HomeMy WebLinkAboutYING'S - FOOD YING'S 3 z-7. O&k
59 CENTER ST. , HYANNIS`
R
FLE�o BOARD OF HEALTH
Town of Barnstable
Or John T. Norman
Board of Health Donald A.Gaudagnoli,M.D.
¢ARNST ID F.P.(Thomas)Lee,.
MASS. 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D. Alt.
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: 160 Issue Date: 01/01/2022
DBA: YING'S
OWNER. R &Y ENTERPRISES, INC
Location of Establishment: 59 CENTER STREET HYANNIS„ MA 02601
Type of Business Permit: FOOD SERVICE
Annual: YES Seasonal:
IndoorSeating: 48 OutdoorSeating: 25 Total Seating: 73
FEES
FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022
RETAIL FOOD:
COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022
B&B-FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBI-E-FOOD:
MOBILE- ICE CREAM: G��
FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent
FOR ESTABLISHMENTS WITH SEATING:
i PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE
t
Restrictions:
:.,�,Iuitials:,
`"E' � Town of Barnstable
�I * Inspectional Services
* BARMAS& E, Y / I
" Check_#_.__����, y1�/
9`�OIE1659. 0� Public Health Division
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT
DATE 12/01/2021 NEW OWNERSHIP RENEWAL X
NAME OF FOOD ESTABLISHMENT: YINGS SUSHI BAR& LOUNGE
ADDRESS OF FOOD ESTABLISHMENT: 59 CENTER STREET,HYANNIS MA 02601
MAILING ADDRESS(IF DIFFERENT FROM ABOVE):
E-MAIL ADDRESS: TANIDAYPJ@GMAIL.COM
TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5( O8 ) 790 - 2432
TOTAL NUMBER OF BATHROOMS: 4
WELL WATER: YES NO X ...(ANNUAL WATER ANALYSIS REQUIRED)
ANNUAL: X SEASONAL: DATES OF OPERATION:_/_/_ TO
yy t ;�r - -
NUMBER OF SEATS: INSIDE: 48 OUTSIDE: 26 TOTAL:
SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV.
***OUTSIDE DINING REMINDER***
OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING
REQUIREMENTS.
IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? YES
IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? YES
TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW)
X FOOD SERVICE
RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer)
BED&BREAKFAST
CONTINENTAL BREAKFAST
COTTAGE FOOD INDUSTRY(formerly residential kitchen)
MOBILE FOOD
FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED)
CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2)
*** SEASONAL,MOBILE & NEW FOOD ONLY***
REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED
PLEASE CALL 508-862-4644
Q:\Application FormsTOODAPP 2020.doc
f
OWNER INFORMATION:
FULL NAME OF APPLICANT TANIDA SURIYAWONG
SOLE OWNER: YES/NO OWNER PHONE # 617-982-4974
ADDRESS 28 MAY LN CENTERVILLE MA 02632
CORPORATE OWNER: R AND Y ENTERPRISES INC
CORPORATE ADDRESS: 59 CENTER STREET HYANNIS MA 02601 ,y(
PERSON IN CHARGE OF DAILY OPERATIONS: PORNIPA SUTTHIMAITREE
List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff
All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT.
**ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You
must provide new copies and POST THE CERTIFICATES at your food establishment.
Certified Food Managers Expiration Date Allergen Awareness Expiration Date
1, PORNIPA SUTTHIMAITREE 02 / 1 /2024 1 PORNIPA SUTTHIMAITRE4)?/118 /2024
70—
aaas2. DIANA SOUZA 11 / 12 /2025
Digitally signed byTanida
Suriyawong
o =DN:cn=Tanida Suriyawong,o,ou,
w},zs� gemail=tanidaypj@gmail.com,c=US
Date:2021.12.14 13:20:43-05'00'
SIGNATURE OF APPLICANT DATE
***FOOD POLICY INFORMATION"*
*
SEASONAL FOOD SERVICE: Ail 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 I st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN
THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC Ist.
Q:\Application FormsTOODAPP REV3-2019.doc
' BOARD OF HEALTH
� Town of Barnstable
Ire,
John T.Norman
r }}1 Board of Health Donald A.Gaudagnoli,M.D.
1J Paul J.Canniff,D.M.D.
111"�j\A Hyannis,
200 Main Street, Hy MA 02601 F.P. Thomas Lee Alternate
a" 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: 160 Issue Date: 01/01/2021
DBA: YING'S
OWNER: R &Y ENTERPRISES, INC
Location of Establishment: 59 CENTER STREET HYANNIS, MA 02601
Type of Business Permit: FOOD SERVICE
Annual: YES Seasonal:
IndoorSeating: .48 OutdoorSeating: 25 Total Seating: 73
FEES
FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021
RETAIL FOOD:
COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021
B&B- FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBILE-FOOD:
MOBILE-ICE CREAM: Q�
FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent
FOR ESTABLISHMENTS WITH SEATING:
PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE
Restrictiions:
I
o$I KX Town of Barnstable BOARD OF HEALTH
John T.Norman
Board of Health Donald A.Guadagnoli,M.D.
aAn.NSTAB F.P.(Thomas)Lee
Daniel Luczkow,
:43� ti� 200 Main Street, Hyannis, MA 02601
Alternate
Phone: (508) 862-4644 Fax: (508)790-6304
www.townofbarnstable.us
Permit to Sell Tobacco
In accordance with regulations promulgated under authority granted by Sections 5,31 and 127A of the General
Laws of the Commonwealth of Massachusetts and Chapter 371 of the Town of Barnstable Code, a permit is
hereby granted to:
Permit No: 160 Issue Date: 1/1/2021
DBA: YING'S
OWNER: R&Y ENTERPRISES, INC
Location of Establishment: 59 CENTER STREET HY NIS MA 026
L)
Type of Business Permit: Non-Flavor ,
Annual Seasonal /
FEES YEAR: 2021
TOBACCO SALES: $85.
Permit Expires: 12/31/2021
Thomas A. McKean, RS, CHO, Health Agent
Restrictions:
PLEASE POST CONSPICUOUSLY
°lime . Town of Barnstable For Office Initial�. _
Q' Date Paid 74 $
MASS. ; Inspectional Services
39. Public Health Division check# p 1 too
Thomas McKean,Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT
DATE 11/25/2020 NEW OWNERSHIP RENEWAL X
NAME OF FOOD ESTABLISHMENT: YING'S SUSHI BAR & LOUNGE
ADDRESS OF FOOD ESTABLISHMENT: 59 CENTER STREET, HYANNIS MA 02601
MAILING ADDRESS(IF DIFFERENT FROM ABOVE):
E-MAILADDRESS: TANIDAYPJ@GMAIL.COM
TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (,JM-M- 2432
TOTAL NUMBER OF BATHROOMS: 4
WELL WATER:YES NO X ...(ANNUAL WATER ANALYSIS REQUIRED)
ANNUAL: X SEASONAL: DATES OF OPERATION:_/_/ TO
NUMBER OF SEATS: INSIDE: -fZ OUTSIDE: _ 5 TOTAL: 92
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? YES
IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? YES
TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW)
—X—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 508-862-46"
Q:\Application Foms\F00DAPP REV3-2019.doc
OWNER INFORMATION:
FULL NAME OF APPLICANT TANIDA SURIYAWONG
SOLE OWNER: XMWO OWNER PHONE# (50R) 241-5992
ADDRESS 29 MAY L111 CENTERVILLE MA 0 6 2
CORPORATE OWNER: SAME
CORPORATE ADDRESS: 59 CFNTER STREET HYANNIS MA 02601
PERSON IN CHARGE OF DAILY OPERATIONS:
List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff
All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT.
**ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You
must provide new copies and POST THE CERTIFICATES at your food establishment.
Certified Food.Managers Expiration Date Allergen Awareness Expiration Date
1.PORNIPA SUTTIMAITREE FEB - 2924 1. PORNIPA SUTTIMAITREE / DEC 42024
2. DIANA SOUZA NOV - 2.025
12/01/2020
SIGNATURE OF APPLICANT DATE
***FOOD POLICY INFORMATION***
SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div.
prior to oaeniw!!' Please call Health Div.at 508-8624644 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/apt)lications.asy.
OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited.
NOTICE: Permits run annually from January 1 st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN
THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st.
Q:\Application Forms\FOODAPP REV3-2019.doc
f I^1
+ `1
Bellaire, Dianna
From: Tanida Suriyawong <tanidaypj@gmail.com>
Sent: Wednesday, December 02, 2020 11:12 AM
To: Bellaire, Dianna
a Subject: Re: 2021 Food Permit and Tobacco Permit rmit
Hello. We mailed a check on Monday for$300 dollars for the food service permit only. You should receive the
check today or tomorrow.
We won't be selling tobacco products this year.
Thank you
Regards,
Ying's Management
On Wed, Dec 2, 2020 at 10:10 AM Bellaire, Dianna<Dianna.Bellairegtown.barnstable.ma.us>wrote:
Hi,
Did you mail in the payment for this permit? Please let me know. We received your application by
fax. However, I didn't receive your tobacco application. Are you not selling tobacco this year? I've attached
the application for your to review. Please send in the completed application with copies of your MA Cigarette
Licenses, Cigar License and there is a new one. If you sell any kind of e-cigarettes, vaping juices or the
I systems thatt deliver those systems, I need a copy of that license. If you DON'T sell those items, I need a reply
email that states what you don't sell.
1
The fee for restaurant is $250.00 and the fee for tobacco is $85.00. Please send in with TWO SEPARATE
E checks. These are not combined anymore due to state regulation.
i
Thank you.
I
Dianna Bellaire
i
Permit Technician
Town of Barnstable
Health Division
i
200 Main Street
I i i
Hyannis, MA 02601
i
Bellaire, Dianna
From: Tanida Suriyawong <tanidaypj@gmail.com>
Sent: Wednesday, December 02, 2020 11:26 AM
To: Bellaire, Dianna
Subject: Re: 2021 Food Permit and Tobacco Permit
Yes. Not a problem. All the tobacco products were the flavors for hookah pipes and the hookahs themselves.
All removed from the premises back in April.
On Wed, Dec 2, 2020 at 11:16 AM Bellaire, Dianna<Dianna.Bellairegtown.barnstable.ma.us> wrote:
Hi,
Okay, there will probably be a county inspector to verify that you have removed the tobacco. I have to alert the county
inspector when tobacco is removed or sold.
I will look for the check. Thank you.
Dianna Bellaire
Permit Technician
Town of Barnstable
Health Division
200 Main Street
Hyannis, MA 02601
P:508-862-4643
Fax:508-790-E.304
Email:Dianna.Bellaire@town.barnstable.ma.us
ahe information contained in this electronic transmission("e-mail"),including any attachment(the"Information"),may be confidential or
otherwise exempt from disclosure.It is for the addressee only.This Information may be privileged and confidential work..product or a
p.rivileged and.confidential communication.The.Information may also be,deliberative arid.pre-decisional in iiature.._-1.s such.,it.is for
internal use onk.'The Information may not be disclosed without the prior written consent of the Lllirector of Public Health and;or the
Town Atto.rney's Office of the Town of Barnstable. If you have received this e-mail by mistake,please notify the sender and delete it from
your system. Please do riot copy or forward it."Thank you.for your cooperation.
1
From: Tanida Suriyawong [mailto:tanidayQj(g ail.com]
Sent: Wednesday, December 02, 2020 11:12 AM
To: Bellaire, Dianna
Subject: Re: 2021 Food Permit and Tobacco Permit
Hello. We mailed a check on Monday for $300 dollars for the food service permit only. You should receive the
check today or tomorrow.
We won't be selling tobacco products this year.
Thank you
Regards,
Ying's Management
On Wed, Dec 2, 2020 at 10:10 AM Bellaire, Dianna<Dianna.Bellairegtown.barnstable.ma.us>wrote:
Hi,
Did you mail in the payment for this permit? Please let me know. We received your application by
z fax. However, I didn't receive your tobacco application. Are you not selling tobacco this year? I've attached
the application for your to review. Please send in the completed application with copies of your MA Cigarette
Licenses, Cigar License and there is a new one. If you sell any kind of e-cigarettes, vaping juices or the
systems that deliver those systems, I need a copy of that license. If you DON'T sell those items, I need a
reply email that states what you don't sell.
The fee for restaurant is $250.00 and the fee for tobacco is $85.00. Please send in with TWO SEPARATE
checks. These are not combined anymore due to state regulation.
! l
t
' l
l
Thank you.
3
Dianna Bellaire
2
Town of Barnstable BOARD OF HEALTH
John T.Norman
Board of Health Donald A.Gaudagnoli,M.D.
HARNSUBM Paul J.Canniff,D.M.D.
MAM a 1 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate
D1N � 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, 3058, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to:
Permit No: 160 Issue Date: 12/10/2019
DBA: YING'S
OWNER: R &Y ENTERPRISES, INC
Location of Establishment: 59 CENTER STREET HYANNIS, MA 02601
Type of Business Permit: FOOD SERVICE
Annual: YES Seasonal:
IndoorSeating: 48 OutdoorSeating: 25 Total Seating: 73
FEES
FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2020
RETAIL FOOD:
COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020
B&B-FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBILE-FOOD:
MOBILE-ICE CREAM: CQ�
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:
For Office Use_Only_ Initials: ' }
Town of Barnstable
t DatePsid ��/� �p��'���—
Inspectional Services1- 1
�. p
Public Health ' Check#
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT
DATE 12/19/2019 NEW OWNERSHIP RENEWAL X
NAME OF FOOD ESTABLISHMENT: YING'S SUSHI BAR & LOUNGE
ADDRESS OF FOOD ESTABLISHMENT: 59 CENTER STREET, HYANNIS MA 02601
3
MAILING ADDRESS(IF DIFFERENT FROM ABOVE):
E-MAIL ADDRESS: TANIDAYPJ@GMAIL.COM
TELEPHONE NUMBER OF FOOD ESTABLISHMENT: 5c 08 790 _ 2432
11
TOTAL NUMBER OF BATHROOMS: 4
WELL WATER:YES NO X ...(ANNUAL WATER ANALYSIS REQUIRED)
ANNUAL: X SEASONAL: DATES OF OPERATION: / / TO
NUMBER OF SEATS: INSIDE:AS F OUTSIDE: 26 TOTAL:
SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV.
***OUTSIDE DINING REMINDER***
OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING
REQUIREMENTS.
IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? YES
IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? YES
TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW)
X 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)
X TOBACCO SALES...(ANNUAL TOBACCO SALES APPLICATION REQUIRED)
***_SEASONAL,MOBILE & NEW FOOD ONLY***
REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED
Q\Application FormsTOODAPPREV2018.doc
PLEASE CALL 508-8624644
OWNER INFORMATION:
FULL NAME OF APPLICANT TANIDA SURIYAWONG
SOLE OWNER: YES/NO OWNER PHONE# 508-241-5892
ADDRESS 28 MAY LN, CENTERVILLE MA 02632
CORPORATE OWNER:R&Y ENTERPRISES INC.FEDERAL ID NO.:
CORPORATE ADDRESS: 59 CENTER STREET, HYANNIS MA 02601
PERSON IN CHARGE OF DAILY OPERATIONS: PORNIPA SUTTHIMAITREE
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 Manners Expiration Date Allergen Awareness Expiration Date
1.PORNIPA SUTTHIMAITREE 02 / 09 /2024 1. PORNIPA SUTTHIMAITREE 1?/18/20?4
2. OLGA RYBAKOVA 04 / 12 /2022
,9 , 12 /19 / 2019
SIGNATURE OF APPLICANT DATE
***FOOD POLICY INFORMATION***
SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div.
prior to opening!! Please call Health Div.at 508-8624644 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://wwiv.townofbarnstable.us/healthdivision/applications.asp.
OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited.
TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and
Employee Signature Form.
NOTICE: Permits run annually from January 1 st to Dec.31'each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN
THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC ist.
QAApplication Fom sTOODAPPREV2018.doc
I
Town of Barnstable For Office Use Only: Initials:
Date Paid Amt Pd$
Inspectional Services
BA"STAB .P Check# Cash
639. Public Health Division
200 Mama Street, Hyannis MA 02601
Office: 598-7934644 Thomas A.McKean,RS,CHO
FAX: 508-790-6304 Director of Public Health
Fee: $85.00
MAIL TO:TOWN OF BARNSTABLE
PUBLIC HEALTH DIVISION
200 Main Street
HYANNIS,MA 02601
FAX 508 790-6304
PLEASE INCLUDE THE REQUIRED FEE OF$85.00
APPLICATION FOR A TOBACCO SALES PERMIT
YING'S SUSHI BAR & LOUNGE
ESTABLISHMENT NAME (D/B/A)
59 CENTER STREET, HYANNIS MA 02601
ADDRESS OF BUSINESS
MAILING ADDRESS (IF DIFFERENT FROM ABOVE)
SURIYAWONG , TANIDA
TANIDAYPJ@GMAIL.COM 508-241-5892
EMAIL PHONE# FEDERAL ID#
Da,you currently possess a state license to sell tobacco products?
YesX No
Each employee who sells tobacco products must receive and understand Chapter 371 of
the Town of Barnstable Code (copy provided herein) and the Massachusetts General
Law Chapter 270, Section 6.00 (a copy is provided on the next page). Each employee
who sells tobacco products must sign the Employee Signature Form (provided
herein).
Signature °� Date
12/19/2019
C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\YZOF4J38\TOBACCO APP2019 dob.docx
ESTABLISI MENT'S NAME
TOBACCO SALES
Employee Signature Form
This form is for official use to indicate that the employee(s) of this establishment received and
understood Chapter 371 of the Town of Barnstable Code and Chapter 270 Section 6 of the
Massachusetts General Laws which describes the penalties for selling and/or giving tobacco
products to any person under the age of twenty-one (21). Below is Section 371-9. of the Town of
Barnstable Board of Health Regulation:
Sales to Minors—6 371-9.Sale and Distribution of Tobacco Products.
1. No person shall sell or provide a tobacco product, as defined herein,to a person under
The minimum legal sales age. The minimum legal sales age in the Town of Barnstable
is 21 years of age.
2. Identification: Each person selling or distributing tobacco products, as defined herein,
shall verify the age of the purchaser by means of a valid government-issued photographic
identification containing the bearer's date of birth that the purchaser is 21 years old or
older. Verification is required for any person under the age of 27.
The following employee(s) received and understood Section 371-9 of the Town of Barnstable
Board of Health Prohibition of Smoking Regulation and Chapter 270 Section 6 of the
Massachusetts General Laws:
'7 Al SO 67 12 1&
Signature Printed Name ` Date
Printed Name Date
V Di
a e Printed Name Date
S►v�`�Por�►�► ���� 121�g�19
Signature Printed Name Date
Signature Printed Name Date
Signature Printed Name Date
Signature Printed Name Date
C:\Users\decollik\AppData\Local\Microsoft\Windows\IIdetCache\Content.Outlook\YZOF4J38\TOBACCO APP2019 dob.docx
a= F Town of Barnstable BOARD OF HEALTH
John T.Norman
Board of Health Donald A.Guadagnoli,M.D.
RNA Paul J.Canniff,D.M.D.
MMA F.P. Thomas Lee Alternate
200 Main Street, Hyannis, MA 02601
Phone: (508) 862-4644 Fax: (508)790-6304
www.townofbarnstable.us
Permit to Sell Tobacco
In accordance with regulations promulgated under authority granted by Sections 5,31 and 127A of the General
Laws of the Commonwealth of Massachusetts and Chapter 371 of the Town of Barnstable Code, a permit is
hereby granted to:
Permit No: 160 Issue Date: 1/1/2020
DBA: YING'S
OWNER: R &Y ENTERPRISES, INC
Location of Establishment: 59 CENTER STREET HYANNIS, MA 02601
Type of Business Permit: Non-Flavored
Annual _X Seasonal
FEES YEAR: 2020
TOBACCO SALES: $85.00
Permit Expires: 12/31/2020
G?n
Thomas A. McKean, RS, CHO, Health Agent
Restrictions:
PLEASE POST CONSPICUOUSLY
J
6NQ
pFTHE roy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: ) Page: of
OFFICE HOURS
PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
BARNSTABLE. 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
v Meyq. `0 HYANNIS, MA 02601 MON.-FRi. No Reference R-Red Item PLEASE PRINT CLEARLY
508 862 4644
FOOD ESTABLISHMENT INSPE TION REPORT
Name Dat Tyne of Tyme of-Ins ec ion
Operation(s) outme
Address Risk Food Service e-ins t/S
TIN
Level Retail Previous Inspection J/
Telephone i7 --- l Residential Kitchen Date:
C/ Mobile Pre=operation
Owner HACCP Y/N Temporary Suspect Illness
Caterer General Complaint
HACCP
Person in Charge PIC)t` a Bed&Breakfast Other t'
Inspector Y v`
Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. n
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) ❑ LL
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 A �
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS [/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 _
FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures aL
❑ 5.Receiving/Condition ❑ 17.Reheating L
❑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 �O
i
❑ 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) T
Corrective Action Required: N
Non-critical(N)violations must be corrected immediately or Overall Rating
within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ mplo ee estric WE lusion ❑ Re-inspection hedule Emergency Suspens6on
C N Official Order for Correction:Based on an inspection today,the items
checked indicate violations of 105 CMR 590.000/Federal Food Code. F] Embargo ❑ mergency o u ary al e
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.
FC-4 590.005 p y B=One critical violation and less than 4non-critical violations 9
25.Equipment and Utensils ( )( ) 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 o 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 i non-critical. If f critical water,sewage back-up,infestation of rodents or insects,or lack of
FC-7 590.008 be in writing and submitted to the Board of Health at the above address violations observed,7 ti anon-critical violations. If 1 critical refrigeration.
28.Poisonous or Toxic Materials ( )( ) 9 violation,4 to Snon-critical violations=C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dump er 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 qgnature 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* 1 3-501.15 Cooling Methods for PHFs
2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 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* 590.004(F)
2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.t I Common Name-Working Containers*
3-501.16(A). Hot PHFs Maintained At or Above 140°F*
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above l30°F*
Applicants* 7-201.11 Separation-Storage*
PP 3-302.1 I(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-SOL19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use*
3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements
590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions*
3 590.003(D) lExclusions and Restrictions* 7-204.1 I Sanitizers,Criteria-Chemicals*
3-306.14(A)(B)Returned Food and Reservice of Food* REQUIREMENTS FOR
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
7-206.13 Tracking Powders,Pest Control and
3-201.13 Fluid Milk and Milk Products* 4-501.112 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. Water* Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of
g 3-401.11 A(1)(2) Eggs-155°F 15 sec
5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
Equipment* Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game * E/r m,e///201
4602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Pathogens
590.006(B) Water Meets Standards in 310 CMR 22.ou Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(t)(2) Pork and Beef Roast-130°F 121 min*
4-702.11 Frequency rf Eggs*
Sanitization of Utensils and Food
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec*
Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009 A Violations of Section 590.009 A
* Ratites-165°F 15 sec* ( )-(D) ( )-(D)in cater-
Sources 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential
Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
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 i Reheating for Hot Holding practices should be debited under#29-Special
5 Recelving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D)PHFs 165°F 15 sec* Requirements.
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30)
12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne
3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the
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
3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F
3-203.12 Shellstock Identification Maintained*
Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004
3-402.12 Records,Creation and Retention* 5-205.1 I Accessibility,Operation and Maintenance
Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005
Within 4 Hours
590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 2 Water,Plumbing and Waste FC-5 .00
27.. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 1Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision
3-502.11 Specialized Processing Methods* 30. Special Requirements 009
. 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.
�p1NE rok, TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page:.. of
P. do OFFICE HOURS
PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
$ARNS•fABLEpi` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
MASS. MON.-FRI.
P CLEARLY
No Reference R-Re Item LEASE PRINT CLEAR
�p ib79,p�m HYANNIS, MA 02601 sos-ssz-4saa
e ence d
'FD1A`� FOOD ESTABLISHMENT INSPECTION REPORT
Name Dat Type of Tyne of Inspection
0gerationig =.-ingpectio
Addres4 RiskIf V od Service Level Retail nspection
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:
La C
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) ❑ D
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
1
❑ 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 9�( �i�
❑ 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 El 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 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
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.
590.009 within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C,
29.Special Requirements - ( )
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view
Permit Posted? y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Si je n Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted. Y_" N
Dumpster Screen? Y N
».� _�-..�. � �.i' K ..tea; �. ... - y.:r -, ..,��-:2^:.. .•`�"*r.,s"stYa'.'�..c'�-'�'!�.r r°.-;i+..,,+,,..,,.^' �' t._'�±^ _ _ _.. _ ,� �`
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*
5910.003(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
__ 15 590.004(F)- 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 590.003(C) Responsibility of the-Person-in-Charge to 7-101.11 Identifying Information-Original Containers*
2
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F*- _ _ 7-102.11 Common Name-Working Containers*
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F*
Applicants* 3=302.1 7-201.11 Separation-Storage*1(A) Food Protection* P g 20 Time as a Public Health Control
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use*
590.003(G) Repo ing.by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* 590.004(11) Variance Requirements
xt _
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 WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
F590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated
r -- - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* _ 4-501.111 - - Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
Y P 7-206.13 Tracking Powders,Pest Control and
3-201.13 Fluid Milk-and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* 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
n Surfaces Foods That are Raw Undercooked or
5-101.11 _ Drinking Water from an Approved System*_ 4 601.11(A) Clean Utensils and Food Contact Su aces of
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* Ery cti-11112001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards iri 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-1 1 min Eggs*
4-702.11 • Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155 155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* - 3-40L11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or -
3-201.15 i Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
Ratites-165°F 15 sec*
Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential
Game and Wild Mushrooms Approved By _ * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 - Shellstock Identification Present* 2-301.12. Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail
3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special
Requirements.
5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23.30)
3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the Foodborne
3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-03.11(E) Remaining Unsliced Portions of Beef Roasts*
illness interventions and risk factors listed above,can be found in the
8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
13 Handwashin Facilities 3-501.14 A CoolingCooked 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[0 41°F/45°F
5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
Tags/Records:Fish Products
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* 126. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision
29. 1 Special Requirements 009
3-502.11 Specialized Processing Methods* 130. 1 Other
i
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 IHE roN, TOWN OF BARNSTABLE .HEALTH INSPECTOR'S Establishment Name: Date: Page:. of
ti 'OFFICE HOURS
AR^ NEoz PUBLIC
200 MA N STREET DIVISION a:oo-s:3oA.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
3:30-4:30 P.M.
9$p M47q:a 0� HYANNIS, MA 02601 MON.-FRi. No Reference R-Red Item PLEASE PRINT CLEARLY
rF0 MAi 508-862�644
FOOD ESTABLISHMENT INSPECTION REPORT
Name Dater ; ~0�+69 of Type of Inspection �.
Routine
Address I Risk Foo ervice ection
Level a ai ction
Telephone Residential Kitchen Date:
Mobile Pre-operation
Owner HACCP YIN Temporary Suspect Illness
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP l faU
In: Other
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 1
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❑ yg c P act ces ❑ g ,
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 Q 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 re(FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations ardless of the number of critical,results in an F.
Equipment and Utensils 590.005
25.E ui (FC-4 6=One critical violation and less than Orion-critical violations 9
q p )( ) 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
FC-6 590A07 aggrieved b this order, ou have a right to a hearing. Your request must C=2 rritiral 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 ( )( ) gg Y Y 9 g q
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 8rion-critical violations. If 1 critical refrigeration.
590.009 within 10 days of receipt of this order. violation;4 to 8 non-critical violations=C.
29.Special.Requirements ( )
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PICature Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y NCS� <:4'C"9QV li
Dumpster Screen? Y N
e '
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 °ry PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
1 .003 A A i nment of Responsibility* Cross contamination Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours*
590 ( ) ss g8 14
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* 19 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* 590.004(F)
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F*
2 590.003(C) Responsibility of the Person-in-Charge[o - 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-Stora e*
Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control
7-202.11 Restriction-Presence and Use*
590.003(F) _ Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements
590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3-304.11 Food Contact with Equipment and Utensils*-
tensils 7-203.11 Toxic Containers-Prohibitions* ( ) q
` - -
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 Adulterated or Contaminated
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B).Compliance with Food Law* 4-501.111 - Manual Warewashing-Hot Water 17.206.12 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* 3-401.11A(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*
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg c"°°uuzom
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
Chemical Stuffing Containing Fish,Meat,Poultry or -( ) 590.009(A)-( )-
3-201.15 Molluscan Shellfish from NSSP Listed * 590.009(A) D Violations of Section D to cater-
Ratites-165°F 15 sec*
Sources* 10 Proper,Adequate Handwashing - ing,mobile food,temporary and residential
Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* 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 77 Reheating for Hot Holding practices should be debited under#29-Special
2 401.11 Eating, Requirements.
5 Receiving/Condition g,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2401.12 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* * (Blue Items 23-30)
3-202.15 Package Integrity g g 3-403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome
3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts*
illness interventions and risk factors listed above,can be found in the
6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
* 13 Handwashing Facilities 3-501.14 A g
3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F
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 FC-7 1.008
HACCP Plans 6-301.12 1 Hand Drying Provision
29 1 Special Requirements 1.009
3-502.11 Specialized Processing Methods* 30. Other
3-502.12 1 Reduced-Oxygen Packaging Criteria*
8-103.12 1 Conformance with Approved Procedures* S..590Formback6-2doc
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
°p IKE r TOWN OF BARNSTABLE - .. HEALTH INSPECTORS Establishment Name: Date: Page: of
'l OFFICE HOURS
PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
&RNSfAB1:1!. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
MONM639• .0�� HYANNIS,MA 02601 508-8 -FRI.62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY - -
"rFn MAC°, 8-8 _
FOOD ESTABLISHMENT INSPECTION REPORT
Name Dat T of Tvoe of Inspection C
O a i n Routine
Address Risk oo rvic -nspecti n
Leve etail ion
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 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)
1714.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
1718.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.
FC-4 590.005 6=One critical violation and less than 4non-critical violations 9
.25.Equipment and Utensils ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically o 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 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) 9 violation,4 to Snon-critiCal violations=C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from,public view
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's e
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N �® 6? �
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, 590.004(F)
. 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F*
2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers*
Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage*
3-501.16(A) Roasts Held At or Above 130'F
Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*
3-304.11 Food Contact with Equipment and Utensils
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* Variance 590.004(11) 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 Reated or of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 17.206.12 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 Pe 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* I SanitizationTemperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of
3-202.16 Ice Made From Potable Drinking Water* 3 401.11A(1)(2) Eggs-Immediate
is sec Animal Foods That are Raw,Undercooked or
5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec*
PP Y Not Otherwise Processed to Eliminate
Equipment* ( )( ) Pathogens
590.006(A) Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meats&Game * ery cnw 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 Hr/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 Shelistock 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* * Other 590.hou violations relating to good retail
( ) * 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec practices should be debited under#29-Special
3-201.17 Game Animals* 11M590.004(E)-
ood Hygienic Practices 17 Reheating for Hot Holding
Requirements.
5 Receiving/Condition ating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* ischarges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* (Blue Items 23-30)
3-202.15 Package Integrity* reventing Contamination When Tasting 3-40311(C) Commercially Processed RTE Food-140'F*
g gntY Critical and non-critical violations,which do not relate to the foodbome
* 12revention of Contamination from Hands 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk actors listed above,can be and in the
3-101.11 Food Safe and Unadulterated f fo
8 Tags/Records:Shelistock reventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
3-202.18 Shelistock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F
Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F item Good Retail Practices FC 1590.000
3-203.12 Shellstock Identification Maintained*
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* R28. Poisonous
nagement and Personnel FC-2 .003
5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient od and Food Protection FC-3 .004
3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F uipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* ter,Plumbing and Waste FC-5 .006
Supplied with Soap and hand Drying Devices
590.004(J) labeling of Ingredients' ysical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 1 Hand Drying Provision A. Special Requirements .009
3-502.11 Specialized Processing Methods* 30. Other
3-502.12 Reduced-Oxygen.Packaging Criteria*
8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc
*Denotes critical 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.
HEATH INSPECTOR•s Establishment Name: Date Pa e: of
oF. r TOWN OF BARNSTABLE OFFICE HOURS 9
PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
i BAINSTABLE. •. 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
MASS. dgMON� HYANNIS,MA 02601 08-8 -FPo.62-4644 58-8 No Reference R-Red Item PLEASE PRINT CLEA p t63q•s
rFDN1P� FOOD ESTABLISHMENT INSPECTION REPORT f
Name I " Date TRe Of -Troe of Inspection C�
r Routine
Address Risk food Service
/ Level Previous Inspection l
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 ✓` 14 h
In: Other
l `
Inspector Out:
Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. p
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 / f
❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities [!J
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS
❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives (/ /L (/ ( W
❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals
FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) r
❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures \
❑5.Receiving/Condition ❑ 17.Reheating \ Q�lit
❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling
❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding VXrZS
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control. L
❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) V
❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP
❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY vV
❑ 11.Good H ( Cn 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 r .19
within 90 da s as determined b the Board of Health. Overall Rating E - Voluntary Compliance y y � ❑ ry p ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction:Based on an inspection today,the items Embargo
checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ ❑ Emergency Closure Other:
Voluntary Disposal ❑
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 andno 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 6 non-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot
C=2 critical violations and less than 9 non critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must
violations observed,7 to anon-critical violations. If 1 critical refrigeration.
28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address
violation,4 to 8pon-critical violations C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
=
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' Sig re Print: q
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N
Dumpster Screen? Y N `�J
s '
Violations related to Foodborne Illness Violations Related to foodborne Illness Interventions
Interventions and Risk Factors(Red Items 142) 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
590.004(F) * °F/45°F
EMPLOYEE HEALTH. 3-302.11(A)(2).Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*
590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers*
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F*
2
Require Reporting by Food Employees and Contamination from the Environment 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*
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 1590.004(11) Variance Re uirements
3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* q
590.003(G) Reporting by Person in Charge* Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Reared orce,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*
q Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004 A-B) Compliance with Food Law* * 3-801.11(D). Raw or Partially Cooked Animal Food and
( P 4-501.111 Manual Warewashing-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 Warewashing-Hot Water Monitoring* 3-801:11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIMEfTEMPERATURE CONTROLS
3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.111 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.I IA(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145*F 15 sec* Animal Foods That are Raw,Undercooked or
5-101.11 Drinking Water from an Approved System* gg 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 r f cesSanitizationquof 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 StuffingContaining Fish,Meat,Poultry or
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
Sowces* 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 3401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165'F* 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 practices should be debited under#29-Special
3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding
Requirements.
2-401.11 Eating,Drinking or Using Tobacco* 3-403.11 A&D PHFs 165°F 15 sec*
$ Receiving/Condition � ( ) ( )
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 Ite n n 30)
3-202.15 Package Integrity Critical and d noon-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 o followin8 sections P Cooling PHFs i o the Food Code and 105 CMR 590.000
3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70`F
Conveniently Located and Accessible Within 2 Hours and From 70°F to 41*F/45`F item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained*
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 P28.
Food and Food Protection FC-3 .004
3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F Equipment and Utensils FC-4 .005
* 5-205.11 Accessibility,Operation and Maintenance
3-402.12 Records,Creation and Retention Within 4 Hours Water,Plumbing and Waste FC-5 .006
Supplied with Soap and hand Drying Devices
590.004(J) Labeling of Ingredients* Physical Facility FC-6 .007
7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision Special Requirements3-502.11 Specialized Processing Methods* 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.o00. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
�F THE r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: DateIPLAN
OFFICE HOURS
PUBLIC HEALTH DIVISION 8:00-9:30A.M.
200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION / OF CORRECTION a en iednss. HYANNIS,MA02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT C _
i67v n 508 862 4644
FOOD ESTABLISHMENT INSP CTI N REPORT
v( 6- G
Name 7f , Da Tvoe of Tgle o c ion
g Routine
Address Risk/ Food Servjce_ -Re-insc-c iori
al Lev I a,l" 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: t
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 Kam.
Z
❑ 1.PIC Assigned/Knowledgeable'/Duties ❑ 13.Handwash Facilities y
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS- -y( p
❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives
❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals
FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Food )
❑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 Pq
❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP4 CAI
O
❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY
❑ 11,Good Hygienic Practices ❑22.Posting of Consumer Advisories i r Ii
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' 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,t 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
26.Water,Plumbing and Wooto (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6uon-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 violatinns and lass 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.
29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C.
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view G C -
Permit Posted? Y - N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N IC' Signatur Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N
Dumpster Screen Y N
� � .
Violations Related to Foodborne Illness Interventions
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 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 7-201.11 Separation-Storage* 3-501.16(A) Roasts Held At or Above 130*F
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*
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004(11) Variance Requirements
. 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions*
590.003(G) Reporting by Person in Charge* Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rated o of Food 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
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 1 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
q 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 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. L16 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- sec Animal Foods That are Raw,Undercooked or
5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immemedisate 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* Effective 11112001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155*F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155*F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary
and - fide in cater-
Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential
10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Game and Wild Mushrooms Approved By - 2-301.11 Clean Condition-Hands and Arms*
Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301'12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
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
5-202.1
( )
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* V/OLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140*F* (Blue Items 23-30)
3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodbome
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 and in the
3-101.11 Food Safe and Unadulterated* fa fo
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
3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70*F
Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item I Good Retail
3-203.12 Shellstock Identification Maintained* Practices FC 590.000
hers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
Tags/Records:Fish Products 5-203.11 Num
3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004
5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45*F 25. Equipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability
28. Poisonous or Toxic Materials I FC-7 1.008
HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009
3-502.11 Specialized Processing Methods*
30. 1 Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures*
S:590Formback6-2doc
*Denotes critical-item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
oFTHE Tpk e TOWN OF BARNSTABLE. HEALTH INSPECTOR'S Establishment Name: Date: Page: of
ti OFFICE HOURS
PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
ennnsrneLe. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
MONMASS. �• HYANNIS,MA02601 -FRI.
+bs9• 508-862-4644 NO Reference -R-Red Item PLEASE PRINT CLEARLY
9�a a 8$
'FDN1P� FOOD ESTABLISHMENT INSPECTION REPORT
Name O Dates ( e of Tvoe of Ins ep ction
�eration(sl Routine
Address Risk (�ood�Sentice� ion /
Level Retail i Previous Inspection • -
Telephone Residential Kitchen Date:
Mobile Pre-operation
Owner HACCP Y/N Temporary Suspect Illness T dL ---
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP
In: Other c
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) ❑ G[
Action as determined by the Board of Health. Allergen Awareness 590.009(G)
J
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 t ot-
FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods)
4.-- - Z
❑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
1_a=
Violations Related to Good Retail Practices(Blue Itemsl Total Number of Critical Violations
Critical(C)violations marked must be corrected immediately. (blue&red items) / t' . Corrective Action Required: ❑ No ❑ Yes
Non-critical(N)violations must be corrected immediately or Overall Rating
within 90 days as determined by the Board of Health. ® Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other:
checked indicate violations of 105 CMR 590.000/Federal Food Code.
23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than 4 non-critical violations
'no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C= critical violations and less than non-critical. If nn critical water,sewage back-up,infestation of rodents or insects,or lack of
27.Physical Facility • (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-cri
28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration.
Within 10 days of receipt of this order. violation,4 to Snon-critical violations=C.
29.Special Requirements (590.009)
30.Other - - DATE OF RE-INSPECTION: Inspector's Sign�ture Print:
31.Dumpster screened from public view
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N 's Signat Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N
Dumpster Screen Y N
�.-- !'--' - ...♦-. . _ ... ..�. -. } -� � n.-s,.. ,�>. .°��-.Yy y.... -rs _�...-... s_. .- -_ , _ _,... � _..�... .. .. • .. ,. - ..� 'f�9A.r ./a.� __. .>, _ - _ _ - _ a+�_ � •- . - r ,�.6 :..t, - - .r
-
y�. V. e
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*
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F
2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-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* 20 Time as a Public Health Control
Applicants* 3-302.11(A) Food Protection* 7-202.11 Restriction-Presence and Use*
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004(11) Variance Requirements
3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions*
590.003(G) Reporting by Person in Charge* Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions*590.003(E) Removal of Exclusions and Restrictions 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Reser
of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
Disposition of or or Contaminated
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources` 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a 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. 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 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of 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* Effective 11112001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130*F 121 min* Eggs*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 3-40L11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or A)- in cater-
590.009(A)-(D) Violations of Section 590.009(
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 3-001.11(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
02.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
3-2
3-2 2.18 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
Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under M29-Special
3-201.17 Game Animals* 11
Requirements.
5 ReceivingiCondition 2-401.11 Eating,Drinking or Using Tobacco* 3-03.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30)
3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodborne
* 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
3-101.11 Food Safe and Unadulterated fa f
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 to 70°F
3-203.12 Shellstock Identification Maintained*
Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F item Good Retail Practices FC 590.000
Tags/Records:s/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
9 24. Food and Food Protection FC-3 .004
5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient
3-402.11 Parasite Destruction* 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices
6-301.11 Handwashing Cleanser,Availability 2 . Physical Facility FC-6 .00
7 Conformance with Approved Procedures/ 28. Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009
3-502.11 Specialized Processing Methods* 30. Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 1 Conformance with Approved Procedures*
5:590Formback6-2doc
*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.
°FtwE r°,r TOWN OF BARNSTABLE HEALTH INSPECTOR's Establishment Name: yl !? Date: Page:__(of
q 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
MASS. $ MON.-FRI.
�OrF.39. 0 HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY
FOOD ESTABLISHMENT INSPECTION REPORT II
Name Date Tyne of Type of Inspection
1 Routine .2
Address Risk �Service Re-inspection 1
Level 4 L
Previous nsp ction G '^
Telephone Residential Kitchen Date: qql Lin ^ d r L
Mobile Pre-operatio� !� bil
Owner HACCP YIN Temporary Suspect Illness
Caterer eral Complaint
Person in Charge(PIC) Time Bed&Breakfast Q
In: Other
Inspector � n 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) ❑ r r ap,h e,
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 k/t lye f
❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives 00
❑ 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 v, ��� r
❑ 5.Receiving/Condition ❑ 17.Reheating
4-1tv 2. An
❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling
❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding 412 di
PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control
❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) (- 2� O
❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP
El 10.Proper Adequate Handwashing' CONSUMER ADVISORY v
El11.Good Hygienic Practices ❑22.Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations ^ i
Critical(C)violations marked must be corrected immediately. (blue&red items) �1 �v� 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. ( r 1 ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction:Based on an in` a ion today,the ems ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other:
checked indicate violations of 105 CMR 590.000/Federal Food Code.
23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (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
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-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 iiiust C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of
)( ) be in writing and submitted to the Board of Health at the above address violations observed,7 toBnon-critical violations. If 1 critical refrigeration.
28.Poisonous or Toxic Materials •„ (FC-7 590.008 9 violation, to c'tical violations-C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
30.Other DATE OF RE-INSPECTION: Inspector's S nature Pri 1
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 Si u Print:
r
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* 19 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
- 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*
* 7-201.11 Separation-Storage*
Applicants 3-302.11(A) Food Protection* 1 20 Time as a Public Health Control
7-202.11 Restriction-Presence and Use*
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements
3-304.11 Food Contact with Equipment and Utensils * ( ) 9
590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions
Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR,
3-306.14(A)(B)Returned Food and Rrated or of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
Y P 7-206.13 Tracking Powders,Pest Control and
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 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* gg
Equipment* Not Otherwise Processed to Eliminate I
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff°eve//112001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
3-201.15 Molluscan Shellfish from NSSP Listed Chemical*
Ratites-165°F 15 sec* in mobile food,temporary and residential
Sources* 10 Proper,Adequate Handwashing g' Por
�
Game and Wild Mushrooms Approved By 3-40 L11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
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 17 Reheating for Hot Holding practices should be debited under#29-Special
3-201.17 Game Animals* Requirements.
5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30)
3-202.15 Package Integrity ( ) Y
12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodborne
3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the
6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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
3-203.12 Shellstock Identification ( ) Item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F[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�02.12 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 29. Special Requirements .009
3-502.11 Specialized Processing Methods* 30. Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc
'Denotes critical 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 THE rq TOWN OF BARNSTABLE• .HEALTH INSPECTOR's Establishment Name: Vl�,f Date: .Je Page: of/,
ry OFFICE HOURS
R Eo: PUBLIC
2 0 MAN STREET 3:3030-4:30 P.M.DIVISION :00- :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
MASS, g, MON.-FRI.
,639•e m HYANNIS,MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY
'F "' FOOD ESTABLISHMENT INSPECTION REPORT VV G IF i,-e ry k r r
Name Date b Tvoe of o Inspection )
I v p Routine ! v(r)
Address i Risk Food Se ection /I
e Level a al Previous inspection
Telephone1`7 Residential Kitchen Date: 1,
Mobile Pre-opdratid�d /
Owner HACCP YIN Temporary Suspect Illness
Caterer General Complaint f
Person in Charge(PIC) Time Bed&Breakfast HACCP
In: Other
Inspector C. ,Q Out: `
I_
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 a v
Cb
❑ g g ❑ 13.Handwash Facilities
r
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 d/
FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) l G
❑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 SUSCEPTIB,L/f 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 8,red items) PU Corrective Action Required: No ❑ Yes
Non-critical(N)violations must be corrected immediately or Overall Rating If
within 90 days as determined by the Board of Health. ! 1� ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
Official Order for Correction:Based on an inspection today, hie items
C N p ❑ 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 arid 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 g
25.Water,Plumbing and waste (FC-5)(590.00 ) establishment permit and cessation of food establishment operations. 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 violation served,7 to 8 non* I critical violations. If 1 critical refrigeration.
29.Special Requirements (590.009) within 10 days of receipt of this order. violat' 4 to on-critical vioa ons=C.
30.Other DATE OF RE-INSPECTION: Inspe is Signa r r Pr' t: V141
31.Dumpster.screened from public view ;vd �-Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y NVV
Observed g P ign
#Seats Print:
Frozen Dessert Machines: Outside Dining Y N
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 Inform 590.004(F)
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F*
Information-Original Containers* .
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* * 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
3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q
590.003(G) Reporting by Person in Charge* - Contamination from the Consumer
3 590.003(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
r 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 Warewashin Hot Water 17.206.12 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* TIMErrEMPERATURE 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*590.006(A) Bottled Drinking Water* 3-401.11 A 2) Comminuted Fish,Meats&Game g * e ectwe mnoa
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 StuffingContaining Fish,Meat,Poultry or
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary
and - ide in cater-
Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential
10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms*
Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors.
590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail
11 Good Hygienic Practices Reheating Hot Holdinpractices should be debited under#29-Special
3-201.17 Game Animals* 17 for H g 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) Commercially Processed 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
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
3-202.18 Shellstock Identification 13 Handwashing Facilities
* 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to.41°F/45°F Item Good Retail Practices FC 590.000
Tags/Records:Fish Products
5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
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) g g Supplied with Soap and hand Drying Devices
Labeling of Ingredients* 2 Physical Facility FC-6 .00
7 Conformance with Approved Procedures/
6-301.11 Handwashing Cleanser,Availability.
28. Poisonous or Toxic Materials I FC-7 1.008
HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009
3-502.11 Specialized Processing Methods* 130. 1 Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures* VS:590Formback6-2doc
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
�p INF row TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: I ! - Date:' Page:�_of
ti OFFICE HOURS
R"N"�r'a Eo PUB2 0 MAN SH EELIC VTSION 3: - :30A.M.
:300-4:30 P.M.
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
FRI
HYANNIS, MA 02601 M 5088- -62-464644 No Reference R-Red Item PLEASE PRINT CLEARLY
'FO1A1" FOOD ESTABLISHMENT INSPECTION REPORT s:zI
Name Date e o of Inspection r (
f`n a" O er Rou �' s h C.
�r kr,rn
Address � Risk t rVio-od ervice -Fe-inspection
Level Level Previous Inspection
Telephone Residential Kitchen Date: /
Mobile Pre-operation L vh / �
Owner HACCP Y/N Temporary Suspect Illness G �/c ',t v J i r IGV�
Caterer General Complaint
Person in Charge(PIC) Time Bed 8 Breakfast HACCP 30 <. r i- r
In: Other \ �
Inspector w� S Out. n
Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. 27 A/C _ i t
�. 4 V
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 i
[]1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS O , d C/�/
❑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) qq y /
❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures l
❑ 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 8,red items) Corr ctive Action Required: ❑ No Yes
Non-critical(N)violations must be corrected immediately or Overall Rating G
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 re ardiess of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005 B=One critical violation and less than Orion-critical violations g
) 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,Plumbinq 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 hearirry. 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 Matrials. (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8rion-critical violations. If 1 critical refrigeration.
e
29.Special Requirements (590.009) receipt within 10 days of recei t of this order. violation,4 to non-critical violations=C.
30.Other DATE OF RE-INSPECTION: Inspect0 s Sig toe Pr'
31.Dumpster screened from public view ✓r J. vV S
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' natu 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) jAssignment of Responsibility* F 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•fiom Unapproved Additives*
l 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*
* 3-501.16(A) Hot PHFs Maintained At or Above 140°F
Other
2 590.003(C) Responsibility of the Person-in-Charge to j - 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 I 1 Variance Requirements -
3-304.11 Food Contact with Equipment and Utensils * ( ) 9
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,
-
3-306.1.4(A)(B)Returned Food and Reared 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 ' 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004A-B Com liance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and
( ) P --- - - - - -- -- - 4-501:111-- �Manual Warewashing-Hot Water 7.206.12 Rodent Bart 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.'M Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs*_ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
Equipment*
gg Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg r8ve 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* 3A01.11(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 practiceRequies 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 PreventingContamination When Tasting* * (Blue Items 23.30)
3-202.15 Package Integrity* g 3-403.11(C) Commercially Processed Rns Food-Roast 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
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* 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.
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°FI„Erb The Commonwealth of Massachusetts
Town of Barnstable
" 2019 E
Certificate of Inspection
,C
Ying's Sushi Bar & Lounge Certificate No.
Issued to Tanida Suriyawong Type: Certificate of Inspection IC-18-151
Identify property address including street number, name, city or town and country Certificate Expiration
Located at Map/Lot 327-066 4/30/2019
in the Town of Barnstable
59 CENTER STREET, HYANNIS
Location Use Group Classification(s) Allowable Occupant Load
1st A-2: Banquet halls, night clubs, restaurants, bars 85
A-2: Outside/Patio 25
Restrictions 13 Bar Seating 85 Patrons Inside
6 Lounge Seating 11 Employees
12 Standing Bar Area 25-Outside Seating, Two
Areas C"l
-- 22 First Room Seating
6 Waiting
20 Second Room Seating
6 Sushi
This Certificate of inspection is hereby issued by the undersigned to certify that the premise, structure or portion thereof as herein specified has been
inspected for general fire and life safety features. This certificate shall be framed behind clear glass and\or laminated and posted in a conspicious place
within the space as directed by the undersigned, Failure to post or tampering with the contents of the certificate is strictly prohibited.
Name of Municipal Building Commissioner Brian Florence Date of Inspection 6/26/2018
Signature of Municipal Building - Date of Issuance
Commissioner 5/1/2018
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FtRLEpE pTION BUREAU
HIGH S Hnnt
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Cetd-ER
MA 02601
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bq�ti /p d✓rt s
F,/00 r �l
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LOCATION SEWAGE PERMIT NO.
�7�L 9 Cent%L S✓i��-tih,u �z.�S ��5= 7 7 5�-
1�ILLAGE
VNST �A /LLER'S NAME s ADDRESS
I U{ (L, E R OR A N EIt
DATE PERMIT ISSUED
J DATE COMPLIANCE ISSUED
2 [.v
Pee
' o
�000 g%x
t
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
....... ......... .....................OF........................................
ApplirFation for Uhipaii al Marks CLnn,s#.rnrtiun .rrntit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System a i t P45 T,4
...(.?.. _�,� etz✓....1!L! ..........d�r✓ek..�.5'�1-:'., ciq.t�
y .... ...._ ...... `-
Location-ddre s or Lot No.
!�` ......�-,,lp.Lr_.P......... -•----------------------------------- •-•-•-•---�--------•--..�'�i 146C_.'1 r.. ---
Owner Addr
W .. .c-.0 JJ70 �'Ia../.�.... ..... ��z.,fr-
Installer Address
Type of Building Size Lot............................Sq. feet
V Dwelling—No. of Bedrooms................................ .....Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) Cafeteria ( )
dOther fixtures ......................................................-•-•------------------•--------------•-----•--•-------------------.....---.........._..._------
W
Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter-_______.__-..-- Depth................
W Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date...................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to groundwater____._..................
P4 ....----•------------------------------------------------•-•-------....---------•---••-•-•-•.._..............................................................
0 Description of Soil............... -----------.. .......-x. -------•--•--
w
V ure o epairs or Alterations—A`nlwer when ap bleV......._....................................................:........................... ._..
ta! f
✓ ---az.uey----------..K.. . ...... atz f�
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITL1 5 of the State Sanitary Code—.The and slgne rther agrees not to place the system in
operation until a Certificate of Compliance ha i ue t e b rd of healt .
Si e .. .----- ----
ApplicationApproved By.............. . . --- •-- .---• --- -- . . ................................... 5
D to
Application Disapproved for the l owing reasons---------------•----..........................................................................................
-----•..................•--------•-•----......--•---------....------------...-----------••----------...--------------•...--•---.....-------------------------------------------•--------...----••••••-•-
Date
PermitNo..................................------•-------------- Issued.......................................................
Date
No...................... Ficz
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..................... ...................OF..........................................................................................
Appliration fax Dhivviial 19orks Toustrurtion Permit
Application is hereby made.,for a Permit to Construct or Repair an Individual Sewage Disposal
.System at*
. 6u C
..62 . .. .... ......................... ........ .- .......... .
...............
Location ..
-4dd K",% or Lot N
re
................................... . ................ .......... .....�PY e..az.-Id........................
'A Owner Add
..ce.............................................................. ...... ......... .. .................
Installer Address
Type of Building Size Lot............................Sq. feet
U
Dwelling—No. of Bedrooms.............................................Expansion Attic Garbage Grinder
a4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria
Otherfixtures ......................................................................................................................................................
Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
04 Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter.............._. Depth................
Disposal Trench—No. .................... Width.................... Total Length......_............. Total leaching area ...................sq. ft.
Seepage Pit No_____________________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution,box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
14 Test Pit No. 1.........I.......minutesperinch Depth of Test Pit.................... Depth to ground water........................
rXq Test Pit No. 2................minutes per inch Depth of Test Pit................_... Depth to ground water........................
.............................................................................................................................................................
0 Description of Soil................. ........ ...... ... ..
---------------- ...................................V... ..........I-------------
'e ?fe� .........C.,
...........................4.......4� ..... .. ....
--77-` -----------
---------------------------------------------- ................................
.....................................................�i-
U X4. 11re of }repairs or Alterations—An§wer when ap! ble........... - Y
—------------------------------------------------------
...........
..............
Agreement: T,
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TLIT11- 5 of the State Sanitary Code—.The and signed further agrees not to place the system in
operation until a Certificate of Compliance ha b n i ,ue`lc bytjeAbord of health.
Size ... ...... ............... ........ . . ... ......................... .........
Application Approved By.............................\ 0/7D a
................... ....................... ........................................
Date
Application Disapproved for the following reasons:...........................................................................................................---
.......................................................................................................................................................................................................
Date
PermitNo..................................................... Issued....---......... .-•----.......................
Date
THE COMMONWEALTH OF MASSACHUSETTS ev^
3L
BOARD OF HEALTH
..........................................0 F................................ .....:..........................................
Trrfif iratr of Tomplianrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired
by.............................. ................. kiy-9W.............................. ................................................
at..........................6-4/0.1.........(.CA)Itasi -0 Installer "i"
---------- ------*---------------------------------------------------------------------------------------—
E 5 of Th e'
has been installed in ficcor ance with the pro�isions of TITLE e Stat' Sanitary Code as described in the
application for Disposal Works Construction Permit No........I.S.-7-21-71-4...... dated..... ...............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTWER .AS A GIA-RANTEE TJKAT THE
SYSTEM WILL FUNCTION SATISFACTORY.:
..........1. pector..................... )Aj ".�. . ......
DATE................Q..-....ztt5.............. ............. Ins ........
THE COMMONWEALTH OF MASSACHUSE S
BOARD OF HEALTH
I
...........................................OF................................................................................... I
No...................... Fzz
Disposal Vorks Tonstrurtiott Permit
Permission is hereby granted.................C.14.... ..............a..MP ...... ..................................
to Cdrigtiuct r Repair an Individual Sewage Disposal System
...................................................................................
at No................10 ItI.
Street
as shown on the application for Disposal Works Cons
truction Permit No.............. ... Dated..... . Rz�........
.......................... ...............................
oiari--n`TH'�i�......
DATE...............
?................................
FORM 1255 A. M. SULKIN, INC., BOSTON
r VWC -
ENERGY. CORPORATION 350 MAIN ST. W. YARMOUTH MA 02673 775-2800
PLUMBING HEATING SOLAR ENERGY SEPTIC GAS 8 OIL SERVICE SPRINKLERS
November 6, 1985
Messrs Ed Jenkins, Plumbing Inspector ' re: Pasta Perfecto
John Kelley, Board of -Health 6,7-69 Centre St
Town of Barnstable Hyannis MA
367 Main Street
Hyannis MA 02601
Gentlemen;
We contracted with the above lute August to install a 1000-gallon
grease separater tank and related piping; also rough and finish
plumbing and gas piping for connection of water heater. We ap-
plied for and received Board of Hee,Llth Permit 85-774, Plumbing
Permit 1124; and madeapplieation for Gas Permit.
The grease separator and related piping were installed and ins-
pected. Rough plumbing was completed to the extent of our con-
tract, and inspection was made. After the inspection, additional
work was requested and a hand sink was installed- in. the display
case area. We have not called for inspection of this work or for
final inspection of the plumbing work.
As of 6:00 pm Friday., November 1, 1985, we, found that another
plumbing contractor had been hired and had relocated a sink pre.-
vicusly. in Dr. Parker's office to another wall in the doctor's
office to allow for the installation af a walk-in refrigeration
box„ No indirect drain has been installed in the walk.-in box.
A mop sink we had installed was re.noved- by others and placed next
to food preparation equipment,
We will not call for final inspection or release of the Permit due
to changes in our plumbing installation..
Very truly yours,
CANCO ENERGY CORPORATIGN-a;«.,-
J Robert C
JRC:Ssm
C C Half a Century of Service
F
s r ttt,, G n t. Yy
0
FORTFIOUSANDS OF YEARS, THE GREAT CIVILIZATION
OF CHINA SPREAD ITS INFLUENCE THROUGH
VIETNA/\A, LAOS, C,A/\ABOD.IA/ RUKMA/ AN.D ALL
SOUTHEAST A51A THE PEOPLES OF THIS AREA
ADOPTED CHINESE CUISINE AND ITS MILD FLAVORS
IN THAILAND. 7'FIEKE WAS ANO-l"I IEK INFLUENCE
BESI.DES THE CI--fINESE: -1*"I-fF- INFLUENCE OF INDI-A
CULTURE MOVING EASTWARD. RARE AND DELICATE
SPICES OF INDIAN CUISINE FLAVORED TRADITIONAL
CHINESE D1511ES AND CREATED A WHOLE NEW
SPECTRUM OF -rAs-r'ES NEVER BEFORE EXPERIENCED .
THE THAI PEOPLE ADDED THEIR OWN NATIVE SPICES
AND SERVED THEIR FOOD WITH Tl---iE ' UNIQUE
GENTLENESS OF A CULTURE WHERE SERVICE . IS A
FORM OF WORSHIP, NOT ) UST AN ART. THIS IS THE
MAGIC OF THAI CUISINE.
ALL ITEMS ON OLM MEN LI MAY BE ORDERED -1-0 GO.
304/MAIN STREET. HYANN IS/ MA o2_6o-.1
(So8) 862.- .16.16
APPETIZERS
I. VEGETARIAN SPRING ROLLS 4.50
DEEP FRIED SPRING ROLLS STUFFED WITH CABBAGE,
CELERY, CARROT AND SILVER NOODLES
2. BEEF SATAY 6.95
VERY POPULAR THAI DISH PIECE OF BEEF SKEWERED
ON BAMBOO STICK, GRILLED AND SERVED WITH
PEANUT SAUCE CUCUMBER DIPS
3. CHICKEN SATAY 6.95
PIECE OF CHICKEN SKEWERED ON BAMBOO STICK, GRILLED,
SERVED WITH PEANUT SAUCE AND CUCUMBER DIPS
4. FRIED TOFU 4.95
DEEP FRIED TOFU SERVED WITH CUCUMBER SWEET'N SOUR SAUCE
5. MEE GROB 5.95
SWEET CRISPY RICE NOODLES, MIXED WITH SHRIMP ,HOME
MADE TOMATO SAUC.E.AND GREEN ONION, BEAN SPROUTS
6. WINTER SHRIMP 6.95
DELICIOUS WHOLE SHRIMPS WRAPPED IN CRISPY EGG ROLL SKIN
SERVED WITH SWEET'N SOUR SAUCE
7. STEAMED MUSSELS 7.95
FRESH MUSSELS STEAMED IN A POT WITH HERBS SPICE S AND
WINE SERVED WITH HOUSE SPECIAL THAI CHILI SAUCE
r
J,
SOUP
8. VEGGIE SOUP 3.25
9. TOM YUM GOONG 3.95
HOT AND SOUR SHRIMP SOUP WITH GALANGA AND LEMON GRASS
1
16. TOM YUM GAI 3.95
HOT AND SOUR CHICKEN SOUP WITH GALANGA AND LEMON GRASS
11. TOM KHA GAI 3.95
CHICKEN IN HOT AND SOUR AND RICH COCONUT MIKE GALANGA
AND LEMON GRASS
12. GULF OF SUM (SERVED IN HOT POT) 9.95
COMBINATION OF SEAFOOD, MUSHROOM,LEMON GRASS AND
THAI HERBS IN HOT AND SOUR SOUP
SALADS
13. GREEN SALAD 3.95
ASSORTED FRESH VEGETABLES SERVED WITH PEANUT SAUCE
14. YUM YAI SALAD 7.95
WITH SHRIMP, CUCUMBER,ONION, CARROT,CABBAGE AND
HARD BOILED EGG
15. YUM WOON SEN 7.95
SILVER NOODLES WITH SHRIMP, GROUND CHICKEN, SEASONED
WITH THAI HERBS, HOT SPICY SAUCE AND LEMON JUICES
16. LARB GAI 7.95
GROUND CHICKEN, SEASONED WITH THAI HERBS, HOT AND SPICY
SAUCE AND LEMON JUICES
17. BOBBY YUM YUM (YUM SEAFOOD) 8.95
SHRIMP, SCALLOPS ,MUSSELS SEASONEDWITH ONION, MINT LEAVES
CHILI AND LEMON JUICES
18. GOONG PLA 7.95
GRILLED MEDIUM RARE SHRIMPS SEASONED WITH ONION, MINT
LEAVES,CHILI AND LEMON JUICES
NOODLES
19. RICHARD NOODLES ( PAD THAI) 8.95
THAI NOODLES PAN FRIED WITH BEAN SPROUTS, GREEN ONION,
CRUSHED PEANUT, SCRAMBLED EGG, CHICKEN AND SHRIMP
20. LARD NAR 8.95
VERY SPECIALTY PREPARED SLICES OF BEEF, PORK,CHICKEN
OR SHRIMP SAUTEED WITH BROCCOLI IN SPECIAL GRAVY AND
TOPPED ON FRIED FLAT NOODLES
21. CHICKEN NOODLES 8.95
PAN FRIED FLAT NOODLES WITH CHICKEN, BLACK PEPPER
GARLIC,AND SCRAMBLED EGG
22. MOO PAD WO ON SEN 8.95
SILVER NOODLES PAN FRIED WITH PORK, GREEN ONION,
BEAN SPROUTS AND SCRAMBLED EGG
23. PAD KEE MAO 8.95
FLAT NOODLES PAN FRIED WITH BEEF AND MINT LEAVES IN
HOT AND SPICY SAUCE
24. LAVA NOODLES SOUP 9.95
THAI STYLE SPICY RICE NOODLES SOUP WITH SHRIMP, SQUID,
SCALLOPS WITH BEAN SPROUTS SCALLIONS AND GROUND PEANUT
25. CHICKEN NOODLES SOUP 8.9
CFIICKEN,RICE NOODLES W.ITI-I B 5 CAN SPROUTS, SCALLION IN SOUP
RICE
.26. FRIED RICE PORK, CHICKEN OR BEEF 7.95
27. SHRIMP FRIED RICE 8.95
28. SPICY FRIED RICE 8.95
(CHOICE OF PORK, CHICKEN, BEEF OR.SHRIMP)
29. PINEAPPLE FRIED RICE 9.95
(CHOICE OF PORK, CHICKEN, BEEF OR SHRIMP)
30. PIK-POW FRIED RICE 9.95
(CHOICE OF PORK, CHICKEN, BEEF OR SHRIMP)
31. YING'S FRIED RICE 8.95
.ASSORTED VEGGIE AND EGG
32. STEAMED WHITE RICE OR BROWN RICE 1.50
CURRIES ,
33. VEGETARIAN CURRY 8.95
ASSORTED VEGETABLES AND TOFU RED CURRY
34. PANANG NUA 9.95
SLICED BEEF IN RED CURRY WITH COCONUT MILK
35. PANANG GAI 9.95
SLICED CHICKEN IN RED CURRYWITH COCONUT MILK
36. KAREE GAI 9.95
CHICKEN IN YELLOW CURRY, POTATOES WITH COCONUT MILK
37. PINEAPPLE SHRIMP CURRY 11.95
SHRIMP IN RED CURRY WITH COCONUT MILK
ENTREES
SERVED WITH STEAMED WHITE OR BROWN RICE
I H CKEN
38. GAI KA PAW 9.95
CHICKEN WITH MINT LEAVES
39. CHICKEN CASHEW NUTS 9.95
CHICKEN SAUTEED WITH CASHEW NUTS, CARROTS, MUSHROOM,
GREEN ONION AND WATER CHESTNUTS
40. GM PAD KHING 9.95
CHICKEN WITH GINGER AND ONION
41. CHICKEN MIXED VEGETABLES 9.95
CHICKEN'WITH MIXED FANCY VEGETABLES
42. SWEET'N SOUR CHICKEN 9.95
BEEF
43. NEAU KANA 9.95
TENDER BEEF WITH FRESH BROCCOLI AND OYSTER SAUCE
44. NEAU KA PAW 9.95
TENDER BEEF WITH MINT LEAVES
45. GINGER BEEF 9.95
TENDER BEEF WITH GINGER AND ONION
46. MONGOLIAN BEEF 9.95
TENDER BEEF WITH MUSHROOM,CELERY,ONION, BELL PEPPER,
CARROT AND OYSTER SAUCE
PORK
49. GARLIC & PEPPER PORK 9.95
50. MOO PAD KHING 9.95
PORK WITH GINGER AND CELERY
SEAFOOD
51. GARLIC & PEPPER SHRIMP 10.95
-52. GOONG KA NA 10.95
SHRIMP WITH BROCCOLI
53. SHRIMP CASHEW NUTS 11.95
SHRIMP SAUTEED WITH CASHEW NUTS,CARROTS, MUSHROOM,
.AND WATER CHESNUTS
54. SWEErN SOUR SHRIMP 11.95
55. SHRIMP MIXED VEGETABELS 11.95
SHRIMP WITH MIXED.FANCY VEGETABLES
56. GOONG & MUEK KA PAW 11.95
SHRIMP AND SQUID WITH MINT LEAVES
CHEFS SPECIALS
57. PIA RAD PRIK 14.95
DEEP FRIED WHOLE FISH AND TOPPED WITH SPICY SAUCE
58. PIA CHOO CHEE 11.95
CRISPY FILLET CATFISH WITH CURRY AND,COCONUT MILK
59. PIA DUK PAD PED 11.95
CRISPY FILLET CATFISH WITH CHILI SAUCE
60. RAMA GARDEN 12.95
STEAMED ASSORTED VEGETABLES TOPPED CHICKEN SHRIMP
WITH CRUSHED PEANUT SAUCE
61. SEAFOOD STIR FRY 12.95
MIXED SEAFOOD AND VEGETABLES STIRFRIED WITH
HOME MADE SAUCE
62. SEAFOOD PARADISE 13.95
MIXED SEAFOOD STIRFRIED WITH.CURRY SAUCE
REVERSE MAKI (GPIECES) PRICE (2TY TOTAL
F59 Center Street (at center Plaza) Hyannis,MA 02601 SPINACH MAKI 3.75
TEL: (508)790-2432, (508)790-9340 ASPARAGUS MAKI 4.50
SERVER TABLE ;PP. DATE CALIFORNIA MAKI 4.75
CrabmeadCucumber/Auncniln/ToGrkn
PAMA
IGIRI 2PIECES PRICYY TOTAL EELASPARAGUS MAKI 5.95
DO 2.75 EEL AVOCADO MAKI 4.95
I(SWP..I'.T SHRIMP) 3.25 EBI.C1301MB)"lt MAKI 4.95
IiBI(SFIRIMP) 3.25
EEL CUCUMBER 5.50
HOTATE(SCALLOP) 3.25 /AVOCADO MAKI
HAMACHI(YELLOWTAIL) 4.00 HAMAKYU MAKI
4.95
I IOKKOGAi(SU12F CI AM) 3.75 Ye&rutai11Cuc,4mber
I IIRAME(FLUK17) 3.50 IKA KYA MAKI 4.50
IKA(S UID) 3.50 S uid/Cueumber
IKURA(SALMON ROE) 4.00 SAKEKYU 4 75
KANI(CRAB) 3.50
Salmnu/CucumGer
MAGURO(TUNA) 3.75 TEKKYU MAKI 4.75
MASU(SF,A TROUT) 3.25 Tuna/Cucumber
MIRUGAI(GIANT SEA CLAM) 4.25 TIiKKA-AVO MAKI
4.75
SAKE(SALMON) 3.75 TuNa/Avocado
SABA(MACKEREQ 3.25 CRISPY SALMON SKIN MAKI 4.95
sUzuKl(sr BASS) 3.25 DELUXE COMBO
TAMAGO(IIAKED ECG) 2.75 NIGIRI SUSI-11 DELUXE 19,95
TAKO(OCI'OPUS) 3.50 (15 PIECES)
FUNI(SEA
IKO(FLYING FISH ROE) 4.00 I'[3NA2tcSAIMON SASHIMI 19.95
O(PA1 IY TUNA) 4.50 COMBINATION
GI(EEL) 4.00 SASHIMI REGULAR 15.95
URCHIN) 4.75 SASHIMI DELUXE 22,95
HOSO MAKI GPIECES sysln nstlrMfcoMllo 22.95
AVOCADO MAKI 2.95 PARTY BOAT
KANI?YO UAPANIISE SQUID) 2.9$ SUSHI LARGE BOAT 39,95
KAPPA MAKI(CUCUBER) 2.95 SASHIMI LARGE BOAT 75.95
OSHINKO MAKI(PICKLE ROLL) 2.95 SUPER BOAT
SAKE(SALMON) 3.95 G9.95
99 95
TEKKA(TUNA) 3.95 SUPER BOAT
I IAMACHI MAKI(YELLOW TAIL) 4.25
NEGI HAMA MAKI 4.95
NEGI SAKI:MAKI 4.75
NI:'.GI TEKKA MAKI 4.75
LUNCH MENU
SERVED MONDAY TO FRIDAY BETWEEN 11:30AM TO 3:00 PM
OBENTO (LUNCH BOXY
COME WITH SALAD,MISO SOUP,RICE AND 3 PIECES OF CALIFORNIA MAKI,
DUMPLINGS AND JAPANESE PICKLE
CHICKEN TERIYAKI 6.95
GRILLED SLICED CHICKEN BREAST WITH HOME MADE TERIYAKI SAUCE
BULGOGI 7.95
GRILLED SLICED BEEF WITH HOME MADE SAUCE
SALMON TERIYAKI 7.95
GRILLED SALMON FILLET WITH HOME MADE TERIYAKI SAUCE
TEMPURA 7.95
LIGHTLY BATTERED AND FRIED SHRIMP AND VEGETABLES
CATCH OF THE DAY (VARIES DAILY) 7.95
LIGHTLY BATTERED AND FRIED WHITE FISH
SEAFOOD CAFE SPECIAL (SASHIMI) 8.95
CHEF'S CHOICE OF 6 PIECES OF SASHIMI
LUNCHEON SPECIALS
UDON 6.95
JAPANESE THICK NOODLE SOUP
TEMPURA UDON 8.95
JAPANESE THICK NOODLE SOUP WITH LIGHTLY BATTERED AND FRIED SHRIMPS
BIBIMBAP 7.95
EXOTIC VEGETABLES, BEEF AND EGG ON A BED OF RICE WITH KOREAN
CHILI PASTE,SERVED WITH MISO SOUP
JAPCI-IAE 7.95
PAN FRIED CLEAR POTATO NOODLES WITH CHOICE OF BEEF,CHICKEN,
SEAFOOD OR VEGETABLES,SERVED WITH MISO SOUP
YAKI SOBA 7.95
PANFRIED WHEAT FLOUR NOODLES WITH CHOICE OF BEEF,CHICKEN,
SEAFOOD OR VEGETABLES,SERVED WITH MOXO SOUP
SUSHI LUNCH 7.95
CHEF'S CHOICE OF 5 PIECES OF SUSHI AND 6 PIECES OF MAK.I,
SERVED WITH MISO SOUP
SASHIMI LUNCH 8.95
CHEF'S CHOICE OF 12 PIECES OF SASHIMI,SERVED WITH RICE AND MISO SOUP
CALI LUNCH 6.95
12 PIECES OF CALIFORNIA MAKI,SERVED WITH MISO SOUP
APPETIZERS
1. EDAMAME 3.95
BOILED GREEN SOYBEANS LIGHTLY SALTED
2. VEGETABLE KOROKE 3.95
JAPANESE-STYLE VEGETABLE DEEP FRIED
3. GYOZA VEGETABLE 4.95
6 PIECES DEEP FRIED OR STEAMED
4. EBI SHUMAI 5.95
8 PIECES JAPANESE-STYLE DEEP FRIED OR STEAMED
5. DON SHUMM 5.95
6 PIECES JAPANESE-STYLE DEEP FRIED OR STEAMED PORK DUMPLINGS
6.WASABI SHUMAI 5.95
6 PIECES JAPANESE-STYLE DEEP FRIED OR STEAMED SHUMAI DUMPLINGS
7. SCALLION PANCAKE 7.95
PANFRIED SCALLION AND SEAFOOD WITH EGG BATTER
8. STEAMED TOFU 3.95
STEAMED TOFU WITH CHOP SCALLION AND KOREAN CHILI SAUCE
9. STEAMED GREEN MUSSELS 5.95
10. SOFT SHELL CRAB 8.95
DEEP FRIED SOFT SHELL CRAB SERVED WITH PONZU SAUCE FOR DIPPING
11. TEMPURA STARTER 7.95
LIGHTLY BATTERED AND FRIED SHRIMP AND VEGETABLES
SOUPS
12. DUMPLING SOUP 3.95
13. MISO SOUP 1.95
14. HOT AND SOUR SOUP 3.95
15. CHICKEN NOODLES SOUP 3.95
SALADS
16. HOUSE SALAD 3.95
17. GARDEN SALAD 4.95
18. OHITASHI 3.95
HOUSE SPINACH.SALAD
19. IUMCHI 2.95
20. SEAWEED SALAD 3.95
NOODLES
21. UDON 9.95
JAPANESE THICK NOODLES SOUP
22. TEMPURA UDON 11.95
JAPANESE THICK NOODLES SOUP WITH LIGHTLY BATTERED AND
FRIED SHRIMP
23. YAKI SOBA 11.95
PA.NFRIED WHEAT FLOUR NOODLES,WITH CHOICE OF CHICKEN,
BEEF,S.EAFOODS OR VEGETABLES
24.JAPCHAE 11.95
PANFRIED CLEAR POTATO NOODLES WITH CHOICE OF CHICKEN,
BEEF,SEAFOODS OR VEGETABLES
TEMPURA&KATSU
25. VEGETABLE TEMPURA 10.95
LIGHTLY BATTERED AND.FRIED VEGETABLES
26. FISH TEMPURA 12.95
LIGHTLY BATTERED AND FRIED WHITE FISH AND VEGETABLES
27. SHRIMP TEMPURA 13.95
LIGHTLY BATTERED AND FRIED SHRIMP.AND VEGETABLES
28. SEAFOOD TEMPURA 14..95
LIGHTLY BATTERED AND FRIED SHRIMP,SCALLOPS,
CALAMARI,WHITE FISH AND VEGETABLES
i
GRILL
(SERVED WITH VEGETABLE,TOFU,SOUP AND RICE)
29. BUL-GO-KI 12.95
GRILLED BEEF WITH HOME MADE SAUCE
30. GRILLED SALMON FILLET 13.95
GRILLED SALMON FILLET WITH CHEF'S SEASONING
31. GRILLED SWORDFISH STEAK 14.95
GRILLED SWORDFISH WITH CHEFS SEASONING
32. TERIYAKI CHICKEN 12.95
GRILLED CHICKEN WITH HOME MADE TERIYAKI SAUCE
33. TERIYAKI SALMON FILLET 14.95
GRILLED SALMON FILLET WITH HOME MADE TERIYAKI SAUCE
34. TERIYAKI SHRIMP AND SCALLOPS 13.95
GRILLED SHRIMP AND SCALLOPS WITH HOMEMADE TERIYAKI SAUCE
35. TERIYAKI SWORDFISH STEAK 14.95
GRILLED SWORDFISH WITH HOME MADE TERIYAKI SAUCE
1 ,
I
KOREAN SPECIALTIES
(SERVED WITH SOUP AND RICE)
36. BIBIMBAP 11.95
.EXOTIC VEGETABLES, BEEF AND EGG ON A BED OF RICE WITH
KOREAN CHILI PASTE
37. TOFU-BIBIMBAP 10.95
EXOTIC VEGETABLES,TOFU AND EGG ON A BED OF RICE WITH
KOREAN CHILI PASTE
38. OKDOL BIBIMBAP 13.95
EXOTIC VEGETABLES,MARINATED BEEF ON.A BED OF RICE WITH
KOREAN CHILI PASTE 1N A HOT STONE POT
39. TOFU-OKDOL BIBIMBAP . 12.95
EXOTIC VEGETABLES,TOFU ON A BED OF RICE WITH KOREAN CHILI
PASTE IN A HOT STONE POT
WOK STIR-FRIED
CREATE YOUR OWN DISH BY CHOICE OF MEAT,SAUCE AND NOODLES OR RICE
(SERVED WITH MISO SOUP)
CHOICE OF MEAT: CHICKEN, BEEF, VEGETABLE, TOFU 12.95
SHRIMP 13.95
COMBINATION SEAFOOD 15.95
CHOICE OF SAUCE: OYSTER, CASHM SPICY BASIL, GARLIC,
GINGER AND SCALLION, GARLIC WASABI,
SPICY KOREAN, SZECHWAN
CHOICE OF NOODLES OR RICE:
NOODLES: EGG NOODLES, CRISPY NOODLES, UDON,
JABCHAE NOODLES, BUCKWHEAT
RICE: WHITE RICE, BROWN RICE
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H ING ' S
59 Center Street
Hyannis, HA 02601
508-790-9340
Check 5885/3 07/14/16-A 7 : 04pm
Guests 7 Olga fable B 0 6
5.,Edamame 19.75
]. .Fried Rice
Combo 15.50
]..Fried Rice
Beef 12.95
2..S10, Only Better 25.90
1..Sl. California RI 6.25
2. .PR1. Deep Impact 29.90
3..Unagi Taki 18.75
2—Fried Rice
Combo 31.00
3. .Bangkok Noodles 35,85
Seafood,Rice Noodles,No
Spro+.its,W/ Broth,Spicy*
p 1—Bangkok Noodles 9.95
BeEf,Rice Noodles,W/ Broth,
Vh I d
3. .iakky 9.00
1..51. California RI 6.25
l..PR12.Fire Crunchy 14, ,a
]..Bangkok Noodles 11.95
Seafood,Rice Noodles,W/
Broth,Hild
1. .CH Noodle Soup 4,50
1 . Pad Kee Mao 13.95
Chicken
1 . Tam Kha 4.95
Shrimp
1. .Pad Kee Mao 13.95
Veggie
l. -PR12.Fire Crunchy 14.95
1. .Coffee/Tea 2.00
2. .Sprite 3.30
!. .Thai iced .fea 3.50
Large (16oz)
1. .Bud 3.74
No Glass
2. .Yings Mai Tai 20.00
Z. -Orange Juice 4.00
4. Lg Sho Chiku Bai 40.00
2. .2 Cups
2. .No Cups
IA-Discount -201.85
Items 376.79
Tax #1 12.25
Discounts -201.85
Subtotal 1 E37 . 19
Tip �.� �—
TOTAL
1.VISA/xxxxxxxxxxxx0287/XXXX S A:212273
SHERPA, DEEKE 0401 07/14 20:23 187.19
('ust me r- Copy
THANK YOU FOR CHOOSING YING'S
COME AGAIN !
4
BEVERAGE
THAI ICED TEA OR COFFEE 2.00 Thal, J,%p&Qe%e
81 ]Kore,%iQ
HOMEMADE LIMEADE 2.00 . ,
ORANGE JUICE, CRANBERRY JUICE 2.00
MINERAL WATER 1.50
SPARKLING WATER 1.50
SOFT DRINK 1.50
HOT TEA,HOT COFFEE 1.25
DESSERT
FRIED ICE CREAM 5.50
FRIED BANANA WITH ICE CREAM 4.25
RED BEAN ON ICE 3.95
RAMBUTAN OR LYCHEE 3.95 \
GREEN TEA-ICE CREAM 2.95 S.
COCONUT ICE CREAM 2.95
GINGER ICE CREAM 2.95
CHOCOLATE ICE CREAM 2.95
STRAWBERRY ICE CREAM 2.95 r
WELCOME
..:.. ; '. .,:..P .... LUNCH MENU
59 CENTER ST. (At Center Plaza) HYANNIS,MA 02601
s
�
PH
ONE:
HONE 08 -
(5 ) 790 2432
FA U (508) 790-9340
rk,
�t OPEN EVERYDAY
s SERVEDLUNCH
MON—FRI: 11z30AM—3:OOPM
fir: 'j e WE DELIVER
(MINIMUM$15)
(FEE$3)
LUNCH SPECIAL
SERVED MONDAY THRU FRIDAY 11:30 TO 3:00 PM BULGOGI 7.95
COMES WITH SALAD,AND SOUP OF THE DAY,AND WHITE OR BROWN RICE GRILLED SLICED BEEF WITH HOME MADE SAUCE
SALMON TERIYAKI 7.95
(ALL ITEMS ARE$7.95) GRILLED SALMON FILLET WITH HOME MADE TERIYAKI SAUCE
1. GARLIC PEPPER SHRIMP TEMPURA 7.95
2. PORK, CHICKEN, BEEF GARLIC PEPPER LIGHTLY BATTERED AND FRIED SHRIMP AND VEGETABLES
3. CASHEW NUTS CHICKEN OR SHRIMP CATCH OF THE DAY(VARIES DAILY), 7.95
4. ASSORTED VEGETABLES WITH TOFU LIGHTLY BATTERED AND FRIED WHITE FISH
5. SILVER NOODLES WITH FANCY VEGETABLES &EGG SEAFOOD CAF9 SPECIAL(SASHIMI) 8.95
6. CHICKEN FRESH GINGER CHEF'S CHOICE OF 6 PIECES OF SASHIMI
7. PAD THAI CHICKEN OR VEGETABLES &TOFU LUNCHEON SPECIAIS
8. CHICKEN OR VEGETABLES FRIED RICE COMES WITH SALAD
9. SPICY FRIED RICE WITH CHICKEN* UDON 6.95
10. YELLOW CURRY WITH CHICKEN* JAPANESE THICK NOODLE SOUP
11. RED CURRY CHICKEN** TEMPURA UDON 8.95
12. GREEN CURRY CHICKEN** JAPANESE THICK NOODLE SOUP WITH LIGHTLY BATTERED
AND FRIED SHRIMPS
13. PAD PRIG KING GAI*
14. PANANG CURRY BEEF** BIBIMBAP 7.95
15• CHICKEN KA PAW** EXOTIC VEGETABLES, BEEF AND EGG ON A BED OF RICE
WITH KOREAN CHILI PASTE,SERVED WITH MISO SOUP
16. PAD PRIG KING SHRIMP*
17. SWEET'N SOUR SHRIMP JAPCHAE 7.95
PANFRIED CLEAR POTATO NOODLES WITH CHOICE OF BEEF,
18. VEGETABLES YELLOW CURRY* CHICKEN, SEAFOOD OR VEGETABLES,SERVED WITH MISO SOUP
*SPICY**MEDIUM SPICY***VERY SPICY YAKI SOBA 7.95
PANFRIED WHEAT.FLOUR NOODLES WITH CHOICE OF BEEF,
(WE DO NOT USE M.S.G) CHICKEN,SEAFOOD OR VEGETABLES,SERVED WITH MISO SOUP
SUSHI LUNCH 7.95
OBENTO (LUNCH BOM CHEF'S CHOICE OF 5 PIECES OF SUSHI AND 6 PIECES OF
MAKI,SERVED WITH MISO SOUP
COMES WITH SALAD,MISO SOUP,RICE,2 PIECES OF
CALIFORNIA MAKI,AND DUMPLINGS SASHIMI LUNCH 8.95
CHEF'S CHOICE OF 12 PIECES OF SASHIMI,SERVED WITH
RICE AND MISO SOUP "
CHICKEN TERIYAKI 6.95 CALI LUNCH 6.95
GRILLED SLICED CHICKEN BREAST WITH TERIYAKI SAUCE 12 PIECES OF CALIFORNIA MAKI,SEFVED V.. MISO SOUP
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�s Town of Barnstable
�p THE Tp�
Regulatory Services Barnstable
Thomas F. Geiler, Director A"mericaC1W
Public Health Division
sn, a MASS. Thomas McKean, Director s
y nss.
1639. 10 2007
200 Main Street
Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
CERTIFIED MAIL,7006 2150 0002 1038 6629
February 5, 2008
Suniun Chaloeicheep
Yings
59 Center Street
Hyannis, MA 02601
Dear Sunun Chaloeicheep,
You are scheduled to appear before the, Board of Health at a show-cause
hearing on February 19, 2008 at 3:00. PM at the Barnstable Town Hall in
the Conference Room, at 367 Main Street, Hyannis.
During the routine inspections performed on July 12, 2007 by Health
Inspector Donald Desmarais, R.S., and on January 24, 2008, by Health
Inspector Marybeth McKenzie R.S. there were -no persons onsite who were
trained and certified in food handling practices on the premises. During a
subsequent visit on February 4, 2008, it was discovered again that there
was not a person who was trained and certified in safe food handling
practices present.
Pursuant to 105CMR 590.003: the permit holder shall be the person in
charge or shall designate a person in charge and shall ensure that a person
in charge is present at the food establishment during all hours of the
operation. The owner or the person(s) in charge . shall designate an
alternate person in charge at all times when they cannot be present. The
alternate, when acting as the person in charge shall be responsible for all
duties specified in FC2-103.11 and must be . adequately trained by the
person in charge to ensure that the establishment operates in compliance
with CMR 590.003..
Per Town of Barnstable Board of Health Policy, two certified adequately
trained and certified (.ServSafe or equivalent) persons are required per
establishment and that one of these persons must be on site during all
operating hours.
QAOrder lettersTood ViolationsWings Feb 200800C
During the hearing, `you will be given an opportunity to be heard, present
witnesses, photographs, and other evidence to show cause why your permit
to operate a food establishment should not be suspended or revoked.
Sincerely,
Tho; as A. McKean
mbm
�I
Q:\Orde:r lettersTood ViolationsWings Feb 2008.DOC
NIGIRI (2PIECES)
AVOCADO 2.75
AMA F.BI(SWEET SHRIMP) 3.25
EBI(SHRIMP) 3.25
HOTATE(SCALLOP) 3.25
HAMACHI(YELLOWTAIL) 4.00
HOKKOGAI(SURF CLAM) 3.75
HIRAME(FLUKE) 3.50
IKA(SQUID) 3.50
IKURA(SALMON ROE) 4.00
KANI(CRAB) 3.50
MAGURO(TUNA) 3.75
MASU(SEA TROUT) 3.25
MIRUGAI(GIANT SEA CLAM) 4.25
SAKE(SALMON) 3.75
SABA(MACKEREL) 3.25
UKI(SEA BASS) 3.25
TAMAGO(BAKED EGG) 2.75
TAKO(OCTOPUS) 3.50
TOBIKO(FLYING FISH ROE) 4.00
TORO(FATTY TUNA) 4.50
UNAG I(EEL) 4.00
UNI(SEA URCHIN) 4.75
*Any sushi available in hand roll*Any a la carte with quail egg,add$1.00
*Any above sushi available in sashimi,add$1.25
HOSO MAKI (6PIECES)
AVOCADO MAKI 2.95
KANPYO UAPANESE SQUASH) 2.95
KAPPA MAKI(CUCUMBER) 2.95
OSHINKO MAKI(PICKLE ROLL) 2.95
SAKE(SALMON) 3.95
TEKKA(TUNA) 3.95
HAMACHI MAKI(YELLOWTAIL) 4.25
NEGI HAMA MAKI 4.95
NEGI SAKE MAKI 4.75
NEGI TEKKA MAKI 4.75
REVERSE MAKI(6PIECES)
SPINACH MAKI 3.75
ASPARAGUS MAKI 4.50
CALIFORNIA MAKI 4.75
Crabmeat/CucumbedA:,ocado/Tobiko
EEL ASPARAGUS MAKI 5.95
EEL AVOCADO MAKI ` 4.95
EEL CUCUMBER MAKI 4.95
EEL CUCUMBER AND 5.50
AVOCADO MAKI
HAMAKYU MAKI 4.95
Ye&tmil/Cucumber
IKA KYA MAKI 4.50
Squid/Cucumber
SAKF.KYU 4.75
Sabnon/Cucumber
TEKKYU MAKI 4.75
Tuna/Cucumber
TEKKA-AVO MAKI 4.75
Tuna/Avocado
CRISPY SALMON SKIN MAKI 4.95
DELUXE&COMBO
NIGIRI SUSHI DELUXE(15 PIECES) 19.95
TUNA&SALMON SASHIMI COMBINATION 19.95
SASHIMI REGULAR 15.95
SASHIMI DELUXE 22.95
SUSHI&SASHIMI COMBO 23.95
PARTY BOAT
SUSHI LARGE BOAT 39.95
SUSHI SUPER BOAT 69.95
SASHIMI LARGE BOAT 75.95
SASHIMI SUPER BOAT 99.95
OD- li4
Crocker, Sharon
From: McKean, Thomas
Sent:: Thursday, February 07, 2008 1:53 PM
To: McKenzie, Marybeth
Cc: Crocker, Sharon
Subject: RE: Yings
I would send the letter and ask Sharon to place it on the agenda.
If the status changes, I can update the Board members at the meeting or�st before the meeting.
-----Original Message-----
From: McKenzie, Marybeth
Sent: Thursday, February 07, 2008 12:40 PM
To: McKean,Thomas
Subject: Yings
r
Tom,
I met with, Sunun Chaloeicheep, the owner of Yings,Al had not spoken with her previously, she now
understands that most of her violations were directly related to lack of knowledge of the food handlers and
that they need someone who will be certified to work,'`during the AM shift. She has two people certified that
work the PM shift. She is sending at least one employee to class that will be able to work in the AM. I held off
sending the certified letter and gave her until MoFnday 2/11/08 to give us confirmation that an employee will
be attending class. If she does not give confirmation then she has been informed that we will proceed with
than show cause hearing. I hope this will be OK with you. I'll talk to you tomorrow.
Marybeth
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1
TOWN OF BARNSTABLE BAR-w 4147
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager
Address of Offender a � ljzl' 5_�_ MV/MB Reg.#
Village/State/Zip �& An, /,'j
Business Name yfV1 pm, on 20
Ik—.
Business Address
Signat e .- -of Enforcin fficer
Village/State/Zip G,
Location NO.Offense
151 5 pn �'� E forcing Dept/Division
Offense .i
Fact
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i
This will serve only as a warning. At thisf time no legal action has bkAn taken.
It is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.
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GonGentrated(chalrs only-not Fixed) -t aF.net H Ibeveraga Gun gu m v� ,a`_•,`c d
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A-WHAT-T PATIO
AREA LU 01 a a
DRAW INC,TYPE:
haatlny and a julpmanl-Plan
• / SHEET NUMBER:
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" A200
i
2&SEAFOOD TEMPURA 14.95
&STEAMED TOFU 3.95 LIGHTLY BATTERED AND FRIED SHRIMP,SCALLOPS BEVERAGE
STEAMED'I.OFU WITH CHOP SCALLION AND CALIMARI,WHITE FISH AND VEGETABLES
KOREAN CHILI SAUCE lkoren
� THAI ICED TEA OR COFFEE 2.00
HOMEMADE LIMEADE 2.00
9.STEAMED GREEN MUSSELS 5.95 GRILL + ORANGE JUICE,CRANBERRY JUICE 2.00 `
10.SOFT SHELL CRAB 8.95 (SERVED WITH VEGETABLE,TOFU,SOUP AND RICE) ;
SPARKLING WATER 1.50
DEEP FRIED SOFT SHELL CRAB SERVED WITH PONZU SAUCE MINERAL WATER 1.50 ���
29.BUL-GO-KI 12.95 SOFT DRINK 1.50
FOR DIPPING
GRILLED BEEF WITH HOMEMADE SAUCE HOT TEA,HOT COFFEE 1.25
11.TEMPURA STARTER 7.95 30.GRILLED SALMON FILLET 13.95
LIGHTLY BATTERED AND FRIED SHRIMP AND VEGETABLES GRILLED SALMON FILLET WITH CHEF'S SEASONING. ' DESSERT
31.GRILLED SWORDFISH STEAK 14.95 FRIED ICE CREAM 5.50
SOUPSGRILLED SWORDFISH WITH CHEF'S SEASONING FRIED BANANA WITH ICE CREAM 4.25
12.DUMPLINIG SOUP 3.95 RED BEAN ON ICE 3.95
32.TERIYAKI CHICKEN 12.95 j RAMBUTWOR LYCHEE(Thai Fruit) 3.95
13.MISO SOUP '' 1.95 GRILLED CHICKEN WITH HOMEMADE TERIYAKI SAUCE { GREEN TEA ICE CREP M 2.95
COCONUT ICE CREAM 2.95
14 HOT AND SOUR SOUP 3.95 33•TERIYAKI SALMON FILLET 14.95 GINGER ICE CREAM 2.95
GRILLED SALMON FILLET WITH HOMEMADE TERIYAKI SAUCE CHOCOLATE ICE CREAM 2.95' t
STRAWBERRY ICE CREAM 2.95 \
15.CHICKEN NOOIf
DLE SOUP 3.95 34 TERIYAKI SHRIMP AND SCALLOPS 13.95
GRILLED SHRIMP AND SCALLOPS WITH HOMEMADE
SALADS J TERIYAKI SAUCE
16.HOUSE SALAD 3.95 35.TERIYAKI SWORDFISH STEAK 14.95 :• .�
GRILLED SWORDFISH WITH HOME MADE TERIYAKI SAUCE
17.GARDEN SALAD 4.95
KOREAN SPECIALTIES "I
�j
1&OHITASIiI 3.95 (SERVED Tr L
D WITH SOUP AND RICE) ' WELCOME
HOUSE SPI
NACH INACH SALAD
19•K ACHI 2.95 36.BIBIMBAP 11.95
EXOTIC VEGETABLES,BEEF AND EGG ON A BED OF
RICE WITH KOREAN CHILI PASTE
20.SEAWEED SALAD 3.95
37.TOFU-BIBIMBAP 10.95 4"
r>
NOODLES EXOTIC VEGETABLES,TOFU AND EGG ON A BED OF
RICE WITH KOREAN CHILI PASTE {
21.UDON 9.95 sk
APANESE THICK NOODLE SOUP
DINNER MGM V
3s.OKDOLBIBIMBAP 13.95
J EXOTIC VEGETABLES,MARINATED BEEF ON A BED OF � ���, ��
RICE WITH KOREAN CHILI PASTE IN A HOT STONE POT = '
22.TEMPURA UDON 11.95 f
JAPANESE THICK NOODLE SOUP WITH I I LIGHTLY BATTERED AND 39•TOFU OKDOL BIBib[BAP 12.95 59 Center St. (at center plaza) Hyannis,MA 02601
FRIED SHRIMP *EXOTIC VEGETABLES,TOFU ON A BED OF RICE WITH PHONE: (SOS) 790-2432
23.YAKI SOBA 11.95 KOREAN CHILI PASTE IN A HOT STONE POT .:
PANFRIED WHEAT FLOUR NOODLE WITH CHOICE OF CHICKEN, x
WOKSTIR-FRY
BEEF,SEAFOOD OR VEGETRBI.ES F•k AtaY.
CREATE YOUR OWN DISH WITH CHOICE OF MEAT, ? FAX:
SAUCE AND NOODLES OR RICE " (SOH) 790-934E0
24 jAPCEIAE 11.95
PANFRIED CLEAR POTATO NOODLES WITH CHOICE OF (SERVED WITH MISO SOUP) OPEN EVERYDAY
3
r �a CHICKEN,BEEF,SEAFOODS OR VEGETABLE CHOICE OF MEATt CHICKEN,BEEF,VEGETABLE,TOFU 12.95 r T.•
SIiRIMP 13.95 'Y' SUN-THURS: 11:30AM- 10:30PM
TEMPURA COMBINATION SEAFOOD 15.95 t i�j ,
(SERVED WITH SOUP AND RICE) E
CHOICE OF SAUCEt OYSTER,CASHER,SPICY BASIL,GARLIC FRI&SAT: 11:30AM - 11:OOPM -
25.VEGETABLE TEMPURA 10.95 GINGER&SCALLION,GARLIC WASABI,
LIGHTLY BATTERED AND FRIED VEGETABLES SPICY KOREAN,SZECHWAN
26.FISH TEMPURA 12.95 CHOICE OF NOODLES OR RICE; WE DELIVER'
LIGHTLY BATTERED AND FRIED WHITE FISH AND VEGETABLES
NOODLES: EGG NOODLES,CRISPY NOODLES,UDON, � � (IVIINIMUM$1 S)
27.SHRIMP TEMPURA 13.95 JABCHAE NOODLES,BUCKWHEAT (FEE$3)
LIGI-ITLY BATTERED AND FRIED SHRIMP AND VF,.rFTABI.ES RICE WHITE RICE,BROWN RICE
Dal Food 17.LARB GAI 7.95
GROUND CHICKEN,SEASONED WITH THAI HERBS,HOT CURRIES 53.GOONG KA NA 10.95
AND SPICY SAUCE AND LEMON JUICE SERVED WITH STEAMED WHITE OR BROWN RICE . SHRIMP WITH BROCCOLI
APPETIZERS 18.BOBBY YUM YUM(YUM SEAFOOD) 8 95 35.VEGETARIAN CURRY 8 95 54 SHRIMP CASHEW NUTS 11.95
SHRIMP,SCALLOPS,MUSSELS SEASONED WITH ONION, ASSORTED VEGETABLES AND TOFU RED CURRY SHRIMP SAUTEED WITH CASHEW NUTS,CARROTS,
. ,I.VEGETARIAN SPRING ROLLS 4.50 MINT LEAVES CHILI AND LEMON JUICE
DEEP FRIED SPRING ROLLS STUFFED WITH CABBAGE, MUSHROOM,AND WATER CHESNUTS
36.P ICED B NUA 9.95 55.SWEET'N SOUR SHRIMP
CELERY,CARROT AND SILVER NOODLES 19 GRILLED
C�ED MEDIUM RARE SHRIMPS SEASONED WITH ONION, 7.95 SLICED BEEF IN RED CURRY WTII[COCONUT MILK ' SHRIMP WITH MIXED FANCY VEGETABLES WITH 11.95
2.BEEF SATAY 6.95 MINT LEAVES,CHILI AND LEMON JUICE 37 PANANG GAI A SWEET'N SOUR HOMEMADE SAUCE
VERY POPULAR DISH•PIECES OF BEEF SKEWERED SLICED CHICKEN IN RED CURRY WITH COCONUT MILK 9.95 SHRISHREWMILD VEGETABLLS 11.95
ON BAMBOO STICKS,GRILLED AND SERVED WITH '
PEANUT SAUCE AND CUCUMBER DIPS NOODLES
38 KAREE GAI. 9.95 SHRIMP WITH MIXED FANCY VEGETABLES
3.CHICKEN SATAY 6.95 CHICKEN IN YELLOW CURRY,POTATOES WITH COCONUT MILK
PIECES OF CHICKEN SKEWERED ON BAMBOO STICK,GRILLED,- 20.RICHARD`S NOODLES{PAD THAI) 8.95 � 57.GOONG Sr MUEK KA PAW 11.95
THAI NOODLES PAN FRIED WITH BEAN SPROUTS,GREEN ONION, 39.PINEAPPLE SHRIMP CURRY 1I.95 SHRIMP AND SQUID WITH BASIL LEAVES
SERVED WITH PEANUT SAUCE AND CUCUMBER DIPS CRUSHED PEANUT,SCRAMBLED EGG,CHICKEN AND SHRIMP SHRIMP IN RED CURRY WITH COCONUT MILK
4 FRIED TOFU 4.95CHEFS SPECIALS
ENTREES DEEP FRIED TOFU SERVED WITH SWEET N SOUR SAUCE 21.SPECIALLY PREPARED SLICES OF BEEF,PORK,CHICKEN LARD NAR 8.95 SERVED WITH STEAMED WHITE OR BROWN RICE
SERVED PEA WITH STEAMED WHITE OR BROWN RICE
5.MEE GROB 5.95
OR SHRIMP SAUTEED WITH 58.BROCCOLI IN SPECIAL GRAVY BAD PR[K 1NARSET PRICE
�
SWEET CRISPY RICE NOODLES.MIXED WITH SHRIMP,HOME AND TOPPED ON FRIED FLAT NOODLES CHICKEN DEEP FRIED WHOLE FISH TOPPED WITH SPICY SAUCE
MADE TOMATO SAUCE,GREEN ONIONS AND BEAN SPROUTS 22 CHICKEN NOODLES 8.95
PAN FRIED FLAT NOODLES WITH CHICKEN,'BLACK PEPPER 40.GAI KA PAW 59.PEA CHDO CHEE 11.95
6.WINTER SHRIMP 6.95 GARLIC.AND SCRAMBLED EGG CHICKEN WITH BASIL LEAVES 9'� CRISPY FILLET CATFISH WITH CURRY AND COCONUT MILK
DELICIOUS WHOLE SHRIMPS WRAPPED IN CRISPY EGG ROLL
SKIN SERVED WITH SWEET N SOUR SAUCE 23,MOO PAD WOON SEN 8.95 41.CHICKEN CASHEW NUTS 9.95 60•PEA DUK PAD PED 11.95
CRISPY FILLET CATFISH WITH CHILI SAUCE
7.STEAMED MUSSELS 7.95 SILVER NOODLES PAN FRIED WITH PORK,GREEN ONION, CHICKEN SAUTEED WITH CASHEW NUTS,CARROTS,
FRESH MUSSELS STEAMED IN A POT WITH HERBS SPICE S AND BEAN SPROUTS AND SCRAMBLED EGG AND RICE MUSHROOMS,GREEN ONIONS,AND WATER CHESTNUTS 61.RAMA GARDEN 12.95
WINE SERVED WITH SPECIAL HOUSE THAI CHILI SAUCE 24 PAD KEE MAO 8.95 42.GAI PAD KHING 9.95 STEAMED ASSORTED VEGETABLES TOPPED CHICKEN AND 8.FRESH ROLL 3.95 FLAT NOODLES PAN FRIED WITH BEEF AND MINT LEAVES IN CHICKEN WITH GINGER AND ONION SHRIMP WITH CRUSHED PEANUT SAUCE
HOT AND SPICY SAUCE 12 95
SHREDDED LETTUCE,CARROTS,FRESH MINT AND RICE
43.CHICKEN MII�D VEGETABLES 9.95 62.SEAFOOD STIR FRY
VERMICELLI,COMBINED WITH SHRIMP THEN WRAPPED 25.LAVA NOODLES SOUP 9.95 CHICKEN WITH MIXED FANCY VEGETABLES HOMEMIXED SEAFOOD AND VEGETABLES STIR-FRIED WITH
INTO A SOFTENED RICE PAPER. THAI STYLE SPICY RICE NOODLE SOUP WITH SHRIMP,SQUID,
HOME MADE SAUCE
SOUP SCALLOPS WITH BEAN SPROUTS SCALLIONS&GROUND PEANUT 44.SWEET'N SOUR CHICKEN 9.95 63.SEAFOOD PARADISE 13,95
CHICKEN WITH MIXED FANCY VEGETABLES MIXED SEAFOOD STIR-FRIED WITH CURRY SAUCE
26.CHICKEN NOODLES SOUP 9.95 IN A HOMEMADE SWEET'N SOUR SAUCE
9. VEGGIE SOUP 3.25 CHICKEN,RICE NOODLES WITH BEAN SPROUTS,SCALLION
45.CAI PAD-PRIG KING 9.95 y D �j
10.TOM YUM GOONG 3.95 27.DAO'S NOODLE (PORK,BEEF,CHICKEN) &95 STIR FRIED STRING BEANS IN HOT PRIG KING SAUCE JAPJXE SE & K01D''P
HOT&SOUR SHRIMP SOUP WITH GALANGA AND LEMON GRASS RICE VERMICELLI WITH MEAT.ON TOP,SHREDDED LETTUCE,
FRESH MINT,BEAN SPROUTS AND ROASTED PEANUTS. BEEF
11.TOM YUM CAI 3.95 SERVED WITH HOMEMADE SAUCE APPETIZERS
HOT&SOUR CHICKEN SOUP WITH GALANGA AND LEMON GRASS 46.NEAU KANA 9.95
RICE TENDER BEEF WITH FRESH BROCCOLI AND OYSTER SAUCE
12.TOM KHA GAI 3.95 1•EDAMAME 3.95
CHICKEN IN HOT AND SOUR AND RICH COCONUT MILK 2&FRIED RICE PORK,CHICKEN OR BEEF 7.95 47.NEAU KA PAW 9.95 BOILED GREEN SOYBEANS LIGHTLY SALTED
GALANGA AND LEMON GRASS TENDER BEEF WITH BASIL LEAVES
29.SHRIMP FRIED RICE 8.95 2.VEGETABLE KOROKE 3.95
13.GULF OF SIAM(SERVED IN HOT POT) 9.95 48•MONGOLIAN BEEF 9.95 JAPANESE VEGETABLE DEEP FRIED
COMBINATION OF SEAFOOD,MUSHROOMS,LEMON GRASS 30.SPICYFRIFD RIDE 8.95 TENDER BEEF WITH MUSHROOM,CELERY,ONION,
AND THAI HERBS IN HOT AND SOUR SOUP BELL PEPPERS,CARROTS IN OYSTER SAUCE 3.GYOZA VEGETABLE
(CHOICE OF PORK CHICKEN,BEEF OR SHRIMP) 4.95
DEEP FRIED OR STEAMED
SALADS 31.PINEAPPLE FRIED RICE 9.95 END
K, S
(CHOICE OF PORK CHICKEN,BEEF OR SHRIMP) 49.GARLIC 8 PEPPER PORK 4•EBI SHUMAI 5.95
14.GREEN SALAD 3.95 9.95 JAPANESE-STYLE DEEP FRIED OR STEAMED
ASSORTED FRESH VEGETABLES SERVED WITH PEANUT SAUCE 32.PIK-POW FRIED RICE 9.95 50,MOO PAD TIRING
AS.YUM YAI SALAD 7.95 (CHOICE OF PORK,CHICKEN,BEEF OR SHRIMP) PORK WITH GINGER AND ONION 9.95 5.JDO NESSEUSTYLE DEEP FRIED OR STEAMED 5 95
WITH SHRIMP,CUCUMBER,ONION,CARROT,CABBAGE AND 33.YING'S FRIED RICE 8.95 SI.MOO PAD-PRIG KING 9.95 6.WASABI SHUMAI
HARD BOILED EGG ASSORTED VEGGIE AND EGG 5.95
STIR FRIED STRING BEANS IN HOT PRIG KING SAUCE JAPANESE-STYLE DEEP FRIED OR STEAMED
16.YUM WOON SEN 7.95 34.STEAMED WHITE RICE OR BROWN RICE 1.50 SEAFOOD N PANCAKE 7.95
I SCALLO
SILVER NOODLES WITH SHRIMP,GROUND CHICKEN,SEASONED 7.SCALLION
SCALLION AND SEAFOOD WITH H EGG BATTER
WITH THAI HERBS,HOT SPICY SAUCE AND LEMON JUICE
52.GARLIC&PEPPER SHRIMP 10.95