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Home My WebLink AboutBLUE MOON RESTAURANT - FOOD ' BLUE MOOht•' �.- �� RESTAURANT 430 Main St., HYA s WE Town of Barnstable BOARD OF HEALTHJohnT. Norman Board of Health Donald A.Gaudagnoli,M.D. BARNSTABLE. 2 F.P.(Thomas)Lee,. 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: 357 Issue Date: 01/01/2022 DBA: BLUE MOON OWNER: BLUE MOON AT 430 MAIN ST. INC Location of Establishment: 430 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 30 OutdoorSeating: 24 Total Seating: 54 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Qh 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 I Restrictions: APPROVED-2014 Grease Trap-1000 gallons, shall be inspected monthly and shall be cleaned when the level of grease is 25% of the effective depth or at least eery 3 months. Town of Barnstable Office Oce Use Only: Initials: �' Date Paid Amt.P� AM : Inspectional Services $ Public Health Division Check# Cash D PAA�A Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Offcc: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 10 ` NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: (�Lu% zwqo 3,1—ac r ADDRESS OF FOOD ESTABLISHMENT: 4>OSLr, tt`f A1��\S , 6J114 60 MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: ��►�1l:��eA'2t P,{��.A►� Y ,[Z,OtJ.ITT TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( TOTAL NUMBER OF BATHROOMS:4 WELL WATER:YES NO ✓ ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL:_Z SEASONAL: DATES OF OPERATION: / /_ TO NUMBER OF SEATS: INSIDE: 7g OUTSIDE: TOTAL: (� SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING.AND MEET OUTSIDE DINING REOUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? i &5 IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? 00 TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-8624644 Q:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT A%KCA RJ- - SOLE OWNER: YE /NO OWNER PHONE#�r ADDRESS_ T`�LN%ati ST,.[xi�5'1 �'—�C�S I Tt aA �� 3 CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least (1) Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. ✓tL�ks 6m%xx>— IL /01 / 1.A-� m JoW-�Ow 08 /.26 Q036 2.A SEA �©W\)S© (0 Q /d2 J�V XQ6 / 9 /gcai 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 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 htW://www.townotbarnstable.us/bealthdivision/apulications.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 APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Wpplication FormsTOOD.APP REV3-20Rdoc 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:'Application FormsTOODAPP REV3-2019.doc Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. ads.�r�r, � F.P.(Thomas)Lee a 200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D.,Alt. Phone: (508) 862-4644 Fax: (508)790-6304 III 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: 357 Issue Date: 09/23/2021 DBA: BLUE MOON OWNER: BLUE MOON AT 430 MAIN ST. INC Location of Establishment: 430 MAIN STREET HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 30 OutdoorSeating: 24 Total Seating: 54 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: ( � 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: APPROVED-2014 Grease Trap-1000 gallons, shall be inspected monthly and shall be cleaned when the level of grease is 25% of the effective depth or at least eery 3 months. I Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. [ ' Paul J.Canniff,D.M.D. � �. 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 357 Issue Da te: 01/01/2021 DBA: BLUE MOON OWNER: BLUE MOON AT 430 MAIN ST. INC Location of Establishment: 430 MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 38 OutdoorSeating: 24 Total Seating: 62 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q.n FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: APPROVED-2014 Grease Trap-1000 gallons, shall be inspected monthly and shall be cleaned when the level of grease is 25% of the effective depth or at least eery 3 months. For Office Us Initials: Town. of Barnstable �" Date Paid ��17z Aait Pd$ 31a s RAWWASM a Inspectional Services 16"3 •`� Public Health Division Check# 1�l �31 Thomas McKean,Director 200 Main.Street,Hyannis,MA 02601 Offm 508-862-4644 Fax: 508-790 6304 I APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: 9&6 AM/--/ Atr 1� A/*01 ADDRESS OF-FOOD ESTABt tSE[MENT-- MAILING ADDRESS(IF DIFFERENT FROM OVE): E-MAIL ADDRESS: ,I , CQlil f TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (SDE) - TOTAL NUMBER OF BATHROOMSt(ANNUAL WELL WATER:YES NO .. WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: % I TO % C _NUMBER OF SEATS: INSIDE: —DA OUTSIDE: &4 TOTAL: Q& l c� SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. **9UTSIDE DINING RED*** OUTSIDE DINING;MUST BE APPROVED By THE REALT€t'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 ESTABLISIIMENTi (PLEASE CHECK ALL THAT"APPLY BELOW) �g/1~O0D SERVICE -RETAIL FOOD ,ONLY-regaired for TCS foods-(foods requiring refrigeration/freezer) RED&BREAKFAST' CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD -FROZEN DAIRYDESSERT MACHINES...-(MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE 42) *** SEASONAL,.MOBILE&NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLKASKCALL SW862-46444 QAAM ication F0r=\FWDAPP.2Q20.doc OWNER INFORMATION: FULL NAME OF APPLICANT" SOLE OWNER: YES/NO OWNER PHONE# �. 041 ADDRESS Q� �J'�-- CORPORATE OWNER: CORPORATEADDRES& PERSON IN CHARGE OF DAILY OPERATIONS:, _ ` ' 0 List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All-FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date L.ve"�na (-/AMCXQ 20 Tb� IM , (V- 2�a 0/ 43/Z z _ SIGNATURFi4l/F APPLICANT' DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:Ali 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 htta://www.townofbarnstable.us/healthdivision/ayvlications asp. OUTDOOR COOKING: Outdoor cocking,preparation,or display of any food product by a food establishment is prohibited NOTICE: Permits run annually from January 1st to Dec.316t each calendar year. IT 1S YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st.. Q-1Applicatian Fo=XFOODAPP REV3-20.19Aoc Bellaire; Dianna From: Scali, Richard Sent: Monday, February 22, 2021 12:10 PM To: charltonferguson@yahoo.com; 'fullbluemoon430@gmail.com' Cc: Parvin, Lindsay; 'Gallant,Therese'; Gallant, Therese; Flynn, Margaret; 'hoxiesr@comcast.net'; Murphy,John; Bellaire, Dianna; Florence, Brian; McKean,Thomas; Coyle, Brenda Subject: Blue Moon- actions to be taken Dear Aubrey and Charlton: Thank you for appearing today at the Licensing Authority hearing.The following is just a reminder of what actions are needed by you to correct the license at 431 Main St.to reopen on April 1st: 1) Appear at our March 22 Licensing hearing to update the Board. 2) Apply for a change of manager to Charlton. See our website under Licensing Dept, applications, alcohol,change of manager. 3) Apply for any entertainment you wish to continue. See our website under Licensing Dept, applications, entertainment. Right now you do not have permission for any entertainment.You will need a plan showing the areas of entertainment, provided by an engineer to scale and approved by the Building Commissioner. Lindsay will hold the money already paid on the entertainment if and until the application is approved. 4) Make sure you have your Certificate of Inspection From Building( Brenda) with the correct numbers-38 interior seats, 24 exterior for a total of 62. Lindsay will correct your license and reissue it to you after March 22d. 5) Make sure you contact the Health Dept. (Dianna) to make sure you renew your health permit and submit all the information needed for fees and Serve Safe etc. 6) Renew your Patio agreement in March with the town. Lindsay will send out a renewal agreement to you in March to start April 1st. 7) Right now if you were to open, pursuant to the Governor's orders,your capacity would be at 40%, or 15 persons inside.This could change in the near future according to when the Governor changes the orders. Lindsay or myself can assist you with any of the applications and she can advise you on deadlines to apply and be heard. Thanks again for your appearance today and your willingness to adhere to this plan. If you have any questions, please do not hesitate to contact us. Richard Scali Licensing Director Richard V. Scali, Esq, Licensing Director Town of Barnstable 200 Main St. Hyannis, MA 02601 508-862-4778 508-778-2412 fax 1 Bellaire; Dianna From: Stanton, David Sent: Wednesday, May 05, 20218:49 AM To: Bellaire, Dianna; McKenzie, Marybeth Subject: RE:yesterday site plan I don't know,you need to wait for his updated application and what he puts on it and charge him accordingly. He still has to have licensing hearing abot.t seat changes. As far as Health, it cannot exceed 66 seats if that helps and he is not exceeding 66 seats. Thanks, Dave From: Bellaire, Dianna Sent: Wednesday, May 05, 2021 6:47 AM To: Stanton, David; McKenzie, Marybeth Cc: Bellaire, Dianna Subject: RE: yesterday site plan Dave can you give me the seat count for Blue Moon on the new one? I know he was going to lower seats. It may change his fee. Thanks. Dianna Bellaire Permit Technician Town of Barnstable Health Division 200 Main Street Hyannis, MA 02601 P:508-862-4643 Fax:508-790-6304 Email:Dianna.Bellaire@town.barnstable.ma.us The information contained iri this electronic transmission("e-mail"),including any attachment(the"Information"),may be confidential or otherwise exempt from disclosure.It is for the addressee only.This Information may be privileged and confidential work-product or a privileged and confidential communication.The Information may also be deliberative and pre-decisional in nature.Assuch,it is for internal use only.The Information may not be disclosed without the prior written consent of the Director of Public Health and/or the .1 own 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 not copy or forward it.Thank you for your cooperation. From: Stanton, David Sent: Wednesday, May 05, 2021 7:52 AM To: McKenzie, Marybeth Cc: Bellaire, Dianna Subject: yesterday site plan FYI, -Chez Antoine, 357 Main st, Hyannis is all set(obviously need to apply, permits, inspection, approval...) 1 -Blue Moon, 345.Main st, Hyannis is all set(obviously need to apply, permits, inspection, approval...) Note: Bread & Roses, 302 Main st. did NOT get approved,they were a no show. Last week they had issues as they need a grease trap or variance. Thanks, Dave 2 i Bellaire,-Dianna >V d v From: Hartsgrove, Elizabeth Sent: Thursday, May 13, 2021 1:49 PM To: Igeminicaribbean@verizon.net'; 'sugard681@gmail.com'; 'charltonferguson@yahoo.com'; 'fullbluemoon430@gmail.com' Cc: Parvin, Lindsay; 'Gallant, Therese'; Bellaire, Dianna Subject: RE: Blue Moon- actions to be taken Good afternoon Aubrey and Charlton, This email is to confirm: • Recommendations from staff at Site Plan that in order to make adjustments within Blue Moon to reduce seating and add a smoothie bar,that an Alteration of Premise will need to be filed with the Licensing Authority. The application can be found on the ABCC's site https://www.mass.gov/guides/amending-vour-alcoholic-beverages- retail-license-abcc • Also, it is recommended that you proceed with a change in manager if Charlton is to continue representing the operation and sign paperwork, as you indicated to Mr. Scali and others in the past.This change will also need ABCC approval through their application found online and filed with the Town for a public hearing consideration. As a reminder,you do NOT have a 2021 license for Blue Moon. As part of the conditions the Board placed,you must come back to them In a public meeting to provide an update.Therefore I am placing you on the May 24 to agenda for that update; this will ensure you have the opportunity to get your licenses issued before Memorial Day weekend. KEEP IN MIND:this license renewal will not incorporate any seating adjustments or the smoothie bar. It is only for renewing the old license. If you have any questions, please feel free to contact me directly. In the meantime, please submit your paperwork for the alteration of premise and change of manager asap, and we will see you on the 24th for the Update to the Licensing Authority. Thank you, Liz Liz Hartsgrove Deputy Director of Asset Management/Licensing Director Town of Barnstable 367 Main Street Hyannis,MA 02601 508-862-4068 Barnstable Mission:Protect the 7-own's quoNty of life and unique character;Engage our citizens;Enact policies that respond to and anticipate the needs of our community. Thank you for contacting the licensing Department. The Town of Barnstable is operating and providing critical services to our community. Town offices at Town Hall and 200 Main are closed to the public and many of us are working remotely. The best way to reach us during this time is by e-mail. For updated information on the Town of Barnstable's response and resources related to COVID-19 visit www.BarnstableHealth.com. Thank you for your patience and support as we continue adjusting to the COVID-19 outbreak. 1 I I understand that,you have been in contact with Health and Licensing earlier this month regarding a number of changes in your operations at Blue Moon (as outlined below from Richard Scali and discussions with Dianna Bellaire in Health regarding possible smoothie bar, reduction of food service and expansion of the alcohol bar) In order for the town to properly guide you with getting the correct permits for your intended changes, it is vital that you communicate to us what your plans/vision is in its entirety for this upcoming season. • Will you be changing managers on record? If so, an application needs to be filed. • Will you be reducing the#of seats? If so, we need a revised floor plan to evaluate next steps. • Will you be adding a smoothie bar? If so,we need a revised floor plan to evaluate next steps. (also,will this include a takeout window?) • Are you intending on having entertainment? If so,what type of entertainment(including recorded/dj music, or dancing by patrons) and we will need a revised floor plan indicating where the entertainment will occur • Are you planning on renewing your outdoor dining agreement? Again, a comprehensive outline of your plans provided to us swiftly will allow town staff the opportunity to assist you in a timely manner in anticipation of the approaching visitor season. I look forward to hearing from you soon, Liz Liz Hartsgrove Deputy Director of Asset Management/Licensing Director Town of Barnstable 367 Main Street Hyannis,MA 02601 508-862-4068 Barnstable Mission:Protect the Town's quality of life and unique character;En a e our citizens,Enact policies that respond to and anticipate,the needs of our community. Thank you for contacting the Licensing Department. The Town of Barnstable is operating and providing critical services to our community. Town_offices at Town Hall and 200 Main are closed to the public and many of us are working remotely. The best way to reach us during this time is by e-mail. For updated information on the Town of Barnstable's response and resources related to COVID-19 visit www.BarnstableHealth.com. Thank you for your patience and support as we continue adjusting to the COVID-19 outbreak. From: Scali, Richard Sent: Monday, February 22, 2021 12:10 PM To: charltonferguson@yahoo.com; 'fullbluemoon430@gmail.com' Cc: Parvin, Lindsay; 'Gallant, Therese'; Gallant, Therese; Flynn, Margaret; 'hoxiesr@comcast.net'; Murphy, John; Bellaire, Dianna; Florence, Brian; McKean, Thomas; Coyle, Brenda Subject: Blue Moon- actions to be taken Dear Aubrey and Charlton: Thank you for appearing today at the Licensing Authority hearing.The following is just a reminder of what actions are needed by you to correct the license at 431 Main St.to reopen on April 1st: r our March 22 Licensing hearing to update the Board. 1) Appear at o g g p 2) Apply for a change of manager to Charlton. See our website under Licensing Dept,applications, alcohol, change of manager. 3) Apply for any entertainment you wish to continue. See our website under Licensing Dept, applications, entertainment. Right now you do not have permission for any entertainment.You will need a plan showing the 2 I areas of entertainment, provided by an engineer to scale and approved by the Building Commissioner. Lindsay will hold the money already paid on the entertainment if and until the application is approved. 4) Make sure you have your Certificate of Inspection From Building( Brenda)with the correct numbers-38 interior seats, 24 exterior for a total of 62. Lindsay will correct your license and reissue it to you after March 22d. 5) Make sure you contact the:Health Dept. (Dianna)to make sure you renew your health permit and submit all the information needed for fees and Serve Safe etc. 6) Renew your Patio agreement in March with the town. Lindsay will send out a renewal agreement to you in March to start April 1st. 7) Right now if you were to open, pursuant to the Governor's orders,your capacity would be at 40%,or 15 persons inside.This could change in the near future according to when the Governor changes the orders. Lindsay or myself can assist you wi-h any of the applications and she can advise you on deadlines to apply and be heard. Thanks again for your appearance today and your willingness to adhere to this plan. If you have any questions, please do not hesitate to contact us. Richard Scali Licensing Director Richard V. Scali, Esq. Licensing Director Town of Barnstable 200 Main St, Hyannis, MA 02601 508-862-4778 508-778-2412 fax 3 Bkaire;Dianna From: Hartsgrove, Elizabeth Sent: Friday, May 21, 2021 10:54 AM To: 'geminicaribbean@verizon.net'; 'sugard681@gmail.com'; 'charltonferguson@yahoo.com'; 'fullbluemoon430@gmail.com' Cc: Parvin, Lindsay; 'Gallant,Therese'; Bellaire, Dianna Subject: RE: Blue Moon- actions to be taken Attachments: Blue Moon 2021.pdf Good morning Aubrey and Charlton, Thank you for submitting your ABCC paperwork for a change in manager and alteration of premise. For us to proceed with creating the required legal ad, I will need a NEW description of the premise. I have attached a copy of existing license for you to use as a reference. Please email me back the new language before Monday May 24`h Also, I understand you talked to Dianna in Health about getting ServSafe certificates and working on that which is great news. I look forward to receiving your new description language before Monday, and have a good day. Liz Liz Hartsgrove Deputy Director of Asset Management/licensing Director Town of Barnstable 367 Main Street Hyannis,MA 02601 508-862-4068 Barnstable Mission:Protect the Town's quclity of life and unique character;Engage our citizens;Enact policies that respond to and anticipate the needs of our community. For updated information on the Town of Barnstable's response and resources related to COVID-19 visit www.BarnstableHealth.com. From: Hartsgrove, Elizabeth Sent: Thursday, May 13, 2021 1:49 PM To: 'geminicaribbean@verizon.net'; 'sugard681@gmail.com'; 'charltonferguson@yahoo.com'; 'fullbluemoon430@gmail.com' Cc: Parvin, Lindsay; 'Gallant, Therese'; Bellaire, Dianna Subject: RE: Blue Moon- actions to,be taken Good afternoon Aubrey and Charlton, This email is to confirm: ® Recommendations from staff at Site Plan that in order to make adjustments within Blue Moon to reduce seating and add a smoothie bar,that an Alteration of Premise will need to be filed with the Licensing Authority. The application can be found on the ABCC's site https://www.mass.gov/guides/amending-vour-alcoholic-beverages- retail-license-abcc • Also, it is recommended that you proceed with a change in manager if Charlton is to continue representing the operation and sign paperwork, as you indicated to Mr. Scali and others in the past.This change will also need ,BCC approval through their application found online and filed with the Town for a public hearing ` consideration. As a reminder,you do NOT have a 2021 license for Blue Moon.As part of the conditions the Board placed,you must come back to them in a public meeting to provide an update.Therefore I am placing you on the May 24th agenda for that update; this will ensure you have the opportunity to get your licenses issued before Memorial Day weekend. KEEP IN MIND: this license renewal will not incorporate any seating adjustments or the smoothie bar. It is only for renewing the old license. If you have any questions, please feel free to contact me directly. In the meantime, please submit your paperwork for the alteration of premise and change of manager asap, and we will see you on the 24"for the Update to the Licensing Authority. Thank you, Liz Liz Hartsgrove Deputy Director of Asset Management/Licensing Director Town of Barnstable 367 Main Street Hyannis,MA 02601 508-862-4068 Barnstable Mission;Protect the Towns quality of life and unique character;Engage our citizens,Enact policies that respond to and anticipate the needs of our community. Thank you for contacting the Licensing Department. The Town of Barnstable is operating and providing critical services to our community. Town offices at Town Hall and 200 Main are closed to the public and many of us are working remotely. The best way to reach us during this time is by e-mail. For updated information on the Town of Barnstab'le's response and resources related to COVID-19 visit www.BarnstableHealth.com. Thank you for your patience and support as we continue adjusting to the COVID-19 outbreak. I understand that you have been in contact with Health and Licensing earlier this month regarding a number of changes in your operations at Blue Moon (as outlined below from Richard Scali and discussions with Dianna Bellaire in Health regarding possible smoothie bar, reduction of food service and expansion of the alcohol bar) In order for the town to properly guide you with getting the correct permits for your intended changes, it is vital that you communicate to us what your plans/vision is in its entirety for this upcoming season. • Will you be changing managers on record? If so, an application needs to be filed. • Will you be reducing the#of seats? if so,we need a revised floor plan to evaluate next steps. • Will you be adding a smoothie bar? If so, we need a revised floor plan to evaluate next steps. (also,will this include a takeout window?) • Are you intending on having entertainment? If so, what type of entertainment(including recorded/dj music, or dancing by patrons) and we will need a revised floor plan indicating where the entertainment will occur • Are you planning on renewing your outdoor dining agreement? Again, a comprehensive outline of your plans provided to us swiftly will allow town staff the opportunity to assist you in a timely manner in anticipation of the approaching visitor season. I look forward to hearing from you soon, Liz 2 Liz Hartsgrove De u Director of Asset Mana ement licensin Director tp tY� g / 9 Town of Barnstable 367 Main Street Hyannis,MA 02601 508-862-4068 Barnstable Mission:Protect the Town's quclity of life and unique character,•Engage our citizens,Enact policies that respond to and anticipate the needs of our community. Thank you for contacting the Licensing Department. The Town of Barnstable is operating and providing critical services to our community. Town offices at Town Hall and 200 Main are closed to the public and many of us are working remotely. The best way to reach us during this time is by e-mail. For updated information on the Town of Barnstable's response and resources related to COVID-19 visit www.BarnstableHealth.com. Thank you for your patience and support as we continue adjusting to the COVID 19 outbreak. From: Scali, Richard Sent: Monday, February 22, 2021 12:10 PM To: charltonferguson@yahoo.com; 'fullbluemoon430@gmail.com' Cc: Parvin, Lindsay; 'Gallant, Therese'; Gallant, Therese; Flynn, Margaret; 'hoxiesr@comcast.net'; Murphy, John; Bellaire, Dianna; Florence, Brian; McKean, Thomas; Coyle, Brenda Subject: Blue Moon- actions to be taken Dear Aubrey and Charlton: Thank you for appearing today at the Licensing Authority hearing.The following is just a reminder of what actions are needed by you to correct the license at 431 Main St.to reopen on April 1st: 1) Appear at our March 22 Licensing hearing to update the Board. 2) Apply for a change of manager to Charlton.See our website under Licensing Dept, applications,alcohol,change of manager. 3) Apply for any entertainment you wish to continue. See our website under Licensing Dept, applications, entertainment. Right now you do not have permission for any entertainment.You will need a plan showing the areas of entertainment, provided by an engineer to scale and approved by the Building Commissioner. Lindsay will hold the money already paid on the entertainment if and until the application is approved. 4) Make sure you have your Certificate of Inspection From Building( Brenda) with the correct numbers-38 interior seats, 24 exterior for a total of 62. Lindsay will correct your license and reissue it to you after March 22d. 5) Make sure you contact the Health Dept. (Dianna)to make sure you renew your health permit and submit all the information needed for fees and Serve Safe etc. 6) Renew your Patio agreement in March with the town. Lindsay will send out a renewal agreement to you in March to start April 1st. 7) Right now if you were to open, pursuant to the Governor's orders,your capacity would be at 40%,or 15 persons inside.This could change ir.the near future according to when the Governor changes the orders. Lindsay or myself can assist you with any of the applications and she can advise you on deadlines to apply and be heard. Thanks again for your appearance today and your willingness to adhere to this plan. If you have any questions, please do not hesitate to contact us. Richard Scali Licensing Director Richard V. Scaii, Esq. 3 PHIS LICENSE SHALL BE DISPLAYED ON THE PREMISES IN A CONSPICUOUS POSITION WHERE IT CAN BE READ AT�r �10:,:04918-RS-0070 A. L Ul�l►7 ALCO L BEVERAGES THE LICENSING AUTHORITY OF The TOWN OF BARNSTABLE, MASSACHUSETTS HEREBY GRANTS A COMFIT FRS iNS�E License to Expose, Keep for Sale, and to Sell All Kinds of Alcoholic Beverages ToB. i c- x�su�i��Dn t�� Frefxtises To: $lete Mdp a43fl 1Vtam Street Ircd/EaIueMoon .......................... .. ..... .... A biey I; ter,Manager a on the followui 3 saratied remis.. 1Vlain.Stree H anns 1VIA ,F rq is A` Building is at street*level,consisting of nnband rdarentxar►ce and exlt,interior seating(32 eats),bar �. seating(6 seats)and patio seating(24 seatsfora totalseating capacity of 62 seats 4 bathrooms(2 staff,2 customer),yl}asement storage,Iratchenarea,Fwash� and total square feet of 1800. This licensexs granted and aecegied.upon the'ex essconCd on9that the licensee shall,in all respects;conform to all the provisiidns of the Liquor Control Act,Chapter 138of the General Laws,as amended,and'�y rules or regv,,btfons m desthereunder by the Ii'p g authorities: Thin license eptl es l�eceinber 31, 202,1 ,unless earlier sunded celled or revoked. a IN I ESTIIvIONOWH REOF,the utlders ig�a liaue�, ereur to fSxed their official y signatures th s 1st dad o€ J�arty�ry,�021 The Hours during which=Alcollolle ' may. �' RES RICTIONS See Below A Beverages may be sold are •e WEEKDAYS 10 A.M.TO 1:00 A.M. ................ •• •• .......... 10i00 AM- 12:45 AM ...................................................... ..... ...................................................... a NOT VALID unless Issued in conjunction ' with a Food Service Permit. - tCENSING AUTHORITY PAID: $3,050.00 RESTRICTIONS Expiration Date: March 1,2021 per Licensing Authority Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARNSfABLE. i Paul J.Canniff,D.M.D. 1as .� 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate p�ya. 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: 357 Issue Date: 12/10/2019 DBA: BLUE MOON OWNER: BLUE MOON AT 430 MAIN ST. INC Location of Establishment: 430 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 38 OutdoorSeating: 24 Total Seating: 62 FEES- FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: APPROVED-2014 Grease Trap-1000 gallons, shall be inspected monthly and shall be cleaned when the level of grease is 25% of the effective depth or at least eery 3 months. 41. Av� For Office Use Only. Initials: Town of Barnstable C� � Date Paid lAmt�d$,� MANSTAB LE : Inspectional Services �'O1.639• s�� Public Health Division Check# b � ED fAA•� , Thomas McKean, Director o 200 Main Street,Hyannis,MA 02601 :S. Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE ` NEW OWNERSHIP RENEWAL C� NAME OF FOOD ESTABLISHMENT: (! migooc� ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENTF OM ABOVE): E-MAIL ADDRESS: � '0 /7 / � "� TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: j' SEASONAL: DATES OF OPERATION:AIAZIZOTO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: SEATING: MUST OBTAIN A COMMON VICTUAL ER'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 D�OOR(S)? /i� TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) // FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 QAApplication Fortns1F00DAPP 2020.doc I l e OWNER INFORMATION: �J FULL NAME OF APPLICANTv� `� SOLE OWNER: Y',F<"/'NO OWNER PHONE# ADDRESS L-" -rP°'l Wfi Pn V-r Tiles 7 J CORPORATE OWNER: CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: C� li/Dit-� L�C �GM 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. (f44 1.�LlLFGYf A-,5,1: 'N ' ,Z / ZZ. SIGNATURE OF APPLICANT DATE Ae ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to oaenine!! 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 httn://www.townofbarnstable.us/healthdivision/auplications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:Wpplication FormsTOODAPP REV3-2019.doc i Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. ' Board of Health Donald A.Gaudagnoli,M.D. BAR-N rraucE. John T.Norman MAS F.P. Thomas Lee Alternate $ aq. � 200 Main Street, Hyannis, MA 02601 rewsa�� 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: 357 Issue Date: 06/01/2019 DBA: BLUE MOON OWNER: BLUE MOON AT 430 MAIN ST. INC Location of Establishment: 430 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 38 OutdoorSeating: 24 Total Seating: 62 FEES j FOOD SERVICE ESTABLISHMENT: $250.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE- FOOD: MOBILE- ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: APPROVED-2014 Grease Trap-1000 gallons, shall be inspected monthly and shall be cleaned when the level of grease is 25% of the effective depth or at least eery 3 months. P�Op%HE Tp For Office Use Only: Initials: Town of Barnstable Date Paid-7L / ' Amt Pd$ BARNSMBLE. Inspectional Services �°'Eo►+u`s" Public Health Division Check# e Thomas McKean,Director1� 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATEf% NEW OWNERSHIP ✓ RENEWAL NAME OF FOOD ESTABLISHMENT: �//e-- N00// � ADDRESS OF FOOD ESTABLISHMENT: U 3 0/'9Q I n S T HUB n n,(!5 !'7�I- 172j�©! MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: �j UOar 1 (�isl B I I a eo m TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: �-F- WELL WATER: YES NO Y ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: _ SEASONAL: DATES OF OPERATION: / / TO j0 -- Id P00 NUMBER OF SEATS: INSIDE: OUTSIDE: 1Y4, 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? ag IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) Y FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(:formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application FormsTOODAPPREV2018.doc r PLEASE CALL 501-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT SOLE OWNER: U/S/NO OWNER PHONE # �o 3— 2 -Q?fq ADDRESS CORPORATE OWNERPIUta FEDERAL ID NO. : — CORPORATE ADDRESS: 1-113 0 /"0 / n S 7 PERSON IN CHARGE OF DAILY OPERATIONS: A70yp S LLr KA P4O V 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.�u e it e4G�� I' 12 2� i 20�z 2. -e (f,/Q 12.021 SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Irv. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation, or display of any food product by a food establidunent 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 1st to Dec. 3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPPREV2018.doe _ d APPETIZERS & SIDES KIDS M-NU Mozzarella Sticks & Chicken Tender Combo......$7.99 i Must be 12 or under, WE CARD " Served with Marinara sauce and choice of dippin's , Fried Pickle Chips...............................................$6.59 Includes choice of Fries or substitute Sweet Waves for$.99 Served with Chipotle aioli dipping sauce Kids Cheeseburger......................................$5.99 Ah Mozzarella Sticks...............................................$6.99 , Kids Hot Dog...............................................$5.99 Served with Marinara sauce Chicken Tenders& Fries.....................................$7.99 Kids Grilled Cheese.....................................$5.99 Served with your choice of BBQ,Sweet&Sour or Honey Mustard Sauce Kids Chicken Tenders::::::::::::::::::::.:.::::......::$5.99 Wicked Good Wings...(Single) $6.99 (Shared) $13.59 Choice of Buffalo,Sweet Chili,Original,Garlic Parmesan or Teriyaki Served with-choice of dipping sauce DESS1'=�� Fried Banana Pepper Rings...............................$6.59 Served with Chipotle Aioli dipping sauce Creme Brulee............................................$7.99 Beer Battered Onion Rings i Carrot Cake..............................................$7.99 Half Pound Thick Cut...........$4.99 Sweet Waves..........$3.99 Chocolate Tart..........................................$7.99 Cheesy Fries , 11b.of our seasoned fries smothered with cheese sauce,served with Ranch Dressing. ....................................................$7.59 3 Add Bacon or Chili..................................................$8.59 Try them Fully Loaded with Bacon&Chili.......................$8.99 Seasoned French Fries.....................................$2.99 V� Mikonos Shrimp ... ..... .$11.99 Diced Tomatoes,Garlic,Onion,sauteed Shrimp,shredded Parmesan,Basil SALADS Balsamic Vinaigrette, Creamy Caesar,Chunk Blue Cheese House Dressing, Ranch or Pomegranate Vinaigrette i Add to Any Salad: i Grilled Chicken,Veggie Burger,Turkey Burger for$2.99 , ,a. w House Salad....................................................ewiterr, nionhred $6.99 Blend Fresh Lettuce with Cucumbers,Red Onions,shredded Carrots and Grape Tomatoes s TheCaesar......................................................$6.99 Crisp Romaine Lettuce,shaved Parmesan Cheese and seasoned Croutons I 430 Main Street, Hyannis MA Before placing your order,please inform your server if a person ' Before placing your order,please inform your server if a person in your party has a food allergy. i in your party has a food allergy. Consuming raw or uncooked meat,poultry,seafood,shellfish, i Consuming raw or uncooked meat,poultry,seafood,shellfish, or eggs may increase your risk of foodbom illness. or eggs may increase your risk of foodborn illness. i MAIN CHOICE oTHERBURGERs CREATE YOUR OWN BURGER Includes choice of Fries or substitute Sweet Waves for$.99 I The Fish Burger.............................................$11.99 � Accompanied with a small bag of chips and a pickle BEEFBURGERS i Baby Spinach,vine ripe Tomato,Red Onion with Chipotle Aioli The West.......................................................$11.99 The Steak Vegis............................................$11:59 Choose Your Burger: Kettle Barbecue Baked Beans,sauteed Onions&Cheddar Cheese Loaded with roasted Peppers,sauteed Mushrooms&Onions with Angus Beef...................................................$8.99 Melted Provolone .$11.99 Hot Pastrami................................................$11 99 Ground Turkey(GF).......................................$8.49 The Chili...................................................... � Beef Chili&Cheddar Cheese on top of a delicious Burger Grilled Chicken..............................................$8.49 Deliciously tender Black Pastrami with melted Swiss Cheese Black Bean &Sweet Potato Veggie Burger...$8.49 TheSwiss......................................................$11.99 Loaded with sauteed Mushrooms,Onions&Swiss Cheese TURKEY BURGER Pick Your Bun: The Mexican (Spicy)......................................$11.99 Pretzel Roll, Brioche Gluten Free Bun....add $1.00 Jalapenos,roasted Red&Banana Peppers,with Pepper Jack Cheese Includes choice of Fries or substitute Sweet Waves for$.99 Choose Your Cheese: TheBlue Moon.............................................$11.99 � The Jerk.......................................................$11.59 , . Smoked Applewood Bacon,Blue Cheese crumbles with vine ripe G Dusted with Caribbean Spices,Pepper Jack Cheese,Red Onion American Tomatoes and Red Onions &Mango Chutney $Wi55 The Yo-Yo.............. ......... ..........$11.59 Creamy Cheddar Provolone The Steak.....................................................$11.99 t Baby Spinach,Avocado,Swiss Cheese&vine ripe Tomato Pepper Jack Bleu Cheese Crumbles.....add 504t Sauteed Peppers,Mushrooms&Onions with Steak Sauce& Cheddar Cheese Choose Your Toppings: Green Leaf Lettuce Applewood Bacon HUNG& CHICKEN BURGERS Baby Spinach Add.99¢ (Grilled Chicken)Includes choice of Fries or substitute Includes choice of Fries or substitute Sweet Waves for S.99 Vine Ripe Tomatoes Sauteed Onions Sweet Waves for$.99 Pickles Add.50t Hot Dog........................................................$5.99 Red Onions The Caesar.....................................................$11.49 i All Beef Hot Dog served on a Brioche Hot Dog Bun Sauteed Mushrooms Crisp Romaine Lettuce,shaved Parmesan Cheese with Creamy Jalapeno Peppers Add.50d Caesar Dressing + Fish and Chips...............................................$14.99 Banana Peppers r The Buffalo................................................. $11.49 Dipped in spicy Buffalo Sauce,with Blue Cheese crumbles& SOUPOFTHEDAY Dress It: crisp Lettuce Barbecue Sauce Fresh Pesto The Pesto.....................................................$11.49 I Honey Mustard Chipotle Aioli Fire roasted Red Peppers,Pesto&Provolone Cheese Chef's Choice JM Burger Sauce Fresh Avocado Add.99q The Avocado................................................$11.89 Hellman's Real Mayo Smoked Applewood Bacon,Avocado,&Pepper Jack Cheese I / —� topped with Mango Chutney I Additions: E Seasoned Fries.............................................$2.99 The Hawaiian...............................................$11.89 I I Sweet Pineapple,Applewood Bacon,Pepper Jack Cheese& I Sweet Waves................................................$3.99 Barbecue Sauce Beer Battered Onion Rings..........................$3.99 Before placing your order,please inform your server if a person I Before placing your order,please inform your server if a person Before placing your order,please inform your server if a person in your party has a food allergy. in your party has a food allergy. in your party has a food allergy. L Consuming raw or uncooked meat,poultry,seafood,shellfish, t Consuming raw or uncooked meat,poultry,seafood,shellfish, I Consuming raw or uncooked meat,poultry,seafood,shellfish, or eggs may increase your risk of foodborn illness. or eggs may increase your risk of foodborn illness. I or eggs may increase your risk of foodborn illness. MO . SEATInrb AREA, �e}l� ` .. . om P, E.. � . cw1.y c.el.v •vcA a5�t ` t � Alp,� :-r ' �Co '0067 C ov At'r our►�{t V 300 O O Iw �T �` ,4uA Lunt.. , MSa 'Oa hflp.y �r •. f l •c�,iv.r s:n K 6==t ��1r1 .1�� -- � t� . • ��,�c tic . ttbi):n e U,n(liS �. l( ti °p THE rp, TOWN OF BARNSTABLE. .-. .HEALTH.INSPECTOR,s Establishment Name: - Date: Sh k gage:.. - of _ `l OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified �p a3q: HYANNIS,MA 02601 eoe-sz 4644 No Reference R;Red Item PLEASE PRINT CLEARLY 'EO""Pya FOOD ESTABLISHMENT INSPECTION REPORT - Name Date l� Tyne of Type of Inspection p Routine Address Risk eFood Service R ection Level spection Telephone Residential Kitchen Date: e Mobile P perat' n Owner HACCP Y/N Temporary 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) ❑ ItA Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ j Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ � L 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 � This prpdu� - "`--- FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) and has not been pasteurized ,therefore may contain harmful ❑ 4.Food and Water from Approved Source ❑ 16.Cooking Temperatures I bacteria that can cause serious illness in ❑ 5.Receiving/Condition ❑ 17.Reheating Children, .the elderly,and persons with ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding �} weakened immune systems. PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control A ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) VY ❑ 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. M 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 Jess than non-critical violations if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation F is scored automatically if: no hot 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If t 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 inserts,or lack of violations observed,7 to 8 non-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 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. - 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen 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* $ Cross-contamination L 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* -- 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* Cooked and RTE Foods.* - *- 19 PHFJiot and Cold Holding. _ 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) * - - - EMPLOYEE HEALTH � 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility-of the Person-in--Charge to Other* g * 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* Storage* - Applicants* - 3-302.11(A) Food Prolection* 7-201.11' Separation 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-Repori To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) - q 590.003(G) _ Reporting by Person in Charge*_ 7-203.11 Toxic Containers-Prohibitions Cohtainination 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 Adulterated of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions - g � ) . - Disposition ofAdulterated 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 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 Bait Stations* * 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk'Products* '" _ 4-501.112 - Mechanical Warewashing-Hot Water 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* _ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff-e-rivzoor 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 IS 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* * e - Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g, P arY 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* _ _ 2-301.12 Cleaning Procedure*_ 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail * 11 - Good Hyglenlc Practices 17 Reheating for Hot Holding practices should be debited under#29-Special 3-201.17 Game Animals g 9 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. revenng Contamination When Tasting* 3-403.11 C * (Blue Items 23-30), 3-202.15 Package Integrity 12 Preventing Ctiti Wh ( ) Commercially Processed RTE Food-140°F 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1$ Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.060. _ 1 oF. r TOWN OF BARNS-TABLE HEALTH iNSPECTOR's Establishment Name: Date: Page;. of � °h�o OFFICE HOURS LIC HEALTH / BARNSTABLE. ` PUBZOO MAIN STREET - 6 30-s:30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. MASS' ,off HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY.- FOOD 508-862-4644 . ESTABLISHMENT INSPECTION REPORT Name j7 Type of Type of Inspection s 1 vaftmmo s Ro Address ` Risk ood.Servi e-inspection /1( �� Level pection L \ Telephone Residential Kitchen Date: Mobile re-operatio / Owner HACCP Y/N Temporary ness 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) ❑ ��(/�- c G� Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ 1_ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities �Y EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 4NO ❑ 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 ZY ❑ 5.Receiving/Condition ❑ 17.Reheating - s ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding ' r_ 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 r ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY 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: Non-critical(N)violations must be corrected immediately or Overall Rating �leil� within 90 days as determined by the Board of Health. E ' ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion El R Anspe on Sche I d ❑ Emergenc vera 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 numberof 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 o 6 non-critical violations 9 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 non-critical. . f critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) ,be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. _ 30.Other DATE OF RE-INSPECTION: Inspector's ASignature Print: U' vN '� 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 PI '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 t 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* 3-501.15 Cooling Methods for PHFs 590.003(B) I Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* - Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Chazge Duties - - - - - - 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients _ 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 15 _. Poisonous or Toxic Substances 590.004(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.Char a to Other* g g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* ( ) P tY g 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- 7-201.11 Separation-Storage*302.11(A) Food Protection* - 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An _ _ 3-302.15 Washing Fruits and Vegetables *7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(I1) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* ' Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR _ _ 3-306.14(A)(B)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 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Com liance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and (- )--- P - - -* - 4-501.111 -Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid'Milk and Milk Products* 4-301.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 1 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 Inking Water*" - - Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg crave t/Irzool 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)(I)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency rf Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155'F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 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* A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail _ _ _ 3-401.11( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 1 Reheating for Hot Holding practices should be debited under#29-Special 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 - (Blue Items 23-30) 3-202.15 Package Integrity , ( ) C ill y 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 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41'F/45°F Item Good Retail Practices FC * Within 4 Hours* 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials 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 1 Conformance with Approved Procedures* S:590F6rmback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. - i �p THE►ok. TOWN OF BARNSTABLE _ _ -HEALTHINSPECTOR'S Establishment Name: Dater Page:: of p '�o OFFICE HOURS BAR- NSTAB�E. PUBLIC MAN STREET SION 330--4:30A.M.30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � ,6.. N0� HYANNIS,MA 02601 MON.-FRI. No Reference. R-,Red Item: . PLEASE PRINT CLEARLY AtFO MPS° � 508-862-4644 . - . FOOD ESTABLISHMENT INSPECTION REPORT Name Da. CU Tyne of ayoe of Inspection O e Ro Address ` Risk od Se a-ins Level a al on Telephone Residential Kitchen Da e: Mobile -operation Owner HACCP Y/N Temporary Hess Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP Ci In: Other Inspector Out: tom,f 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) 1 ❑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 L YAW ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations � Critical(C)violations marked must be corrected immediately. (blue&red items) orr Action Required: r ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating f 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 El Embargo ❑ Emergency Closure Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils B=One critical violation and less than 4Hon-critical violations g (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 g violation,4 to 8Hon-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.Dumpsler screened from public view M I v q(, 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.) { i FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According so 1 590.003(A) Assignment of Responsibility* F 6 Cross-contamination L14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* - * 19 PHF Hot and Cold Holding _ 2-103.11 ]Person-in-Charge Duties - - � - 3-302:14 Protection�from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or'Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003 C Responsibility of the Person-in-Charge to_ Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F ( ) P tY - - - - - -- 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 Pelson In Chaige* 3-304.11 Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice.of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 59'0.003(E)- Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590 004 A-B Compliance with Food Law* * 3-801.1](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) Cl Equipment*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* _ .. f gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* � 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* effe°"°e tnn°°t 4-602.11 Cleaning Frequency of Utensils and Food_ Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 3 f0 CMR 22.0*' Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish Frvni 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 Meals-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* - Shellfish* -- 4-703.11 Methods of Sanitization Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS - Stuffing Containing Fish,Meat,Paul or 3-201.15 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* in mobile food,temporary and residential Sources 70 Proper,Adequate Handwashing g' P 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* 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. 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 Piactices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* Lu Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F 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 P Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-002.12 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. Spacial 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. oFtNE rok TOWN OF BARNSTABLE HEATH INSPECTOR,sWabent Name: Date: Page of ' p` c OFFICE HOURS PUBLIC HEALTH DIVISION 800-9:30A.M. BARNBTABLE. ' 200 MAIN STREET 3:3o-a:3o P.M. ode C-Critics Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e; HYANNIS, MA 02601 MON.-FRI. erence R-R d t PLEASE PRINT CLEARLY - A'F°"`"`' FOOD ESTABLISHMENT INSPEC ION REPORT 508-862-46a4 i !ram Name Datf�IQJ Type of Type of Inspection O O Routin C r 41 Addressrr_ Risk ood Service inspectio Level ai nspection Telephone Residential Kitchen jDa (� Mobile re-operation "` Owner HACCP Y/N Temporary uspec ness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast (n: Other - Inspector U Out: P`w Zq✓� Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. ' J Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ r�•/ 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) ❑ i FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands Jf ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardo Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating `/ / ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY r ❑ 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 XM� � within 90 days as determined by the Board of Health. V '"`'" ` ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on ction today,the items ❑ Embargo Emergency Closure Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 g 29.Special Requirements (590.009) `Within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 0111 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 IC' ignature Print- Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N Violation 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 I PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assint of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* gnme 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 fiom 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* 2 590.003 C Responsibility of the Person-in-Charge to. Other* g g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* ( ) P Y - -- --- - - - - -- - 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants*- - - 3-302.11(A) Food Protection* - - -" P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An _ 3-302.15_ Washing Fruits and Vegetables _- * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* *" 7.202.12 Conditions of Use - -- 590:004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) q 590.003(G) Reporting by Person in Charge*_ _ _ 7-203.11 Toxic Containers-Prohibitions Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g ( ) -- Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.1](B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* _ _ _ _ _ * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501-.1-11-- Manual Wazewashing--Hot Water 7.206.12 Rodent Bait Stations * 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.172 Mechanical Wazewashing-Hoi Wat& 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 * 4-60,1.11(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* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 1112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B), Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source _ - _ 3-401.11(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 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g, P �' 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. h*W 2-301.14 When to as * Other 590.009 violations relating to good retail I 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. 5 Receiving/Condition - - - - 2-40L.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 Commercially Blue Items 3-30) 3-202.15 Package Integrity Tti C( ) C Y Processed RTE Food-140°F* n 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 343.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 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(1) 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 1 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria*- 8-103.12 Conformance with Approved Procedures* t 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. k" np THE ro TOWN OF BARNSTABLE HEALTH.INSPECTOR`S Establishment Name: - Date: Page:. of," v�' o OFFICE HOURS PUBLIC HEALTH DIVISION 800-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e;: `0$ HYANNIS, MA 02601 MON.-FRI. No Reference, :R-Red Item PLEASE P INT CLEARLY . �DrEO MPS° 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT G� Name Da Tvae of Tyne of Inspection ion Routinerin Address Risk/ od sew-1 Re-inspection Level Previous Inspection Telephone - Residential Kitchen Date: Mobile P - peration "^ ✓ Owner HACCP Y/N Temporary . 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 l Anti-Choking 590.009(E) ❑ `� r- 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) Ind- ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands 1.PIC Assi ned/Knowled eable/Duties �.... ❑ g g ❑ 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 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 r PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control C ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS( SP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ) 1 ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories '6rA 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 checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other:. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (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 g 25.Water,Equipment and and Waste if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot Plumbing (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations l than 9 non-critical. If critical water,sewage 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must ons and an non-cr no c ga back-up,infestation of rodents or insects,or lack of violations observed;7 to anon-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address within 10 days of receipt of this order. violation,4 to 8 non critical violations=C. 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N V #Seats Observed Frozen Dessert Machines: Outside Dining Y N el"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 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* * * 3-501.15 Cooling Methods for PHFs 590.003(B) Demonstration of Knowledge 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives - 2-103.11 Person-in-Charge Duties Cooked and RTE Foods. 19 3-302.14 Protection from Unapproved Additives* 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 EachIdentifying 590.004(F) ' ( )O P 7-101.11 Information- 2_ 590.003(C) Responsibility of the Person-in-Charge to _ _ Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants*• 3=302.11(A) Food Protection* P g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 _ Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* 590.003(G) Reportin Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* ( ) q _ g 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 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 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* _ - -_ * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501:111- Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and P 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 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 Wafer* 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* sg afve mnoor 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.tl- -Frequency of Sanitization of Utensils and Food 3-40 1.11(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 ContainingFish,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- - 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 CleainCondition-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 nim 3-201.17 Game Aals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsrho ld be debited under#29-Special 5 Receiving/Condition- - 2-401.11. _ Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3,202 11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* _ 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness 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 10.5 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 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. Op.NE re TOWN OF BARNSTABLE ., _ HEALTH INSPECTOR's Establishment Name: - Dater .Pa9e� -` of "lo 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 �p a3q: `0� HYANNIS,MA 02601 sos-sz FRI. No Reference R-Red Item PLEASE PRINT CLEARLY ""gyp FOOD ESTABLISHMENT INSPECTION REPORT - Name Dat T e o Tyoe of Inspection O e RoutineAzo- Address Risk Service Re-inspection Level Previous Inspection Telephone Residential Kitchen Date: Mobile eration Owner HACCP YIN Temporary Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP a In: Other Inspector Out: Z_ r , 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, J I ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives md ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals v FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperaturesdo V ❑ 5.Receiving/Condition ❑ 17.Reheating 1�6- ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding W`\ �f L PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control �t� ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 01 ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ° C ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Id f f Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Correcti c Required: - ❑ es Non-critical(N)violations must be corrected immediately or Overall Rating 41 L within 90 days as determined by the Board of Health. ❑ Voluntary.Compliance ❑ Employ a Ictl e-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. Embargo ❑ Emergency Closure ❑ Voluntary Disposal Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (F6-4)(590.005) cited in this report may result in suspension or revocation of the food 6=One critical violation and less than 4 non-critical violations 26.Water,Plumbing and Waste if no critical violations observed,4 to 6npn-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot g (FC-6)(590.007) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must ( )( ) 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 8npn-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view 141 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI '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 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination L114 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 EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) *- - - - * 7-102.11 Common Name-Working Containers 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*g rime me 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•I'o 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* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(13) 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 y Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Com Hance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Warewashin 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 1 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 aroe mnoor 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 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 9 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 77 Reheating for Hot Holding Requirements. radicsshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* _ 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3,301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23.30) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(I) Rumaining 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 Fuod Code and 105 CMR.590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F to 70°17 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 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6 2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. o.NE rqt TOWN OF BARNSTABLE_ r+EALTH.INSPECTOR'S Establishment Name: Date: Page: of v` 10 OFFICE HOURS : PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARN ABLE. ` 200 MAIN STREET 3:3o-a:3o F.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified mAss. $ MON.-FRI. "rF.639. 0 HYANNIS,MA 02601 soa-as2�saa No Reference R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT VzzName Date Tvae of Type of Inspection e Routine C Address Risk7 , od Service Re-inspection MCA C Lev Previous Inspection Telephone Residential Kitchen Mobile Pre-operation Owner HACCP YIN Temporary c- Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector zpc Out: .�-- Each violation checked requires a explanation on the n6rMrIve 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 IV EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ""� C ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures - ❑ 5.Receiving/Condition ❑ 17.Reheating - ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health.Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY r- ❑ 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 checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo Emergency Closure Voluntary Disposal Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (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-S)(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.Water, Plumbing 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 PhysicalFacility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address Within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. n a 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpstef 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 IC' 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 Intervei/tions `' 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 r Cross-contamination 1q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* I 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties - - Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 - - P_HF Hot and Cold Holding _ Contamination from 15 Poisonous or Toxic Substances Raw Ingredients 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. * 590.004(F)- * - ( )O P 7-101.11 Identifying Information-Original Containers * 2_ ;5900..003;(.G) onsibility of the Person-in-.Charge to_ Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F 7-102.11 Common Name-Working Containers ire 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* icants 3-302.11(A) Food Protection* 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* onsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* icant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils * ( ) q rting 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 590.003(E) Removal _ of Exclusions and Restrictions Disposition of Adulterated or 3-306.14(A)(B)Resumed Food and Rered or of Food*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 g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004A-B y 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 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 1 Eggs and Milk Products,Pasieurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-20256 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* Egecri,e 1/1n001 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* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency r f aces of Equipment*Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec* _ - Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hat Water and 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* foodborne illness interventions and risk factors. 2-301.14 When to Wash* * Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms*_ 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements.practices ould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C * (Blue Items 23-30) 3-202.11 Package Integrity ( ) 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 3-403.11(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) 1 Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked PHFs from 140°F to 70°17 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 2 . Water,Plumbing and Waste FC-5 .00 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 128. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. `gyp THE rpk'Y TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: - Date: Page:, of OFFICE HOURS PUBLIC HEALTH DIVISION a oo-9:30A.M. BARNSTABLE. • 200 MAIN STREET 3:30-a:3o F.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. �. MON.-FRI. ,679•p�0 HYANNIS,MA 02601 sos-asz asaa No Reference R-Red,Item PLEASE PRINT CLEARLY 'FDN1P' FOOD ESTABLISHMENT INSPECTION REPORT Name Dat s)°'/j Tyoe of �e of Inspection I Routine Address Risk od Service Re-inspection dG� Level Previous Inspection Telephone < Residential Kitchen Dat _ Mobile re-operation Owner HACCP Y/N Temporary Y 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) ❑ J 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 l� ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Ha dous Fos) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling 1J ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holdingon PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) n ❑ 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 i 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 R quired: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations re ardless 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 6=One critical violation and less than 4 non-critical violations 9 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) receipt within 10 days of recei t 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 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 IN Dumpster Screen? Y N r.w..•.,.y.._.-.-•4_-.. :w...�...•.--�.-.mot-..+.^r....-�.s;... .ti .-+...... .�..-w�-+-+-,.-.a-.`r--1.-ti..r'.+-^_. -�.we.... ,.v-..-.--...-ems..-... ...�,•-..w-�� ++.`..-.:Fri..sK'•,�'•`+!%+'wi.-..w.'...�4++-.+t-'^"'^+-.:-.t-+--.�-r. _..a. -�.�..'.'r•-'+-.i ..rf`...�,1r�...�.x .-. ._ .- �..- -.. .. . ♦...-.o��---._. .+�_.vn..:-- .-.+Ml-r-�.•:r--.:r:-�'+.•..-r^-^^'�.,�; Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 4 590.003(A) Assignment of Responsibility* 8 Cross-contamination L14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * - 19 _ PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties - - - 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(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 7-101.11 Identifying Information-Original Containers* * _2 .590_003 C Res _ _Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°_�' � 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 a 1'"""' Separation-Storage Applicants*- -- 3-302.11ZA) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An _ 3-302.15 _ Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* Applicant To Repoli 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* 7-204.11 Sanitizers,Criteria-Chemicals* _ REQUIREMENTS FOR _ _ - 3-396.14(A)(B)DispRetuosition Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP ' S90.003(E) liemovaof Exclusions and Restrictions g � ) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.A I I- - 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* Pe 7-206.13 Tracking Powders,Pest Control and 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products*- � - - � 4-SOL112- � Mechanical Wazewashing-Hot Water Monitoring* 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 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* 5-101.1] 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 t _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 3401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * - Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g• P 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 an8 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. 590.004O Wild Mushrooms* 2-301.14 When to Wash* 3-401A I(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 I Game Animals* 11 Good Hygienic Practices - 17 Reheating for Hot Holding practices should be debited under!/29-Special Requirements. $ Receiving/Condition 2-401.41 Eating,.Drinking or Using Tobacco* __ 3-403.11(A)&(D) 'PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) • Commercially Processed RTE Food-140'F* Blue Items 23-30) 3-202.15 Package Integrity y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness 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) Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification g 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC Tags/Records:Fish Products 5-203.11 Numbers an P d Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging,Criteria* 8-103.12 1 Conformance with Approved Procedures* S: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. °FINE ro TOWN OF BARNSTABLE HEALTH INSPECTORS Establishment Name: Date: Page • of '{ OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. = 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified pg .639. �0� HYANNIS, MA 02601 -8 -4 No Reference R-Red Item PLEASE PRINT CLEARLY. FOOD ESTABLISHMENT INSPECTION REPORT Name Dat 3 " dyne of Type of Inspection Routine �Pp//�J Address Risk ood Se Re-inspection `iW` Level "Previous Inspection 4/0 X Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect II Caterer a Complai Person in Charge(PIC) Time Bed&Breakfast CJ In: Other J Inspector Out: e 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.P.IC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records%Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 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 Violationi Critical(C)violations marked must be.corrected immediately. (blue&red items) 1 � Corrective Action Required: ❑ No Non-critical(N)violations must be corrected immediately or Overall Rating / 19 [1 Yes within 90 days as determined by the Board of Health. ❑ Voluntary,Compliance .❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C NOfficial Order for Correction.Based on an inspection today,the items Embargo EmergencyClosure VoluntaryDisposalOther: checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ ❑ ❑ 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 C 590.005 6=One critical violation and less than 4non-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if:.no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 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 8non-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 8 non-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signa ------ 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* $ 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 3 561.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation 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 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)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 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* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145° Not Otherwise Processed to Eliminate F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System * gg Equipment 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ege°"°e inrzom 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* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3401.11(A)(3) Poultry,Wild Game,Stuffed PIIFs 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* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing Ratites-165°F 15 sec*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 goad 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 * (Blue Items 23-30) 3-202.15 Package Integrity (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 3-403.11(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$ 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*17 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 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Op IKE Toy, TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: _ of ti OFFICE HOURS P ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSTABLE. - 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � 639• .0�. - HYANNIS, MA 02601 MON.-FRL No Reference R-Red Item PLEASE PRINT CLEARLY pTFD MPS a, 508-862-4644 - FOOD ESTABLISHMENT INSPECTION REPORT 1 Namef-pe P Dat /�Ili T e o o f sec i 1 O io outin Address Risk d Sery spection Level Retail Previous Inspection Telephone Residential Kitchen Date:. Mobile Pre-operation Owner HACCP- Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) , _ Time Bed&Breakfast HACCP In: j�� Other L Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Ij/L ` 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) ® C Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS !� ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control L 1444Z �i ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP . q ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY C( ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories w Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations 5 Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: Ny ❑ 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 Re% xclusion ❑ Re inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today, he 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_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,Plumbin C=2 critical violations and less than non-critical.g and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If p,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 . If critical water,sewage back-up, 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 8non-critical violations. 1 critical refrigeration. y 29.Special Requirements (590.009) s o within 10 days f receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y NjW #Seats Observed Frozen Dessert Machines: Outside Dining Y N A ature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N i-,\) jj 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* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 7-202.11 Restriction-Presence and P g Use* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements Contamination from the Consumer 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q * 7-204.11 Sanitizers,Criteria-Chemicals* 90.003(D) Exclusions and Restrictions REQUIREMENTS FOR 35 3-306.14(A)(B)Returned Food and Reservice of Food* 590.003(E) Removal of Exclusions and Restrictions Disposition o/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 HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served 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* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* ege�me iiiizam 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 -(D 3-201.15 Molluscan Shellfish from NSSP Listed590.009(A)Stuffing Containing Fish,Meat,Poultry or latif Si 590.009 D in cater- Chemical* ) Violations o Section (A)-( ) Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 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 8 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 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the $ Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1$ 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 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. l y Page-:�pF,ME rok, TOWN OF BARNSTABLE HEALTH INSPECTOR•s Establishment Name: I� ) T Date: 9 of v tip OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MARS t6S9. 0� HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item P E P T C -ARLY �A a 508-8624644 tFD MAC •F000 ESTABLISHMENT INSREPTIAN REPORT Name 04 Date Type o� Type of Inspection O Routine A Address isk bl pod Service- Re-inspection Level Re Previous Inspection Telephone Residential Kitchen Mobile re operati Owner HACCP Y/N Temporary Suspect-Illness Caterer General Complaint Person in Charge(PIC Time Bed&Breakfast HACCP el Other # - Inspector 4 La Each violation checked requires arl n explanation on the narrative ages)and a citation of specific provisions)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items l 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 yl ❑ 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 V, 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 0 ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP I ❑ 10.Proper Adequate,Handwashing CONSUMER ADVISORY 'V(L1J ❑ 11.Good Hygienic Practices. ❑ 22.Posting of Consumer Advisories MOP Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations I n Critical(C)violations marked must be corrected immediately. (blue&.red items) �C �) (� Corrective Action Required: - Yes Non-critical(N)violations must be corrected immediately or ❑ within 90 days as determined b the Board of Health. Overall Rating ry p ❑ Employee ❑ p ❑ 9 Y p Y Y � ❑ Voluntary Compliance Restriction/Exclusion Re-ins ection Sch dul d Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26.Water,Plumbing and Waste if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot g (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 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)(590.0o8) 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. ,oqtW,n to 8 non-critical viol ions- 30.Other DATE OF RE-INSPECTION: In tor's ignature t: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N 2z z22 #Seats Observed Frozen Dessert Machines: Outside Dining Y N IC's Si at Print: Self Service Wait Service Provided Grease Trap Size Variance Letter-Posted. Y N Dumpster Screen? Y N Violations rolatod 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 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each - 7-101.11 Identifying Information-Original Containers* Other* g3-501.16(A) Hot PHFs Maintained At or Above 140'F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F _ 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P * 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* Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR_ 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washin Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and Food 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 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 3-801.11(C) Unopened Food Package Not Re-Served* 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 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. 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 dness* 22 3-603.11 Consumer Advisory Posted for Consumption of 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* g PP y Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* P 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg-rive 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 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* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 . Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140'F* (Blue Items 23-30) 3-202.11 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.1 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification � ) 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402. Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 59p,004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback&2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. °p THE Tpk, "� TOWN OF BARNSTABLE .. 0. HEALTH INSPECTOR'S Establishment Name: ,11�,i III(/�I V Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION �i\\� 8:00-9:30 A.M. BARNSTABLE. • 200 MAIN STREET 1 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified a19. .0� HYANNIS,MA 02601 5M06-8 -FRI"62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY FOOD rgSTABLISHMENT INSPIEQrIQN RE .ORT Name Date ' Tyne of Tyoe of Inspection o Routine AddressFAI Risk _ Fo d Serv' Re-inspection Level Re i Previous Inspection Telephone Residential Kitchen Mobile <Z� -operat" i Owner HACCP Y/N Temporary Suspect Illness Caterer General.Complaint Person in Charge(PI Time Bed&Breakfast HACCP Other Inspect r Each violati'mchecked require an explanation"on the narr tiv 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) ❑ i Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ v FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS 12) ❑ 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 -.0 ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control _ Fi 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 �t/1� �tC Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no.more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils FC-4 590.005 B=One critical violation and less than 4pon-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,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 no -critic 1 violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. vi on,4 to o 8 non-Critical latio =C. 30.Other PATE OF RE-INSPECTION: s ector' natur O Print• 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y - N Dumpster Screen? Y N Violations related to Fuudborne Illness Violations Related to Foodborne Illness Interventions " y Interventions and Risk Factors(Red Items 1-22) and Risk Fac/u►s(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 ds for 5°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* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140'F* Require Reporting by Food Employees and Contamination from the Environment 7- 7-202.11 P g Common Name-Working Containers* Separation-Storage* 3-501.16(A) Roasts Held At or Above 130'F* Applicants*- 3-30211(A) Food Protection* 20 Time as a Public Health Control . 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 3-304.11 Food Contact with Equipment and Utensils Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* ( ) Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Re teed or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition ofAdultereted 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* TIMEITEMPERATURE CONTROLS 3-202.14 1 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 16 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 * ( ) Eggs-Immediate Service 145°F 15 sec Animal Foods That are Raw,Undercooked or 4-601.11 A Clean Utensils and Food Contact Surfaces of * 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 1orz001 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 3401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g � 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * - Ratites-165°F 15 sec* in mobile food,temporary and residential Sources g. P mrY 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 Anmmals* 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 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) 1 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 Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained Within Tags/Records:Fish Products 5-203.11 Numbers and Capacities* 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* I 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. 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. pF THE ro >< TOWN OF BARNSTABLE - HEALTH INSPECTOR,s Establishment Name: � n42 Date: / � Page: . of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. _ Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified e3v: `0� HYANNIS,MA 02601 M-8 -FRI. No Reference -R-.Red Item PLEASE PRINT CLEARLY..,A sossz-asaa ' rFOMa+" FOOD ESTABLISHMENT INSPIFE-CiTriON REPORT NamenwAl Date41M a of Type of Inspection Operation(s) Routine Address Risk / j Food Service Re-inspection. Level Retail Previous Inspection Telephone Residential Kitchen Date: U Mobile Pre-operation PI Owner HACCP Y/N Temporary Suspect Illness G e - Caterer General Complaint - Person in Charge(PIC) Time Bed&Breakfast HACCP 7l In: Other Inspector Out: i Each violation checked requires an a planation 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 J ❑ 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 VY ❑ 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. No Yes " Non-critical(N)violations must be corrected immediately or (blue 8�red items) Corrective Action Required: ❑ within 90 days as determined b the Board of Health. Overall Rating Y Y ❑ 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 b a Board of Health member or its agent 24.Food and Food Preparation (FC-3)(590.004 P 9 y 9 A=Zero critical violations and no more than anon-critical violations. F=3 or more critical violations.9 or more non-critical violations, 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.von-critical violations=B. Seriously Critical Violation=F"is scored automatically if; no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of"food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 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 8raon-critical violations. If 1 critical refrigeration. viol within 10 days of receipt of this order. 4 to 8 af 29.Special Requirements. (590.009) on-critical violations=C. Y P - , 30.Other DATE OF RE-INSPECTION: Insp' or's S• a r Pri 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N to #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI 's Sign ure 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 47 - 4s Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* P g Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 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 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* TIMEITEMPERATURE CONTROLS 3-202.14 1 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-I55°F 15 sec dness* 22 3-603.11 Consumer Advisory Posted for Consumption of 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* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective tiirzoot 4,602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency rf ces 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-Ho[Water and 3-201.15 Molluscan Shellfish from NSSP Listed Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Chemical* es- sec Ratites 165°F 15 * Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements. radicsrho ld be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) "1 12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodbome 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing 3-501.14 A 3-202.18 Shellstock Identification Facilities ( ) Cooling Cooked PHFs from 140°F to 70°17 Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41*F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3 402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 5-205.11 Accessibility, an d Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 008 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. moon - Ll urvs In Bellaire, Dianna From: Hartsgrove, Elizabeth Sent: Wednesday, March 31, 2021 1:49 PM To: 'charltonferguson@yahoo.com'; 'fullbluemoon430@gmail.com' Cc: Gallant,Therese; Parvin, Lindsay; Bellaire, Dianna; Flynn, Margaret Subject: Blue Moon- actions to be taken Good afternoon Aubrey and Charlton, I understand that you have been in contact with Health and Licensing earlier this month regarding a number of changes in your operations at Blue Moon (as outlined below from Richard Scali and discussions with Dianna Bellaire in Health regarding possible smoothie bar, reduction of food service and expansion of the alcohol bar) In order for the town to properly guide you with getting the correct permits for your intended changes, it is vital that you communicate to us what your plans/vision is in its entirety for this upcoming season. • Will you be changing managers on record? If so, an application needs to be filed. • Will you be reducing the#of seats? If so, we need a revised floor plan to evaluate next steps. • Will you be adding a smoothie bar? If so,we need a revised floor plan to evaluate next steps. (also,will this include a takeout window?) • Are you intending on having entertainment? If so, what type of entertainment(including recorded/dj music, or dancing by patrons) and we will need a revised floor plan indicating where the entertainment will occur • Are you planning on renewing your outdoor dining agreement? Again, a comprehensive outline of your plans provided to us swiftly will allow town staff the opportunity to assist you in a timely manner in anticipation of the approaching visitor season. I look forward to hearing from you soon, Liz Liz Hartsgrove Deputy Director of Asset Management/Licensing Director Town of Barnstable 367 Main Street Hyannis,MA 02601 508-862-4068 Barnstable Mission:Protect the Town's quality of life and unique character;Engage our citizens,Enact policies that respond to and anticipat-a the needs of our community. Thank you for contacting the Licensing Department. The Town of Barnstable is operating and providing critical services to our community. Town offices at Town Hall and 200 Main are closed to the public and many of us are working remotely. The best way to reach us during this time is by e-mail. For updated information on the Town of Barnstable's response and resources related to COVID-19 visit www.BarnstableHealth.com. Thank you for your patience and support as we continue adjusting to the COVID-19 outbreak. From: Scali, Richard Sent: Monday, February 22, 2021 12:10 PM To: charltonferguson@yahoo.com; 'fullbluemoon430@gmail.com' Cc: Parvin, Lindsay; 'Gallant,Therese'; Gallant, Therese; Flynn, Margaret; 'hoxiesr@comcast.net'; Murphy, John; Bellaire, Dianna; Florence, Brian; McKean,Thomas; Coyle, Brenda Subject: Blue Moon- actions to be taken 1 {gear Aubrey and Charlton: Thank you for appearing today at the Licensing Authority hearing.The following is just a reminder of what actions are needed by you to correct the license at 431 Main St.to reopen on April 1st: 1) Appear at our March 22 Licensing hearing to update the Board. 2) Apply for a change of manager to Charlton. See our website under Licensing Dept, applications, alcohol, change of manager. 3) Apply for any entertainment you wish to continue. See our website under Licensing Dept,applications, entertainment. Right now you do not have permission for any entertainment.You will need a plan showing the areas of entertainment, provided by an engineer to scale and approved by the Building Commissioner. Lindsay will hold the money already paid on the entertainment if and until the application is approved. 4) Make sure you have your Certificate of Inspection From Building( Brenda)with the correct numbers-38 interior seats, 24 exterior for a total of 62. Lindsay will correct your license and reissue it to you after March 22d. 5) Make sure you contact the Health Dept. (Dianna) to make sure you renew your health permit and submit all the information needed for fees and Serve Safe etc. 6) Renew your Patio agreement in March with the town. Lindsay will send out a renewal agreement to you in March to start April 1st. 7) Right now if you were to open, pursuant to the Governor's orders,your capacity would be at 40%,or 15 persons inside.This could change in the near future according to when the Governor changes the orders. Lindsay or myself can assist you with any of the applications and she can advise you on deadlines to apply and be heard. Thanks again for your appearance today and your willingness to adhere to this plan. If you have any questions, please do not hesitate to contact us. Richard Scali Licensing Director Richard V. Scali, Esq, Licensing Director Town of Barnstable 200 Main St. Hyannis, MA 02601 508-862-4778 508-778-2412 fax 2 Bellaire, Dianna From: McKenzie, Marybeth Sent: Thursday, April 15, 2021 11:54 AM To: 'geminicaribbean@verizon.net' Cc: Bellaire, Dianna Subject: RE: Specs for Blue Moon Hello, Please send the specs for the prep sink faucet too.The expansion of the bar area is ok'd. Make sure that you have notified any of the other departments for their approval too before you start the work. Also, I just want to make note that you have not asked for any cha.-iges in the kitchen. If you plan on changing any equipment in that area it will need approval too. If you have any questions let me know. Regards, Marybeth McKenzie R.S. From: geminicaribbean0)verizon.net [mailto:geminicaribbean@verizon.net] Sent: Wednesday, April 14, 2021 5:40 PM To: McKenzie, Marybeth Subject: Re: Specs for Blue Moon Hello Ms. Marybeth, Per your request, please see attached the specs for the hands free type sink faucet. Kind Regards, -----Original Message----- From: McKenzie, Marybeth <Marybeth.McKenzie(c town.barnstable.ma.us> To: 'gem inicaribbean@verizon.net' <ceminicaribbean(d-)verizon.net> Sent: Wed, Apr 14, 2021 3:51 pm Subject: RE: Specs for Blue Moon Hello, Thanks for the specs, but the hand sink faucet must be a hands free type. What one will you be using for the prep sink? From: gem in icaribbean(a)verizon.net fmailto:geminicaribbean(o)-verizon.net] Sent: Wednesday, April 14, 2021 2:3E PM To: McKenzie, Marybeth Subject: Specs for Blue Moon Good Afternoon Ms. Marybeth, I hope this email finds you well. Please see attached the specs for the equipment purchased for Blue Moon. Kind Regards, Pann 1 THIS LICENSE SHALL BE DISPLAYED ON THE PREMISES IN A CONSPICUOUS POSITION WHERE IT CAN BE READ LICENSE No. 04918-RS-0070 A ALCOHOLIC BEVERAGES THE LICENSING AUTHORITY OF The TOWN OF BARNSTABLE, MASSACHUSETTS HEREBY GRANTS A COMMON VICTUALER License to Expose, Keep for Sale, and to Sell All Kinds of Alcoholic Beverages To Be Consumed On the Premises To: Blue Moon at 430 Main Street Inc, d/b/a Blue Moon ........................................................................................................................................... Charlton Ferguson,Manager ................................. ................................................................................... on the following described premises 430 Main Street,Hyannis,MA ......................................................................................... Building is at street level,consisting of front and rear entrance and exit, interior seating(30 seats)and outdoor patio seating(24 seats)for a total seatir_g capacity of 54 seats. 4 bathrooms(2 staff,2 customer),basement storage,kitchen area,wash area,and juice bar-total square feet of 1800. This license is gra-ited and accepted upon the express condition that the licensee shall, in all respects,conform to all the provisions of the Liquor Control Act,Chapter 138 of the General Laws,as amended,and any rules or regulations made thereunder by the licensing authorities. This license expires December 31,.2021.... ,unless earlier suspended,cancelled or revoked. IN TESTIMONY WHEREOF,the undersigned have hereunto affixed their official signatures this 12th day of ....................July 2021 The Hours during whic-i Alcoholic Beverages may be sold are: t WEEKDAYS 10 A.M.TO 1:00 A.M. ............................................................. ................., ...:.•. 10:00 AM- 12:45 AM �, Q ............................................................... NOT VALID unless issued in conjunction ••••••••••••• . .. . . • • ....... with a Food Service Permit. LICENSING AUTHORITY PAID: $3,050.00 RESTRICTIONS NAME F OFF NDER DAD_7 696 �§ TOWN OF ADD SSQFTFFENDEfl Dnn +dir BARNSTABLE CITY,S�TA/jjltE,11ZIP CODE �?? dF 1 MV/MB REGISTRATION NUMBER y O FFyENSE / t j�jJ / J� NAN\:'1'AeIJ:.O • ,11 I J �f �q^""� /r"- MASS. / ! x '�� 'w+ ./� F'' 4 t TIME A D VIOLATION LOCA ION OF V LATION ! ! CV NOTICE OF �: (A.M./ P.M.)ON , 20 ' t41, /Av"z (l1 , SIGNATURE OF ENFO N P ON ENF R ING DEPT. „/� BADGE N0. W VIOLATION tr,�. U,. O OF TOWN Lu ' HEREBY CKNOWLEDGE RECEIPT OF CITATION X CIL- ORDINANCE Unable to obtain I ur ,of f e der. 1 y tj THE NONCRIMINAL FINE FOR THIS OFFENSE IS S! Date mailed t V w OR YOU HAVE THE FOLLOWIN ALTERNA IVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL 2 DISPOSITION WITH NO RESULTING CRIMINAL RECORD. w REGULATION (1)You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, yaj before: Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, � Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. d �2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST RNSTABLE DIVISION,COURT COMPOUND,MAIN STREET ARNSYABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ -.. _ Signature Town of Barnstable - � Banding Department- BrianCB ---- Florence.C3O Building Commissioner— _. 200 Mafia Street,Hyannis,MA 0260 i _ _ www.town.barnstib_ .ma.as. _ . -� ►-1 - � - - �� Pre-application for Business Certificate a( Date � Map � l Parcel 1 Applicant Information Applicants Name Blue Moon At 430 Main Street Inc. 5 Trenton Street Applicants Address—West Yarmouth MA fl?h�� Email Address-sugard681@gmal.-com Telephone Number 603-892-0799 Listed❑ Unlisted ❑ Business Information New Business? ----------• Yes No ------------------------------ Business is aregistered corporation? ------------------------ No If yes Name of Corporation Does business operate under the registered corporate name? (Yes) No Is the business a sole proprietorship or home occupation? --------- Yes No If yes then a Home Occupation Registration is required-See Building Division Staff Name of Business Blue Moon At 430 Main Street Business Address 430 Main Street, Hyannis Type of Business Restalirsnt Building Commissioner Office%X-1 Conditions UA Building Commissioner Date Clerk Office Use Only 19 Town of Barnstable Regulatory Services �8A M'M Richard V. Scali, Interim Directot t639. o Nay Public Health Division Thomas McKean, Director 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 9, 2015 GEROLISA SIMOES LUCKY'S TREAT TRUCK (formerly GEROLISA'S ICE CREAM TRUCK) , 1324 ALEWIFE CIRCLE SOUTH YARMOUTH MA 02664 x ' ATTENTION: (� Your food service/retail permit(s)-were invalid after December 31, 2014. ESTABLISHMENTS FEE FOOD SERVICE RETAIL FROZEN DESSERT MOBILE FOOD 35.00 John Laliberte From: John Laliberte <j.lal.i ,eate{ccapewdee.nte_cprises.com> Sent: Wednesda�,Oct. ob 8, 2014 10:11 AM To: 'marybethmcken'zie@town.b table.ma us' Subject: vist de mare We will be testing this week I let you know what we find. F&W �G C2 • DATE �F"THE l FEE PD. Town of Barnstable 4 BARNSTABLE, * CHKLST(1-14) MASS. a �$ 1639• Regulatory Services.Department Argo 200 Main Street,Hyannis MA 02601 APPLICATION FOR.OUTSIDE DINING/SIDEWALK CAFE LOCATION ` Name of Establishment: Establishment Address: 430 "14VV) 524 • U3IDb ni 016 D 1 APPLICANTSNAME: �� SQY *' a,°' eY0 Phone# L15P4? SEATING FACILITIES/EQUIPMENT Total#of Seats Existing _ #of Restrooms Provided . Size of Grease Trap Total#of Seats Proposed C� Air Curtains(Yes or No) (Total means overall number of seats indoors plus outdoors) Hose Bib (Yes or No) Screens (Yes or No) Brief Description of Seating Arrangement,Type of Furniture Proposed,Hours of Operation,Projected Openin andlClos'ng Dates J V r K r--T aO h1 6 ` Va�uo ID ' � '41-1 ItU Fri SeL-0- "V�f-UAL AV YIN" kilo Uwe the undersigned certify that the above information which I/we provided is correct. Uwe have read and fully understand the Town of Barnstable Code Chapter 322 and further understand that failure to comply with said procedures may result in the immediate revocatio of this permit. Signature of Applicants : Date: , / Date: IMPORTANT-PLEASE REMEMBER TO INCLUDE: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Sep`ga�tion ,`-,� ZE Distances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedes .. Walkways.— 3 Copies of Pictures of the Proposed Outside Dining Location(Front and Side Vie4 sue-' I Copy of the Menu ` -33 FOR OFFICIAL USE ONLY -off u7 Town Manager Approval: Public Health Division: Licensing Board Approval: Certificate of Insurance: License Agreement: 8 ,0 rn Comments: Q:\Applicadon Forms\OUTDINAP.DOC § 322-5e Outdoor dining: Checklist. Instructions: Please read the following requirements for outdoor dining. Place a checkmark on each line next to the number which you meet the criterion of. If you do not meet the criterion or if you are unsure,leave it blank. A. No person, corporation, or firm shall provide outdoor dining or an outdoor cafe at a food establishment until after all of the following requirements are met: (1)The applicant shall file a written request for outside dining or for an outside cafe on a form prescribed by the Town and shall submit plans of the proposed dining area. The seating capacity shall be determined by the Board of Health after a determination is made whether requirements of Subsection A(2)through(14)below will be met and after a visual inspection is conducted by an agent of the Board of Health. A replacement food establishment permit shall be issued by the Board of Health indicating outside dining is permitted and listing the overall seating capacity, only after it is determined by an agent of the Board of Health that all of the requirements Subsection A(2)through(14) of this section are met. (2) A menu shall be submitted to the Board at the time of application. (3)The dining area must be appurtenant and contiguous to the restaurant property. The dining area must be mentioned on the described premises as in the case of a common victualler's license. (4) Sufficient restrooms,both for customers and employees, must be furnished counting the additional outside seating as required by the State Plumbing Code and Town of Barnstable Health regulations. (5) A grease trap shall be of sufficient capacity,based upon 15 gallons per seat, as required by the State Environmental Code, Title V,and Town of Barnstable Health regulations. A grease recovery device may be installed to supplement an existing in-ground grease trap, after receiving the approval of the Board of Health. (6)All entrance and exit doors used by food service personnel and customers must be screened and provided with air curtains meeting National Sanitation Foundation standards. All windows or openings used for the transfer of food will be screened and provided with air curtains. Food cannot be stored or kept outside. All food must be prepared inside the facility's kitchen and kept inside until served. (7)A drainage system designed to eliminate odors will be required for all outdoor dining areas.Hose bibs with vacuum breakers must be available for washing down the dining area. (8)Trash dumpsters shall be situated no closer than 50 feet from an outdoor dining area. If such a dumpster is in the line of sight from the dining area,it must be hidden from view. The area around the dumpster and stockade must be kept clean and free of litter. Dumpsters must be closed with adequate covers designed to prevent entrance of rodents and birds and sealed to control odors. (9)The patio or other ground surface must be of constructed of material readily cleanable and not susceptible to dust, mud, or debris. (Brick,tile, and concrete are examples of acceptable materials.) (10)Table tops must be smooth,nonporous, easily cleanable and durable, and readily maintained in a clean and sanitary condition. (11)Food-service personnel must constantly police the dining area for wastepaper, garbage and other trash. Placement clips, cup holders and other such devices must be utilized to prevent blowing paper. Covered trash receptacles must be provided in close proximity to the dining area and must be emptied as needed to prevent overflowing. (12) Strict cleanup practices must be adhered to. Waitstaff and buspersons must clean up after each patron as in indoor dining. Each establishment must abide by all regulations contained in Article X,Minimum Sanitation Standards for Food Service Establishments, of the Commonwealth of Massachusetts,Department of Health Sanitary Code. (13) Outside food handlers must have easy access to handwash sinks and cleaning cloths. Facilities for preparation and disposal of sanitizing solutions must be accessible. (14)Hair nets or other effective hair restraints, such as hats covering exposed hair, shall be worn by all outside food or drink handlers. Beards and mustaches must be neatly trimmed. B. Exemption from doorway air curtain requirement in Subsection A(6) above: The Board of Health may waive the requirement to provide air curtains at the doorways only if no waitstaff services will be provided to the outside dining area(self-service only). Q:\Application Forms\OUTDINAPCHECKLIST.doc J Town of Barnstable Barnstable Board of Health j a``aC j Mass L 200 Main Street,Hyannis MA 02601 m �ps639. 10� 2007 rfD�A Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Cannift;D.M.D. V Junichi Sawayanagi July 25, 2013 Mr. Thomas George 17 Thacher Road Yarmouthport, MA RE: Vista de Mara Diner, 430 Main.Street Hyannis Grease Trap Variance Request M y, zF Dear Mr. George, You are granted temporary permission, until August 20, 2013, to operate a food establishment at 430 Main Street Hyannis. On or before August 20'h, you have the options to (a) install an inground grease trap at 459 Main Street Hyannis, or(b) connect the facility into an existing grease trap of sufficient capacity, or(c) present plans and a timeline for the installation of a new grease trap to the Board of Health at the regular meeting of the Board of Health scheduled for August 20, 2013 at 3:00 p.m. Back on May 23, 2013, you submitted a variance request application, along with the required $95.00 fee to the Public Health Division Office. The variance request was relative to a proposal to operate a food establishment at 459-B Main Street Hyannis. Specifically, the request was for a variance from Section 322-3,of the Town of Barnstable Code which requires grease traps at all food establishments._ The Town of Barnstable Code specifically reads as follows: "grease traps must be provided at restaurants, nursing homes, schools, hospitals, bakeries, or similar establishments as determined by the Board of Health. The capacity of the grease trap shall be calculated by the kitchen flow rate of 15 gallons per seat or chair, per day, but in no case shall be less than 1,000 gallons. This applies to establishments connecting to Town sewer, or establishments with on-site sewage systems." On June 18, 2013, Mr. Jorge Montero, Manager, requested permission to withdraw the variance request. Then during the public meeting of the Board of Health held on July 9, 2013, you requested permission to operate the food establishment temporarily until the grease trap is installed. This request was approved. This permission is temporary until August 20, 2013. Sincerely yours, Wayne Miller, M.D. Chairman ` Cc: Stephen Hayes, Attorney at Law I Q:\WPF ILES\VistadeMaraTempGreaseTrapPermission2013.doe Excerpt from the Board of Health Meeting Minutes on July 9, 2013 B. Stephen Hayes, Attorney, representing Jorge Montero, LLC, owner of Vista de Mare Diner (formerly Caffe E Dolci) —430 Main Street, Hyannis, grease trap variance. Attorney Stephen Hayes and Thomas George, owner of property were present. The owners of the restaurant, Jorge and Sergio Montero, were also present. They are petitioning to operate the restaurant pending the installation of the grease trap. Mr. McKean said Roger Parsons was under the belief that there was a commitment by an installer to do the work. Mr. George had contacted Rusty's to install it. Rusty's contacted Roger Parsons directly this morning and by the conclusion of the call Rusty's determined it was a larger job than they could handle as it involved paving and engineering. Mr. George will be speaking with Bortolotti's and Robert Our for a quote. He was not able to reach them prior to the meeting. Mr. George said it has always been a food service facility as long as he can remember and is asking that the new tenants be allowed to function while the work is being handled. Dr. Miller has said when he spoke to Roger Parsons, Roger had understood that it will only take a month to tie in. Upon a motion duly made by Dr. Miller, seconded by Dr. Canniff, the Board voted to adopt a conditional variance with the operation of the facility with the existing Big Dipper (GRD) and the submitted menu dated 7/09/13 until the August 20, 2013 meeting. If the grease trap has not be installed at that time, the applicant will come to the August meeting with the actual plan and a definitive time frame of when the grease trap will be installed for the Board to consider. (Unanimously, voted in favor.) Excerpt from the Board of Health Meeting Minutes on August 20, 2013 C. Stephen Hayes, Attorney, representing Jorge Montero, LLC, owner of Vista de Mare Diner (formerly Caffe E Dolci) —430 Main Street, Hyannis, grease trap variance (continued). Attorney Stephen Hayes and the property owner, Thomas George were present. Mr. George said he left a deposit off at Baxter Nye Engineering and they will do the plan for the grease trap connection as soon as possible. Dr. Miller said he was glad to see it moving forward and would like to see it finished by the October 8 meeting. Mr. George said he will contact Baxter Nye Engineering to inform them. Upon a motion duly made by Dr. Miller, seconded by Mr. Sawayanagi, the Board voted to continue the item until the October 8, 2013 meeting. (Unanimously, voted in favor.) QWINUTES\EXCERPT OF MINUTES\Excerpt BOH Jul-Aug 2013 Caffe Dolci-Vista De Mare.doc Excerpt from Board of Health Meeting on December 8, 2009: IV. Variance — Food (New): Louis Capolino, Caffe "E" Dolci — 430 Main Street, Hyannis, grease trap variance previously granted, addition to menu. Mr. Louis Capolino was present and had the most recent grease recovery device inspection (August 4, 2009) with him and his current expanded menu. He requested an increase in his restricted menu to include additional types of lasagna and more meatball dishes. He has currently been operating with the extended menu. The Board reviewed the prior variance approval and stated the applicant was restricted to the submitted menu of 2007 with the one grease recovery device (GRD) in place. The GRD is not designed to handle the expanded menu. Upon review of the grease trap inspection report, it appeared the level of grease going into the sewer is 4.0 instead of the required maximum of 1.0. The Board receives a clearer picture of the situation when a daily log is kept of the amount of grease actually removed and requests this to be done using the Health Division's Log form. The Daily log must be by the GRD and easily accessible to the Health Inspector. The dual sink/refrigerator equipment was discussed. The sink is used to dispense water and is not as a prep sink. Mr. Capolino said the equipment was purchased in Italy and came as a complete unit, along with the PVC pipe used to drain sink. Dr. Miller and Mr. Sawayanagi stated the piping does not meet the plumbing codes which require a trap plumbed with copper for the drinking water. Provided the applicant properly blocks off the waste pipes under sink and brings the plumbing up to code, the Board will allow the left side of the refrigerator unit to be used for storage. For the increased menu: 1) the applicant will need a second Grease Recovery Device (GRD), and 2) instead of the independent test every six months, the Board would want a log maintained of the amount of grease removed. For the refrigerator/sink unit, either 1) remove the entire refrigerator/sink unit or 2) the refrigerator located under the sink must be rendered unuseable, 3) the Plumbing Inspector must approve the plumbing of the sink and the section of the refrigerator that the waste pipes are above must be blocked off, then the refrigerator section without waste pipes may be used as food storage. The Board said the pictures the Health Inspector provided showed inadequate cleaning. Mr. Sawayanagi noted the pictures show a leak in the ceiling. Mr. Capolino said it was due to the air-conditioner and is not over the food prep area. The Board stated the approval of an extended menu will be based on satisfactory inspections by the Health Inspector over the next two years. The Board will give the applicant one month to clean up the establishment before any license suspension. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted on the approval of the extended menu. (Unanimously, voted to DENY with the following requirements to avoid suspension: 1) Caffe "E" Dolci must return to the original approved menu, 2) clean up health inspection violations, 3) repair leak in ceiling and replace ceiling tiles, 3) bring waste pipe up to code and block off front section of refrigerator with piping, or close off refrigerator entirely, and 4) return to the Board at the January 12, 2010 meeting. If all items are satisfactory, the Board will approve the increased menu provided an additional GRD is installed. r • �r EXCERPTS FROM BOARD OF HEALTH MEETING JANUARY 12, 2010 IV. Variance — Food (Cont.): A. Louis Capolino, Caffe "E" Dolci — 430 Main Street, Hyannis, grease trap variance previously granted, addition to menu (continued from December 2009 meeting). Thomas McKean presented today's health inspection at the site. All items identified at the prior inspection were fine. The health inspector recommended that the plumbing inspector view the changes at the sink. Louis said they are interested in using the refrigerator (as it cost $12K) and asks whether they could block off the pipes and use the remainder of the refrigerator. The Board said they would like the plumbing inspector see it. The owners brought in the grease log they kept. Very little grease is showing. Upon a motion duly made by Dr. Canniff, seconded by Mr. Sawayanagi, the Board voted to approve the expanded menu temporarily until a period of when the Big Dipper representative can appear before the Board with the following conditions: 1) continue with the grease log, 2) health inspections will continue every two weeks, 3) not to use the refrigerator as storage until further discussion, ( 4) the trap must be installed in the sink drain), and the 5) discussion will continue in approximately 2 months once the Big Dipper Representative is available. (Unanimously, voted in favor.) �� _�� ``eX� � f, ct ? � < � a � ,'� � � � �F �2 �►:� a "� '� �.�,�e � � .. `� �� 3 �,s. -a; S, �� e � v ..�, �'. a •! -.� sr e Q �i a: � � � \ � � � .� '�,. � � '� � .,.�skr' � �: �. �- �b: � t, \ A � � � �. 3 e �� e S, f �:u �. �.• .�, e ; yE b r f :, � � r �z,. a e � _� ,e � � .•�; it � �. r � -. e � � s � " � �� c o� �� ace � � �� a s v �� d � � � �: � e � �� _ � e ,� .e �I l.. ` � � �� a� _� � � � �C � � � v � � � � � � a�� V s'*�'^ ..x•. e e �. � , -s i�� s Fib/d � � 'ice` z �;. .� ,r � � '� �. Bellpiire, Dianna From: McKenzie, Marybeth Sent: Wednesday, March 31, 2021 2:55 PM To: Hartsgrove, Elizabeth Cc: Gallant, Therese; Parvin, Lindsay; Bellaire, Dianna Subject: FW: Attachments: 20210331_143658jpg Hello Liz, Dianna sent me the email that you have contacted Aubrey about the Blue Moon.Just wanted to let you know that I met with Aubrey last Friday at the Blue Moon and we went over what would be required, by Health,for the approval of.any changes. He is planning on extending the bar area approximately 8-10 feet into the dining area. I would wish I could give you the exact size, but the plan was not done to scale correctly. His intentions are to change the menu to a smoothie bar and serve fried items, such as chicken tenders and other"finger foods". He did not send in a revised.menu at this time. He is showing 12 seats at the extended bar and 9 tables of two in the dining area.There will not be many changes to the back kitchen. I have attached the plan that was dropped off late yesterday afternoon. I told him at the meeting that he must contact all the other departments so to meet their requirements. I have attached the floor plan that I received yesterday. Please let me know if you have any other question or if I can help. Thanks, Marybeth From: McKenzie, Marybeth Sent: Wednesday, March 31, 2021 2:38 PM To: McKenzie, Marybeth Subject: Sent from my Verizon, Samsung Galaxy Tablet 1 Admiral Craft Black Diamond BDCF-19-CG Sliding Glass Top Chest Freezer — 19.2 Cu Ft Curved Sliding Glass Top Chest Freezer 19 Cu Ft 71 Inches is great for merchandising your top-selling frozen treats, while maintaining consistent internal temperatures. Ideal for concession stands, convenience stores and other food service establishments, this display freezer boosts the selling potential of your frozen goods. Features include tempered sliding glass doors with coated trim, white PCM aluminum interior and brilliant internal LED illumination. The easy-to-use manual temperature controller with light-up indicators lets you know the status of the machine, and wire-coated baskets provide organization. The drain plug inside the unit allows for easy refrigerant andfri cleaning. The environmentally-friendly R290 r e g insulated walls ensure this freezer will always maintain consistent temperatures. This model is ETL Listed and ETL Sanitation. 19.2 Cu. Ft., 115V, 2.2 Amps, 71.26"w x 26.8"D x 33.5"H Admiral Craft Black Diamond BDCF-I9-CG Sliding Glass Top Chest Freezer — 19.2 Cu Ft Tempered sliding glass doors with coated trim White PCM Aluminum interior Brilliant Internal LED Illumination r Environmentally-Friendly R290 Refrigerant Manual Temperature Controller with light up indicators Manual Defrosting Wire-coated baskets for organization inside the unit Drain plug inside the unit for easy cleaning Cooling System Refrigeration units use environmentally-friendly R290 refrigerant Maintain a temperature range of -40—100 F Thick wall insulation helps to keep ideal temperature inside the cabinet Electrical Control Manual temperature controller with 0-7 settings Power and operating light indicators to know when the unit is on and running 8' power cord with NEMA 5-15 plug from the back of the unit 115V connection for all models LID(S) Tempered sliding glass doors with coated film Framed by dark gray plastic and silver aluminum Cabinet Construction i constructed of a steel with a durable white powder Exterior s co st coating Interior is constructed of white PCM aluminum The cabinet is insulated throughout with a foamed-in high density cell polyurethane insulation Drain plug located on the bottom of the cabinet allows for easy cleaning Baskets Includes plastic-coated wire baskets to help keep your stored items organized and properly merchandised inside the cabinet. Model Features The bottom of all units have built in casters for sliding in and out of spaces for easier cleaning. We also carry a large selection of Chest Freezers that vary in size and capacity, so you can pick one that best suits your needs! Amps 2.2 Base Material Steel with White Powder Coating Brand Black Diamond Capacity (Cu Ft) 19.2 Certifications ETL Listed Color White Construction Coated Steel Exterior, White PCM aluminum Door Style Slide Door Type Glass Hertz 60 Insulation High Density Polyurethane Item Depth (inch) 2 6 4/5 Item Height (Inch) 33 1/2 Item Width (Inch) 71.26 Nema Plug 5-15P Number of Baskets 6 Number of Doors 2 Phase 1 Power Type Electric Refrigerant R290 Sold EA Temperature Range -40 F — 10O F Voltage V 115 Weight Obs) 190 J l I Breville BJE830BSS Juice Founatin Cold XL Centrifugal Juicer, Brushed Stainless Steel Specifications Accessories Included Accessories: XL 70 fi. oz. Seal and Store Juicing Jug. Cleaning Brush. Juice Nozzle to juice directly into a glass. Capacity Removable Jug and Pulp Bin: For your convenience. Cold Spin Technology Less than 1.8°F temperature transfer. Disclaimer: Based on independent laboratory tests on Breville juicers vs. slow/masticating juicers vs. high speed blenders commissioned by Breville done by the Australian Government National Measurement Institute. Details and reports can be found at www.j'uicingscience.com Construction Materials Titanium Reinforced Cutting Disk. Italian Micro Mesh Filter. Stainless Steel Juicing Basket. Dimensions (WXDXH) 7.9" x 15.7" x 19.7" Elevated Juicing System Allows for juicing directly Into 70 fl 0z jug. Extra Large Feed Chute 3.5 inch feed chute caters to whole fruits and vegetables. Power 1200 Watts. OPERATOR ' S MANUAL ARCTIC CARNET D'INSTRUCTIONS Compact 12L - 20L U LMANUAL DE INSTRUCCIONES r n ) V V I � Y 5 r O O o p Arctic Compact 12-20 UL z G 4 O 12 ELENCO RICAMBt-Dfsponibie in internet afl'indirizzo http://wwwu.golini pa':comLdownload SPARE PARTS LIST-:Available on the internet-at : http.:Ilwww.ugolinispa.comldowritoad LISTE DES PIECES DE.RECHANGE-Sur le site Internet a Padresse http://www.ugoliiiisp"e.com/download ERSATZTEILLISTE -Auf der,Internet-Seite:http:liwww.ugotinispa.comtdownload DESCRIPCION PIEZAS DE REPUESTO-En eVsitio de internet en hitpc//www.ugolinispa.coin/download 3 L Arctic Compact 12-20 UL 1 TECHNICAL CHARACTERISTICS keep them for possible future use. 1/12 2/12 3/12 4/12 1120 2120 3120 4120 IMPORTANT a Transparent removable bowls n 1 2 3 4 Capacity of each bowl,approx. 1 12 12 12 12 When handling the machine never grasp it by the bowls. 20 20 20 20 The manufacturer refuses all responsibilities for possible Dietensiaaesz damages which may occur through incorrect handling. width cm 18 36 54 72 2 Inspect the uncrated unit for any possible damage. If depth cm 47 47 47 47 damage is found,call the delivering carrier immediately to file a height 12 it cm 61 61 61 61 claim. 20 It 71 71 71 71 3 Install the unit on a counter top that will support the combi- Net weight approx. 12 It kg 17 23 37 50 'ned weight of dispenser and product bear to mind what is 20 if 18 26 42 52 � � � bearing Gross weight,approx. 12 It kg 19 26 40 55 stated in the preceding point 1 IMPORTANT warning. 20 It 20 29 45 56 4 A minimum of 15 cm(6")of free air space all around the unit Adjustable thermostats n 1 2 3 4 should be allowed to guarantee adequate ventilation. Hermetic compressor 5 Ensure that the legs are screwed tightly into the base of the Air-cooled condenser machine. Overload protector Replace the standard legs originally installed with the 100 mm Noise level lower than 70 dB(A) (4')legs whenever they are provided with the unit. 6 Before plugging the unit in,check if the voltage is the same as that indicated on the data plate.Plug the unit into a groun- ded, protected single phase electrical supply according to the applicable electrical codes and the specifications of your machine.When the unit has no plug, install a proper grounded IR�PORTAIbI'f plug, in compliance with electrical codes in force in your area, Read electrical ratings written on the data plate of the suitable to at least 10 Amp 250 Volt(220-230 Volts 50-60 Hz individual units;the data plate is adhered on the dispen- areas)and 20 Amp 250 Volt(100-115 Volts 50-60 Hz areas) sing side panel of the unit,just behind the drip tray(the applications.Should you prefer to connect the unit directly to right side drip tray in multiple bowl models). The serial the mains, connect the supply cord to a 2-pole wall breaker, number of the unit(preceded by the symbol#)is adhered just below the right bowl. Data plate speciftcations will whose contact opening is at least 3 mm.Do not use extension always supersede the information in this manual. cords. Specifications are subject to change without notice. PATENTION.,._, Failure to provide proper electrical ground according to 2 INTRODUCTION applicable electrical codes could result in serious shock hazard. 7 The unit doesn't came presanitized from the factory.Before Please read all sections of this manual thoroughly to familiarize serving products,the dispenser must be disassembled,clea- yourself with all aspects of the unit. ned and sanitized according to this handbook instructions Like all mechanical products,this machine will require cleaning (chapter 5.3 CLEANING AND SANITAZING PROCEDURES). and maintenance. Besides, dispenser working can be compromised by operator's mistakes during disassembly and cleaning.It is strongly recommended that personnel responsible a for the equipment's dairy operations, disassembly, cleaning, ® jj PORTANT,,. $: $. sanitizing and assembly,go through these procedures in order Install the dispenser so that the plug is easily accessi- to be properly trained and to make sure that no ble. misunderstandings exist. 4 TO OPERATE SAFELY 3 INSTALLATION 4 Do not operate the dispenser without reading this opera- tor's manual. 2 Do not operate the dispenser unless it is properly groun- 9 Remove the corrugate container and packing materials and ded. 4 3 Do not use extension cords to connect the dispenser. obstructed by wall or boxes.Allow at least 15 cm(6")of free 4 Do not operate the dispenser unless all panels are restrai- clearance all around the dispenser. ned with screws. In any case if the product in the bowls is cold the unit is running 5 Do not obstruct air intake and discharge openings: 15 cm Properly. 5 How to reset beverage temperature:to reset beverage tem- (6")minimum air space all around the dispenser. perature please apply to a technician. 6 Do not put objects or fingers in panels louvers and faucet The proper temperature is preset at the factory. outlet. 7 Do not remove bowls, augers and panels for cleaning or S. 3 CLEANING AND SANITIZING routine maintenance unless the dispenser is disconnected from PROCEDURES its power source. Cleaning and sanitizing of the dispenser are recommended to guarantee the conservation of the best product taste and the highest unit efficiency. This section is a procedural guideline AT,LEtil7.ltlil �" only and is subject to the requirements of the local Health Authorities. Prior to the disassembly and cleaning, the machine must be In case of damag es,the power cord must be replaced by emptied of product. qualified personnel only in order to prevent any shock hazard. 5.3. 1 DISASSEMBLY 5 OPERATING PROCEDURES 1 Clean and sanitize the unit according to the instructions in � this manual. See chapter 5.3 CLEANING AND SANITIZING L ATTENTION , PROCEDURES. -- AX 2 Fill the bowls with product to the maximum level mark. Do Before any disassembly and/or cleaning procedure make not overfill. sure that the dispenser is disconnected from its power The exact quantity of product(expressed as liters and gallons) source by unplugging it or switching off the 2-pole wall is shown by marks on the bowl. breaker. 3 in case of products to be diluted with water,potable water,. pour water into bowl first,then add correct quantity of product. 1 Remove cover from the bowl. In case of natural squashes, it is advisable to strain them, in 2 Remove the empty bowl by lifting pulling lever(1) and its order to prevent pulps from obstructing the faucet outlet. front side(faucet side)up and off bowl gasket(see figure 1). 4 Install the covers and check that they are correctly placed over the bowls. 5 Set the control switches as shown in chapter 5.1 DESCRIPTION OF CONTROLS. 6 The dispenser must always run with the covers installed to prevent a possible contamination of the product. 7 Always leave the dispenser on, as the refrigeration stops �`If automatically when the beverage reaches the dispensing tem- perature.The mixing devices will continue to turn. -- 8 To maintain a high standard of flavour, keep refrigeration and mixing devices on during the night when beverage is in the bowl. IMPORTANT: .,.; figure 1 Operate the dispenser with food products only. 3 Remove the bowl gasket. 4 Remove the pump impeller from its location. S. 1 DESCRIPTION OF CONTROLS S Pinch tube faucet: push the dispensing handle (1) and take the pinch tube off from its seat(2)(see figure 2). The dispenser is equipped with the power switch only.When it is set to position I,the power is turned on both to mixing devices TP and to refregeration. 5.2 OPERATION HELPFUL HINTS 1 The length of time for cooling down the product is governed by many variables,such as ambient temperature and beverage initial temperature. 2 To shorten product cooling down time and increase pro- ductivity,it is advisable to pre-chill the product to be used in the dispenser. 3 To shorten product cooling down time and increase pro- ductivity, the bowl should be refilled after the product level drops lower than half and at the start of each day. 4 The dispenser must be able to emit heat. 1 In case it seems excessive, check that no heating source is dose to the unit and air flow through the slotted panels is not figure 2 5 r Arctic Compact 12-20 U L 6 Gravity faucet: extract the piston and then remove the soft bristle brush. dispensing handle(see figure 3). 5 Rinse all cleaned parts with cool dean water. 5.3. 3 SANITIZING Sanitizing should be performed immediately prior to starting the machine. Do not allow the unit to sit for extended periods of time after sanitization. 1 Wash hands with a suitable antibacterial soap. 2 Prepare at least two gallons of a warm (45-60°C 120- 140°F)sanitizing solution(100 PPM available chlorine concen- tration or 1 spoon of sodium hypoclorite diluted with two litres of water)according to your local Health Codes and manufactu- rer's specifications. 3 Place the parts in the sanitizing solution for five minutes. 4 Do not immerse the lighted top covers in liquid. Carefully figure 3 wash their undersides with the sanitizing solution. 7 Slide drip tray out and empty it. 5 Place the sanitized parts on a dean dry surface to air dry. S. 3.2 CLEANING 6 Wipe dean all exterior surfaces of the unit.Do not use abra- sive cleaner. 5. 3.4 ASSEMBLY IMPORTANT 1 Slide the drip tray into place. Do not attempt to wash any machine components in a 2 Pinch tube faucet: push the dispensing handle (1) and dishwasher. insert the pinch tube into its vertical seat in the bowl bottom(2). Lightly pull the pinch tube end downwards til itl is well arranged (3)(see figure 4). ATTENTION 2 Before any disassembly and/or cleaning procedure make sure that the dispenser is disconnected from its power source. 7 Prepare at least two gallons of a mild cleaning solution of warm (45-60°C 120-140°F)potable water and dishwashing detergent.Do not use abrasive detergent. Important: if present, follow label directions, as too strong a 3 solution can cause parts damage,while too mild a solution will not provide adequate cleaning. figure 4 IMPORTANT- 3 Gravity faucet:install the faucet handle and the piston with In order to prevent any damages to the dispenser use its gasket(see figure 5). only a detergent suitable with plastic parts. 2 Using a brush,suitable for the purpose,thoroughly clean all disassembled parts in the cleaning solution. ATTENTION When cleaning the machine, do not allow excessive amounts of water aronrrd the electrically operated com- ponents of the unit. Electrical shock or damage to the machine may result. M 3 Do not immerse the lighted top covers in liquid.Wash them figure 5 apart with the cleaning solution.Carefully dean their undersi- 9 des. 4 In the same manner clean the evaporator plates using a 4 Fit the bowl gasket to the evaporator.Note:the largest brim 6 oB of the gasket must face against the drip plate(see figure 6). pole wall breaker,then remove front panel(dispensing . ( 9 side) Condenser fins are very sha rp..Use extreme caution when de- aning. � I• figure 6 5 Place bowl on the unit.Wet the gasket for ease of insertion. Please take care that the hook on the backside of the bowl be inserted property in its seat on the upper drip plate.(see figure 7). i i figure 7 6 Use fresh product to chase any remaining sanitizer from the bowl(s).Drain this solution.Do not rinse out the machine. 5.4 IN-PLACE SANITIZATION The In-Place Sanitization prior to starting the machine may be performed, if needed, only as further precaution, in addition to the Disassembled Parts Sari tization described before,but never in lieu of it. Prepare two gallons of a warm(45-60°C, 120-140°F)sani- tizing solution(100 PPM available chlorine concentration or 1 spoon of sodium hypoclorite diluted with two litres of water) according to your local Health Codes and manufacturer's speci- fications. 2 Pour the solution into the bowl(s). 3 Using a brush suitable for the purpose,wipe the solution on all surfaces protruding above the solution-level and on the underside of the top cover(s). 4 Install the top cover(s)and operate the unit.Allow the solu- tion to agitate for about two minutes.Drain the solution out of the bowl(s). 5 Use fresh product to chase any remaining sanitizer from the bowl(s).Drain this solution.Do not rinse out the machine. 6 ROUTINE!MAINTENANCE Daily:inspect the machine for signs of product teaks past seats and gaskets. If proper assembly does not stop leaks around seals or gaskets, check for improper lubrication, worn or damaged parts. Replace parts as needed with original spare parts from the supplier. 6. 1 MAINTENANCE(TO BE CARRIED OUT BY QUALIFIED SERVICE PERSONNEL ONLY) Montly:clean all internal components,primarily the condenser, using compressed air. To clean these internal parts,unplug the unit or switch off the 2- 7 Sandwiches Main Choice (Syicq slanto Oriltc Igrk Ohick*-Ii Wrap Grilled chicken breast coated with spicy mango Jerk chicken, lettuce and teriyaki sauce served with Your choice of toasted tomatoing a flour tortilla sauteed vegetables. wrap. bread with American and cheddar cheese served Fish &C'hips Smoked Saln+on �1n��1ne with French fries pasta Panko cod fillet fried and served with French fries._ AI dente fresh cooked linguine pasta served in a Pull T°uea, creamy sauce. "V tt;rq UgUir Fri.-rd Pull Tuna meat mixed with thiC t mayonnaise, garlic, onion Lobst;i.gr Rill All spice marinated chicken and ground peppers breaded and fried to served with red onions. Succulent lobster meat, onion, served with pepper, garlic, Cole slaw. mayonnaise and celery Q Y`. t� �iald I'trr served on a warm roll. Fresh marinated turkey Evtrq h-alt;hq sip thakes breast slow roasted with lettuce tomato pepper Itar � Iza t;r our , p pp (r.rilted SaIttet ' jack cheese and pickle stir®®bhi attd tfiabvral served with French fries. Atlantic grilled salmon juice hvroe f em our covered in a smoky tomato juice bar. chipotle sauce served with "+ Classic Club sauteed vegetables. Smoked bacon, eggs, „ chicken breast, lettuce and tomato served between 3 slices of toasted bread with French fries. ---. Appetizer T'relical 8:eafood Salads K�:e�bab� Fri-.ed t' caevt Oapreat Sabad Urithr Dry rubbed shrimp, sea Organic tomatoes, mill- scallops and spicy Italian feuille marinated fresh Marinated jumbo shrimp sausages served with mozzarella cheese with an breaded and fried served grilled mango and drizzled herb vinaigrette. with mango chutney. with herb oil. Jbacatt Wrap Clank C'a-.egar Plaftain salad `' h,i�l�etn Witlg� Caribbean grown plantain Crispy hearts of romaine, Crispy fried chicken wings garlic croutons and wrapped in smoked bacon tossed in the sauce of your and topped with a passion parmesan cheese with a choice: Barbeque, Buffalo, Caesar dressing fruit coli Sweet Safthet T'a�o Slinach and Sauteed Atlantic salmon on $Guy Crarib:errq salad a bed of greens with Fresh crunchy spinach avocado and pineapple Clam Chowder leaves, dried cranberries salsa served in a taco shell, and orange with balsamic vinaigrette Fri-.ed talaMari Hovg:e- Salad Battered and fried squid served with a mild Baby mixed greens,red onions, marinara sauce. tomato,redish,pecan nuts, /v serve with raspberry dressing. C,Wlt-d Poacized vidd eh,icAf6, shrimp, bacoft ®r 869ak to Your aaladf Marinated shrimp served with layers of market Before placing your order please inform your greens and topped with a server if a person in your party has a delicious home-made fooallergy.Consuming raw or under cooked tropical fruit salad. meat,poultry,seafood,shellfish,nuts or eggs d may increase risk of food bourne illnesses. y • �- MAIN"FEATURES • Heavy-duty 3.5 peak'HP high performance motor 1 voith'2 speed selections is the strongest in-its class It powers through the.toughest ice and frozen fruit r mixtures in seconds. • Super-high,4- 000 RPIv1 motor speed is ferocious - enough for everything from smoothies and frozen •� drinks to thick spreads, desserts dressings.and a!l types-of food.preparation. ® e _ •The Raptor®64 oz.;stackable, unbreakable,'-- is dhwasher-safe, BPA=free copolyester container High-grade, high-impact,stainless steel blatle'is user replaceable for easy servicing ' Va Easily removable container cover with removable Blear cap for adding ingredients-and pressure reduction M during hoffo6&blending. User-re laceable'metal-on-metal .stainless steel ' coupling system between base and container,for durability and reliability. •Optional sound enclosure easily retrofits to base for,. . • noise reduction. - • Recommended for 75+drinks per,day. •timited Three-Year motor.Warranty and.Two-Year , :.,Parts;&Labor Warranty. •� *Made in USA with US and foreign parts. • e ELECTRICAL SALES FEATURES Voltage: 120 Get smooth, consistent results every time with 4he Waring®MXt 100XTX.This heavy-duty 3 5 HP Frequency: 60Hz blender teams up with The Raptors jar and blade • Watts: 1560 assembly for maximum power'and,efficiency Amps: 12.5 Features.an easy-to-clean,electronic membrane keypad w Plug Type: A F aith HIGH; LOW, OFF and PULSE functions, O NSF® -and a 30-second electronic countdown timer. Perfect Cord Length: 6 feet bar, health'facility,school or coffee shop': ©2019 Waring Commercial jjn 314 Ella T.Grasso Avenue,Torrington,CT 06790 e Tel.800-492-7464•Fax 860-496-9008 @waringcommercial waringeommercialproducts.com Hi-Power Electronic,Keypad Blender with Timer and 64 oz., fY . ' Cop,olyesterContainer OOXTX PARTS &ACCESSORIES DIMENSIONS T CAC90 CAC95-12 t64 oz.Stainless Steel 64 oz.Green Container Copolyester Container CAC93X CAC95-28 -`-- - — - 48 oz.Copolyester + ' 64 oz.Orange Container Copolyester Container CAC93X-03 CAC116 j! l` 48 oz.Yellow Copolyester Container o Blending Assembly Kit a G and Retainer Ring Kit 18"H — s ? s —(- — ------T}— CAC93X-06 48 oz Blue CAC119 ' Copolyester Container Retainer Ring Wrench h CAC93X-10 i CAC158 ®❑e 48 oz.Purple Blending Assembly Kit ®� Copolyester Container o CAC93X-12 CAC159 48 oz Green Retainer Ring Kit t-- 8.5"W —b —8.25"D—► Copolyester Container CAC160 If Drive Coupling CAC93X-28 fl 48 oz.Orange CAC161 Copolyester Container �. Drive Coupling Removal Tool o CAC95 815"D The Raptorm-Aggressive, All-Purpose,Stackable, CAC1169 64 oz.,BPA-Free Copolyester Spatula-Custom `- Container designed for use with �' 3°„�na�'a CAC95-03 MX Series Blenders g 64 oz.Yellow Copolyester Container SE7000 t— 8.5"W —► large Sound Enclosure CAC95-06 64 of Blue SE500 Copolyester Container Small Sound Enclosure _ CAC95-10 "' 64 oz.Purple x Copolyester Container Out of:Box Weight 94.60 Ib DROEti1NS11�fUNNtATiQPt #SiS stFTBOX WBtC SDXOIMEKSIONS UKC1tSE IBC BICDIM�isI= M#C PKs WE16HT FEET- D X W X H PK6 WEIGHT U X W X H ±MJ(tiflOXTX;Ni Power Eteetrorgc 1; ,- 15:75 1,033 11.375"x 10.125 x 151" 0400720170Q1 h- 177"` 11.75"x°-10.75"x 16.125 10040072017008 _Keypad Blenderwith Timer and 64 oz.,BPR Capotyesf TGOntauter ! ©2019 Waring Commercial ff 0 ► U 314 Ella T.Grasso Avenue,Torrington,CT 06790 _ V40V Tel.800-492-7464•Fax 860-496-9008 arlilgCDRlmerCial WaringCO[flmerCialproducts.COfl'1 19WC063863/REV 09/19 :MAIN FEATURES J - Ultra-heavy=duty"3:75 HP commercial motor perfect for large loa8 'c1 long blending times •3-speed selection and MAX PULSE-to.chop ' Cw and.mix • Easy-to-clean and easy-to-use.electronic membrane keypatl ' • s s •".1 gallon stainless steel,container with two • k handles for carrying and pouring, and lid.clamps' • • Easy=off, rubberized hd with removable ear-cap, for:adding ingredients and,for pressure reduction[ • ...4 '" during hot food blending ' i zTs Durable high=performance stainless steel blade. • Metal-on-metal, stainless steel coupling systernJor " durability and rellabllity •:Durable,full die-cast motor housing with rugged ,. rubber feet to reduce vibration " y A • Dishv�asher--safe, one piece jar pad for"easy a : cleaning b •:Recommended for 100+drinks or-servings per day • Limited Three-YearMotor Warranty `Made in USA with US and foreign parts. ELECTRICAL SALES FEATURES Voltage: 120 The,Waring®CB15 has your f;ack"whenit comes to Frequency: 50/60Hz ultra heavy-duty blenders, making<100+drinks per: Watts: 1800 day:-Chop,mix a g that nd shred lare loads need long blending times with a powerful 3.75 HP.motor and Amps: 151, electronic keypatl controls.The durable, 1 gallon Plug Type:A stainless'steel container rneans business with two Cord Length: 6.6 feet COUS �$F® handles for carrying and pouring,an lid clamps for security. . Intertek AIM Idmilb, 02018 Waring Commercial W >s �n 314 Ella T.Grasso Avenue,Torrington,CT 06790 Tel.800-492-7464•Fax 860-496-9008 @waringcommercial waringcommercialproducts.com l� e INCLUDED ACCESSORIES DIMENSIONS CB15BU Base Unit CAC77 Vinyl Lid for 1 Gallon Blender Jar CBL10 Hot Blending Lid for 1 Gallon Blenders 1 01114 CAC72 Two-Handle, 1 Gallon Stainless Steel 26"H Container with Blade Assembly and Lid OPTIONAL ACCESSORIES CAC125 Two-Handle, 1 Gallon Stainless Steel ® � Container with Spigot,Blade Assembly �� and Lid �n T7 CAC170 1 Gallon,Stackable, 128 oz.,BPA-Free Copolyester Container with Blade Assembly Li U IWO and Lid CAC32 40 oz. Glass Container Complete with Blade Assembly and Lid(requires AD1) AD1 1 Quart Adapter for 1 Gallon Blenders £ 10°D CAC19 48 oz.,BPA-Free Copolyester Container { Complete with Blade Assembly and Lid (requires AD1) t--- 10°W CAC33 32 oz_Stainless Steel Container a� Complete with Blade Assembly and Lid (requires AD1) CACO2 Outer Lid ONLY for 48 oz., BPA-free Copolyester or 64 oz.Stainless Steel Container CAC04 Outer Lid ONLY for 32 oz.Stainless Steel Container Out 0f Box Weight 32;41b CAC05 Center Lid ONLY for CAC01,CACO2,and CAC04 ORDEflIk6UlH1R11FATW YSTD. 6iFIBQIt .titiBtC B#IXEHdABISli1NS UPC EASE M€ . MICQUAE1�10A6S- UDC P!(0 . 4UEF6HT• .fEET ,Lz xN PKG. WE1GHT txWxH C615 One Gam 3 Speed Food Blender 1 38 2 i ,22 0 x 14.r x 14.8"-` 040072000836 - 1 40 22 5 x 15 3"x 16" 10040072000833 ©2019 Waring Commercial j� 314 Ella T.Grasso Avenue,Torrington,CT 06790 Tel.800-492-7464•Fax 860-496-9008 @vi+aringcorramercial waringcommercialproduc$s.com 19WC058218 REV09/19 "C 0 M M E R C—I A _L _ �f :3.im5 I — DESIGNED AND MANUFACTURE........... FOR COMMERCIAL KITCHENS _ - _ t t" -k .d` CCB-3550 a ti� x ACIAL A�Z� f m• of -YC � o z�� :. • 3.5 HP* 161=O'watt with thermal reset protector ` . k x, • .,.-,.H Easy to clean digital control with High, Low,=-Pulse'and:Tlmer feature • '64oz dishwasher" safe; BPA Free Jar AFT, �s s4or u . `U SE • Heavy duty commercial quality ;stainless;steel blades4' OIJ E B", _ Sfi • :Space swing stackable far desigI"i T n gn INA Inte4tek 6itertek , " $ �wWW chefbuiltcommercia1.corn r 1 � L .0 .. R. t DESIGNED AND MANUFACTURED FOR COMMERCIAL KITCHENS 3m5 NP* DIGITAL POWER +y'pS I a 4 BLENDER 19" C -355p 3 m h , 4 f': f YEAR , us 10.3" Intertek Intertek p.2„ v IPECIFICATIONt ITEM ELECTRICAL PLUG-TYPE CERTIFICATION DIMENSIONS BLENDER WARRANTY H x W x D JUG-CAPACITY 120V-60Hz ' .1 1 ETLus; 18064 1610W r NEMA 5-15P ..ETLsanitation 19"x 8.2"x 10.3" 64 oz. Limited 2 Year DESCRIPTION MODEL# STD PKG. SHIP WEIGHT CUBIC FEET UPC'CODE (Ibs) CHEF-BUILT® 3.5 HP*POWER BLENDER cc -3550 ' 1 1'1. Ibs " 1.08 829486 180644. *-peak input For Sales and Inquiry call 1-866-832-4843 or e-mail help@chefbuiltcommercial.com www.chefbuiltcommercial.com Sensio Inc. New York, NY 10016/USA opIKE roy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of v� ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. saeNsrnaLe. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified Mass. g MON.-FRI. No Reference R-Red Item. PLEASE PRINT CLEARLY ,639. HYANNIS,MA02601 soa-862-4644 lFDN1P�' FOOD ESTABLISHMENT INSP CT ON REPORT v Name Date TvDe of Type of Inspection feL-Oice�is RoutineAddress L Risk d Re-inspection Level Retai Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation U Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP c-d In: Ottier Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing. CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations _ Critical(C)violations marked must be corrected immediately. (blue&red items) 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 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 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 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 within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009) y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? 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 RT'E 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* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers* 3-501.16(A) Roasts Held At or Above 130°F* Storage* - Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation g 20 Time as a Public Health Control 590.003 Responsibility of A Food Employee or An (� p° h' 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* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.11 Sanitizers,Criteria-Chemicals* 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 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* I 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* I Concentration and Hardness* 3-401.11 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of 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 Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.1](A)(2) Comminuted Fish,Meats&Game Pathogens* Eg c ,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 3 441.11(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 3-201.15 Molluscan Shellfish from NSSP Listed Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Chemical* 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* -'I-- 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 3-202.15 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 foodbome 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 3-202.18 Shellstock Identification ( ) r26. Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F 5-203.11 Numbers and Capacities* Within 4 Hours* Management and Personnel FC-2 .003 Tags/Records:Fish Products P Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 1 Other 3-502.121 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. ..41 �F IKE rpm , TOWN OF BARNSTABLE HEALTH INSPECTORs Establishment Name: Date. Page: of OFFICE HOURS h PUBLIC HEALTH DIVISION 8:00-9:30 A.M. I -. BARNSTABLE. 200 MAIN STREET 3:30-4,30 RIV :,�No Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified v -'39. .•0p HYANNIS, MA 02601 MON.-FRI. Reference R-Red Item PLEASE PRINT CLEARLY "reu AMA p 508-862A644 _ FOOD ESTABLISHMENT INSP CT,ION REPORT IV +4.1 t `~ Name Date 7 t)e of TyRe of inspection --= ' c✓ , Operation(, Routine Address l( //} Riskr Etood Service Re-inspection '' "f •1 r , - . Level Retail Previous Inspection ' ;`. Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP �s� Ottl 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) ;� y � Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑; a v Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ .�) /��q t��'� �� w .FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands 1.PIC Assi ned/Knowled eable/Duties / `'❑ g g ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS -,❑-2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives 4: ° -❑ 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 ,k '❑ 5.Receiving/Condition ❑ 17.Reheating z ®6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling ❑'7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding 4 PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control h -c _❑ 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 # 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. �I;;_ ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items,` ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code.. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent': A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations'; regardless of the number of critical,results in an F. 25.Equipment and Utensils FC-4 590.005 B=One critical violation and less than 4non-critical violations g ( )( ) cited in this report may result in suspension or revocation of the food I if no critical violations observed,4 to 6nnn-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If :C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address{; violations observed,7 ti anon-critical violations. If 1 critical refrigeration. ) within 10 days of receipt of this order. violation,4 to 8non-critical violations=C. 29.Special Requirements (590.009 Y P 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 f' - #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 I` 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 Assi nment of Responsibility* 8 Cross-contamination Law Cooled to 41°F/45°F Within 4 Hours* ( ) g 14 Food or Color Additives 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.* 19 PHF Hot and Cold Holding 3-302.14 Protection from Unapproved Additives* Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F 590.004(F) EMPLOYEE HEALTH. 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* Require Reporting by Food Employees and Contamination from the Environment 7-202.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* 7- 01.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P -0 Time as a Public Health Control 590.003 Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* * �) P ty3-302.15 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* 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* ontamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* C 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* 590.003(E) Removal of Exclusions and Restrictions 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 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* I 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* I Sanitization Temperatures* TIME/TEMPERATURECONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eJ/cme innom 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 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* Proper,Adequate Handwashing 10 Ratites-165°F 15 sec* 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 Tastin * * (Blue Items 23-30) 3-202.11 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 3-403.11E Remaining Unsliced Portions of Beef Roasts* ( ) g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 13 Handwashin 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* g 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 Capacifies* Within 4 Hours* 23. Management and Personnel FC-2 .003 4.11 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* 5-20 5-20 .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. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1009 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. h� o Iva . LD / North Street parking lots / North Street i J North Street parking lots / / parking lots )f f ! ® gr 1.(100 ease tray f p Installed Map Parcel Nov,2013 li 309 219 ' 430 Main Street Hyannis ( ' tied in N 442 (' Jan 3 p 14 #420-428 #410-412 Bank Bldg furniture store B restaurant u , i •.-Hain Street.Hyannis.., . Plan View Sewer Connection for Town of Barnstable , Mass Scale: 1"=39 430 Main Street , Hyannis Department of Public Works Grease Trap Installation _ J Crocker, Sharon From: Childs, Barbara Sent: Monday, May 02, 2016 2:59 PM To: Crocker, Sharon Subject: Sketch Attachments: MAIN STREET.pdf 7 1 F91FU9 9 ° Spesification 6 4 3 9 hand sink 2 2-ba sink g 3 Coffee station 4 Soda stadon 2 g Ice machine 6 Cash register ; 7 Cooler 6 ReN erator j 81 V Blenders 4 s '�--� 90 Juicer 0 21 ' 9 9 Hand free hand sinlr 9 Splash guards 2 pi"191ass Finish schedulle ( 90 Floor Ceramic boor the 48' _ - - - — Coiling Washable ceiling vela Wells bar a a _. Walls Cd1ning area Paint I C Fill 2- 18'5° C I (c]L- C SITE: TITLE: SCALE AT Al DATE: DRAWN: CHECKED: PROJECT NO: DRAWING NO: REVISION: I I I BAJCTER NYE ENGINEERING & RUN TANK VENT ROOF INDEPENDENTLY THRU -✓ SURVEYING ROOF BY P.C. 240 COVER do FRNdE, ,.. I REFER TO MANHOLE EXTENSION I BUILDING Registered Professional Engineers REPAVE To MATCH EwsnNc and Land Surveyors - jFMSH CILAOE: » 37.'Jlt �'' 78 North Street — 3rd Floor 240+ /WVJI IV V�Vt/G 1�11 t'f 4 �..' r. Hyannis, n n s Massachu setts 0 1 8 SEINER BRICK WITH TEE .:» 3 4 CEMENT MORTAR I a,Mr rs. WATERPROOFING �PRooFrc oursloE (508) 771-7502 c� TEc Phone sa- Fax — 508 771-7622 INv. .� INv. 35.os www. _ . ' x ba tern coin `P1AC PM CALILK a. 7ttP, SEIY OOfa7RlJCItON I � A sE*L AROUND PPE aoKr WIM Burn. Rueeoe MATERnGHT--TT P. EVE LWUID 3 odn ON ALL PRECAST STRUCTURES FOR INLET & 0tnLEr(HEIC M NOT STANDARD) 2rmin 4•-Tr I STAMP STAMP SL STT1rL CLAMP s E V. ANCOM TEE 70 BOLT ON MSOE OF TANNK �"OF iy MAUL 7W. S M TEES �. AS+ I d` 4 WALLS A 0 ROTO� � 1000 GIWLON PREt`J1ST SET ON LEVEL StWACE � PHE .SEPTIC TANK-H-2O y lOADlIG 0 216 Q F � S G I S N 0 E Ir-d' LONG NAL owl 4-10" WE tN1ofSTtIRBED EARTH Cm Ruc"NOWD I N CO S TAN UL T 1. DATUM — N.G.V.D.29 2. • THE CONTRACTOR S CONTACT DIG AT CAUTION: HALL 0 SAFE 1-888—DIG-SAFE AND UTILITY COMPANIES TO LOCATE ALL EXISTING UTILITIES, AT LEAST 72 HOURS BEFORE THE START OF CONSTRUCTION. THE CONTRACTOR SHALL DETERMINE THE EXACT LOCATION, BOTH HORIZONTALLY CONSULTANT AND VERTICALLY, OF ALL EXISTING UTILITIES BEFORE THE START OF ANY . WORK. THE LOCATION OF EXISTING UNDERGROUND UTILITIES ARE SHOWN IN NOTES. AN APPROXIMATE WAY ONLY, MAY NOT BE LIMITED TO THOSE SHOWN A GREASE TRAP WILL BE SET ON A LEVEL STABLE 8A5E. HEREON AND HAVE NOT BEEN INDEPENDENTLY VERIFIED BY THE OWNER OR ITS REPRESENTATIVE. THE CONTRACTOR AGREES TO BE FULLY RESPONSIBLE B. GREASE TRAP WILL CONIFORM'M H-20 LOADING SPECFI AT10NS. FOR ANY AND ,ALL DAMAGES WHICH MIGHT BE OCCASIONED BY THE C. ACCESS COVERS V M 2te COVERS SHALL BE CONSTRUCTED 70 'GRADE OVER PREPARED FOR : CONTRACTOR'S FAILURE TO LOCATE THE UTILITIES EXACTLY. IF ELEVATION INLET AM OUTLET PIPM- INFORMATION DIFFERS FROM PLAN INFORMATION, THE CONTRACTOR SHALL D. GREASE TTtIIP SHALL BE, INSPECTED MONTHLY AND SHALL BE CLEANED WHEN NOTIFY THE ENGINEER IMMEDIATELY FOR POSSIBLE REDESIGN. AT UTILITY THE LEVEL OF GREASE CIS 25% OF THE EFFECTIVE DEPTH OR ALE4SST EIVM CROSSINGS, VERIFY IN FIELD THE LOCATION / INVERTS OF ELECTRIC, GAS, 3 MONTHS. W. George TELEPHONE & DATA/COMM AND RELOCATE IF CONFLICTING WITH PROPOSED Thatcher Shore Drive INVERTS PER THE ENGINEERS DIRECTION. THE CONTRACTOR SHALL PRESERVE ALL UNDERGROUND UTILITIES AS REQUIRED. _ YarffKxjdlpoft AAi4 02675 =0 G&LON CREAM TRAP 3. FIELD ADJUST GREASE TRAP INVERTS TO AVOID ROOF DRAIN LINE 4. A SEWAGE PUMP WILL NEED TO BE :INSTALLED IN THE BASEMENT TO x 37.6 DISCHARGE TO EXISTING PLUMBING. 5. ALL PIPING AND TEES SHALL BE CAST IRON AND MEET APPLICABLE DE51GN FLOW: 50 SEATS x s cPD/SEAT `• 75o cPD CODES. X 37:7 USE local GALLON t ink% TRAP (YNdMAUM ALL+ONIED) I x 37.9 i 37.7 PARKING AREA I I x 37-7 I x 38.0 ; i t I _ x 37.5 c>c 3 -# i a ACCESS STAIRS TO 137. i 1 --� SECOND LEVEL' ' a, 37.3 i ni CHAIN LINK FENCE �, PROD fODG ' 37.1 1 �.. R=36.70 i GALLON GREASE i I _ i 1-34.50 � -37.5 137.7 ' I i i I i O i ROOF W RAIN r..D S =36.8 N IN=35.11 � � _ — 1 OUT 35.01 7. F- B L D � I �3 7 1 YP ONCRE� Z� V C r i ! PROP06m NY. _ 3�o W i 3 p BERM FROPO D Ml. = Xw O CA�O 61' 1 N / a . DRpt .L R00� =� I i POOR 2 N!K .f E:37.5 Egli VA Z>� D Z — ►- I � y1 I , t I F t W f t s+a�+oa- o III. I I a 0 i m z SHEET TITL E Pro sed Grease , 14 p►o a cq Tr ap Plan 0 SHEET NO Ciao I � ` di I q DATE . 09 10 13 m 10 ' 0 0 10 20 a , ._ SCALE IN FEET SCALE . 1 — 10 0 DRAWN/DESIGN BY. NIMISAW CHECKED BY. 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