RE:Villaggio Yes they corrected there dishwasher and fixed all other violations noted on inspection report. Ok for 2019. From: Bellaire, Dianna Sent: Friday, December 14, 2018 2:22 PM To: McKenzie, Marybeth Cc: Bellaire, Dianna;,Bellaire, Dianna Subject: Villaggio Marybeth; I don't have an okay on this one but, you inspected on 12/5. Are they a hold or ok for 2019? 1 did receive their SS/AA but, be aware all 3 certificates expire 05/19. Thanks! 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 oFiI E.or TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: l of , OFFICE HOURS BARN STABLE. PUBLIC 2 0 MAIN STREET 3:30-4:30A.M. Item Code C Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. a3. �•� HYANNIS, MA 02601 M-8 -FRI. No Reference R-Red item PLEASE PRINT CLEARLY ArEO MAC° 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Date 1 Tyue of Type of Inspection l Routine 1 Address (� Risk F-od Service Re-inspection ection tAl Level Previous Inspection Telephone Residential Kitchen Date: ,�` V( Q J Mobile Pre-operation AAR '1 V wo Owner HACCIP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: ther Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) �' �`l /1� Corrective Action Required: g ` ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating aL 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 re 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. y 29.Special Requirements (590.009) s o within 10 days f receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Sig t 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 Sig Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - - � - 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(F) 590.003(C) Responsibility of the Person-in-Charge[0 7-102.11 Common Name-Working Containers*Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 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 Con 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* 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 Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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 Wazewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* ( )( Pathogens JI 590.006(A) Bottled Drinking Water* 3-401.11 A 2) Comminuted Fish,Meats&Game * e-eve rnrzom 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* * Eggs* 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 E s* 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* P 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* in mobile f temporary and residential Sources* g, ob e food, po 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 Wl/d 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 11 Good Hygienic Practices practices should be debited under#29-Special 3-201.17 Game Animals* 17 Reheating for Hot Holding Requirements. $ 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 * 12 Prevention of Contamination from Hands 3-403.11E Remainin Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 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 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 Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) labeling of Ingredients' 27. Physical Facility F -6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1 008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 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. 1 North American Restaurant Equipment 10 industrial drive 401-639-3271 Smithfield , Rhode Island 02917 United States i Billed To Date of Issue Invoice Number Amount Due(USD) ViIlagio 11/15/2021 015846 $49885.38 AryV'1� f Due Date 11/15/2021 tM Va F (4 i Description Rate Qty Line Total P-67 $2,699.00 1 $2,699.00 N American 67" pizza.prep new +MA Precision PPT-1 $1,899.00 1 $1,899.00 50"1 door pizza prep table all stainless on casters raised topping rail, +MA holds dough boxes digital temp control Subtotal 4,598.00 MA(6.25%) 287.38 Total 4,885.38 Amount Paid 0.00 kAmount Due(USD) $4,885.38 I Terms RETURNS -NO RETURNS ON SPECIAL ORDER NON STOCK ITEMS -MUST BE MADE WITH IN 10 BUSINESS DAYS -ALL RETURNS ARE SUBJECT TO 35% RESTOCKING FEE -ANY ITEMS THAT HAVE BEEN USED CANNOT BE RETURNED -ANY RETURNS MUST BE DELIVERED BACK TO NARE -BY ACCEPTING THIS INVOICE YOU ARE AGREEING TO THESE TERMS ANY SCRATCHED DENTED OR DAMAGED ITEMS NO RETURNS �a IRE ro o TOWN OF BARNS.TABLE. HEALTH INS OURSR'S Establishment Name: Date: Page: of �P PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,639• �0� HYANNIS, MA 02601 508-862-4644 No Reference R-Red.Item• PLEASE PRINT CLEARLY prFO MP+p FOOD ESTABLISHMENT INSPECTION REPORT Name Date r'� Type o Type of Inspection I - O r Routine Address 14 I �, -1 Risk Food Se Re-inspection �x lY Level Retail Previous Inspection /}��_ / J Telephone Residential Kitchen Date: y .�IUQ�G Mobile Pre-operation �,` Owner HACCP Y/N Temporary Iness / e Uv Caterer General C.;m;-p lie Person in Charge(PIC) , I l b� Time Bed&Breakfast Other v In: M Inspector Out: OJ T� h w h Each violation checked req Tres 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) ❑ v C -� l/✓cy Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands L ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities / ] EMPLOYEE HEALTH PROTECTION FROM CHEMICALS t/l Y� Y v ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals r 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 ✓� y ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding !��( PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control c-n w I ✓ _ D ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) viiljV 0. d ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP /� ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ( S er 4 e d,/( ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories I A.IV4 C C 4 Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 41� �Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ElYes dzzeilNon-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 Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. El Embargo Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils B=One critical violation and less than 4npn-critical violations 9 (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i 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 anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 g violation,4 to 8npn-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Si t Print: 31.Dumpster screened from public view 194�1 A Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's ure Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violation Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility 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 Storage*- Applicants* 3-302.11(A) Food Protection* 7-201.11 SeparationL.2O_ 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* ( ) q 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 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 y Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with 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 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* 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(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of A11 4-601. Clean Utensils and Food Contact Surfaces of * Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* ( .) t f Eggs-Immediate Service 145°F 15 sec" Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef crive 11112001 4-602.11 Cleaning Frequency of Utensils and Food 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* Animals-155°F 15 sec* * 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 3-401.1](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-Ho[Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-001.11 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 non-critical 23-30) 3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodbome * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 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 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 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 1 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Qp IKE Tok, TOWN OF BARNSTABLE ,. HeALTH INSPecTORs Establishment Name: Date: Page: . Of.2- ti OFFICE HOURS BARNsrAR�E o) PUBLIC 2 0 MAN STREET 3:30-4:30 P.M. 8: 0- :30 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � Mayo: `0� HYANNIS, MA 02601 MON.-FRI. No Reference R Red Item PLEASE PRINT CLEARLY prFD MA+° FOOD ESTABLISHMENT INSPECTION REPORT 508-862-4644 Name Date(( 2 Tyne of Tyoe of Inspection Routine (•C Il�•� L Address 9 Risk Re-Previous Inspection J Level Retail P Telephone Residential Kitchen Date: l Mobile Pre-operation / � Owner HACCP Y/N Temporary 0C� Caterer omplaint Person in Charge(PIC) Time Bed&Breakfast HACCP ,�-` C✓��L�--�� f In: Other Inspector Out: Each.violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. tL- a. Gt� 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) ❑ y� Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ S r A,FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands , ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities �a . 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 /'1� �. FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) �l �(i,'_.?_ ❑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 l/ T PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items] Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No El 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 i 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 anon-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 ignatu a Pri t: 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 ature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violation related to Foodborne Illness Violation 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) JDemonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 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* Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* P g 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* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* T0.004(11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashin 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* 3-401.11 A(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 - Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef crave 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* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C CommerciallyProcessed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 3-501.14 13 Handwashing Facilities Cooling Cooked PHFs from 140°F to 70°F (A) g 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 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. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S: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. �p ZMET TOWN OF BARNSTABLE•. _ _ _ HEALTH INSPECTOR-s Establishment Name: Date: _ Page:,.. I - of '.2� Y OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE, • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 639' �0� HYANNIS,MA 02601 M-8 -FRI. No Reference R=.Red Item. PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT �iOTFo MAC° 508-862-4644 3 ftCe �I Name 'l `O 2 Date Tvpe of Inspection p outine Address ��- Risk em a Re-mspe ion Level Retail Previous Inspection _- Telephone Residential Kitchen Date: Mobile Pre-operation ✓11�t e Owner HACCP Y/N Temporary Suspect Illness 0,1 Caterer General Complaint Person in Charge(PIC) eAl6� Time Bed&Breakfast HACCP ftJ In: Other Oki Inspector Out lb I Ic In Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. d -7 jr 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) ❑ ` t OC Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT. ❑ 12.Prevention of Contamination from Hands i ❑ 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 eI IQ Ljeje�j 4if �i / n. / .i FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) 0_4J W- fit/ ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures l � 11, ✓e ❑ 5.Receiving/Condition ❑ 17.Reheating ❑fi.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling je ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time Asa Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) t Lf LlD CL�G ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP f _ If 10.Proper Adequate Handwashin CONSUMER ADVISORY P I;q 9 ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories ��O Violations Related to Good Retail Practices( )Blue Items Total Number of Critical Violations cc- -!-C. Y"�1 Critical(C)violations marked must be corrected immediately. (blue&red items) r Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating Ij , '�� �� Fid 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 checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ g 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 (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 if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. 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 anon-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 Signat u e Print: 31.Dumpster screened from public views U 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 atlas Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 79 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*7-102.11 Common Name-Working Containers 590.004(F) * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* * 7-201.11 Separation-Storage* Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* _ . 590.004 Variance Requirements * 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* (11) q 590.003(G) Reporting by Person in Charge Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR _-. 3-306.14(A)(B)Returned Food and Reated 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*- P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water I 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(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* Equipment* gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effe crave to/zoo/ 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 Cough[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 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. 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 practiceRequirements.sshould 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* C Commercially Processed RTE Food-140°F* (Blue Items 23.30) 3-202.15 Package Integrity* am on en 3-403.11( ) ommerc y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 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 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 5-205.11 Accessibility,Operation and Maintenance 3-402.12 Records,Creation and Retention* Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. 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. Op ISE ro TOWN OF BARNSTABLE - HEALTH INSPECTORs Establishment Name: Date: Page: Z. Of '4 OFFICE HOURS p ° PUBLIC HEALTH DIVISION 8:00-9:30A.M. ennNsrne�e. = 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified M67•�`0� HYANNIS,MA 02601 MON.-FRI. No Reference R.-Red Item. PLEASE PRINT CLEARLY rFo MPS 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name I Datelb Z e of Type of Inspection Q^,, / Operation(s) Routine 6 Address '�G .C/� 4 �CY Risk Food Service Re-inspection I Level Retail 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 ln/II I � Gv In: Other Inspector Out: IAAA1� 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) ❑ Z�/� 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 tF-CL"[Ace ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals /� c i FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) wf ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Re eiving/Condition ❑ 17.Reheating Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling f {A? ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils B=One critical violation and less than 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. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically la hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9non-critical. If no critical water,sewage back-up,infestation of rodentsor 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 Sig ature Prin 31.Dumpster screened from public view IRA 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? Y N r�- -...�:__� - �-.-. .-.--"-z•.••---�.:,..., > ..-. ._�---..-.r..r-.--. -.r`r-'. _ y - . .� - -���_. ,-J-......_. �-____- - �vr- _. -.�-- _- - ._.�. .. - .J � � -. r. s. -...- •- r._ ,..�:,'yr__ __.^r�.,-�-', - Violations related to Foodborne Illness Violations Related to Foodbome Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 44- Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked-and RTE Foods.* Additives* 19 PHF Hot and Cold Holding - - 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 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 Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Foam* 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* 3-801.1](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 Wazewashin 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 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* 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* 3-401.11 A(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 Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meals&Game Pathogens* ery crive uinoo✓ 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* - Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and 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 Ali Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 1 Reheating for Hot Holding Requirements.practices 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 * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items non-critical 23-30) 3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F[0 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45*F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. ' a e: oF,�row TOWN OF BARNSTABLE HEALTH INSPECTOR s Establishment Name: g of ti 1 1, OFFICE HOURS BARN E. PU62 0 MAN STREEETSION 8:3:3 0- :30A.M. 0-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified LIC HYANNIS,MA 02601 MON.-FRI. No Reference- R-Red Item PLEASE PRINT CLEARLY �p +aav Awe 508-862-4644 'E0N1°� FOOD ESTABLISHMENT INSPEICT,ON REPORT Name Date� e of Ins ec ion O s outine Address isk d Se ce spec on evel tail Previou oh Telephone Residential Kitchen Date: Ian/ Mobile Pre-op C Owner HACCP YIN Temporary Suspect III iess Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Other n` Inspecfor all oil u :' V Each violation checked re uiVsan xplanation on the narrati.e e(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) ❑ r FOOD PROTECTION MANAGEMENT ❑j12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS n ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives AS L ) y ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) j ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures IIIIt ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 8.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION 20.Time As a Public Health Control A F ^ f ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food 2and Food Preparation for HIP IV ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY /�✓7 ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories , Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) 1 I� 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 it ms ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food C de. 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 4non-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and waste .. (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 n n-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC77)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critil viola ons. If 1 critical refrigeration. 4 to 8 non-critical violati 29.Special Requirements (590.009) within 10 days of receipt of this order. =C 30.Other DATE OF RE-INSPECTION: In e is S nature 1AP k5 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 lure 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 t Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11 A)(2) Raw Animal Foods Separated from EachIdentifying * 590.004(F) ( P 7-101.11 Identi n Information-Original Containers 2 590.003 C) Responsibility of the Person-in-Charge to Other* g g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* ( Po ty7-102.11 Common Name-Working Containers * Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage Applicants* 3-302.11(A) Food Protection* * 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* ( ) Variance q 590.004 11 Vari Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food 7-204.12 Chemicals for Washing Produce Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g ( ) Disposition of or Contaminated 7.204.14 in Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and Food Drying g P 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(J3) 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(1-)) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 1 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°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* ( )( ) Pathogens* ff� 590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game g * E give 1/I12001 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* Ratites-165°F 15 sec* Sources* 10 Pro ing,mobile food,temporary and residential Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Wild Mushrooms*-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"17 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 12 Prevention of Contamination from Hands 3-403.11(E) Remainin Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated* g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) g 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 5-20411 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(l) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 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:590Formbackfr2doc *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� r TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: �(' /Date: Pager of q OFFICE HOURS PUBLIC HEALTH DIVISION ` 8:00'430A.M. BARN57'ABLE, • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified o MASS. HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �p .639•ago 508-862-4644 7'FDN1Ay FOOD ESTABLISHMENT INSPE TON REPORT Qi r Name Date a of Type of Inspection IM571 Ooeration(s) Routine Address Risk Food Service Re-inspection 17 Level Retail Previous Inspection Telephone Residential Kitchen Date: I Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other F / Iry - Inspector ' Out: Each violation checked requires an xplanation 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 t✓ ❑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 A i. ❑ 5.Receiving/Condition ❑ 17.Reheating 01 ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling / ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑8.Separation%.Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils FC-4 590.005 B=One critical violation and less than 4non-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. if C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility ,(FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations 9Dserved,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation, to 8 riti violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's SI natur Print: 31.Dumpster screened from public viewt),�- fn 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 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 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-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* 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 Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual 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* Hermetically,Sealed 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 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils an g8 d Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* EJr,five 1112001 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 3-401.1](B)(1)(2) Pork and Beef Roast-1 1 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) 155 Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PBFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) hem Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F[0 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 .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. �F IME ro TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: ( I Date: Page: of v` 10 OFFICE HOURS snnNSTAB�E. PUBLIC 0 MAN STREEETSION 3:30 4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. MASS" _ MON.-FRI. p t63 a�0� HYANNIS,MA 02601 sos-as2 asaa No Reference R-Red Item PLEASE PRINT CLEARLY" _ rFD MP+ FOOD ESTABLISHMENT INSP C ION REPORT C-7 i" Name Date Lfoe o s ectio p out in Address isk od Servic ec eve) Previous Ii Telephone Residential Kitchen Date: _0 Mobile Pre-oltON. �- Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP % W Other Inspector O :5 and citation of specific provision(s)s violated. 901 IV A on narrative a e s a a c Each violation checked requires an explanationo e a g ( ) p p ( ) 11 c, 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 Ilk- E] 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 TIMErrEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating - r` ❑ G Tags/Records/Accurac of IngredientStatements ❑ 18 Cool ing 9 ❑ 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) i ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic"Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices Blue Items Total Number of Critical Violation V t t ( ) Critical C violations marked must be corrected immediately.( ) Y (blue 8�red Items) ��/� '�� Corrective Action Required: ❑ No El Yes Non-critical(N)violations must be corrected immediately or Overall Rating J J� 7 within 90 days as determined by the Board of Health. F] Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,th ems ❑ Embargo ❑ Emergency.Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Pertiunnel (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 4 non-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 n 9 than and le ti l i l ritica violations less a a 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 c non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of violations observed,7 to 8 non-c�t Ical v 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 violation,4 to 8 non critical viol/.ions-C. 29.Special Requirements (590.009) within 10 days of receipt of this order. / 30.Other' DATE OF RE-INSPECTION: I for Signature Pri 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 Prirf Self Service Waft Service Provided Grease Trap Size Variance Letter Posted. Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods' 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-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 7-202.11 Restriction-Presence and 20 Use* Time as a Public Health Control 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* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 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 Rated or of Food*Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or 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 Wafer 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 Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P * _ 4-501.111 - Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations ' 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical 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. 18 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System _ gg 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 rf ces of Equipment* 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 Violations of Section 590.009 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* Ratites-165°F 15 sec* 590.009A ( )-(D) (A)-(D)in cater- ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices - 17 Reheating for Hot Holding practices should be debited under#29-Special 2-401.11 Eating,Drinking or Using Tobacco* * Requirements. 5 Receiving/Condition g. 8 8 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 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs 8 Tags/Records:Shellstock P 9 following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* 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 2 . Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 25. Water,Plumbing and Waste FC-5 .00 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 29. Secial Re HACCP Plans 6-301.12 Hand Drying Provision pquirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S.590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. oF� r TOWN OF BARNSTABLE, HEALTH INSPECTOR'S Establishment Name: V 15' � Date:L Page: of ti OFFICE HOURS PUBLIC HEALTH AR"N®Eoe 2 0 MA NST R DIVISION : 0 ET 33 - :3 .M. 40 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. MON.-FRI. .639. `q� HYANNIS,MA 02601 sos-ssz-4644 No Reference R-Red It e PLEASE PRINT CLEA Y M"'' FOOD ESTABLISHMENT 11NSP,,PC'hPV REPORT Name Date Type o jyao4 Inspection O s outine Address Risk od Se a ins ection 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 / In: Other Inspector Out: Each violation checked requires n 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 �a ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS. ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ElNo El Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6von-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operation If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request t C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28..Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above addr violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590,009) PY within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Ins p Sig ur PFinnt. 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N / #Seats Observed Frozen Dessert Machines: Outside Dining Y N P i na r rint: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives - Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12•. Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 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* 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* 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 Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* _ REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Rrated or of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B)_Compliance with Food Law* 4-501.111 Manual Wazewashin 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 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 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 Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective ulnom 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency r f ces of Equipment* 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 cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( ) ( ) ( )-( ) in 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 3A01.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiceRequirements.sshould 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 Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity* O Y Critical and non-critical violations,which do not relate to the foodbome j * 12 Prevention of Contamination from Hands 3-403.11 Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated �) g illness interventions and risk factors listed above,can be found in the 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 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 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 E3-502.11 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials Fc-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 Specialized Processing Methods* 30. Other - . Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Villaggio at the Regatta - Italian Specialties, Signature Seafood and Tuscan Steakhouse Page 2 of 3 STARTERS ITALIAN SPECIALTIES SIGNATURE SEAFOOD TUSCAN STEAKHOUSE For Starters... �i 1 CARPACCIO Thinly sliced Prime Tenderloin served with minced red onion,capers and lemon zest with arugula and a drizzle ofexcra virgin olive oil.$16 4 _ FRIED MOZARELLA Triangles of M zzarella seasoned will)a light breading;,deep Fried and T served with our"Fontato sauce.$9 BRUSCHETTA RUSTICA CRAB CAKE AIOLI Grilled Tuscan peasant bread rubbed with garlic oil,,topped with Fresh House-made Itunp crab meat cake pan seared and Baked,garnished basil,chopped tomatoes,and fresh mozzarella,finished with a drizzle of baby arugula and served with a crushed red pepper flake re.moulade. barrel aced balsamic.$8 CALAMARI NAPOLETANA SHRIMP COCKTAIL l.ighdy breaded squid fried with fresh 1rali:m herbs tossed with scut 3 jumbo shrimp served chilled with a traditional cocktail sauce and a cirrus chopped tomatoes,kalarnact olives and sliced banana peppers,serve, aioli garnished with sliced banana peppers,kalamata olives and diced our spicy ccuntao sauce.$15 tomatoes.$12. LOBSTER TACO SALSICCIA STUFFED MUSHROOM CAPS Hand rolled fried dough with lobster meat.acinusaioli,arugula,ch Baked mushroom caps stuffed.with ground sweet and spicy Italian sausage, tomato,fonana cheese and avocado.Finished xvich powdered sugar, par mesas topped with fresh mozzarella and finished wish ads rleofbutclagedbalsamtc,So EGGPLANT ROLLATINI ASPARAGUS WRAPS Thinly sliced eggplancdipped.ineggsauteed arid rolled.withricotta, crumbled gorgonzola and basil served atop a creamy pesto.Topped Grilled jumbo asparagus wrapped and baked with provolone,prosciutto blend of five Italian cheeses.$u and finished with a drizzle of barrel aged balsamic.$cz Insalate ANTIPASTO(FOR TWO) CAESAR Aicsclun greens with a mixture otchopped Italian cheeses and Radian meals Crisp ronraine lettuce served in our Caesar dressing,topped.with an with tomatoes,red onions,tricolored Bell peppers,kalamata olives,sliced assortment of baked crourons.$8 banana peppers,cucumbers,mushrooms,pepperoncini with a prosciuuo Add marinated white anchovies$,, and provolone stuffed chcny pepper.$14 add chicken breast$6 Add shrimp$3 each ROMAINE WEDGE Halfa head of fresh romaine lettuce topped with avocado slices,diced TUSCAN tomatoes and slivers of almonds.$to Baby arugula served with tomatoes,red onions,kalamata olives,cuc CAPRESE mushroorns,sliced banana peppers,tricolored bell peppers,pancrtr: Mesdun greens with fresh mozzarella and tomato slices seasoned with salt goat cheese.$ro and fresh ground black pepper topped with fresh basil,tricolored hell VILLAGGIO peppers,red onions and sliced banana peppers drizzled.with an extra virgin M'esclun greens served with tomatoes,cttcuntbcas,kalamata olives,s olive oil.$to banana peppers,red onions,mushroorns and tricolored bell peppery: Dressings:Oil arid Vinegar,Italian,7infindel Vinaigrette,Caesar.Low Cart Ranch,Gorgonzola Blue Cheese,Balsamic Zuppa NEW ENGLAND CLAM CHOWDER $6 ITALIAN WEDDING SOUP S6 FRENCH ONION SOUP$7 I We appreciate your patience,all of our entrees are cooked to order.A 20,Y gratuity will be added to all parties 7 or more.S I O split plate fee on all entree tBefore placing your order,please inform your server if a person in your party has a food allergy,The consumption of raw or undercooked foods can inc the possibility of foodborne illness. http://www.villaggiocapecod.com/menu—starters.html 1/21/2015 Villaggio at the Regatta - Italian Specialties, Signature Seafood and Tuscan Steakhouse Page 1 of 1 r Valentine's Day Weekend n Make a Resery ratit1heia io Introducing...our New Lighter Fare Tap Room Menu gg Italian Specialties • Signature Seafood • Tuscan Steakhouse REGATTA Historical Cape Cod Dining at its Very Best HOME STARTERS ITALIAN SPECIALTIES SIGNATURE SEAFOOD TUSCAN STEAKHOUSE ABOUT US MENU Italian Specialties Entrees WINE LIST ,911dinnerenrr-l%esaa•serred e•idr c'nurd7aiceaFoneofriretblloseing: MAR$ALA TAVERN [' eraLl ofdc an Ki.rrn SreakFrrs 1lashcdlortue, orl' to s a h rti;,Ei r urn{Pennr (+r 71r r7 Zerruarn i tvirh otrr COMM)Sauce. (-/ricken$e TIC,] WEDDINGS& _lrrlo c(.Xie, Sautled with tgarlic,shallors,portabello mushrooms and fresh[taliar FUNCTIONS ;Ilfredo or'Era 1?i310lo---$2 simmered it)a marsala vino denti-glace. P GALLERY ICCATA q ("hrrken$r,Vert$�p OUR HISTORY Sauteed with garlic.shallots.fresh Italian herbs and capers.simmeed - w-bite vino lemon burger sauce. DIRECTIONS t ` ' f OSCAR CONTACT US Chicken$2SVe.J$:o ' r Served with gr itled aspar anus,topped with fresh lobster meat and fir RESERVATIONS c Lxn withazestyhollandaiseudfriedonionshoestrings. ` SALTIMBOCCA Chick Szj t'el:�'7 " l z r Sautc.td with s tge,garlic ant[shallots,then layered with Prosciutto,s and Provolone cheese.and baked in a marsala vino demi-lace. �r SCARPARIELLO °`.} •.-" "` Chicken$25T'eJS7Shring2k$) PARM IGIANA Sauteed with garlic,shallots.chopped tomatoes,sliced banana peep. spicy Indian sausage.simmered in a roasted.red pepper c earn sauce I Chicken$z V`a/,524 with a hire of spicy chilli puree. Bala d in our tomato s.urc C t 0pped With a blend of five 1 ralian cheeses. Pasta Sauce;Choices Our Family'[-omar.i,Pcstq,At;lio,1?ra lliavolo,tiotognes; { Cirbormt a.,Alfiedo Add Meatballs$4 a s r t Add Sweet or Hot Sausages$r Add Chicken Breast$( a Add Broccoli$3 Add Shrimp$-,each We appreciate your patience;all of our entrees are cooked to order.A 20%gratuity will be added to all parties 7 or more.S 10 split plate fee on all entree 1'Before placing your order,please inform your server if a person in your party has a food allergy.The consumption of raw or undercooked foods can inc the possibility of foodborne illness. Villaggio at the Regatta on Cape Cod 14631 Falmouth Road(Route 28),Cotuit MA 02635 1 508-548-5000 O Video Tour mangia®villaggiocapecod.com I Open Daily Year Round,Bar Opens at 4pm,Serving Dinner at 5pm O Alison Caron De http://www.villaggiocapecod.com/menu_italian_specialties.html 1 .1/21/2015 Villaggio at the Regatta- Italian Specialties, Signature Seafood and Tuscan Steakhouse Page 1 of 1 1 1 Valentine's Day Weekend n v Make a Reser 111aO; Introducing...our New Lighter Fare Tap Room Menu gg11 Italian Specialties Signature Seafood • Tuscan Steakhouse dt the REGATTA Historical Cape Cod Dining at its Very Best HOME STARTERS IT.ALIAN SPECIALTIES SIGNATURE SEAFOOD TUSCAN STEAKHOUSE ABOUT US M MENU Signature Seafood rt �� a13�'a, ',ti • i WINE LIST Entrees TAVERN All dinn renrr�es,teeserrciivhhvourcbei ,ofoneofnccfrUcurng: *s ° WEDDINGS& [<ge,rcJ��ofl �rl','Kr.tree,,4reaklrrs..l,lashcdl'ot.arrx� orAtstr y ; FUNCTIONS Penile, (x�pellux Ferrucrinrj wirh our rornaro.sau.e, GALLERY Addracnal.,aucecduoicetercourFa Pr sni.AddHol?gnese. rrq.aklioeOlio, Alfredo or Era Diavolo -V2 OUR HISTORY SALMON MACADAMIA DIRECTIONS $alLtton filler dipped ilia light qg wash and soared with macadamia nur bread crumbs,sauteed(golden brown and finished wirh a 1Yt;tcadami;i Nut CONTACT US Liqueur,sun-dried tomato:und butter create Sauce.$z7 RESERVATIONS SEAFOOD ZINGARELLA SHRIMP SCAMPI Lobster meat,jumbo shrimp and sea scallops sauteed with;asparagus, Five jumbo shrimp sauteed will,garlic,shallots,chopped tomatoes an artichoke hearts and sun-dried totatoes,shnrnered in a S:ainirvca cream fresh Italian herbs simnnercd in a white vino lemon butter sauce,serve sauce served over pasta.$3S pasta.$16 PANCELLA SCALLOPS CACCIUCCO Fresh sea scallops sauteed with garlic,shallots,fresh Italian herbs and Tuscan seafood stew with scallops,jumbo shrimp,calamari and shelle chopped pancetr.served over pasta with a white Vine lemon butter sauce. clams,sinunered in a tomato saffron and white vino broth,served ove $z8 pasta.$35 HADDOCK TOSCANA SALMON FLORENTINE Fillet of haddock baked with lemon.whire vino and parmesan cracker Char-grilled salmon fillet.topped with sauteed spinach,chopped toms crumbs,topped with chopped tomatoes and kalamata olives.$as and crumbled gorgonzola,finished with a drizzle of barrel aged balsan $2S SEAFOOD FRA DIAVOLO Lobster meat with scallops and shrimp simmered in our fret-diavolo sauce served over pasta finished with tried.onion shoestrings.$34 LOBSTER RAVIOLI Six jumbo raviolis stuffed and topped with lobster meat.sundried.tcnnaroes and fresh basil,finished in a port wine and lobster cream sauce.$;z We appreciate your patience,all of our entrees are cooked to order.A 20%gratuity will be added to all parties 7 or more s to split plate fee on all entree tBefore placing your order,please inform your server if a person in your party has a food allergy.The consumption of raw or undercooked foods can inc the possibility of foodborne illness. Villaggio at the Regatta on Cape Cod 14631 Falmouth Road(Route 28),Cotuit MA 02635 1 508-548-5000 © Video Tour mangia@villaggiocapecod.com I Open Daily Year Round,Bar Opens at 4pm,Serving Dinner at 5pm O Alison Caron De http://www.villaggiocapecod.com/menu—Signature_seafood.html 1/21/2015 Villaggio at the Regatta - Italian Specialties, Signature Seafood and Tuscan Steakhouse Page 1 of 1 Valentine's Day Weekend P Make a Resery ratit1hela ioi, Introducing...our New Lighter Fare Tap Room Menu gg Italian Specialties • Signature Seafood • Tuscan Steakhouse REGATTA Historical Cape Cod Dining at its Very Best HOME STARTERS ITALIAN SPECIALTIES SIGNATURE SEAFOOD TUSCAN STEAKHOUSE ABOUT US MENU Tuscan Steakhouse Entrees WINE LIST Fare=red cool center TAVERN x Medium Rare=red warn center " Medium=pink center WEDDINGS& Medium Well=slightly pink center FUNCTIONS Well=cooled through S GALLERY `F Illoftheentreci to the%hareser�?d terrbfredonron.ihrzrstr:nk.ia M ''3 chwc'eoftheK'Vlo in,sducs:arsrrho11widtise,BearmMFeoracgn OUR HISTORY porcinirnuihrourupepprrcorttdcnzr,lace. DIRECTIONS I CRISPY DUCK BREAST (..Descent panes Long Island seared boneless breast of duck Finished CONTACT US balsamic demi glace with sun dried tomatoes.SA RESERVATIONS , f PORK OSSO BUCO i6oz.pork shank baked in our corriato sauce with fresh ludian herbs. 9.1,'dirvze:renn'r,leesarezo rcz^cf sihrourrlroiceat me ofrlrefi.11orrnnR: PORK CHOP PIZZAIOLA G leo[dre dat;Risotto,Sreakfh n hlhslz LPosux>Cs,urPastx (,Spat hettr L.rrx,urm;Penuc,�,.1?pcllrnx,1 ertur rne;with our tomato sauce^. rzi+z.char grilled.?t�taine Family Farm pork drop tricolored bell peel: Additions; sort.choh'r,to r'your fntsm. l dd Bar'c,,rxsre. Olio, onions and pottahello mushrooms,simmered in a chianti tomato sa with a hint of gushed red pepper,served Deer pasta.$a.l Aliicdo or 1--hi LNa volo—,Sz Out hi ,eh t rSl;:>A Prime i uuralrin�,,us bmild tl BRACIOLA brJ a;ed/LrcrweeAstoprcrrdsasuperiorfizlld.ncredrasreaud Plank steak rolled with pro:sciucto and provolone,filled with garlic,! tcnde rues.;.Priced to market.(:heck with roar server. golden raisins,pine nuts,chopped egg and fresh ltali:ut her scut?inl simmered in our tomato sauce.$ S 9 OZ. FILET MIGNON 14 OZ. NEW YORK SIRLOIN 22 OZ. BONE-IN DELMONICO STEAK We appreciate your patience.all of our entrees are cooked to order.A 201,gratuity will be added to all parties 7 or more.c l0 split plate fee on all entree ,Before placing your order.please inform your server if a person in your party has a food allergy.The consumption of raw or undercooked foods can inc the possibility of foodborne illness. Villaggio at the Regatta on Cape Cod 14631 Falmouth Road(Route 28),Cotuit MA 02635 1 508-548-5000 © Video Tour mangia'Pvillaggiocapecod.com I Open Daily Year Round,Bar Opens at 4pm,Serving Dinner at 5pm ©Alison Caron De http://www.villaggiocapecod.com/menu—tuscan—steakhouse.html 1/21/2015 I oaa ' 4 I I 1 I J---------------------- L___=vl I r ,aa v- a c ____I�_______________ _ LF - O y F 4 a�• 1 t 4 O A Q O J BI' 11 11 �pmyH m' z G -_� 00 <0 o 00 I I , Z � IIII r I I N v m 0� � m G) x I I � I I v_ z O z N O Ir r ; < n, C7m z=2 m O mfs - Crnn-ImO�OS cnc�o�a�y G] �F4 � -1r�-Zm2rn_m -«z?<�z NDOD -- �ryC �T1 Czj C rz 0 n C, r1 r OO 0 p p p -� p p p p m r O rnp�nm 2C ju� m m m .� ° z z z z z z i p czm� rnn D C r Gl m GZ1 Gz'i m m C� O n T m m a a u a o V) o w< mOx Z ♦Nn O m m 6i GAi = N z _ ,,o c O r �Z(n v, z o m m m w ,n �= n.1 3 m z z p 1 cn _E v� O�Z T 0 m { '� X o p o m o ,n � v T Z Z C I Z (� D r ti w m 0 N w a w nl .11 D n car. O '" A z o m z v n Z C o Z O cs N x r- 0 c r m rD- D C w o 'A 0 m o iv A A in 0 y m � Z z W 1 K D m 0. yn eo G) m - o x X � z N m 9 m 3 N r m T 2 Z a D j° A NEW REMODELING FOR; BQ�COTUIT BAY DESIGN, L N D 43 BREWSTER ROAD �M I. o m VILLAGIO RESTAURANT PH.(5 E 2 4-A1166649 4631 FALMOUTH ROAD COTUIT, MA OI C. P t- Ca 2 N-i>OOC mpm, 'o omr 77 'n � 'o00 DT ti n0y, 1y OC m iyp�9izOC § �rDr ODC a3 r mcoo Cam~ZZ 04 O ;DOZm <C 2 maZ L)m3y p< � O_p1 a^ m R C) O Z CZ> m�Z0<Z Ir 0mPomoy0a: � 1 mr�-; A o- 0.2, O N_ �yN O fZ11 f2f1'�1R G O Gf NOD >, v Z m?F O 000� N X m o a z O Z to C m D 1no WG Z ' x m y "CO V7 V O -z o- O oa pC # O ON m J O- a � O II m z c m NCD-iy� P n m m- 104 X.-m rt C L� L O z ? m- Q7 2 0 2 N y m 2 1 O m z m >� = Z O 0r C m�z I= Z a C 2 r S a G7 O m T r v 9 00 n 2 O �� sZM. D m Z GZi m z m z rn 00 Ax O Q 0 z i m T 1 Z m C m n Z � �1 O m � o I� 9 O O o o? _ a O O m Z OLL a m O z 0 r O O r - Z z D Z a 2 o w z y D co Z o C7 co mrn r m 1� A NEW REMODELING FOR; eF-<®COTUIT BAY DESIGN, LI Y N D 43 BREWSTER ROAD m VILLAGIO RESTAURANT PH.(508)2 4A1166649 4631 FALMOUTH ROAD COTUIT, MA NOTICE OF.PUBLIC HEARING ALTERATION OF PREMISES ON AN ALL ALCOHOL COMMON VICTUALLER LICENSE Application of Danny Kay's Cu- linary Productions, Inc. d/b/a Villaggio Ristorante, 4631 Fal- mouth Rd., Cotuit, John Bartolomei, Manager for an Al- teration of Premises description of the existing premises.Altera- tion of premise is for re- allocation of seats to the bar area from the dining room.No addi- tional capacity is being request- ed. New Description: A two and one-half story building located at 4631 Falmouth Road,Cotuit with 2 floors consisting of a restau- rant, bar and lounge, kitchen with basement and attic for stor.. age. Restaurant on first floor seating 71,including bar with 23 seats. Upper level dining seating 55 and outside seasonal patio with five tables seating 20. All changes approved by the Building Commissioner on 5/9/19. Said hearing will be held on Monday,June 10,2019 at,9:30 a.m. or as soon following as practical in the Town Hall.Build- ing, 2nd Floor Hearing Room, 367 Main Street,Hyannis. Martin E.Hoxie,Chairperson Ron Semprini David Nunheimer Larry Decker Nancy Karlson-Lidman David A Hirsch Barnstable Licensing Authority 5/17/19 1 The Commonwealth of Massachusetts Alcoholic Beverages Control Commission ❑ For Reconsideration LICENSING AUTHORITY CERTIFICATION Barnstable 00329-RS-0070 TRANSACTION TYPE(Please check all relevant transactions): City/Town ABCC License Number The license applicant petitions the Licensing Authorities to approve the following transactions: ❑ New License ❑ Change of Location Change of Class(i.e.Annual/Seasonal) 9 P ❑ g ❑ Chan e Corporate Structure li.e.corPntq ❑ Transfer of License Alteration of Licensed Premises ❑ Change of License Type(i.e.club/restaurant) ❑ Pledge of Collateral(i.e.License/stock) ❑ Change of Manager ❑ Change Corporate Name ❑ Change of Category(i.e.All Alcohol/Wine,Malt) ❑ Management/operating Agreement ❑ Change of Officers/ Change of Ownership Interest ❑ Issuance/Transfer of Stock/New Stockholder ❑ Change of Hours Directors/LLC Managers ❑ (LLC Members/LLP Partners, Trustees) ❑Other ❑ Change of DBA APPLICANT INFORMATION Name of Licensee Danny Kay's Culinary Productions Inc. DBA [Villaggio Ristorante Street Address 4631 Falmouth Rd.,Cotuit,MA 02635 ❑ ❑ Manager John Bartolomei Granted under Yes No Legislation? §12 Restaurant Annual [All Alcoholic Beverages If Yes,Chapter Tvoe Class Cateaory of the Acts of(year) (i.e.restaurant,package store) (Annual or Seasonal) (i.e.Wines and Malts/All Alcohol) DESCRIPTION OF PREMISES Complete description of the licensed premises A two and one-half story building located at 4631 Falmouth Road,Cotuit with 2 floors consisting of a restaurant,bar and lounge,kitchen with basement and attic for storage. Restaurant on first floor seating 71,including bar with 23 seats. Upper level dining seating 55 and outside seasonal patio with five tables seating 20. LOCAL LICENSING AUTHORITY INFORMATION Application filed with the LLA: Date Time Advertised Yes ❑X No ❑ Date Published Publication 5/17/19 [Barnstable Patriot Abutters Notified: Yes Q No ❑ Date of Notice 5/21/19 Date APPROVED by LLA 06/10/2019 Decision of the LLA Approves this Application Additional remarks or conditions (E.g. Days and hours) For Transfers ONLY: Seller License Number: Seller Name: Alcoholic Beverages Control Commission The Local Licensing u Ralph Sacramone Executive Director ��r✓lo�%tv� /Voo � VIZIM 00 \�-•^ 1 r Main r TO rA P. Kitchen atio 48' x 'I 8' ',17� ✓ , _ =r , j 5-, c fe 4. .n5 CL IMP �.,Z1 1, ' � Z i E 3 Via;a� P A �`� r l� O F 1 i • f TIN a _ 87 ® rl45) ef , 69 ev ell; SC Soo, I f � �k,D o i V Bellaire, Dianna From: Miorandi, Donna Sent: Thursday, January 02, 2020 10:35 AM To: Bellaire, Dianna Cc: Scali, Richard; Parvin, Lindsay; McKean, Thomas; Flynn, Margaret Subject: RE:Villaggio Hi Dianna: Tom and I and some staff have discussed this along Maggie Flynn, Richard Scali and Lindsay Parvin. I guess it didn't go to site plan review for tis restaurant. However, Brian Florence signed off on the architectural plans submitted for a total of 146 seats. I have obtained those plans and put in file (Health Restaurant file). The plans that are in our file allegedly shows old floor plan showing he was removing nine (9) dining seats and adding them to the new bar going from 14 seats at bar to 23 seats thereby an increase of 9 seats to bar. This would not have netted an increase to the total number of seats. Tom McKean I believe is going to have them come to the Board of Health via a letter he shall have Sharon write and mail. Donna From: Bellaire, Dianna Sent: Monday, December 23, 2019 8:50 AM To: Miorandi, Donna Cc: Bellaire, Dianna Subject: RE: Villaggio Okay, please let me know, because he wants a new permit with new seating. Thank you. 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 From: Miorandi, Donna Sent: Friday, December 20, 2019 1:26 PM To: Bellaire, Dianna Subject: Re: Villaggio Oh no-one he was t taking away 7 seats in restaurant to add 7 seats to bar if my memory serves me right. I can check building permit later Donna Sent from my tablet -------- Original Message -------- i From:"Bellaire, Dianna" SentTri, 20 Dec 2019 12:52:56 -0500 To:"Miorandi, Donna" Cc:"Bellaire, Dianna" Subject:Villaggio Importance:High Hi Donna; I received a call from the owner and he stated our permit is wrong for seating. He stated he had a renovation and an increase in seats. Can you please tell me what the correct seating is? If it was allowed? He stated he has a whole new dining area. 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 2 BAXTER & NYE, INC. . Registered Land Surveyors and Civil Engineers 7 Parker Road/Osterville,Massachusetts 02655/Tel.(617.)428-9131 WIII IAM C.NYE,RLS.-President RICHARD A.BAXTER,RLS.-Vice President PETER SULLIVAN,P.E.-Vice President-Engineering November 30 , 1987 Mr ryan M. rantz 463 Falmouth Cotuit, MA 02635 RE : Septic Evaluation Regatta Restuarant Crocker House Dear Mr . Brantz : Per your request I have made an evaluation of the existing septic system at the Regatta Restaurant. The. existing system consists of a grease trap, a septic tank, • a distribution box and 4 leach pits. Based upon field measurements, the components have the following capacities: Component Capacity(gallons) Seat Potential Per Component Grease Trap 1680 ll? ( 15 GPD a Septic Tank 5250 100 ( 35 GPD&50% ) Leach Pits ( 4 ) 3256 93 ( 35 GPD) The seat potential is based upon Title 5 allowable daily flows, Sections 15 . 02 ( 13 Volume of Sanitary Sewage and 15 .06 ( 1) Septic Tank , Capacities. If .you were to add one leach pit ( for a total of 5 pits ) you could increase the seat potential per component to 116 . If you have any questions, please do not hesitate to call me. Very truly yours, T .c..., Peter Sullivan P. E. F 0 Baxter & Nye, Inc. `: L PS/fmj MEMBERS OF CAPE COD SOCIETY OF PROFESSIONAL ENGIrIEERB AND LAND SURVEYORS/AMERICAN CONGRESS ON SURVEYING AND MAPPING MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGOVEERS -r-. ��`�'z".L �`rit��S'ttiP�/. . . ���s.� ems- � �f,..<s•a �y i�0�gss r V 1'� - � '4- � �'i ���)�♦�11�y ii$ N'-'J �"�i��' C�//a9 �� � =�'�L fib. � �`� IIN YX RV 24 z I �'I f F I 1 tiY,�•,,.,9,+r � 1 ��s�•-+A.. r �j � - •,,. �i,a� �E �J1 •�_ - -��_,_,_.-:-r 12i�K3i��lu _� - � r � n 1210"�ISZ�.'I� i �1, 0(`� 'A 6 7�'/1�1�(�iJ�J �1 ' I Ir .•a: t a �s.�?�`�'rc'1. _ r 10 F ..N Ada dim rg d r; iI r7�6,;"}, � '. ^S� `•`• i'�'`1�,�.!a:�+bp+tt:p K" t r• . Y t•s !'= -y; J WIN ©2018-Town of Barnstable-ParcelLookup 4/4 t . F Parcel:024-157 Location:4631 FALMOUTH ROAD/RTE 28,Cotuit Owner:P&P COTUIT LLC Parcel Developer lot: Road index 024-157 LOTS 1 &2 0522 Location Fire district Secondary road -4631 FALMOUTH ROAD/RTE 28 Cotuit :e Village Interactive map Cotuit r g r Town sewer at address w = I`---� No V_Owner. P&P COTUIT LLC Owner Co-Owner Book page P&P COTUIT LLC 26882/347 Streett Street2 74 CLARENDON STREET STE A City State Zip Country BOSTON MA 02116 r_ Land Acres Use Zoning Neighborhood 2.28 REST/CLUBS MDL-94 RF C105 Topography Street factor Town Zone of Contribution SPLIT(parcel is split between districts and should be looked up on the map) Utilities Location factor State Zone of Contribution IN r_ Construction v_ Building 1 oft m Year built Roof structure Heat type 1790 Gable/Hip Hot Water I i Living area Roof cover Heat fuelx 4367 Asph/F GIs/Cmp Oily 'ens Gross area Exterior wall AC type 5733 Clapboard Central a. " ' Style Interior wall Bedrooms , *$ Restaurant Plastered,Drywall 00 Model Interior floor Bath rooms 3 7 Commercial Pine/Soft Wood 0 Full-0 Half ` s Grade Foundation Total rooms BUY � Custom Minus Stone Walls - -- - Stories 2 r_ Permit History Permit Issue Date Purpose Number Amount InspectionDate Comments 07/31/2019 Sid/Wind/Roof/Door 19-2403 $3,500 siding 04/29/2019 Alt-Int work-Comm 19-936 $10,000 Remove old Bar and Build new one,same area 04/19/20.13 Commercial 201301168 .$11,000 06/30/2013 ROOF REPAIR-REPLC TRIM 3 VANITIES,2 WINDS,SOME SHTRCK,STORMDR,PULL STAIRS 06/25/2010 Repair Work 201003131 $2,000 06/30./2011 REPL ROTTEN TRIM,SIDING,SIDE DOOR 07/10/2008 Repair Work 200803701 $1,000 06/30/2011 EXPIRED-ROT CLAPBD&DOOR 12/01/1989 Remodel B33417 $3,006 01/15/1990 CO ALTER 02/02/1984 Commercial B26109 $20,000 06/15/1985 316 S 11/02/1982 Commercial B24598 $38,000 06/15/1983 CO 880 S V_ Sale History Line Sale Date Owner Book/Page Sale Price 1/4 Line Sale Date Owner Book/Page Sale Price 1 11/26/2012 P&P COTUIT LLC 26882/347 $350,000 2 11/29/2006 1V�FIZELL,WELDON R TR _ _ 21562/235 $1,000,000 3 08/15/1987 BRYAN MOTOR INN INC 5873/18 $679,500 4 05/15/1983. PENDOLARI,DENNIS J TR. 3742/294 $0 .. v_ Assessment History Save# Year Building Value; " XF Value OB Value Land Value Total Parcel Value 1 2020 $540,500 $21,500 $73,600 $229,400 $865,000 2 2019 $540,500 $21,500 $77,300 $229,400 $868,700 3 2018 $525,100 $21,500 $79,200 $229,400 $855,200 4 2017 $511,100 $22,600 $80,700. $229,400 $843,800 5 2016 $511,100 $22,600 $80,700 $229,400 $843,800 6 2015 $511,500. $21,200 $28,600 $134,660 $695,900 7 20.14 $511,500 $21,200 $29,300 $134,600 $696,600 8 2013 $511,500 $21,200 $30,000 $134,600 . $697,300 9 2012 $361,400 $18,500 $2,700 $485,300 $867,900 10 2011 $335,600 $0 $2,900 $485,300 $823,800 11 2010 $835,600 $0 $3,100 $485,300 $824,000 12 2009 $335,600 $0 $3,200"" $460,100 r V$798,900 13 2008 $472,200 $0 t $6,300 $460,100 _ $938,600 15 2007 $380,800 $0 $6,300 $256,800 $643,900 ~ 16 2006 $556,100 $0 $1,400" : $256,800 _v. $814,300 17 2005 $472,800 $0 $1,400 $256,800 �- $731,000 18 2004 $411,500 $0 $1,400 $128,400 $541,300 19 2003 $236,900 $0 $1,400: $192,600 $430,900 " 20 2002 $236,900 $0 $1,400 4 $192,600 __ $430,900 21 2001 $236,900 $0 $1,400 $192,600 $430,900 22 2000 $226,300 $0 $1,400 $122,500 $350,200 23 1999 $226,300 $0 $1,400 $122,500 $350,200 24 1998 $226,300:. $0 $1,400 $122,500 $350,200 25 1997 $293,700 $0 $0 $61,300 $356,400 26 1996 $293,700 $0 $0 $61,300 $356,400 27 1995 _ $293,700 _ $0 $0 $61,300 $356,400 28 1994 $280,100 $0 $0 $84,100 $365,600 29 1993 $280,100 $0 $0 $84,700 $366,200 30 1992 $319,400 $0 $0 $93,400 $414,300 31 1991 $532,100 $09 $0 $129,800 $663,400 32 1990 $532,100 $0: $0 $129,800 $663,400 33 1989 - $532,100 $0' $0 $129,800 $663,400 34 1988 $240,400 $0 $0 $104,200 $346,000 35 1987 $240,400 $0 $0 $104,200 $346,000 36 1986 $246,400 $0 $0 $104,200 $346,000 37 1985 $0 $0 $0 $6 $0 r v_ Photos 2/4 FEB 2�2................... THE COMMONWEALTH OF MASSACHUS-.TTS BOARD OF HEALTH 0 v ol ................. OF...... ........................ Appliratiou for Uhiposal Morkii Tonstrurtion thrutit CIA plication is hereby made for a Permit to Construct (Y,) or Repair an Individual Sewage Disposal System at: WTIJ I ... ......................................... ..................Vaurm...... T... ........................................... ................................ Iocation-Add or Lot No. ........................b0pi4j:AN................ .... ....................*............................................................................ Address ..................... ... ..I...................................... ..................................................................................................59..t..ip Installer Address Type of Building Size Lot----4-4e.1.4,60...Sq. feet Dwelling—No. of Bedrooms.............S............................Expansion Attic Garbage Grinder ( ) PL4 Other—Type of Building No. of pers'ons..'1'5..5.!9A-r1--- Showers Cafeteria ( ) Otherfixtures ...................................................................................................................................................... Design Flow..............$5.......................gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity.4, gallons Length................ Width-_____-____.____ Diameter_-__--__--______ Depth.....__.._..._.. Disposal Trench—No..................... Width.......i............ Total Length............. .... Total leaching area....................sq. ft. Seepage Pit No......_4-------- iameter........1 ..... Depth below inlet.......4 ........ Total leaching area.l&q�_]Msq. ft. Z Other Distribution box ( DosiE&tank ( ) Percolation Test Results Performed Date.... .............. ......... ........ Test Pit No. 1......�.__�..minutes per inch Depth of Test Pit......17L-------- Depth to ground water..___.*. .............. Test Pit No. 2.......—Z—minutes per inch Depth of Test Pit.......17V.... Depth to ground water..................... ............................................................................................................................................................ 0 Description of Soil----------------or-#------------------------- ............................ ..... ................................................................... .................................................................. ----------------------------*.....*-------------- ............... ........................................................................................................................................................I............................... U Nature of Repairs or Alterations—Answer when applicable------------------------------------------------------------------------ ...................... .............................................I........................................................................... ............................................................................ Agreement: The undersigned agrees to install the aforede ed Individu S age Dispo.%al System in accordance with the provisions of 771'HE 5 of the Stale SanitaryThe and si ed further es not to place the system in operation until a Certificate of Compliance ha e ued t rd of health. Si . . ....................................ARXI .................................. ................................ Date Application Approved By...... .......... Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date • THE COMMONWEALTH OF MASSACHUSETTS 4. �,. BOARD OF HEALTH ................OF..: , .t .!Z:!`.,1'� -/ � .,. .... Astp irFation for Biovoii al Works Tonstrnrtion rrmit Application is hereby.made for a Permit to Construct ( *A) or Repair ( ) an Individual SewaF Disposal System at: ..... - __... 4L.L im.. ------•--......".. .1......_i..... ........................ c ........ �C7 I_ - .� ..... Location-Addres or Lot No. ►bra .......................�a,21.... caner I Address W a -------------------- ..... .. . - ....--- nstaller Address L . d Type of Building Size Lot.__46,4�4__ Sq. feet Dwelling—No. of Bedrooms_____________S...........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ( tv Sin ul? t,1 t. No. of persons....S... _._ Showers ( ) — Cafeteria ( ) a' Other fixtures W Design Flow..............5_!_......................gallons per person per day. Total daily flow____.__._.____._______________.___._..._._..gal Ions . WSeptic Tank—Liquid capacity_ tDgallons Length................ Width................ Diameter--------------__ Depth................ x Disposal Trench—No..................... Width.....__I__._........ Total Length.............. Total leaching area....................sq. ft. Seepage Pit No________ ________ Diameter--------- � r-._._. Depth below inlet ........ Total leaching area._t. -sq. ft. Z Other Distribution box ( ✓� Dosing tank ( ) Percolation Test Results Performed by—� .IL:€I<�-__. ._llil�________ _:�.�! � __ Date_._._�_�_:: n:: `__..___. a Test Pit No. 1......:" _minutes per inch Depth of Test Pit_.._._ 7L�..... Depth to ground water......"'r_____________ Lt, Test Pit No. 2....... Z.._minutes per inch Depth of Test Pit--------C�... Depth to ground water_--___!_____________ 9 •---•-----------------------------------•----------•---••-------....-----....._........-----•------.......................................................... O Description of Soil-------------------.......................... tf................................I--- ti ------------------------ •----------------- •----------- •----------- W -----------------------------------------------•------------------------------------------••-_._..__...-------•-_.._..--••-----------•-••---.......................................................... U Nature of Repairs or Alterations—Answer when applicable................................................................................................ Agreement The undersigned agrees to install the aforede ed IndividuajPS age Dispo 1 System in accordance with the provisions of TITLi; 5 of the State Sanitary The unders ed further es not to place the system in operation until a Certificate of Compliance has a issued by the°t5�afd of health. jjjjjj Sig + ...... ..................... •----- •-•._......_..._- * Date Application Approved By.. -a. �_,�`� � e�,. ��'Q�eZ.• Date Application Disapproved for the following reasons-------------•----------•----------------------•--------------•-------------•----•------------------•--------•--- ..............•----•.........._._...----...--•--••---•••-•---------••--•••------••...---•--•-••-••------------•_._._.__..••---•---•-•-----•-•--------•------•••---------•••---•---••-------•----•---•--. Date PermitNo.......................................................- Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....TOW L3 ..................OF..................................... . ...._......._............ ..... Tntifiratr of Tifutpfinnrr THIS IS >, CERTIFY That the,Individual Sewage Disposal System constructed Y% or Repaired g P -�' ( ) ( ) `- Installer at.__ ------ ------ has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_...a.2__-_> _.__.__ d< ____________________________________________ THE ISSUANC OF THIS CERTIFICATE SHALL NOT BE CONST E S A GUARANTEE THAT THE SYSTEM )VI F TION SATISFACTORY.- -- .,j DATE--- ... -•-=�-1 •......... ------------------------------------------------ Inspector--- ......................-------�---.....-•-----................................ THE COMMONWEALTH OF MASSA USETTS BOARD OF HEALTH . 0F._.........� IC is No.. - - r ^ • _................................. FEE...... J .'�w•.... i oo�t1 orh T nptn Winn rrmit Permission is hereby granted ,.: ....... ---....... to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No... - ..... .,T..•--•--...F_. I/I-0.*-----" �E.. .------- s .................................. Street as shown on the application for Disposal Works Construction Permit No..................... Dated..................___.................... Board of Health DATE----�---•-----••------••-------•----•-•-•---••..................•-----_:_........ i �� FORM 1255 HOBBS & WARREN, INC..,, PUBLISHERS I �$ !p LCJ4V 5 � Z 1 LC I � �� b G9•-a. MAP s.4 � ; k'XP• I 1 tu I 3 +jamb%'`✓��j l "� _Z i. . o G�' ' S aAT ! � � Flo G'P'�•�g��w� '' 330 �.• � ��� . 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