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WILLOW TREE MARKET - FOOD
Willow Tree Market ° 15 Charles Street Hyannis 327-OZ`� I Town of Barnstable BOARD OF HEALTH CJohn T.Norman Board of Health Donald A.Gaudagnoli,M.D. Mrt..NimAB,e, F.P.(Thomas)Lee,. 6 4 200 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, 3056, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 752 Issue Date: 01/01/2022 DBA: WILLOW TREE MARKET OWNER: SHER CORP Location of Establishment: 15 CHARLES ST HYANNIS„ MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $100.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - - - MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: i Town of Barnstable For Office Use Onlv: Initials: Date Paid 0 Anit Pd$ rp MASS.BARNSTABM t Inspectional Services �$ Public Health Division Check# Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 . APPLICATION FOR PERMIT TO OPERATE 'A/FOOD ESTABLISHMENT DATE l'Z+Z NEW OWNERSHIP RENEWAL V NAME OF FOOD ESTABLISHMENT: 514E1? ce (�du will", I rc - 1'"J. ADDRESS OF FOOD ESTABLISHMENT: S ckrIS5 St ` Gnn;S /r 02�01 MAILING ADDRESS(IF DIFFERENT FROM ABOVE):E-MAIL ADDRESS: Sl4C-k L,O�P© OUf10'6/C•C4M TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( ) qa _ 1177 TOTAL NUMBER OF BATHROOMS: 1 WELL WATER:YES NO X ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: x SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: 0 OUTSIDE: p TOTAL: V SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE X 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.FonnsTOODAPP REV3-2019.doc OWNER INFORMATION: FULL NAME OF APPLICANT RA►�fiGl C�agd{�/y SOLE OWNER:- 'F /NO OWNER PHONE# Rbf ZV 3fsSt 3 ADDRESS �I_ *f V��461) Or Spyd"A /44 62 S63 CORPORATE OWNER: SAe f C61)1. CORPORATE ADDRESS: / S- 1,Ai4 !�-k HY611.4'i N* -OZ GUl PERSON IN CHARGE OF DAILY OPERATIONS: PCA t I C 64u r List (2) Certified Food Protection Managers AND at least(1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 2. ll Zap Z� 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 openimfl Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.31 s`each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Applicatioa FormsTOODAPP REV3-2019.doc MAIL-IN REQUESTS Please mail the completed application form to the address below. Also include copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, please include the required fee amount (see fees at bottom of this page). Make check payable to: Town of Barnstable. Our mailing address is: Town of Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, please fax copies of your employees' food protection manager training certificates (at least two) and food allergen awareness training certificate (at least one.) In addition, you must mail the required fee amount(see box below). Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. FEES: Bed&Breakfast Permit= $55; Food Service Permit 0-49 seats= $250; 50 or more seats $300; Continental Breakfast= $30; Retail Food(only TCS Foods)= $20; Retail Food Store—Less than 8,000 S.F. _ $100, more than 8,000 S.F. = $285; less than 1,000 S.F.; Retail Food Combo/Limited Prep. - $200.00; Cottage Food Industry=$75; Mobile Truck= $50; Mobile Ice Cream Truck= $35; Frozen Dessert License=$30; Additional non-refundable Fee for New Establishment or New Ownership= $100-$500(see staff), Late Fee= $10 Q:Wpplication FormsTOODAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,.M.D. BAMNSrx�si..e. '' Paul J.Canniff,D.M.D. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: 508 862-4644 Fax: S08 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: 752 Issue Date: 05/7/2021 DBA: WILLOW TREE MARKET OWNER: SHER CORP Location of Establishment: 15 CHARLES ST HYANNIS, MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $100.00 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, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: KE Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. DARNSrABUL Paul J.Canniff,D.M.D. Maw F.P. Thomas Lee Alternate 200 Main Street, Hyannis, MA 02601 FaR Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 752 Issue Date: 05/03/2021 DBA: WILLOW TREE MARKET OWNER: WILLOW TREE MARKET INC. Location of Establishment: 15 CHARLES ST HYANNIS, MA 02601 Type of Business Permit: RETAIL- FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 10 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $200.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Initials: Town of Barnstable Date �;bl_ Amt Pd$ Inspectional Services ` MAW l� 16 •~'� Public Health Division Check# C 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 NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ✓/lel coo?; ita yKAW I� / ykl c—f ADDRESS OF FOOD ESTABLISHMENT: l.S C)6 rleu 5-1 �yGyhi� /w GZ bol MAILING ADDRESS(IF DIFFERENT FROM ABOVE):) E-MAIL ADDRESS: .S he6rP 0 00 4,,k- &m TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( 6S) TOTAL NUMBER OF BATHROOMS:_ WELL WATER: YES NO V ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: V SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: ZU OUTSIDE: 0 TOTAL: 20 SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING.MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING.AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) _FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTPIENTAL 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 FonnsTOODAPP 2020.doc ~OWN�R INFORMATION• FULL NAME OF APPLICANT �p6ej CW6� SOLE OWNER: OS /NO OWNER PHONE # �(6 ZqZ f�`3 ADDRESS 1 &Y'etw;"'-Id JY" -52)4#14 All 0-2 5�3 CORPORATE OWNER: CORPORATE ADDRESS: `S1 C&& St PERSON IN CHARGE OF DAILY OPERATIONS: ' CMG 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. SUB j 2. kooll k "ovi W�& 1*t t�ea0^. /X/ C 1 'C/ 01V l,?I l 2,4c)Z 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 508-862-4644 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 H alth 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 htti)://www.townofbarnstable.us/healthdivision/ai)Dlications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Guadagnoli,M.D. Bauer URIX # F.P.(Thomas)Lee 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,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: 752 Issue Date: 5/3/2021 DBA: WILLOW TREE MARKET OWNER: SHER CORP Location of Establishment: 15 CHARLES ST HYANNIS, MA 02601 Type of Business Permit: Non-Flavored Annual Seasonal FEES YEAR: 2021 TOBACCO SALES: $85.00 Permit Expires: 12/31/2021 Thomas A. McKean, IRS, CHO, Health Agent Restrictions: Will provide Servsafe/Allergen if commercial kitchen is re-instated. PLEASE POST CONSPICUOUSLY ' 1 For OMce ice t)d Initials: 'Town. of Barnstable k, DAte Eajd dg, Inspectional Servicesd S „ . Pubic Health Division �-- Thomas McKean,Director 200 Main Sheet, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 TOBACCO ES'I'ABLIM1EENT PERMIT.APPLICATION Non-Flavored DATE. NEW BUSINESS OWNERSHIP RENEWAL NAME OF TOBACCO ESTABLISHMENT: iikrj f ADDRESS OF TOBACCO ESTABLISHMENT: 1 s . e�tq�?es: S PY 6 /fir 02 40/ MAILING ADDRESS(IF DIFFERENT FROM ABOVE): EMAIL ADDRESS: GrO1 .Co+'N TELEPHONE NUMBER OF TOBACCO ESTABLISHMENT: �' 1177 OWNER'S NAME:.—.� � OWNER'S PH#,M2X.- 33 OWNER'S ADDRESS: L e ... 5qA 6 CORPORATE NAME: CORPORATE AD CRESS: Tfi __ c3Zl�l CORPORATE ANNUAL: SEASONAL: DATES OF OPERATION; 1 f TO f � DAYS CLOSED EXCLUDING HOLIDAYS(EX.MONDAYS) _ 116xe TOWN OF BARN'STABLE CODE/MA_GENERAL LAW INTERNET_LINKS: TOWN OF BARNSTABLE TOBACCO CODE LINK FOR CHAPTER 371-9: httus.'/www,gcode360.com/33996392 MA GENERAL LAW CHAPTER 2701SECTION 6: htt 's:t/male islature. ov/l aws/Gen ralLgw /PartIV/Titlel/Cha ter270/`Section6 ***NEW BUSINESSES AND NEW OWNERS ONLY*�* REQUIRED TO CALL HEALTH DIVISION AGENT FOR AN INSPECTION PRIOR TO PERMIT BEING ISSUED, PLEASE CALL 508-375-6621 ALL APPLICANTS ARE REQUIRED TO SUBMIT THE FOLLOWING REQUIRED DOCUMENTS; 1) MA State License to Sell Cigarettes 3) IRS Federal Tax ID#Document 2) MA State License to Sell Cigars and Stroking Tobacco 4) Payment of Fee(s) -see page 4 SIGNATURE: ��AGi e 1 ,qu PRINTED NAME:. DDATE:U 1 lZ l ZOz Q:tApplication Form<1T'OBACCO APP-NonFavor 12-18-19.docx I kildi., Tr"pjoc-r ESTABLISHMENT'S NAME TOBACCO SAES 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—4 371-9. Sale and Bistributjon 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 of2�7. The employees)below 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: � h Signature _ hinted Naive T, Date Signature Panted Name Date Signature Printed Name Date Signature Printed Name Date Signature _ Printed Name Date Signature Printed Naive Late Signature Printed Name Date Q:tApplieation Forms\TOBACCQ APP-NonFavor 12-18-19.docx 5%t�rFj� Commonwealth of Massachusetts Letter ID: L1526683968 Department of Revenue Notice Date:December 21,2020 �a Geoffrey E.Snyder,Commissioner lf Account ID:CGL-19734082-003 ftiTriypt��� mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARETTES . 11111111�ni11�nl��l�ln�rll�ili1�l11�i1�il11llll�l�l��ln��lu o R CHAUDHRY S= SHER CORPORATION N 15 CHARLES ST HYANNIS MA 02601-5596 Attached below is your Retailer License for Sale of Cigarettes (Form CT-3). Cut along the dotted line and display at your business location. At any time, you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800)392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ------------------------------------------------------------------------------------------------------------------------------------------------ s?X,c sFT� MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3 R � Retailer License for Sale of Cigarettes y & This license must be posted and visible at all times.The sale of tobacco products to anyone under 21 years of age is prohibited. SHER CORPORATION Account ID: CGL-19734082-003 15 CHARLES ST License Number: 1620789248 HYANNIS MA 02601-5596 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date: December 21,2020 Expiration Date: September 30, 2022 t�sF Commonwealth of Massachusetts O R Letter ID: L0901454144efl_ s Department of Revenue Notice Date:December 18,2020 ■Fir • c �+' Account ID:CRL-19734082-006 +,1. Geoffrey E.Snyder,Commissioner f �'h rcrc mass.gov/dor RETAILER LICENSE FOR SALE OF CIGARS AND SMOKING TOBACCO Jill o= R CHAUDHRY o SHER CORPORATION 15 CHARLES ST HYANNIS MA 02601-5596 Attached below is your Retailer License for Sale of Cigars and Smoking Tobacco (Form CT-3T). Cut la-y..at-your business on. At any time,-you-carL log into-your-, Mass axConnect�accountdatpm ss.gov/ma staxconnecti to view nd re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800) 392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ------------------------------------------------------------------------------------------------------------------------------------------------ 5'XCH sF�� MASSACHUSETTS DEPARTMENT OF REVENUE Form CT-3T ' Retailer License for Sale of Cigars and Smoking Tobacco Y�J it y oF�` This license must be posted and visible at all times.The sale of tobacco products to anyone under 21 years of age is prohibited. SHER CORPORATION Account ID: CRL-19734082-006 15 CHARLES ST License Number: 1641453568 HYANNIS MA 02601-5596 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell at retail at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:December 18, 2020 Expiration Date:September 30, 2022 .cHt�rF Commonwealth of Massachusetts O'O � Letter ID:L0436595008 Department of Revenue � Y p Notice Date: December 21,2020 6 ;1•, i ;� D Geoffrey E.Snyder,Commissioner Account 1D:EDL-19734082-009 Y Os mass.gov/dor LICENSE FOR SALE OF ELECTRONIC NICOTINE DELIVERY SYSTEMS ili lilni�n��l1i1�1�1��11illlil�lulilili1111i�11�1�linli��li1 o— R CHAUDHRY a=_ SHER CORPORATION 15-CHARLES ST MOM HYANNIS MA 02601-5596 Attached below is your Retailer License for Sale of Electronic Nicotine Delivery Systems. Cut along the dotted.line and display at your.business location. At-any time, you can log into your MassTaxConnect account at mass.gov/masstaxconnect to view and re-print a copy of this license. If you have any questions about your license, call us at(617) 887-6367 or toll-free in Massachusetts at (800)392-6089,Monday through Friday, 8:30 a.m. to 4:30 p.m. DETACH HERE ------------------------------------------------------------------------------------------------------------------------------------------------- '`` sF�� MASSACHUSETTS DEPARTMENT OF REVENUE Retailer License for Sale of Electronic Nicotine Delivery Systems y This license must be posted and visible at all times. The sale of �F�7 OFF tobacco products to anyone under 21 years of age is prohibited. SHER CORPORATION Account ID: EDL-19734082-009 15 CHARLES ST License Number: 1946339328 H`lANNIS MA 02601-5596 This certifies that the taxpayer named above is licensed under Chapter 64C of the Massachusetts General Laws to sell electronic nicotine delivery systems at the address shown above. This license is non-transferable and may be suspended or revoked for failure to comply with state laws and regulations. Effective Date:December 21, 2020 Expiration Date: September 30, 2022 �pF THE TOWN OF BARNSTABLE - HEALTH INSPECTOR,s Establishment Name: �,�IItU}nl 11G� M()1�( Date: a Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSrARLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY ,e n 508-862-4644 'FO MPS FOOD ESTABLISHMENT INSPECTION REPORT Name 11I�WffCe 1v 1C1f kj�t Date I q 122 Type of Type of Inspection Operation(s) Routine Address I5 Ch ,( `.eSS J Risk Food Service Re-inspection Y` 1(� `� \� 1 1 Level Retail Previous Inspection 9"ocd ` ' 1� Telephone Residential Kitchen Date: ne Mobile Pre-operation It Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP 0 In: Other Inspector --yoydan v 1 Out: 3 I w Each violation checked requires an explanation on he narrative page(s)and a citation of specific provision(s)violated. L Q Z 'r Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ l Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ - Q lr Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands C 1 S 1.PIC Assigned/Knowledgeable/Duties 13.Handwash Facilities AMMU J EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures bond.uk-0-s ❑ 5.Receiving/Condition ❑ 17.Reheating - _ vn t a (VQQj ' Q ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling _ � � Y ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control v bC S ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP U)Qi 1 c ncA- now rnr- MS t _,10.Proper Adequate Handwashing CONSUMER ADVISORY V L ` V7 �li }� ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations t Critical(C)violations marked must be corrected immediately. (blue&red items) �) VJ 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 ❑ 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. ❑ g ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (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 er 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 ti l i violations and less than 9npn-critical. If no critical water,sewage back-up,27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical9 p,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) receipt within 10 days of recei t of this order, violation,4 to 8 non-rritir..al violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Si nature Print: 31.Dumpster screened from public view -Tcy-c n '(n V, la-4 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N ��JJ11�LJJ�R//�� l_J� #Seats Observed Frozen Dessert Machines: Outside Dining Y N P Ignature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N „�-._.,_°„`.r.. r_w-.-.,.� -.�,.,.�.r�ro.-...r-��..._ -._-.�.r ,.-._-..:.-�..,__-a.,! -:._ _ ...� .-., _.__T _ _... .....�, ..s .,-°-. �__.� �... � -�. _.. -.-- ...-w-�-.- .-�. �,�r.- ,- -q -.ter... �----�._•- .. - - - ., -- '�-?'�c-.^- �� 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-Chazge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 95 590.004(F) Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°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 7-101.11 Identifying 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 Se azation-Storage*Applicants* 3-302.11(A) Food Protection* P g * 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use 590.003(F) Responsibility of A Food Employee or An 3-302.15_ Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance 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 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 Wanting Labels* 4 Food and Water From Regulated Sources ! y Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* I 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Elf-"-1012001 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 Stuffin Containin Fish,Meat,Poultry or 3-201.15 1 Molluscan Shellfish from NSSP Listed_ _ _ Chemical* g g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- - Sources* Ratites-165*F 15 sec* ing,mobile food,temporary and residential 1 p Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* - 3-403.11 C Commercial) Processed RTE Food-140°F* Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the g 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 3-202.18 Shellstock Identification 3-501.14 A CoolingCooked 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 4l°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 .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. THE r TOWN OF BARNSTABLE. HEALTH INSPECTOR's Establishment Name: Date: OV Page: Of OFFICE HOURS AR Eo: PUBLIC 200 MAIN STREET DIVISION , t 3:30-4:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified mass. g. MO -FRI. � ,bsv, �• HYANNIS, MA 02601 508-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT Name Da Type o Type of Inspection Operations) Routine Address Risk Foo ervice Re-inspection ` Leve etail Previous Inspection Telephone esl ential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Bed&Breakfast -Other Inspector Out: zea 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 +rkz ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling. ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) fti;`` ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories �' Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) _ Corrective Action Required: No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo Emergency Closure Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of,the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005 6=One critical violation and less than 4 pop-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. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and.cessation of food establishment operations. If Seriously Critical Violation F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,yu have a right.to a hearing. Your request must C=2 critical violations and less than i Ical critical. If no 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; . to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials. ( )( ) violation;4 to 8 non-nritical 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 Y g #Seats Observed Frozen Dessert Machines: Outside Dining N PIC's Si ture Print: - Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N L0. - 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* 6 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Not and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45`F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*7-102.11 Common Name-Working Containers 590.004(F) * 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separationg-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(17)i 7-202.11 Restriction-Presence and Use*_ Responsibility of A Food Employee or An 3-302.15 .Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11' Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for 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 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 * Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145'F 15 sec* 5-101.11 Drinking Water from an Approved System gg Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 4-602.11 Cleaning Frequency of Utensils and Food 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ep t-11112001 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 Fisfi and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practiceRequirements.sshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 PreventingContamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g 3 403,11(C) Commercially Processed RTE Food-140°F 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* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 13 Handwashing Facilities * 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 * 5-205.11 Accessibility,Operation and Maintenance 3-402.12 Records,Creation and Retention Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 130. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc '-Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 1 i INS V� 3 °FINE r°h TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: of ti 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 HYANNIS, MA 02601 NON.-FRI.508-862�644 No Reference R-Red Item PLEASE PRINT CLEARLY 'rev MPS p, FOOD ESTABLISHMENT INSPECTION REPORT Name 1 -� Date Type of Tyoe of Insoection L'" Routine i Address y/` Risk odd erui Re-inspection _ Level a ai Previous Inspection Telephone ential Kitchen Date: 'r' a!7 Mobile Pre-operation 4t Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) 3 !me Bed&Breakfast HAe a oe I 1 Inspector L 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 c / ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities 9 i EMPLOYEE HEALTH PROTECTION FROM CHEMICALS n ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) / Al ❑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 V \� 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. 0? ❑ 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 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6von-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 i cal violations. . f critical water,sewage bads-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 a non-critical violations. If 1 critical refrigeration. violation,4 to Snon-critical violations=C. .Special Requirements ( ) 590.009 within 10 days of receipt of this order. 30 s Signature Print: Ins ector' _ .Other _ DATE OF RE-INSPECTION: 31.Dumpster screened from public view �/)� � Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N / �'� #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions 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 r 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41'F/45'F Within 4 Hours* 590;:003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 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* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( P 4-501.111 Manual Wazewashin Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* 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 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 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 1/1r2001 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 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-(D)in cater- * Ratites-165*F 15 sec* in mobile food,temporary and residential Sources � 10 Proper,Adequate Handwashing g' P �' Game and Mid Mushrooms Approved By * 3-401.l l(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* 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 Remaining Unsliced Portions.of Beef Roasts* 3-101.11 Food Safe and Unadulterated �) g illness interventions and risk factors listed above,can be found in the 6 TagsiRecords:Shellstock 590.004(E) Preventing Contamination from Employees* Lu Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 3-501.14 13 Handwashing Facilities Cooling Cooked PHFs from 140*F to 70'F (A) g 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70'F to 41°F/45°F Item Good Retail Practices FC 590,000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41`F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Han dwashing 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 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. Fzz THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Application for Dispnstt1 Works Tonstrudiurt jkrutit Application is hereby made for a Permit to Construct ( ) or Repair (L-) an Individual Sewage Disposal System at: s --.... � w .: kQ . ......-----1..: _ � MT ............ Loca res or o No. �� .......... ��nu,sc :...._ .: ...................... ................ �' s5 x.�r._..... ..�?:u:.sP..... ....... A dress ............L.....ZA t2L .................. ...............••--=1 �!ckw ��.5..---- ...•--.......... ............... M Installer Address Q7i Type of Building Size Lot.....................:......Sq. feet U Dwelling—No. of Bedrooms......................... ____.Expansion Attic ( ) Garbage Grinder ( ) Other— e W yp of Buildin g ..�.C�L�-•,�U� No. of persons____________________________ Showers ( ) — Cafeteria ( ) dOther fixtures ..............• •-•----------.._._............_...--•••••---........_..'......-•••-•------•-----••--•••-•-•••-•---••.........•-•---••-•..........._... WW q Design Flow.........._....................._...........gallons per person per day. Total daily flow........................._............-.....gallons. W "/ r—Fank—Liquid capacity- Mgallons Length....F._...... Width,_..`-{........ Diameter________________ Depth................ xDisposal 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 ( ) aPercolation Test Results Performed by.............._............................................................ Date......................................... Test Pit No. 1________________minutes per inch Depth of Test Pit.................... Depth to ground water................._...... f=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wafer------------------------ .............................................---------------------------------------------------------------------------------------------=-------•-------......_....._:..-------••--•----•----•------•... 0 Description of Soil.....................•--..........-••-•-•---••-••--•--------•---••-----...-•--••------------...--•---•--••--•--••---------...._._._:...------•--•--.................._.. W V -••• --••-••-----•--.._..---•-••----------•---•----•---------- ----------- •--------- -------------•••------_-•-- ---•----____--•--_______---_____-_-------•--•---____-.........--- W UNature of Repairs or Alterations—Answer when a plicable......:.X1✓�&_S.AAt..:___._..`__ ........ �.�....... .�,,`w.. -`�-`'`-'_�`_'•_--•--.�.. -Y ......... ........................................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisioiis of iITL i� 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed.......... ----------------- --.._.-- ---- a - --- -------- Date Application Approved By.................. ......................... ........... .- 7 Date Application Disapproved for the following reasons:........................................................................................................... ..................•---......-•---...........---...........__....•---•---•--•--..._._............_..........---------^---...._•--....._....•-•---•••-•--•--•-----•-•----......---•--• ....----•---- Date PermitNo.---- 7.".._....1-- ........................_ Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD.. OF HEALTH Application is hereby made for a Permit to Construct ( ) or Repair (L-) an Individual Sewage Disposal System at: or Lot No. Own ess Installer Address � Type of Building Size Lot. Sq. feet Dwelling—No. of Bedrooms -----------------Expansion Attic ( ) Garbage Grinder ( ) of Building '!EL7_/70-:2� No. c6 persons............................ 86mwcco ( ) -- Cafeteria ( ) '- Other fixtures ....................................................................................... ............................................................. ........................................go1lnm per person per 6uy` Total daily flow............................................ . ~7 —Liquid gallons Length-'�F ....... Widt6_. 4........ Diameter—...---- Depth................ Trench--No..................... Width.................... Total - Total leaching area....................sg f t. Seepage Pit BJu-----_...— Diameter.................... Depth below inlet.................... Total leaching area..................sq. f t. Z Other Distribution box ( ) Dosing tank ( ) � ~~ Percolation Test Results Performed by.---.---'---'----'_--_-----'-'--------' Date........................................ 1.4 Test Pit No. l................minutes per inch Depth c6 Test Pit.................... Depth tn ground water........................ Test Pit No. 3___'--'�iooteeper i�6 Depth of Teo �.------'--'� Depth to ground water----------- A4 ' ------.---.—.----_-_--__--_---'-----------__--___-_'/`'_---'_-'---___'--- �� _ c� So�____-____-__-' -__'-_-----_—__---'�-'-'------------------------ �� '_---' .... ............................................................................................. -- Agreement: | The ��u to ��u d� u��d�c��d �d��u Sewage D�nmu System in accordance with | undersigned ^ ~ the provisions of T I TlZ 5 of the State Sanitary Code—The undersigned further agrees not to place the system in i Bellaire, Dianna From: Saeed Chaudhry <chaudhry43@yahoo.com> Sent: Monday, December 14, 2020 11:33 AM To: Bellaire, Dianna Cc: McKenzie, Marybeth; Parvin, Lindsay Subject: Re: 2021 Permit for Willow Tree Market- new ownership? Hello Dianna, Thank you for the notice,we will apply for all the required licenses and permits as soon as the transfer is complete with the ABCC and before the actual business transfer begins. It can take up to 8 weeks for the ABCC to approve the transfer of the beer and wine license, especially with COVID happening. Until then I am still running the business.The new owner will be in touch over the next few weeks to get their permits ready and potentially go in front of the Board of Health. If you have any questions you can reach me at 508-274-6666 or this email. You can reach the new owner Raheel Chaudhry at Rchaudhry292@gmail.com or at 508-292-3883. Have a great week, Saeed Chaudhry Sent from my iPhone On Dec 14, 2020, at 10:33 AM, Bellaire, Dianna <Dianna.Bella ire@town.barnstable.ma.us>wrote: Mr. Chaudry, I just received a notification that you are selling Willow Tree Market. The person who is buying Willow Tree Market, needs to apply for a retail food permit AND we will need new Tobacco Licenses from the state for Sher Corporation. Please have the new owner contact Ms. Marybeth McKenzie(copied on email) regarding food permit. Her phone number is 508-862-4649. 1 see you renewed for 2021 but,the new owner should have renewed. She is copied on this email and there is a variance in place. The new owner may need to go before the Board of Health regarding this variance. Please let me know the time frame of the new ownership. Thank you. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us TOWN O� BA:�ZNSTABLE LOCATION S � ,� e SEWAGE # -zj�j VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. iz C TANK CAPACITY 1 LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL QR-P LIC WATER a BUILDER OR OWNER o--Avw"i_. Fy,C Ly- --t— DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No au ' 1 1 p nyV S o G cyfw t�a� �C2YtiP V.) oft G z; YL a I Bellaire, Dianna From: Raheel C <rchaudhry292@gmail.com> Sent: Friday, May 07, 2021 10:05 AM To: Bellaire, Dianna Subject: Re: Food Permit for Willow Tree Hi Dianna, We've decided to not apply for the food permit right now and will just do an application whenever.we have something in place for the deli area. If you can void the check that would be great and I can drop off a$200 check on monday. Thank you for the help!! Have a great weekend, Raheel On Fri, May 7, 2021 at 9:52 AM Bellaire, Dianna<Dianna.Bellairegtown.bamstable.ma.us>wrote: Hi, I heard from Marybeth that she has given you a choice to apply for the food permit and take care of the code issues or you can just adjust to a retail permit. I have your check for$300.00. If you are going to just stay with a retail permit, then you would only need to pay $200.00. 1 can void this check with accounting because it hasn't been taken to the bank. If you want to apply for the food then I will keep this check. I need to know if I must contact accounting to make sure this check is not processed fully. Please let me know. Thank you. d i Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 F P:508-862-4643 i Fax:508-790-6304 i , 1 1 s� f /w�.� F r y. .y�. 1 /1?��' 1 d rs7 u►L t - r • s 4 1 : t • f w Sr �c , - 1 i i{+ UP cr 4- 1 f a f � , , -- r � r , t l 4 � 1 78 _ 40;t&r+t.. It 44 J��O,4t,14- 1, Rol ..... _ l yy ?, k - r i u , i E a,a - - — f Lx t, .+��w'T.._wwr,�rr ..rer...r �]�±IMY� w�.�.M�^.-„_._.�..-w—• 4 v Val 44 • , T 6b � -