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HomeMy WebLinkAboutFRESH KETCH - FOOD 462 Main St. DIY � FORMERLY: MAIN ST. SEAFOOD & GRILL f flFtK€ Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudagnoli, M.D. crcti �nt F.P.(Thomas)Lee wad Daniel Luczkow,M.D. Alt. 200 Main Street, Hyannis, MA 02601 Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 234 Issue Date: 01/01/2022 DBA: FRESH KETCH OWNER: STEPHEN ROY Location of Establishment: 460 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 175 OutdoorSeating: 0 Total Seating: 175 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: ' For Office Use Only: Initials• Town of Barnstable Date Paid : .� AS& Inspectional Services 039. Public Health Division cheek# 1A _ Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE AFOOD ESTABLISHMENT DATE Irks, NEW OWNERSHIP RENEWAL i✓/ NAME OF FOOD ESTABLISHMENT: F/1-tS ADDRESS OF FOOD ESTABLISHMENT: rn 9,^1 r%of� ��/ar1..1% rA 4 �7 2fo a j MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: Corr TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (S� )' 11 _ I i TOTAL NUMBER OF BATHROOMS: w WELL WATER: YES_// NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: _,DATES OF OPERATION:�1 / -L TO/'0 NUMBER OF SEATS: INSIDE: 210 OUTSIDE: Yl--TOTAL: 2- SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVI, E DOOR(S)9 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) ti CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: j ejA FULL NAME OF APPLICANT S�J�t l f SOLE OWNER: (9/NO D.O.B U 7 r7 6 1 OWNER PHONE # -1 L — ,T 4 2 J I ADDRESS_ ,. �—!of A 0 Eck-- d® CORPORATE OWNER: c C7 CORPORATE ADDRESS: ! 2 m e I,P S M EC 1- rl N qr!M/1 s►^�} v Z o/ 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 LVALWA Miur� 1. • 2. � SE�Fil1 i IL i t new JGNATIRE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments, including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/bealthdivision/anplications.asa. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.31't each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC Ist. QAApplication FormsTOODAPP REV3-2019.doc t ` Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARN-STABLF- - Paul J.Canniff,D.M.D. MAI 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, 305113, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 234 Issue Date: 01/01/2021 DBA: FRESH KETCH OWNER: STEPHEN ROY Location of Establishment: 460 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 175 OutdoorSeating: 0 Total Seating: 175 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: ----- - ----------- MOBILE-FOOD: MOBILE-ICE CREAM: t Qn FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Town of Barnstable For Office Use QjIly: Initials: Amt Pd$�6- aAs , : Inspectional Services Public Health Division Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FO-OD ESTABLISHMENT " DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: MAILING ADDRESS(IF DIFFERENT FROM ABOVE): _IX E-MAIL ADDRESS: __<--r6'P4C1J r l �2` C`� A o C_ TELEPHONE NUMBER OF FOOD ESTABLISHMENT: O TOTAL NUMBER OF BATHROOMS: `7 WELL WATER:YES NO (ANNUAL WATER ANALYSIS REQ IRED) ANNUAL: SEASONAL: DATES OF OPERATION.0 l L%,V TO �a l `I / 2-1 NUMBER OF SEATS: INSIDE: 40 OUTSIDE: `i TOTAL: r� SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING.AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT �/qz' SOLE OWNER:po /NO D.O.B b7 OWNER PHONE # 71-1y ADDRESS - en/ A/ r` /,/y 4t4MJ ^a 01 -y j CORPORATE OWNER: " f"f/&V cl CORPORATE ADDRESS: I '�'�,^� J r m /9 � N�h �►✓� �'�'� I 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 I.-) 2./L" r�G G i // i 27 -k ATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q\Application FonnsWOODAPP REV3-2019.doc T-i U 0 ' r 0 C ZZ --t - _ HYANNIS FIRE DEPARTMENT . 0 D _� A A 41-o' r F J (!5 (o f THIS LICENSE SHALL BE DISPLAYED ON THE PREMISES IN A CONSPICUOUS POSITION WHERE IT CAN BE READ LICENSE No. 00226-RS-0070 S ALCOHOLIC BEVERAGES THE LICENSING AUTHORITY OF The TOWN OF BARNSTABLE, MASSA.CHUSETTS HEREBY GRANTS A COMMON VICTUALER License to Expose, Keep for Sale, and to Sell All Kind, o Alcoholic Beverages TO � cVn``the remise To: RCSJ Group,Ific;td/bI Fresh " .............. Ketch k R ,y� o � Ro ;Vtatger ' on the followin ibgd remises P g esor x 4tib Mal +e >,Ajnit Cl,I annis,MA x a One story build�g at 466 Main Street ` handicap aces ;one rear exit. ` o ,enlrance and etcit oA,Ma Street with a tigi 7i?tisiy"of the restaurant with 28 seats(3 tables of four"to,lel and bles p our t e r of ma new patio to east sWofre ee) 4 t b1eS 6 seats on a s _ idetva ng is o19 with lensA` _ Pm own Manager. This license is grai>ted and accept d upofe stress condition Itcesee shall,in all respects, cobfonV[to allahe provision'S of th@"L"itluf�r`' ontrol Act,Clia ter I38'of the General Laws,as amended,and any rules or regulations,.nade Wereunder b This license expires December•31 202p Y �rlcensing authorities. ,,. „. ,unless earlier suspende(1;cancelled or revoked. IN TESTIMONY:;WHIrREOF,the�Indersigned have hereunto affxed their official signatures this 1st day of ...... _ rtl'2020 . y .,�� , The Hours during which Alcohohc Beverages may be sold are: RESTRICTIONS-See Below WEEKDAYS: 8 A.M. TO 1 A.M. ........... ......................... SUNDAYS: 12 MIDNIGHT TO 1 A.M. ......................•---•-•...........---•- 12 NOON TO 1 A.M. .............................. nl `... ... NOT VALID uess issued in conjunction with a Food Service Permit. ....................••--- #* PAID: $3,050.00 LICENSrN AUT RITY RESTRICTIONS u HdePand s 3/ t r �r5 LogOul J r a �j��� Sear,h by A#dress < 3 �Pra�d Renew I(hspe �C90 S�gnaif(U`�•,•�Personnel(Rt�wis I WeDa�Sdceduk� � (II 3 ,�- f,,� . ,L eO=BC ifltO( r& At 7QSiI RFATAUAAHT T x n j Street House J F ae as A >'Trsr `,hfaosoft` HAPi STREET(HYAHH- € h9"r.kesDi(etch �. s< G TefE[-0Un05famP/0.0 y� y//// //gip/r� � KC'ass460tSanStred sr7�g��rx��k,4liesas939rdiMd EEC r�� �": g nnB` 6{a 02561{ ` 6e#mnl hot fly, q . y s -permits s�a C a freshpar ^', arr;{SOB}n18S6S° z {/11? 53d4 a s b' stephenmy112O�gmaEamat (A4(3525344 Penagct,Step]�nRuy a TE.MS I r i LiceDse3nto €if'?';? r"Inactive vG•20.163 f{ Street House# ApilSuie EffectrreDale walionDate � , � lE�� 1 �� tll � UA➢{5(P'ET(f�'�h5a��1�a i.- i�3 ., �st1O�Y 4i�Cf�2t� Ranaw -x:. ..; #ill Coo a DpEtCmv -�POd9-IB l)I we y.Oram ,'� lfcameiar Ass�gnedNspedar s ;: `�� #§ i PO.19.75 1 ( as s FDD / Teranttlaw ReMencePme ;mend (mdhcane ark? -- AcrobatGofDEID$ 82 — g ReaderDCrSteettam PzrmdSelect / ���ShowNlTypes � �to�r Re uirementsiCuFields `7 ( U.eGrcup s,r Communiry0e4 ? ( MapParcd 3O9t2` Locatnn UuGroup Cape*Add desflopsr l#�nYce>6a fRi Inspectional Sros Iltratnn�tDseGtoup '�Ru�er � 1� ` r� °' ' 1d A2iBen dDal.2A: 94 DEN +I °11<N7H" Mua� tbo(�e % Health � q � ✓ �e Fire / f ., Edilibde: p` s e"• F�f pmt p e .n i L, e a�E44 + j �" Daahbo-ard Gil r 4 s �.f , ff ff f�= � � a � r 1r 0 "41 ��... `�I i r ,�'� _' s ��,}�- � F w k 3,�a__ � � >k M i r•+��� t�<,.�a<,.�,. v ,,,..,�„ � z'�qR�'u+._, I HEALTH INSPECTOR'S Establishment Name: °ft�rog TOWN OF BARNS.TABLE Date: Page: of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSfABLE. • 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MAss. g MON.-FRI. A 1679• �0 HYANNIS,MA 02601 sos-as2-4saa No Reference R-Red Item - PLEASE PRINT CLEARLY 'ED MP�p FOOD ESTABLISHMENT INSPECTION REPORT Name ' Date Type of Type of Inspection erati Routine Address Risk ervice Re-inspection t Level < ai Previous Inspection Cold Telephone Residential Kitchen C�-- Caterer Mobile Owner HACCP Y/N Temporary General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector `'� -� �_ Q 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 LL_ ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities \ jam EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives \�V - �,/�0,/ ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals n�qdj .N FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating Loka ❑ 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) \1 - Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Y Y � ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils B=One critical violation and less than 4 non-critical violations 9 (FC-4)(590.005) cited in this report may result in suspension or revocation er the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.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 non-critical violations. If 1 critical refrigeration. y 29.Special Requirements (590.009) s o within 10 days f receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION - Inspector's Signature �5 Print: (� 31.Dumpster screened from public view � l � Permit Posted? Y N Grease Trap Previous Pumping Date Y N 4 Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signat a 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* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 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* . * 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 7-10211 � Common Name-Working Containers * 3-501.16(A) Roasts Held At or Above 130°F 7�201-'11'�� Se azation-Storage* Applicants* - * P g 20 Time as a Public Health Control 3-302.1 1(A) Food Protection 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use 3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements 590.003(G) Reporting by Person in Charge* - Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.1](B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TWEITEMPERATURE 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* 3-401.1]A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 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,Meals&Game Pathogens* ep-me iunom 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 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 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 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* toodborne 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23.30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 TagsiRecords:Shellstock 590.004(E) Preventing Contamination from Employees* r 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) Cooling Cooked PHFs from 140°F 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. 1 Physical Facility FC-6 .007 7 Conformance with Approved Procedures I 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 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. of THE r° TOWN OF BARNSTABLE.. _ - HEALTH INSPECTOR'S Establishment Name: Date: Page: of e OFFICE HOURS AR E.° PUBLIC 0 MAIN STREET ' 3:30-4:30,P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. p 63. `0� HYANNIS, MA 02601 MON.-FRI. No Reference R-.Red Item. PLEASE PRINT CLEARLY rFo Ma+° 508-862-4644 FOOD ESTABLISHMENT INSPECTION REPORT Name Dat T e Type of Inspection eration S Routine Address Risk ood Sery Re-inspection Level ail Previous Inspection Telephone Residential Kitchen Date: 1 Mobile Pre-operation t� Owner HACCP Y/N Temporary Suspect Illness Caterer Gen I Complaint Person in Charge(PIC) Time Bed&Breakfast CID ' In: ther Inspector Out: V 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 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 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 �) TV 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 B=One critical violation and less than 4 non-critical violations 9 (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. y 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view • Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y Dumpster Screen Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge*- 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-]03.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B)590.004(F) *old PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-102.11 Common Name-Working Containers Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Time as a Public Health Control Applicants* 3-302.11(A) Food Protection* P g 20 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202. 3-501.19 Time as a Public Health Control* _ 11 Restriction-Presence and Use* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reaervior 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* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a He * * Raw Seed Sprouts Not Served Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145F 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* Eg-"°°urrzoor 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130`F 121 min Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial) Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 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* y * 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours 9 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of'ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. -7 Ktal Op THE Tq, TOWN OF BARNS-TABLE _ _. - _ HEALTH INSPECTORs Establishment Name: Date: Page: . of _ l OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSTABLE. • 200 MAIN STREET 33o-a:3o F.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. $. MON.-FRI. ,ass• .0 HYANNIS,MA 02601 eoe-862-asaa No Reference, R-Red Item PLEASE PRINT CLEARLY CEO MP�� FOOD ESTABLISHMENT INSPECTION REPORT Name 1 Dat Tvpe of Tvme-ot Inspection O e ' outine _ on Risk Address , Level eod Servic Previous Inspection Telephone Residential Kitchen Date: (/ Mobile Pre-operation `_ Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. C Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ '� ' Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ J FOOD PROTECTION MANAGEMENT t ❑ 12.Prevention of Contamination from Hands � e ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS n �I n Illj L ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives (f•,.,,(N" Ser y ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazard F. dU ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures f ❑ 5.Receiving/Condition ❑ 17.Reheating - ` ? 0 ❑ 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) f ❑ 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: TO No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo Emergency Closure ❑ Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical.violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than o 6 non-critical violations 9 26.Water,Plumbingand Waste if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot (FC-5)(590.006) establishment permit and cessation of food establishment operations. If back-up,sewage If no critical water, a 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. g p,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 g violation,4 to Snon-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's S gnatur Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y IN Dumpster Screen? Y N ,,�-.-�--.-�...'�w�....-- e�-*...�. �..:_. _r ....-:-..-.u. ....._,4_r-.+w�°`+��...i .:.--.•..r-`.,..�. ..-. ...._. _. -+_ _. _ �.,.. .o.r--_..-r-c �.t� � .. ter-.r- - - �,. a - . - ._ �-- -�- .: _ °.--.•- •- - _+ ...-...w. a,,. Wolations 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 3-20212'-- 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 Se azated from Each * 590.004(F) * - - ( )O P 7-101.11 Identifying Information-Original Containers 2 590.003(C)-' .Responsibility of the Person-in--Charge to _ _ _ ______ Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 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) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* - REQUIREMENTS-FOR 3-306.14(A)(B)Returned Food and Reated or of Food* 7-204.12 Chemicals for 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-13) Compliance.with Food Law* _ _ _ _• _ _ * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111 Manual Wazewashing-Hot Wafer- 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*`` - 4-501.1 i2 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 Poiable 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* * k • .- gg Not Otherwise Processed to Eliminate Equipment 590A06(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective rnnooi _ _ ___-- 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- * - 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 Ames* 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* toodbome illness interventions and risk factors. 2-301.14 When to as * Other 590.009 violations relating to good retail 590.004(C) _ Wild Mushrooms* Wash*_ 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec practices should be debited under#29-Special 3-201.17 Game Animals* 11 - Good Hygienic Practices 77 Reheating for Hot Holding Requirements. 5 Receiving/Condition 2-01.11 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)' i 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 3-403.11E Remainin * Critical and non-critical violations,which do not relate to then the me 3-101.11 Food Safe and Unadulterated ( ) g Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A 3-202.18 Shellstock Identification ( ) 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* * 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours 9 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* Temperature Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 * 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients[0 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials I FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 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. oFIKE roy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of XP� 4 OFFICE HOURS BARNSTABLE. • PUBLIC 0 MAINHEALTH DIVISION 3:30-430A:M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified 3:30-4:30 P.M. e3v: .0� HYANNIS, MA 02601 -464-862 4 MON.- 64 NO Reference R-Red Item PLEASE PRINT CLEARLY �prFG s 508 MPy FOOD ESTABLISHMENT INSPECTION REPORT Name DateL_ ((Type of Type of Inspection 1OjIo&I Routine - Address Risk ood Servicc ) Re-inspection le Level Previous Inspection Telephone Residential Kitchen jDa Mobile a-o eratio Owner HACCP Y/N Temporary Iness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP , 1 In: Other Inspector Out: pvq- 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(Recto Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ f ��� -' Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ I Kam' Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ • i FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands \A a ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals i 1P / FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Haalardou-//oods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling V 1­71.-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 bo5 Violations Related to Good Retail Violations Related to Good Retail Practices(Blue ltemslltemsl 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 �Pj 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 6=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 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) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view 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 QO Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers*Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Se azation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables * 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111. Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations Raw Seed S routs Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and P 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-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. L16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of 3-202.16 Ice Made From Potable Drinking Water* 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145'F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 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* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- * Ratites-165°F 15 sec* in mobile food,tern o and residential Sources g� P �' 10 Proper,Adequate Handwashing 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* foodborne illness interventions and risk factors. * 2-301.14 When to Wash* 3-401.11 A 1 bj All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3403.11(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* 3-403.113-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30) 12 Prevention of Contamination from HandsRemaining * Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated (E) Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F 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 an m d Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* oc 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* 30. Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S.590Formback6-2doc *Denotes critical item in the federal 1999 Food,Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. I oF. Tom TOWN OF BARNSTABLE HEATH INSPECTOR'S Establishment Name: Date: - �Pa9e � of dlP� y� OFFICE HOURS PUBLIC BARNSTABLE 200 MAIN LSTREEETSION �3::30-0-4:30:30 P.M.P A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MA55. g. MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY �A .e,y. �0 HYANNIS,MA02601 Sos-as2-asaa ' FOOD ESTABLISHMENT INSPECTION REPORT . Name Date Type of Tyoe of Inspection Routine Address Risk and S Re-inspection Level Previous Inspection,, - Telephone f Residential Kitchen Mobile re-operation _ 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) ❑ 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) c 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 i I ❑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 Itemsl Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) CQ. . Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee.Restriction/Exclusion ❑ Re-inspection Scheduled ® Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24,Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25..Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4npn-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.PKysical 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 anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to anon-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 1 V #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N 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 F 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 RI'E Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501:16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH , 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Workin * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 Require Reporting by Food Employees and Contamination from the Environment 7-201.11 Separation-Storage* g Containers* 3-501.16(A) Roasts Held At or Above 130'F* Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control* 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 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* * 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* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs - CONSUMER 3-202.16 Ice Made From Potable Drinking Water* ADVISORY 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* Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.l l(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective rnrzoot 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-155'17 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3 101.11(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* 8 590.009(A)-(D) Violations of Section temporary and - ide in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen operations should be debited under Game and WIN 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 ces should 15 sec* Other e9 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 1 T Reheating for Hot Holding practis 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140'F* (Blue Items 23-30) Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140'F to 70°F 3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70'F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers an P d Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45'F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 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. pa TK�E Toy, TOWN OF BARNSTABLE _ HEALTH INSPECTOR'S Establishment Name: Date: _ Page: of OFFICE HOURS BARNSTABLE.O` PUBLIC 2 0 MAIN LST EET 3:3030-4:30 P.M. SION :00- :30A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified - HYANNIS, MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY AtFO MAC° 508-8624644 FOOD ESTABLISHMENT INSPECTION REPORT Name Da 41 54pType of Type of Inspection O e s Ro Address Risk pod Service e-inspection Level Previous ection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors (Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑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 �q I ❑ 11..Good Hygienic Practices ❑ 22.Posting of Consumer Advisories 111 Violations Related to Good Retail Practices(Blue Itemsl Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils FC 4 590.005 B=One critical violation and less than 4npn-critical violations 9 ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If g 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 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 observed,7 to anon-critical violations. Iff critical water,sewage 1 critical refrigeration. a back-up, 10 days of receipt of this order. violation,4 to Snon-critical violations=C. 29.Special Requirements (590.009 within y p 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view 4-5� Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y IN / •V _ #Seats Observed Frozen Dessert Machines: Outside Dining Y N PI s Signalure_ 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* F8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs 2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding Contamination from Raw Ingredients 15 590.004(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* * 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 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 590.003(G) Reporting by Person in Charge* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 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 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. 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 * Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* ( ) Eggs-Immediate Service 145°F 15 sec Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg cdw 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* 3-201.14 Fish and Recreationally Cough[Molluscan _ 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* � Contact Surrff aces 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 Cleanon 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 practiceRequirements.sshould be debited under#29-Special 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave 165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items non-critical 12 Prevention of Contamination from Hands Critical and n non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 16 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-202.18 Shellstock Identification g r5. 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* 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 Food and Food Protection FC-3 .004 * 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 28. 1 Poisonous or Toxic Materials I FC-7 008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1009 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. pp IME rpm TOWN OF BARNSTABLE HEALTH.INSPECTOR'S Establishment Name: -'Date* Page., of v` ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-s:30 A.M. BARNFrABLE. = 200 MAIN STREET 3:30-4:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 MON.-FRI.862 4644 No Reference- R-Red Item PLEASE PRINT CLEARLY - tesq• . 508 FOOD ESTABLISHMENT INSPECTION REPORT ` Name Dat eVra of section _JypRoutine Address Risk oo ion Level Retail Previous Inspection oo Telephone d ,i Residential Kitchen Date: (� Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness R- Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP r In: Other Inspector / Out: / Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Gt� Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ G, Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ Jf FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS vy- "A ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals t p ( a FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) e7liOff'+ ❑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 I� 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 Required: ❑ No ❑ Yes. Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically la hot C=2 critical violations and less than 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-cri 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address non-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to Snon-critical violations=C. (590.009)29.Special Requirements 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N MA #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's natureU Print:Self Service Wait Service Provided Grease Trap Size Variance Letter PostedY N v"�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 * 14 Food or Color Additives Law Cooled to 41"F/45°F Within 4 Hours* ( ) gnment of Responsibility S Cross-contamination 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods* * 19' PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH_ 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140'F 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Stora e* Applicants* * P g 20 Time as a Public Health Control PP 3-302.11(A) Food Protection 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* 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) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)ReturnedFood and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* * 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 4-501.112 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* 3-401.1 IA(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 DrinkingWater from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* PP Y Not Otherwise Processed to Eliminate Equipment* 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective inizom 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155*F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf aces of Equipment* , Shellfish* 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 590.00and _ide in cater- * Ratites-165°F 15 sec* in mobile food,tam 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. * 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 590.004(C) Wild Mushrooms J 3-201.17 Game Animals* 11 Good Hygienic Practices 17 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 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 12 Prevention of Contamination from Hands Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F 3-203.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials 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:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.006. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. TOWN OF BARNSTABLE HE R' 11 f / HEALTH INSPECTOR Establishment Name: re fh - Date: a-3 Page:. oF.NE row OFFICE HOURS -t-of PUBLIC HEALTH DIVISION 8:06-9:30 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 MASS. 63: �0 HYANNIS,MA 02601 M- -FRI. 508862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY �p a . 'FOM FOOD ESTABLISHMENT INSPECTION REPORT 1 Name Date Type of Tyue of Inspection Routine Address r Risk FoodServi Re-inspection �. 1V / Level Previous Ins ction Telephone Residential Kitchen Date- I Mobile re-opera " Owner HACCP YIN Temporary pest Illness Caterer General Complaint n J Person in Charge(PIC) Time Bed&Breakfast HACCP Q, ar _ In: Other rP Inspector Vj 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 I 1 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 ( en 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 Ad equate Handwashing CONSUMER ADVISORY Ll V8 ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No [ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined by the Board of Health. Overall Rating 19/voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. ' F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the-number of critical,results in an F. 25.Equipment and Utensils (FC-4 590.005 B=One critical violation and less than 4non-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,.Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have.a right to a hearing. Your request must C=2 critical violations and less than 9non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 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 anon-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to non-critical v' lations=C. 30.Other DATE OF RE-INSPECTION: Inspe or's Sig t re Pr' ' 31.Dumpster screened from public view tO Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N driature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y. N Dumpster Screen? Y N Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(F) 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers*Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130'F* Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* 590.003(G) Reporting by Person in Charge* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed 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 Pe 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 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-155'17 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* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.1l(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 A in cater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-�) Ratites-165°F 15 sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 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 * (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* ( g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41'F/45°F Item Good Retail Practices FC 590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 5-205.11 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3 402.12 Records,Creation and Retention* Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients` Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 30. 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 Rem in the federal 1999 Food Code or 105 CMR 590.000. Town of Barnstable BOARD OF HEALTH p� John T.Norman Board of Health Donald A.Gaudagnoli,M.D. HASNWABLE, Paul J.Canniff,D.M.D. Kma dg� , 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate D � 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: 234 Issue Date: 01/01/2020 DBA: FRESH KETCH OWNER: STEPHEN ROY Location of Establishment: 460 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 175 OutdoorSeating: 0 Total Seating: 175 FEES FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: oft tqr For Office Use Only: Initials: ti Town of Barnstable a Q' Date Paid Zo20Amt Pd$+ JW— :.BABN3TABLE. : Inspectional Services y (� 639: Check# Cash r-'t�`O 'O�fOrAOya Public Health Division ,; Thomas McKean, Director 0 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304i APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE -l�zu2D NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: rnAtti( S � MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: STo,AeN"q t Ir— TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: A WELL WATER: YES_NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: 041 241W TO 10 /91 /U NUMBER OF SEATS: INSIDE: 230 OUTSIDE: `Jq TOTAL: 2 �I 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? �S IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? ES TYPE,OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL, MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT Jl'' pij Eo 12�q SOLE OWNER: OE /NO D.O.B U 0ll % j OWNER PHONE # ADDRESS b w%A►-I 41 O L1 A 4 01' l ►+n x oz&0 1 CORPORATE OWNER: `�'1t;Pl h-I 1t-w/1 C SS- 6(Lou-.P soc- CORPORATE ADDRESS: A41, r,10IJ 41 d!4A o4,4rj rna oZ6 a 1 PERSON IN CHARGE OF DAILY OPERATIONS: li'�V'��-t 2� I 1,��t.P- Er.- - /'-c4 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 -'` /ye 1,0 1, I I! IF i 0. ATURE 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 openinE!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 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 rtt! z Town of Barnstable BOARD OF HEALTH Paul J Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. S: FIA%N1Wk8LE. John T. Norman F.P. Thomas Lee/Alternate 200 Main Street, Hyannis, MA 02601 ; rD, „A Phone: (508) 862-4644 Fax: (508)790-6304 %f 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: 234 Issue Date: 03/01/2019 DBA: FRESH KETCH OWNER: STEPHEN ROY Location of Establishment: 462 MAIN STREET HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: Seasonal: YES IndoorSeating: 175 OutdoorSeating: 0 Total Seating: 175 FEES (� FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: ---- ----- ----- - - - - MOBILE- FOOD: MOBILE ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: I PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 366 r e oFTHEti For Office Use Only: Initials: Town of Barnstable Date Paid ���/ / Amt Pd$ ✓�� „� Inspectional Services pTEo'9. °�0 _. `Public Health Division Check COSa4�y. ''� ,., o. P , Thomas McKean,Director r; 200 Main Street,Hyannis,MA 02601 � Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 0 �� NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ADDRESS OF FOOD ESTABLISHMENT: 41e Z m A i rq 1-1!j q>✓,J► 1, >r A 0 2&o l MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: S T.c F d 4 R v 1 1170 (4) 4 m A TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (sDJ ) � TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: r✓ DATES OF OPERATION: TO /0 NUMBER OF SEATS: INSIDE: S 3a OUTSIDE: 44- TOTAL: 2 1-L] SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? 1 5 IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? C S TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) XFOOD 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 PERMIMBEING'ISSUED Q:\Application FonnsTOODAPPREV2018.doc PLEASE CALL 508-862-4644 OWNER INFORMATIONL�7LPtic# /� FULL NAME OF APPLICANT 1 SOLE OWNER: YES/NO D.O.B 0 Z0!0/g/ OW R PHONE# 7 q ADDRESS YY�A1/d cryLC-E1- flyA-,'l d/j MA C 2[io � CORPORATE OWNER: JTL'f4le^t FEDERAL ID NO. : CORPORATE ADDRESS: 4 10 2 rn A -c-riece T _ j��f Ai�I�/�l mA 02le PERSON IN CHARGE OF DAILY OPERATIONS: i -repyrx, 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 r en Awareness Expiration Date 2. Scm\n t,A ��" �{ / al / aD NATURE OF AP LICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1st to Dec.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPPREV2018.doc rru .. • ra o r. 0 F FI U- c �v o ��Iv i.IJ � - Postage $ 7 ru / 9 Certified Fee ru la Return Receipt Fee ! /OPostmarL O (Endorsement Required) O Restricted Delivery Fee O (Endorsement Required) A r S O Total Postage&Fees fU Sent To O Street,Apt.No.; `J �+- or PO Box No. _I & 2 rY-1 Gt i r'1 �— City State,ZIP+4' -------------------'---- a n n i 5 Zoo t Certified MairProvides: ' 0 A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Mails or Priority Mails. o Certified Mail Is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 1 UNITED-STATES POSTAL,SERVICE, First-Crass Neil Postage&Fees Paid USES -PermiL46.GI ° Sender: Please print your name,address,nd ZIP+4 in I�o3r° Town of Barnstable ' Health Division N 200 Main.Street r- Hyannis, MA 02601 I . ,.- _. ., `-_;. .. � lt�r!lit�lit7i=F.'.�i! it ...t:�ttl :litlt �•�III tit F''it�:t., � � t: t t tee }, ii• i is d ■ Complete.items 1,2,and 3.Also complete^=`' ::.:::. A. Si.nat re item 4 if Restricted Delivery is desired. '' X ❑Agent ® Print your name and address on the reverse Q Addressee so that we can return the card to you.. B. Rf eived by(Pnnted Name) C f Delivery ® Attach,this card to the back of the_mailpiece, � or on the front if space permits. ' D. Is delivery address different from item 1 Yes 1 Article Addressed to: If YES,enter delivery address below- ❑ No (0 2 fYla� n //* 3. Service Type ,Certified Mail ❑Express Mail v (d0 ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2, Article Number i i 7 012 11D ib I a a'o o'2 8 51 O 121t I{r" (Transfer from service labe PS Form 3811.February 2004 Domestic Return Receipt 102595-02-M-1540:� { 4r= ' r 1HE Town of Barnstable Barnstable Regulatory Services Department AN-Ame'caCky MASS. 1m� Public Health Division �DN � 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX 508-790-6304 Thomas A.McKean,CHO 7/10/2013 Fresh Ketch 462 Main St. Hyannis, MA 02601 To: Fresh Ketch, This letter is being sent to inform you that our records at the Health Division office show your food establishment is not currently connected into an in-ground grease trap. The Board of Health wishes to inform you that at the time your property changes ownership or the property has a new leasee, or if there is a change in menu, the Board of Health and Department of Public Works will require the installation of a minimum 1,000 gallon in- ground grease trap. Mechanical grease recovery devices are riot recommended by the Plumbing Inspector or the Town Engineer. According to the Massachusetts State Code: 310 CMR 15.230: Pretreatment Units-Grease Traps 3)Crease traps shall have a minimum depth of four feet and a minimum capacity of 1,000 gallons,and shall have sufficient capacity to°provide at least 24-hour detention period for the kitchen flow. Kitchen flow shall be calculated in accordance with 310 CMR t5.203. (15.203 requires 15 gallons per seat i.e. 100 seats 1,500 gallon grease trap capacity.) If you have any questions or need more information, please contact the Health Division at 508-862-4644. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S.CHO Agent of the Board of Health UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box• 044 01 ��Ip9fflli�f 71FF��i1!2}?IlilFF i�ltift�l}I}F-Jll�ilitilt371I71 F! SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A Ign item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse Addressee so that we can return the card to you. . R eived by(Printed Name) C. D�of ry ■ Attach this card to the back of the mailpiece, Is or on the front if space permits. D. Is delivery address different from item 1? Yes 1. Article Addressed to: If YES,enter delivery address below: 13 No . I 3 Type I JJ � Certified Mail ❑Express Mall ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4."Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number r#!# ! 7�p6 'p81�!'�0'00 352515835� E (Transfer from service label) Ps Form 3811,_February M4 Domestic Return Receipt 102595-02-M-1540 1 Town of Barnstable CFTHE t Regulatory Services Barn Thomas F. Geiler, Director ;FAmedcaMy Public Health Division ' ( ' BMW&rnsLE, Mnss. Thomas McKean, Director 20c� AT 1639. 1 3.�a�0 200 Main Street Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 17, 2011 Mr. Raymond Roy Fresh Ketch 462 Main Street Hyannis, MA On April 15, 2011 Fresh Ketch was given a temporary permit. The temporary was given so that an air curtain could be installed above the door that the wait staff uses to serve food. On May 17, 2011, on re-inspection, it was noted that an air curtain was not installed. The inspector spoke with Steven Roy about the situation and about the outside dining regulations. Mr. Roy expressed his reticence about installing an air curtain and it was explained that to have wait staff serve food outside an air curtain is required by the town, 322-5 A (6). If the outside dining is for self serve and wait staff is not used to serve food then an air curtain is not required per 322-5 B. An extension of the temporary permit, until June 17, 2011, was granted to Fresh Ketch on the condition that wait staff will not be serving food outside; it will strictly be self serve. If Fresh Ketch would like to apply for a variance to explain their reticence, from 332-5A (6), then it must be applied for before the expiration of the temporary. The next Board of Health meeting will take place on June 14, 2011. Enclosed is a variance application and it must be submitted 15 days prior to the meeting. If you have any questions please call the health department. Sincerely, Thomas McKean R. S., C.H.O. Director of Public Health `l Town of Barnstable SINE ray, Regulatory Services Barn �g' tio Thomas F. Geiler,Director I ed� Public Health Division I I ' / v MASS g Thomas McKean, Director 2007 i6.3 a`` 200 Main Street f0 MA'S Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 17, 2011 Mr. Raymond Roy Fresh Ketch 462 Main Street Hyannis, MA On April 15, 2011 Fresh Ketch was given a temporary permit. The temporary was given so that an air curtain could be installed above the door that the wait staff uses to serve food. On May 17, 2011, on re-inspection, it was noted that an air curtain was not installed. The inspector spoke with Steven Roy about the situation and about the outside dining regulations. Mr. Roy expressed his reticence about installing an air curtain and it was explained that to have wait staff serve food outside an air curtain is required by the town, 322-5 A (6). If the outside dining is for self serve and wait staff is not used to serve food then an air curtain is not required per 322-5 B. An extension of the temporary permit, until June 17, 2011, was granted to Fresh Ketch on the condition that wait staff will not be serving food outside; it will strictly be self serve. If Fresh Ketch would like to apply for a variance to explain their reticence, from 332-5A (6), then it must be applied for before the expiration of the temporary. The next Board of Health meeting will take place on June 14, 2011. Enclosed is a variance application and it must be submitted 15 days prior to the meeting. If you have any questions please call the health department. Sincerely, Thomas McKean R. S., C.H.O. Director of Public Health y DATE Town of Barnstable FEE PD.. BARNSTABLE, * CHKLST(1-14) MASS. a 9�A 1659• � Regulatory Services Department ifs A 200 Main Street,Hyannis MA 02601 ti7 CA •a 4.^s' APPLICATION FOR OUTSIDE DINING/SIDEWALK CAFE LOCATION Name of Establishment: &7Z Establishment Address: APPLICANTS NAME: �. Phone# SEATING FACILITIES/EQUIPMENT !L Total#of Seats Existing !" " #of Restrooms Provided 7 Size of Grease Trap Total#of Seats Proposed Air Curtains(Yes or No) c (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 Opening and Closing Dates n f / by�� A�ri•� r �e% . �s: � e �� err ///6 Cl - 76-1, 'r 1 /r��la �..�" � /V��r �j l✓lLCt�lG�7" �lZa� �/���/>C-. ?A-77 r Uwe the undersigned certify that the ` ove information which I/we provided is correct. I/we have read and fully understand the Town of Barns a le ode hapter 322 and further understand that failure to comply with said procedures may result in he i edi e revocation of this permit. Signature of Applica (s): Date: f Date: IMPORTANT-PLEASE REMEMBER TO INCLUDE: 3 Copies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation Distances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedestrian Walkway 3 Copies of Pictures of the Proposed Outside Dining Location(Front and Side Views) 1 Copy of the Menu FOR OFFICIAL USE ONLY Town Manager Approval: Public Health Division: Licensing Board Approval: Certificate of Insurance: License Agreement: Comments: QAApplication Forms\OUTDINAP.DOC §=322 00utdoor 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. Alf 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:\AppHcation Forms\OUTDINAPCHECKLIST.doc Town of Barnstable °Ft"Er°'y Regulatory Services Thomas F. Geiler,Director &4RNSrnsi.e. 9� MASS. Licensing Authority s6Sq. ♦0 200 Main Street Hyannis,MA 02601 www.town.barnstable.ma.us Telephone: (508) 862-4674 Fax: (508)778-2412 AGREEMENT Agreement by and between Town of Barnstable and Fresh Ketch , 460 Main Street, Hyannis, MA for outside dining on the Town sidewalk from May 1 , 2009 to November 15, 2009. cc: Town of Barnstable Health Department Barnstable Police Department BOARD OF HEALTH REGULATION,PART H,SECTION 1.00,#14,Requirements a through n (a) 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"b"through"n" 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"a"through"n"of this Regulation#14 are met. (b) A menu shall be submitted to the Board at the time of application. (c) 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. (d) Sufficient restrooms,both for customers and employees,must be furnished counting the addition outside seating as required by the State Plumbing Code and Town of Barnstable Health regulations. (e) 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 inground grease trap,after receiving the approval of the Board of Health. (f) 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 kep outside. All food must be prepared inside the facility's kitchen and kept inside until served. ?\ A drainage system designed to eliminate odors will be required for all outdoor dui ling ose areas H bib ith vacuum breakers must be available for washing down the dining area. (� yj�K (h) 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 adequatV covers designed to prevent entrance of rodents and birds and sealed to control odors. (i) 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). ✓ (j) Table tops must be smooth,non-porous,easily cleanable and durable;and readily maintained clean and sanitary condition. - V (k) Food service personnel must constantly police the dining area for waste paper,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. (1) Strict clean-up 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 Massachuse� Department of Health Sanitary Code. (m) Outside food handlers must have easy access to handwash sinks and cleaning cloths. Facilities r preparation and disposal of sanitizing solutions must be accessible. (n) Hair nets or other effective hair restraints,such as hats covering exposed hair,shall be womb 11 outside food or drink handlers. Beards and mustaches must be neatly trimmed. § 322-5.bufdAr dining. 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). g_D f' re,S�•, :+e �, %1tiJ- 00 0 C 4 (ZAM ? }� 00 a 1 t. _ .� 1 . ..� � I .._.._. _.._____. .._....._._ �._..��...�.�_ �i9 ym aid /�oY �D _ �37_legs" 8 i Stephen Roy ownerlRestauranteur RCSJ Group Inc. 462 Main Street— Hyannis, MA 02601 508-771-8585 i ` .i calroom 0 [/DIRER �✓/PRIM -fir Y{.:;wr .� +�►�. w t PPP I 1 [ � r row loollewf , ilk Z��7 � �► �'J A Y� r�mot,q,],-`'\n? , ,u _ �^�„'�1�. w� r�ram.� �+��"� �- -,;.,� —�`a...• "`a,.�.e n_�,�1 �ec � Oro'/.2�_�6 Canon � 1 I 1 I I I 1 I 1 1 1 1 1 DIRECT PRINT W vi ��, �� � F► 1 �� ��� ''� Ras/ • �'.�,�, r.-�-t�r� �� $'• _ L �+t. fit, �q,»..i•�4. iQF.�.•c-+�; �. -Ea.x ''u'3a�,,, r ;i` , ��`-.+r. ,jG'+R� �c�'.sd..eo.� � .. .••ram-.:c;;,`. ..;, Canon DIRECT PRIM 6 McKenzie, Marybeth From: noreply-alerts@corrigo.com Sent: Monday, April 12, 2021 10:27 AM To: McKenzie, Marybeth Subject: Corrigo Service Request Invoice Attachments: Client_Copy_wSignature_Block.pdf;462 Main St-ljpeg;462 Main St jpg R Ready Rooter, Inc P.O. Box 371 Sandwich MA 02563 ----------------------- INVOICE-----------------------Work Order#: WO-36817 Bil o:462 Main Street Hyannis MA 02601 Attention: Stephen Roy, 774-368-5344 PO#: -----------------------CHARGES----------------------- Category: Price List Item: SEPTIC:septicpump-size:greasepump Description: Pumped and cleaned grease @ $.30 per gallon.Total gallons: 2000 Qty: 1 Rate: 600.00 Amount$: 600.00 Category: Price List Item: SEPTIC:septicpump-size:interiorgreasetrap Description: Pumped and cleaned interior grease trap in crawl space. Qty: 1 Rate: 260.00 Amount$: 260.00 Category: Price List Item: SEPTIC Description: Pumped and cleaned sewage ejector pump in basement crawl space. ($275) Qty: 1 Rate: 275.00 `f Amount$: 275.00 Sub Total: 1135 Discount:0 Tax: 0 Total Amount Due: 1135 ---------------------------------------------------- For questions please call 508-888-6055. CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! 1 r r Barnstable Public Beaches Semi-public permitted Beaches Covells Beach Barnstable Yacht Club Craigville Beach Cotuit Bay Shores Association Cross Street Craigville Beach Association Dowses Beach Hyannis Yacht Club East Town (Eugenia Fortes) Oyster Harbors Club Kalmus Seaside Park Improvment Association (SPIA) Kennedy MemorialNeterans Wianno Club (107 Seaview) Keyes Beach (Sea Street) West Beach Club Loop Beach Fresh Water Organizations: Millway Beach Fair Acres(Shubael) Ropes Beach Homestead Homeowner's Association(Crocker) Sandy Neck Long Pond Farms Association Fresh Water Beaches: Regency Drive (Mystic) Hamblin Pond Sand Shores Association (Shubael) Hathaway Pond Wequaquet Heights Association Inc. Joshua's Pond Wianno Club (Crystal Lake) Lovells Pond Wequaquet Estates Beach Association Middle Pond Holly Point Association(Bearse) Wequaquet Town Weququet Yacht — —4 .- e I WA , 10 , -, . � - - ". � , 4 . . %,� — r ;�: 1 . E S ,�1 t r, Y Ji. . ",- - %... v. , a,sr r' •r ' ... •-T�: 3. a s I d .4 irk .f � t y "i .} vT �. ` `'d !.ti•Y p' % ,.. a• I S. - ; fw i 'r •.t. x ✓ _ d^ Y ',Y t S` (r 5 r ' •` tE 4'Jc i ..� .. .t, - s T; 1 s- 'wR. t y m A \a ,i'i+'r y a, C'I ,?,.,.a-"p , ,, y,. }."�f 4, ,+ It w, !„ r.(x »lea. .'' C - v, S ,het ,q:. -f s ;`S ♦- #' M? ^""# n§,.. 'a , r } � 1 r „� _ .x t r 'k ,,[ f Ft-•+/ T{ 441a l f,„ 3 ^r'�{ r r F: F yy- �'rhy'rt�,S 'ro`1 i e,q. W I �M1,r* �rr� YC�.+�ir'i", ..xa. 't, .4$R q Di/'. r rr`{,,r p Jt' i •- -,;. 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M1t r i R �, r6°r'r -J..:�,f .^...lY e*4 "J' y: r + "' "13 ! • # , amC• 4y„ ry - ! .# i F 9 a yA K'� r t" il r. I't +!{ 4 d?. t e i y x,4 v L t a r �`'i . s ' ' r s 4 a •4 * r.- ..f. t . z.I - a a '7' r' 9 - '. ..e r !...tt Y� 5?.-�- t :: 1.' .,� _ Ft €.% ti ` � is t '' - r ru $' zt * ��, s.y ^� �� " g 'Y - s r: t ! d fk t '. 1 E. r T :,s %� re,*"` a r ; , 4' V-r a' P' 3 8 C`allda ` .r .:. J ; g'� ,.., ce Tellier, w } E j q �% s. y# t �`• ,{ -oV a yr. { _.p � E Z .ry f . e !,r ,l l'1 Green Dunee _r,I ,� �r -i i.3 r .. - e.,r : ley tri , f + t} t I.. r .` I L M1 r -, ` - West I�p1.annisport, b� ,..02672 3 r ; �yy 1 C s,..:� �q{: an r- 'I•, .11 ,� 4. x " _t` +} +.SS_,, C sa rrrr .s }t a s! s - 2, A vr, : . P t " .r • ' `r Y• r a *},�, ,=€, $g ,'� a ^!I r is t.- 4 `' f�Dear '+ sr Teltierr 'C! Il L 21' 1fl ,,�'.111l r a , ! ,I z x 'LL } Dr N1tI w F 1 • *s,+fi-. s� �. � f, ....: -, r y y:` s Y i.t.• # -.l '�,d+Jear c. *r t z µ. ;,� y S x J-m,.,. 'I.,qt. .sk, t ,,, f��., .n *iz �t r aq._,:.'I ;}S , F".- ,+w" t.n`+y , ' '^�y.! wE+r :'-' w . ! " 'r*+f%,r .. ,..,I ... c,,`.�'Y' _'� i.. * q r. '. d.. s f ".: {,f Y©uJ are:granted a variance*from lteg <on ,L of,the Toev o "Barnstable ' � s " !' <` Ii s�.r ,tom C-YY :x !. _• v r _ & ., "r. •� y .;;rI H :alth Regulations, -fo1.r, outside ng., at a ,Aiainstree "Courtyard � tt ",. �� f s * Restauran �Pfain 3tfeet kiyana s, P the=follo g conditions ' ,a:�°, .� r �;'!} ; k`If r w, T# < # ;+ rt.J, �r a T+. r } 1 < s r * ,i ' 4. ' 1 + . (1) You must receive approva a b Boar *Selectmen.. Y*,. r a _ � ; A.' 3 rP •.F ,�'t ° ..H ..�: =,'C, ',M -a,yyp .,� `.: r :i ; �rt d .'T ,r J ryM1 r. $ I. ,Nq K4 Y ff f d. *` r d "`. r � �� ,� -�� i'k' `'-- `'(2) ;You are restricted`t );tab s� �ith3seati g�fc�r 32`pereons"' �=� ,. ',C`.� i Aye K ; ,m } 11 ! t @ * f k. a J F r, t ,.r a : • e - y + •[ . , - x-. t '}mac` -; st , , ��, sy`, , j' I r 1 ' . °y F(3) All other criter et forth in'' agra r`A through`ti'oij.the'Minir`ist►m -, '"` ir~i yL.�� ` s _ t fCriterih.;for=t 5 A royal of z ' I e . s : : �.1. ,rI- € ,t} pP�, x , fiances for Outside Dining, must b _ g . ss s - +-_•-, �. An strict,cornpl nce. *` ' ;` #L. t ` , K% :'$ ' .s* 't� V. , ^� 3 r f. i P 10 "rig Y+ } r �� dI -�' , - ` r4 y k + -� e ; {r .Js t .-- >'- as *• k rr �" § ' %' i I You -are granted,tl i ar=trance on a al .basis This variance is,subject to " "� , ' ' v -. 1. f �'� y'revo,ation even olations� cting health or safety"are observed �� `r t: f<r4 t�. -I' N zI � .r;, -9F yV. 't r' t ns� "�. j ; 4 r A'�N t * a. • P e r ,�a (I� :, -yi 4 f ., r r .'f• a - fir' c - ; Y 7 n ,' xv ; s '` + Ve oilr6 `a -' ' _' . ,.�� *rf . 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'} ' r y s " +^ Jt s-'� br..', f r I F . t r 'I't -€, `'i 3I' `I , ;.'.e b s'.. , ..£_ A; ! '� ." k t4 * '„} "' t f _ r 'rI4�» �x � r`• "'k^I. Y*#F,.�r " i''-iA �f ;' ti`i8.:, _t:`; `1R �... r#. �� }Y a y M5r', s ? , r'—da t El�t �pFTMF?p n TOWN OF BARNSTABLE FEE Z OFFICE OF t BsaSK 9A BOARD OF HEALTH .� YI1�R - vo i639` 367 MAIN STREET -, HYANNIS, MASS. o26ol VARIANCE REQUEST FORM All variance requests must be submitted five (5) days prior to the scheduled Board of . Health meeting.NAME OF APPLICANT C ON n 0G« �'O- TEL. NO. 775- 86 O 0 ADDRESS OF APPLICANT /�/ 62s_en yvnej in/es Hy4,7e ts'e0-o_'r . -Mc4sS NAME OF OWNER OF PROPERTY wo�� -Fq I ro C.(Z SUBDIVISION--NAME. _ DATE APPROVED:, .: .__._._LOCATION-'OF REQUEST q' Q� Cov 1 a q�^ ST =- w-- VARIANCE-:-FROM REGULATION-(List _regulation)_.=_ _. I VARIANCE-REQUESTED'(Specific-request-):___ - : O ip 4 V"+!tz rdig - - - _ /"1.e a 1 4-k_Q_ CZA__^1o1 0C '45h2J ® CoinC%Anfno6. . i REASON FOR .VARIANCE. (May attach letter if more space needed) -.--f Q/T3 _5y9_✓;4-1ttej Skou/ o� LgsS �clo�s✓(� a�n Le-Ff C^.0 of t3��ioi��, ��li� +•..ill n° t' . --- 6Q CortS'iYL✓G�C Tl \ TAkl 142.ACe L-e- fi✓De✓1 Lit-fa +D PLANS Two copies-of:-plan must be submitted -clearly outlining variance._requested:._._.J-vMAKQ VARIANCE APPROVED NOT APPROVED _ REASON FOR DISAPPROVAL Robert L. Childs Chairman Ann Jane Eshbaugh f Grover C.M.. Farrish, M. D. BOARD OF HEALTH TOWN OF BARNSTABLE c� T D cn S2.cn a cn ,� � D 03 O j m N m N m cC O N y a cam �� CD I CD a c , 3 CD iii a) in O CD CD O a m co 'o CD (J1 y (� CD () C 0CD 0 _ 3 3 0. � y DN"i\A � 00 � o 07 O 9 O � � co oo 73 q _ � � v �(C cn 3 3 0 3 cn SA T a N CL c N m n 3 V CD CT (D V CD C1 d O it lA 3 N• T� CCL`OL G () n O C.) O 00 Z1 (�w �m -( 4 Cu .0) m 0) � D �CD QW NQ O � �O a a O) X 5. to OQ CD m �1 O `.�`.r. CD N CD CD W N m D CD O Vv a:) rn(DCD (@ O O 0 m 99 W CD 3 -0 SU C5. 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" fit OW 1..... .. u ,5'ir r w �a•xvy a����'< < �S Prat re+ .;.v?E�''a+�,�d;+�1"u�j�wA�+�jrne. t�t�,P�,yWtrw Rko-�b°�dYztr��,y,a azg rek5 ,,;,� 1,� >�pt cu :d )Wr Yd F4a •;zap' z �,@�y�t �#�.'r ,z �"�'�r a 7s?Cre, - ; x an-:< ,m�t�`, 4�iraata� "�zsa;',',F§°�xu txs�, �, �� ; „ .� a� � +✓ t its r S t � S F oq ' a: �4 �,r a � ��sa� ��n a �� � r£;" �rai .•', a axis;; � � °�a h, Hkn °' M r Af MAJO 35-r .........:.... d ayy CXCI/ V e a 5� Hare, h,=ao' y li �- 1, � .� �► - � ,� ��°``�.,, �� _ l ..� ,.�. �. ` ~ ..�r�. `'1\,.4. \tiff � • ` _ ` - orl oe tK ti ff t, i t , i \\`� �` .\ '`\�,\ -_____�..r _ -.�.-_..._��i ��,;/J ,A.-•r�'f' �,.�'•"r' ram/ A, \\ - _ APPR O'iED BY \ SGALE ��_� � DRAWN 8Y \ t DAIS 1 ^_ REVISED - � v 11RAWlNG NUMBER , f / 1 A N £xisT S Poll Li Li Li Of : I I i i , 6 .y fT co-ntc� 1 ca.., ors Rtc� ' Cobs^ct3 c*r• - - noe/' I � � �. Cab 17 Ca 1644 , { { — —a jkk Lii E]L:5 ,--,i �l 1 ....................L L.."d c f Cunvc 1�^ V T • Mom, sy��a� {{ ' ! co oFfOEFA T CRAWN I r c r k 2