HomeMy WebLinkAboutTUMI CEVICHE BAR & RISTORANTE - FOOD TUMI'CEVICHE BAR
& RISTORANTE 3u8
592 Main St., HYA x
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Town of BarnstableBOARD OF HEALTH
John T.Norman
Board of Health Donald A.Gaudagnoli,M.D.
awn.NSrABM F.P.(Thomas)Lee,.
MAS& Daniel Luczkow,M.D. Alt.
s39. 200 Main Street, Hyannis, MA 02601
�gn � 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: 1030 Issue Date: 01/01/2022
DBA: TUMI
OWNER: JD CAMAS, LLC.
Location of Establishment: 592 MAIN STREET HYANNIS„ MA 02601
Type of Business Permit: FOOD SERVICE
Annual: YES Seasonal:
IndoorSeating: 80 OutdoorSeating: 55 Total Seating: 135
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: GQ�
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 Only: Initials:r
�
D*rJw $ .=
HARIMA11M : Inspectional Services
`� Public Health Division f
D Mld�
Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT_
DATE NEW OWNERSHIP RENEWAL !s
NAME OF FOOD ESTABLISHMENT: U/YV(` �✓�� C.e
ADDRESS OF FOOD ESTABLISHMENT: `O✓L eye S_ �Z ub
MAILING ADDRESS(IF DIFFERENT FROM ABOVE): �_tU Ljj V_e•_!CF 6 rvt o2,2 Z-
E-MAIL ADDRESS:
TELEPHONE NUMBER OF FOOD ESTABLISHMENT: C�_O -
TOTAL NUMBER OF BATHROOMS:
WELL WATER:YES NO ...(ANNUAL WATER ANALYSIS REQUIRED)
ANNUAL: // SEASONAL: DATES OF OPERATION:1/_4ALT0 40/3 ,/_z
NUMBER OF SEATS: INSIDE: �0 OUTSIDE:-SZ TOTAL: j3
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 ldtchen)
MOBILE FOOD
FROZEN DAIRY DESSERT MACHINES...(MONTHLY LAB ANALYSIS REQUIRED)
-CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2)
*** SEASONAL,MOBILE &NEW FOOD ONLY***
REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED
PLEASE CALL 508-8624644
Q:1Application FormsTOODAPP 2020.doc
.?OWNER INFORMATION•
FULL NAME OF APPLICANT c� J,� U e2Go� ,�P (GQ r►�It
a
u� �r
SOLE OWNER: YES/N� D.O..B OWNER PHONE
ADDRESS 3-lmu, - CA 41
CORPORATE OWNER: ISp v
CORPORATE ADDRESS: ,�'P 2_ ✓-C- t
PERSON IN CHARGE OF DAILY OPERATIONS: Y S� U le/L VV
XI
List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff
All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT.
**ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records.You
must provide new copies and POST THE CERTIFICATES at your food establishment.
Certified Food Managers Expiration Date Allergen Awareness Expiration Date
2. lb ;Y LP
u
A 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 opegina!! 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/apotications.asp.
OUTDOOR COOKING: Outdoor cooking,preparation,or display ofany food product by a food establishment is prohibited.
NOTICE: Permits run annually from January 1st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN
THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC lst.
3
Q;AApplication FormsTOODAPP REV3-2019.doc
A
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ti
O�{It Town of Barnstable BOARD OF HEALTH
John T.Norman
Board of Health Donald A.Gaudagnoli,M.D.
NSTA is •` Paul J.Canniff,D.M.D.
MASI 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate
Phone: (508) 862-4644 Fax: (508)790-6304
www.townofbarnstable.us
Permit to Operate a Food Establishment
In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections
305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to:
Permit No: 1030 Issue Date: 01/01/2021
DBA: TUMI
OWNER: JD CAMAS, LLC.
Location of Establishment: 592 MAIN STREET HYANNIS„ MA 02601
Type of Business Permit: FOOD SERVICE
Annual: YES Seasonal:
IndoorSeating: 80 OutdoorSeating: 55 Total Seating: 135
FEES
FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2021
RETAIL FOOD:
COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021
B&B-FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBILE-FOOD:
MOBILE-ICE CREAM: Q./
FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent
FOR ESTABLISHMENTS WITH SEATING:
PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE
Restrictions:
t
Op1KE tp� For Office Use Only: Initials: _
- Town of Barnstable ��
Date Paid( Am Pd$
' Inspectional Services
' 039. ,0� Public Health Division —Chec v
i
Thomas McKean, Director
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO OPERATE A� FOOD ESTABLISHMENT
DATE V I (� NEW OWNERSHIP RENEWAL L/
1
NAME OF FOOD ESTABLISHMENT: --t-t a'j l yk A-0V� ka�0 ye'n\
ADDRESS OF FOOD ESTABLISHMENT: yo �► � /i' 3 '�Ow��6
MAILING ADDRESS(IF DIFFERENT FROM ABOVE):S lit uJ �Cfk `Yl e e.7`Y-e el,°,i& lo- o7. 63`Z V
E-MAIL ADDRESS: J,g' j,? jgt��I
TELEPHONE NUMBER OF FOOD ESTABLISHMENT: ( -
i
TOTAL NUMBER OF BATHROOMS:
WELL WATER: YES_ZNO ...(ANNUAL WATER ANALYSIS REQUIRED)
ANNUAL: !/ SEASONAL: DATES OF OPERATION: G / / TO
NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL:
SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV.
***OUTSIDE DINING REMINDER***
OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING
REQUIREMENTS. i
IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? 1/ (
IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? :k'
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
I
OWNER INFORMATION: l
FULL NAME OF APPLICANT
i
SOLE OWNER: YES/NO D.O.B OWNER PHONE#
ADDRESS " 7 r�9—mil �►._. ��T�- 1- 9i- / Yew, ere
CORPORATE OWNER: U G Z—
V
CORPORATE ADDRESS: H'2 �l� 5
� c
PERSON IN CHARGE OF DAILY OPERATIONS:
List (2) Certified Food Protection Managers AND at least(1)A ergen 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
U11 .(40ue rnt,/ U�Ti� 1. J ` 'tu'✓e�.c, CG� �I`
2. jv6,e0er V 0 C2=1 r� 2
12-Il zl�
I 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.townolbarnstable.us/healthdivision/applications.ast).
OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited.
NOTICE: Permits run annually from January 1 st to Dec.31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN
THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1 st.
Q:\Application FormsTOODAPP REV3-2019.doc
pft Town of Barnstable BOARD OF HEALTH
John T.Norman
Board of Health Donald A.Gaudagnoli,M.D.
aAari AUM + Paul J.Canniff,D.M.D.
200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate
nab Phone: (508) 862-4644 Fax: (508)790-6304
www.townofbarnstable.us
Permit to Operate a Food Establishment
In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections
305A, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to:
Permit No: 1030 Issue Date: 12/10/2019
DBA: TUMI
OWNER: JD CAMAS, LLC./JORGE SIGUENCIA
Location of Establishment: 592 MAIN STREET HYANNIS, MA 02601
Type of Business Permit: FOOD SERVICE
Annual: YES Seasonal:
IndoorSeating: 80 OutdoorSeating: 55 Total Seating: 135
FEES
FOOD SERVICE ESTABLISHMENT: $300.00 YEAR. 2020
RETAIL FOOD:
COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020
B&B-FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBILE-FOOD:
MOBILE-ICE CREAM: C,i
FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent
TOBACCO SALES:
FOR ESTABLISHMENTS WITH SEATING:
PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE
Restrictions:
[�p
Town of Barnstable Office
For Use Only: Initials:
Date Paid Amt I'd$
. BABN3fABLB. : Inspectional Services
9 s Public Health Division CG�hg # 39 a
�fD MAt
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT
DATE a
TO4
NEW OWNERSHIP RENEWAL
NAME OF FOOD ESTABLISHMENT: ` t)m t 6eue"ci� ✓
ADDRESS OF FOOD ESTABLISHMENT: j L sK t•`� S l v�°�( C��/��. .e'�`9 �,'� �;/
MAILING ADDRESS(IF DIFFERENT FROM ABOVE):
E-MAIL ADDRESS: � iL.ue `Z• i I• �^�
TELEPHONE NUMBER OF FOOD ESTABLISHMENT:
TOTAL NUMBER OF BATHROOMS:
WELL WATER: YES�NO ... (ANNUAL WATER ANALYSIS REQUIRED)
12 3r �o2C�
ANNUAL: /� SEASONAL: DATES OF OPERATION: / /_&TO _
NUMBER OF SEATS: INSIDE: -2 OUTSIDE: TOTAL: 3
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:Wpplication FormsWOODAPP 2020.doc
b
OWNER INFORMATION:
FULL NAME OF APPLICANT �Or+
SOLE OWNER: YES/�� D.O.B OWNER PHONE# aqLL"'� S 2-
ADDRESS
CORPORATE OWNER:
CORPORATE ADDRESS: 0
T
PERSON IN CHARGE OF DAILY OPERATIONS:
i
List(2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff
All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT.
**ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You
must provide new copies and POST THE CERTIFICATES at your food establishment.
Certified Food Managers Expiration Date Allergen Awareness Expiration Date
CV1, V 21 have S� C6,OD �/ J
A3
2. Ila
�- d -TrYI 1116r'11
S RE 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 ovenine!! 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 htta://www.townofbarnstable.us/healthdivisionwww.townofbarnstable.us/healthdivision/applications.asp.
OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited.
NOTICE: Permits run annually from January 1 st to Dec. 3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN
THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st.
Q\Application FormsWOODAPP REV3-2019.doc
oF. roe," TOWN OF BARNSTABLE HEALTH INSPECTORs Establishment Name: Date:' Page: of
+'}y��/-4• PUBLIC HEALTH
DIVISION OFFICE HOURS
B ARNSfABLE.O, 2 0 MAN STREET 3::30-0-4:30:30 P.M.P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
...S HYANNIS, MA 02601 so ON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY
prFo'"'"p FOOD ESTABLISHMENT INSPECTION REPORT
rL- L46W
Name �� Date Tyne of ec ion o
O 'on s" Routine
Address Risk Food Se ection
S� ��' Level a ad Previous In pection rke 0
Telephone Residential Kitchen Date:71� �p
Mobile Pre-opera6:ioY�
Owner HACCP Y/N Temporary Suspect Illness A/C- / t
Caterer General Complaint ��-
Person in Charge(PIC) Time Bed&Breakfast HACCP �' s^+ �L w L J /tY S •� (/i•1�
In: Other
Inspector r Out: Z N� ��•� `i r` G 0 2 �.
VI U E
Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. , I
Violations Related to Foodborne Illness Interventions and Risk Factors Red Items G
( ) Anti-Choking 590.009(E) ❑ //
Violations marked may pose an imminent health hazard and require immediate corrective . Tobacco 590.009(F) ❑ 4
Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ i
V�4 F c:
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands
❑ 1.PIC Assigned/Knowledgeable/Duties 13.Handwash Facilities ' Q P ,� v
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS A A X/'d.1
❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives V.
❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) I r U
❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures r�
❑ 5.Receiving/Condition ❑ 17.Reheating _ J e „P `
❑ 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
❑ 16.Proper Adequate Handwashfng CONSUMER ADVISORY I
❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations
Critical(C)violations marked must be corrected immediately. (blue&red items) \ ' 3I -I 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 0 Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction: Based on an inspection today,the items Embargo Emergency Closure C] Voluntary Disposal ❑ Other:
checked indicate violations of"105 CM 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 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, to on ritical violations=C.
30.Other DATE OF RE-INSPECTION: Inspector' ignatur in
31.Dumpster screened from public view
. 1 ,S
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signatur Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted, Y N
Dumpster Screen? Y N
Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions
Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
1 590.003(A) Assignment of Responsibility* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45'F Within 4 Hours*
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs
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 7 5 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F)
2 590.003(C) Responsibility of the Person-in-Charge to _ Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F*
Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F*
Applicants* * 7-201.11 Separation-Storage* 20 Time as a Public Health Control
3-302.11(A) Food Protection
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use*
3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements
590.003(G) Reporting by Person in Charge* Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions*
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) I Removal of Exclusions and Restrictions 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
Disposition of Adulterated or Contaminated
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations
590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
7-206.13 Tracking Powders,Pest Control and
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures*
gg TIME/TEMPERATURE CONTROLS
* 4-501.114 Chemical Sanitization-Temp., H. CONSUMER ADVISORY
3-202.14 Eggs and Milk Products,Pasteurized P�P 1$ Proper Cooking Temperatures for PHFs
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
4-601.11(A) Clean Utensils and Food Contact Surfaces of 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* ery cn�tnrzoot
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs*
4-702.11 Frequency r f ces o f qui 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 PI-IFs SPECIAL REQUIREMENTS
3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009 A D Violations of Section 590.009 A D in cater-
Chemical ( ) ( ) ( ) ( )
Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential
10 Proper,Adequate Handwashing 3-401.11 C 3 Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* ( )( ) P
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 practices should be debited under#29-Special
17 Reheating for Hot Holding Requirements.'
5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30)
3-202.15 Package Integrity* g g 3-403.1 I(C) Commercially Processed RTE Food-140°F Critical and non-critical-violations,which do not relate to the foodborne
12 Prevention of Contamination from Hands
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
$ 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 Witten 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 1590.000
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004
3 402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. water,Plumbing and waste FC-5 .006
590.004(J) Labeling of ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009
3-502.11 1 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 item in the federal 1999 Food Code or 105 CMR 590.000.
�p INE r TOWN OF BARNSTABLE, _ _HEALTH INSPECTOR-s Establishment Name: Date: _ P_ age: of
OFFICE HOURS
PUBLIC HEALTH DIVISION 8:00:6:30A.M.
+ BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
1619: �0� HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY
�OrFo MPS° 508-862-4644
FOOD ESTABLISHMENT INSP CTION REPORT �� <
Nam Date T e of Type of Inspection
Op
er i s Routine
Add r 's Risk Servi Re-inspection
c Level e a 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 H 1
In:Inspector Out: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) ❑
4
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands
❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS
❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives
❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals
FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures
❑ 5.Receiving/Condition ❑ 17.Reheating
❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling
❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control
❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP
❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY
❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations
Critical(C)violations marked must be corrected immediately. (blue&red items) 1I 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 FG4 590.005 6=One critical violation and less than 4 non-critical violations 9
( )( ) cited in this report may result in suspension or revocation er the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot
26.Water,Plumbing and waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 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 C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,
28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,"7 to 8rion-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 Si to 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 3-50.1.14(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.* Additives* 19 PHF Hot and Cold Holding
2-103.11 Person-in-Charge Duties - 3-302.14 Protection from Unapproved
Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*7-102.11 Common Name-Working Containers 590.004(F)
P g *
2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F*
7-201.11 Separation-Storage*
Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Emits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*
*
Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use
3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements
590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions*
Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served*
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water 1 Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* I Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
5-101.11 Drinking Water from an Approved System*
4-601.11(A) Clean Eggs m Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
Equipment* Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef°d9C 111/2001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.1](B)(1)(2) Pork and Beef Roast-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
Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
Chemical* Ratites-165°F 15 sec*
Sources* 1 p Proper,Adequate Handwashing ing,mobile food,temporary and residential
Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
* 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 ( )( )O
3-201.17 Game Animals* 11 Good Hygienic Practices 1 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 me 2 Minute Standing Ti * VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 PreventingContamination When Tasting* * (Blue Items 23-30)
3-202.15 Package Integrity g 3-403.11(C) Commercially Processed RTE Food-140°F 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
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 .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.
1
�F IKE rpm TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date:' Page: of
y OFFICE HOURS
BAR EOM PUBLIC
2 0 MAN STREET 3:30-4:30 P.M.
SION - ` : 0- :30 A.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
HYANNIS, MA 02601 MON.-FRI.508-862-4644 No Reference R-.Red Item PLEASE PRINT CLEARLY
FOOD ESTABLISHMENT INSPECTION REPORT
Name Date gype of T ns ec io
outine
Address Risk Food Se ion
Level etail Previous Inspection tA
Telephone S Residential Kitchen Date:
Mobile Pre-operation
Owner HACCP WIN Tern porary Suspect Illness 't-A-1 A f
Caterer General Complaint
Person in Charge(PIC) 1/' Time Bed&Breakfast HACCP G t�
` In: Other
Inspector D t: (�•
Each violation checked requires an explanation o 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 p �
❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities k p f� /tY/
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS !tA"I,�(/V
❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives /P
❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals 1 J,V/t �V r
FOOD FROM APPROVED SOURCE TIMElfEMPERATURE CONTROLS(Potentially Hazardous Foods) ,
❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures i
❑ 5.Receiving/Condition ❑ 17.Reheating
❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling _ r W
❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control t)
❑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
L - _ irt
❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations �-f- �, �i�
Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ Yes
Non-critical(N)violations must be corrected immediately or
within 90 days as determined b the Board of Health. Overall Rating
y y ❑ Voluntary Compliance . ® Employee Restriction/Exclusion ❑ Re-inspectio cheduled ❑ 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 4 to 6von-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed, 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.Dump ter 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 r I v
v c
Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions
Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours*
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs
Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding
2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved
Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH_ 3-302.1](A)(2) Raw Animal Foods Separated from Each * 590.004(F)
7-101.11 Identifying Information-Original Containers
2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-102.11 1 Common Name-Working Containers*
3-501.16(A) Hot PHFs Maintained At or Above 140°F*
P 8
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F*
3-302.11(A) Food Protection* 7-2A1.11 Separation-Storage*
Applicants* tion* 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use
3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements
590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions*
Contamination from the Consumer
3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions��] Disposition of Adulterated or Contaminated � )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
q Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
y P 7-206.13 Tracking Powders,Pest Control and
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
Eggs
5-101.11 Drinking Water from an Approved System*
4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
Equipment* Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef cd-11112001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
3-201.15 Molluscan Shellfish from NSSP Listed Chemical*
Ratites-165°F 15 sec*
Sources* ing,mobile food,temporary and residential
10 Proper,Adequate Handwashing
Game and Wild Mushrooms Approved By * 3-401.1](C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority KII
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* Cleaning Procedure* 165"F*' foodbome illness interventions and risk factors.
590.004(C) Wild Mushrooms* When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail
* 11Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special
3-201.17 Game Animals Requirements.
$ Receiving/Condition Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
(Blu* . Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* Critical
Items 23-30)
3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne
12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts*
3-101.11 Food Safe and Unadulterated* ( ) 8 illness interventions and risk factors listed above,can be found in the
6 Tags/Records:Shellstock E5-204.11
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* 13Handwashing 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 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
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* 1 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 1 Specialized Processing Methods* 130. Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures* S.590Formback6-2doc
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
F,ME r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of
OFFICE HOURS
PUBLIC HEALTH DIVISION 6:00-9:30A.M.
BARNSTABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
MASS MON.-FRI.
9q,�FOMP+pO� HYANNIS,MA 02601 50e-e62-4644 No Reference R-Red Item PLEASE PRINT CLEARLY
FOOD ESTABLISHMENT INSPECTION REPORT -
Name Dat 4ea
f Tyne of Inspection
Routine .-r
Address Risk R ' spection If '
Level ection
Telephone Residential Kitchen Date:
Mobile Pre-operation j.
Owner - HACCP Y/N Temporary Suspect Illness
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP
In: Other
Inspector Out:&14 IA 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) ❑ L
Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ !✓ �Y
Action as determined by the Board of Health. Allergen Awareness 590.009(G)
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands J� !
��tN(/ el
❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS
❑ Lwnc-
2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additivesd-
❑ 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 � �,Q��y
❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling .�! N��
❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding ice,
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 (1 Inj
❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items--I Total Number of Critical Violations 1
Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Yes
Non-critical(N)violations must be corrected immediately or Overall Rating
within 90 days as determined by the Board of Health. � ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction:Based on an inspection today,the items
checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure Voluntary Disposal Other:
23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than non-critical violations
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 Critical violations and less than i cal violations.
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.
violation,4 to 8non-critical violations=C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view g 4�_,
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N P 's Sig tt re Prin r
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N 1
Dumpster Screen? Y N \ GGG
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*
* 3-501.15 Cooling Methods for PHFs
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives
Cooked and RTE Foods.* * 19 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*
590.003(C) Responsibility of the Person-in-Charge to
Other* 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F
2
Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F*
7-201.11 Separation-Storage*
Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control
7-202.11 Restriction-Presence and Use*
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements
3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q
590.003(G) Reporting by Person in Charge* Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and
* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations
3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served*
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(l)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145F 15 sec° * Animal Foods That are Raw,Undercooked or
5-101.11 Drinking Water from an Approved System* Equipment* gg Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg awe iiuzooi
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A)-{D)in cater-
* Ratites-165°F 15 sec* in mobile food,temporary and residential
Sources 1 p Proper,Adequate Handwashing g' P �
Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 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 Requirements.
radicsshould be debited under#29-Special
5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* + 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercially Processed RTE Food-140°F* (Blue Items 23-30)
3-202.15 Package Integrity ( ) y Critical and non-critical violations,which do not relate to the foodborne
12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts*
3-101.11 Food Safe and Unadulterated* ( ) g illness interventions and risk factors listed above,can be found in the
8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
* 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F
3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004
3 402.11 Parasite Destruction* Temperature Ingredients to 41'F/45°F 25. Equipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 009
3-502.11 Specialized Processing Methods* 130. 1 Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc
'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
`oF.HE rq TOWN OF BARNSTABLE HEr+L?H.wsPECTOR's Establishment Name: Date: Page: of
OFFICE HOURS
ARNSTABLE.O` PUBLIC
2 0 MAIN STREET
30 P.M.
DIVISION 3:30-.9:3oA.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN F CORRECTION Date Verified
3:30-4:
�A e3 n�0� HYANNIS,MA 02601 .. sos-esz-4644 No Reference R.=Red;item• .< - PLEASE PRINT CLEARLY -
'EON1P� FOOD ESTABLISHMENT INSPECTION REPORT
Name c D e o jjjtff39 I s ectio
O er outine
Address Risk Se ctron
Level a'ER"II- Previous Inspection
Telephone Residential Kitchen Date:
Mobile Pre-operation
dAS
Owner HACCP WIN Temporary Suspect Illness
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP
Other
O
Inspector Out: I
Each violation`checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated.
Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑
Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑
Action as determined by the Board of Health. Allergen Awareness 590.009(G)
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands
❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities
Olt
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ,L a4l
❑ 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 L
❑ 5.Receiving/Condition ❑ 17.Reheating -
❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling
❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control
Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
)(8.
Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ,l✓
0.Proper Adequate Handwashing CONSUMER ADVISORY /
1.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories I
Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations r
Critical(C)violations marked must be corrected immediately. (blue&red items) y - C( FEorrective Action Required: ❑ No ❑ Yes
Non-critical(N)violations must be corrected immediately or ti
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 o
checked indicate violations of 105 CMR 590.000/Federal Food Code. ElEmbar 9 ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other:
23.Management and Personnel (FC-2)(590.003) This report,when signed,below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B-One critical violation and less than 4'non-critical violations
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of
be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration.
28.Poisonous or Toxic Materials (FC-7)(590.008) 9 C ti
4 to 8non-critical violations=C.
29.Special Requirements (590.009) within 10 days of receipt of this order. violation, -
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view
Permit Posted o Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed
Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N
Dumpster Screen? Y N
Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions
Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
1 590.003(A) Assignment of Responsibility* $ Cross-contamination L1 q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours*
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs
Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding
2-103.11 Person-in-Chazge Duties 3-302.14 Protection from Unapproved Additives
Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
590.004(F)
EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*
2 590.003(C). Responsibility of the Person-in-Charge to Other* g g * 3-501.16(A) Hot PHFs Maintained At or Above 140°F*
P tY7-102.11 Common Name-Working Containers *
Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F
7-201.11 Separation-Storage
Applicants* 3-302.11(A) Food Protection* 20 Time as a Public Health Control
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* 3-304.11 Food Contact with Equipment and Utensils*
7.202.12 Conditions of Use* 590.00411 Requirements
590.003(G) Reporting by Person in Charge* - 7-203.11 Toxic Containers-Prohibitions*
( ) Variance
Contamination from the Consumer
3 590.003(1)) Exclusions and Restrictions* 7-204.11 Sanitizers,-Criteria-Chemicals* REQUIREMENTS FOR
3-306.14 A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals.for Washing Produce,Criteria* s 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*
q Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and
( ) P 4-501.111 Manual Wazewashin Hot Water 7.206.12 Rodent Bait Stations
3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
P 7-206.13 Tracking Powders,Pest Control and
_ g
3-201.13 Fluid Milk and Milk Products* - - 4-501.112' Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
3-202.16 Ice Made From Potible Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
4-601.11(A)• Clean Utensils and Food Contact Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
5-101.11 Drinking Water from an Approved System* _ _ Equipment* gg Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effect-rmzoor
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 * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
Chemical Ratites-165°F 15 sec*
Sources* 10 P ing,mobile food,temporary and residential
Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms*
Regulatory Authority- 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
h*W 2-301.14 When to as * Other 590.009 violations relating to good retail
_ 590.004(C) Wild Mushrooms* - 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec
3-201.17 Game Animals* 11 Good Hygienic Practices 17 _ Reheating for Hot Holding Requirements.practicesshould be debited under//29-Special
$ 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-foodbome
3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the
6 Tags/Records:Shellstock [5-203.1
El
Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
* 13Handwashing 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 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
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
3402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 '008
HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009
3-502.11 Specialized Processing Methods* 30. Other
3-502.12 Reduced-Oxygen Packaging Criteria* _
8-103.12 Conformance with Approved Procedures* $: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.
HEALTH INSPECTOR'S Establishment Name: Date: �.�-lPa
P`ft� e: of TOWN OF BARNSTABLE - 9
y, OFFICE HOURS
:T BARN57'AB�E.O` PUBLIC
200 MAIN ST HEALTHRETSION - - : 0- :30 A.M.
3:30-4:30 P.M.
Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
MAss. MON.-FRI.
HYANNIS,MA 02601 No Reference R-Red Item . PLEASE PRINT CLEARLY
�p ,na9•e�m 508-862-4644
'FD MP+ FOOD ESTABLISHMENT INSPECTION REPORT
03
Name r' Dat - Tyoa of T I s c ion
O utine
Address Risk od Service
on l
Level Previous Inspection T
Telephon Residential Kitchen Date: I L
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. d-
ka
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) ❑ UPS
Evil
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands
r .�❑ 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 i Y
❑ 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 AAA
❑ 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: ❑ Yes
Non-critical(N)violations must be corrected immediately or Overall Rating
within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction: Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other:
checked indicate violations of 105 CMR 590.000/Federal Food Code.
23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations
if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If
C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to anon-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.
violation,4 to 8non-critical violations C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
= .
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view
- i
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 o Y N
Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions ~'
Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
1 590.003(A) Assignment of Responsibility* 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours*
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs
2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding
Contamination from Raw Ingredients 15 ._ Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
590.004(F)
EMPLOYEE HEALTH 3-302:11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*
2 590.003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F*
7-102.11 Common Name-Working Containers
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F*
* 7-201.11 Separation-Storage*
Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use** 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use
3-304.11 Food Contact with Equipment and Utensils* 590.004(I1) Variance Requirements
590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions*
Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for 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*
I 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
Y P 7-206.13 Tracking Powders,Pest Control and
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 AnimalConsu Foods
Tat Posted for Consumption of
5-101.11 Drinking Water from an Approved System* 4 601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec*
Animal Foods That are Raw,Undercooked or
Equipment* Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef crf°e 11112001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
Stuffing Containing Fish,Meat,Poultry or
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*
Sources* ing,mobile food,temporary and residential
10 Proper,Adequate Handwashing A 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Game and Wild hority _Mushrooms Approved By 2-301.1 i Clean Condition-Hands and Arms*
Regulatory Aut 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.
$ Receiving/Condltion 2-0Ol.l1 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165'F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-301.12 PreventingContamination When Tasting* * (Blue Items 23-30)
3-202.15 Package Integrity* g 3-403.11(C) Commercially Processed RTE Food-140°F
* 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate to the foodborne
[3-203.12
101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the
8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
202.18 Shellstock Identification* 13 Handwashing Facilities' 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F
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 I FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision 29. 1 Special Requirements 1.009
3-502.11 Specialized Processing Methods* 130. 1 Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
P`oFaE rho TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Pager Of
OFFICE HOURS
PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
BARNSTABLE. ' 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
67q. �e� HYANNIS,MA 02601 MON.-FRI. No Reference ,R Red Item-: :: - PLEASE PRINT CLEARLY
-862-4644
,EDMP,a. FOOD ESTABLISHMENT INSPECTION REPORT 508
Name Date - Type of sec ion rX
r Routine
Il
Address Risk Service pion
Level Retai Previous Inspection
Telephone Residential Kitchen Date: -
Mobile Pre-operation
Owner HACCP Y/N Temporary Suspect Illness42e�irun_
Caterer General Complaint t
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. t AA
® -y
Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑
Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ i
Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands
❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities t x t ,w �
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS V � ` It
❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives vv-`
❑ 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 It
❑ 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 p.► 70
❑ 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: C1. ❑ Yes
Non-critical(N)violations must be corrected immediately or Overall Rating
within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employe E - ectio I Emergency Suspension
C N Official Order for Correction:Based on an inspection today,the items o
checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ffl 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 g ardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than non-critical violations re
if no critical violations observed,4 too 6 von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up, infestation of rodents or insects,or lack of
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 PATE 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 I . -
Dumpster Screen? Y N t:
l_
_ .� �._ - sr ; � _,.. � :. v.� -.:.,.�... .�_. . -_.-/ -•-. '" ..-.. .._ .- _ ... .. .� .......�-t. �.- -.� �.�+_.�.-r.-. ,_-'�.. � rrS..--�--'e-���.. �' .•._ r. -_,..may. �.�+...�-. -, _ _. ._ - �_ � ____
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 1q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours*
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3 202.12 Additives* 3-501.15 Cooling Methods for PHFs
Cooked and RTE Foods.* *- _ 19 PHF Hot and Cold Holding
2-103.11- Person-in-Charge Duties - ---- - -- - - 3-302.14 Protection from Unapproved Additives
Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F)
P g *
2.. 590.003(C) _ Responsibility of-the Person-in-Charge to- 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* 20 Time as a Public Health Control
Ch
7-202.11 Restriction-Presence and Use*
590.003(F) Responsibility of A Food Employee or 3-302.15 Washing Fruits and Vegetables _ * 3-501.19 Time as a Public Health Control*
Applicant To Report To The Pelson 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 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)Returned Food and Reservice of Food*_ 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions 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 t 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 - - 4501 A I I - -Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations
3-201.12 Food in a Hermetical) Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
y 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* _ _ e Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
- - Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of
' 3=202.16 Ice Made From Potable Drinking Water* - 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or
5-101'.11 _ Drinking Water from an Approved System* _ _- 4-60111(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* Ef i-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*
4702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) I Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703:11 Methods of Sanitization-Ho[Water and Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
Proper, Ratites-165°F 15 sec*
3-201.15 Molluscan Shellfish from NSSP Listed in mobile food,tern or and residential
Sources 10 Proper,Adequate Handwashing g' p
�
Game and Wild Mushrooms.Approved By __ .__ 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 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 929-Special
2-401.11 Eating,Drinking or Using Tobacco* * Requirements.
"`'5 '' - Receiving/Condition - - - - - g� g g 3-403.11(A)&(D) PHFs 165'F 15 sec
3-202.11 PHF's Received at Proper Temperatures* 2-001.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3301.12 Preventin Contamination When Tasting* * (Blue Items 23-30)
3-202.15 Package Integrity*. g g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodborne
3-101.11 Food Safe and Unadulterated* - 12 - _ Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the
6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
* 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F
3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004
3402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005
* 5-205.11 Accessibility,Operation and Maintenance
3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision 29. 1 Special Requirements .009
3-502.11 Specialized Processing Methods* 130. 1 Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc
'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
oFINE rp TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of
OFFICE HOURS _
PUBLIC HEALTH DIVISION 8:00=9:30A.M.
BARN ABLE. 200 MAIN STREET s:so-a:so P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
�p a3v.a m� HYANNIS,MA 02601 - No Reference R-Red Item PLEASE PRINT CLEARLY
rFD MPS 508-88-862-464644
FOOD ESTABLISHMENT INSPECTION REPORT
Na Date ' e of T section
r io s outi ne
Address Risk Service nspection
a Level Previous Inspection
Telephone Residential Kitchen Date:
Mobile Pre-operation
Owner HACCP Y/N Temporary Suspect Illness
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP
In: Other
Inspector Out:
Each violation checked requires 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 Au
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
within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other:
checked indicate violations of 105 CMR 590.000/Federal Food Code.
23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed;4 to 6 non-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically la hot
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 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 Prin'
Self Service Wait Service Provided Grease Trap Size Variance Letter.Posted Y N
Dumpster Screen? Y N
r
Violations related to Foodborne Illness - Violations Related to Foodborne Illness Interventions
Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
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 d
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 7-101.11 590.004(F)
590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers*Identifying Information-Original Containers* *
2-
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F*
7-201.11 Separation-Storage*
Applicants* 3-302.11(A) Food Protection* 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) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warring Labels*
4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and
* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations
3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served*
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
* Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of
3-202.16 Ice Made From Potable Drinking Water 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or
* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec*
5-101.11 Drinking Water from an Approved System gg
Equipment* Not Otherwise Processed to Eliminate
* 3-40L11 A 2 Comminuted Fish Meats&Game 1
590.006(A) Bottled Drinking Water ( )O Pathogens* eg�"e 11 lzoo
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006 Water Meets Standards in 310 CMR 22.0* - Pasteurized E Substitute for Raw hell
(B) Contact Surfaces of Equipment* * 3 302.13 Eggs*
ed Eggs Sus o S
' Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min E s*
Shellfish rs o pp gg
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
Stuffing Containing Fish,Meat,Poultry or
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g �' 590.009(A)-(D) Violations of Sectiom590:009(A)-(D)in cater-
Sources* ing,mobile food,temporary and residential
Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arens*
10 Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail
3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special
Requirements.
5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30)
3-202.11 Package Integrity Critical and non-critical violations,which do not relate to the foodborne
12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts*
3-101.11 Food Safe and Unadulterated* ( ) g illness interventions and risk factors listed above,can be found in the
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 3-501.14 A g
3-202.18 Shellstock Identification Handwashing Facilities ( ) Conlin Cooked PHFs from 140°F to 70°F Item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004
3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance
Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser;Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008
HACCP Plans 6-301.12 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.
oFTNE r TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of
1 OFFICE HOURS
WP ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
BARNSTABLE, ' 200 MAIN STREET 3:3o-a:3o P.M. Item Code cal Item DESCRIPTION OF VIOLATION/P N OF CORRECTION Date verified
MASS. g. MON.-FRI-
.a�q-pie No Ref;a ce R-Red I PLEASE PRINT CLEARLY
HYANNIS,MA 02601
508-862-4644
rFD1A FOOD ESTABLISHMENT INSP CTION REPORT 0
Name Dat Tyne of Type of Inspection yp
Ion 5' Routine �L
Address -L(f Risk od Servi spection
pection
Telephone 51t )K :�cv& Level/ 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 ❑ It Li(�
Action as determined by the Board of Health. Allergen Awareness 590.00 G)
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands '� l
❑ 1.PIC Assigned/'Knowledgeable I Duties ❑ 13,Handwash Facilities
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS �'
IS
❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives 011
❑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 10QN If
-
❑5.Receiving/Condition ❑ 17.Reheating
❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling
171 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control {i
❑8.Separation/Segregation I Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(H P)
❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP v
❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY b� ,
❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories -
Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Al9
Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required:
Non-critical(N)violations must be corrected immediately or Overall Rating
within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Em 5 y n i n/Exclu i e ti edule y U 2nsign
C N Official Order for Correction:Based on an inspection today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ ther:
checked indicate violations of 105 CMR 590.000/Federal Food Code.
23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 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
n C=2 critical violations and less than it non-critical. .
f 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-crit
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.
violation,4 to 8non-critical violations C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
=
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view Y V L vvk-
f�
Z
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining _Y_N P C's Sigm ure Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N
Dumpster Screen? Y N
Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions
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 L14 Food or Color Additives Law Cooled to 41'F/45'F Within 4 Hours*
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs
Cooked and RTE Foods.* 19 PHF Hot and Cold Holding
2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives*
Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH_ 3-302.11(A)(2) Raw Animal Foods Separated from EachIdentifying
* 590.004(F)
7-101.11 Identi in Information-Original Containers
Other* g g 3-501.16(A) Hot PHFs Maintained At or Above 140'F*
2 590.003(C) Responsibility of the Peison-in-Charge to 7-102.11 Common Name-Working Containers* *
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F
Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*g 20 Time as a Public Health Control
590.003(F) Responsibility of A Food Employee or An7-202.11 Restriction-Presence and Use*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
Reporting by Person in Charge*
Contamination from the Consumer 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( )
590.003(G)
3 590.003(D) Exclusions and Restrictions* * 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rrated or of Food 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
q 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 Warewashing-Hot Water 7.206.12 Rodent Bait Stations *
3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served
Y P 7-206.13 Tracking Powders,Pest Control and *
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served
3-202.13 Shell Eggs* Sanitization Temperatures* 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
Eggs 5-101.11 Drinking Water from an Approved System*
4-601.11(A) Clean Utensils and Food Contact Surfaces of E s-Im F mediate Service 145' 15 sec* Animal Foods That are Raw,Undercooked or
Equipment* Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Pathogens* Eff errve 11112001
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source � 3-401.11(B)(1)(2) Pork and Beef Roast-130'F 121 min Eggs*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155'F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
3-201.15 Molluscan Shellfish from NSSP Listed Chemical*
Sources* Ratites-165°F IS sec* ing,mobile food,temporary and residential
10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms*
Regulatory Authority _ 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail
practices sho
3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requirements]d 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 Tune* 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)
3-201.11 Package Integrity Y Critical and non-critical violations,which do not relate to the foodborne
3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3 403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the
6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
* 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70'F
3-203.12 Shellstock Identification ( ) Item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F 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 FG-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 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 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
HoFTHE*oy TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: 'oY Page:
11- 4 OFFICE HOURS
P PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
+ BARNSTABLE. • 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified
MON9 M679• .0� HYANNIS,MA 02601 - -FRI.
508-8624644 No Reference R-Red Item _ PLEASE PRINT CLEARLY
�i°lfo MPS° 8-8
FOOD ESTABLISHMENT INSPF,,CTION REPORT
Name ` Da Type of Tvoe of Inspection
O Routine
Address Ris < od Se Re-inspection
Le el a aI Previous Inspection
Telephone Residential Kitchen Date:
Mobile Pre-operation r
Owner HACCP Y/N Temporary Suspect Illness
Caterer General Complaint
Person in Charge(PIC) ime Bed&Breakfast HACCP
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 r
❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals
i
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 l
❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control
17718.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP), ,� r
10
❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HIS
❑ 10.Proper Adequate Handwashing44
CONSUMER ADVISORY I
11.Good Hygienic Practices / 22.Posting of Consumer Advisories `+t
❑ Y9 ❑ 9
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: El No El Yes
Non-critical(N)violations must be corrected immediately or Overall Rating
within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled" ❑ Emergency Suspension
C N Official Order for Correction:Based on an inspection today,the items o
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 B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t Ftion 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 9npn-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.
s
violation,4 to 8npn-critical violations C.
29.Special Requirements (590.009) Within 10 days of receipt of this order.
=
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N IC'IS' natu Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y IN
Dumpster Screen? Y N
Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions
Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
1 590.003(A) Assignment of Responsibility* 6 Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours*
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs
2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding
Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH, � 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F)
2
Other*590.003(C) Responsibility of the Pelson-in-Charge to 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 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
3-304.11 Food Contact with Equipment and Utensils* 590.004(11) Variance Requirements
590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions*
Contamination from the Consumer
3 590.003(13) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rted or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HSP HIGHLY SUSCEPTIBLE POPULATIONS
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated ( )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 17.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served*
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* I Sanitization Temperatures* TIMEITEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
4-60111(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec*
Equipment Animal Foods That are Raw,Undercooked or
.
5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* El/cave 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*
3-20L14 Fish and Recreationally Cough[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 m cater-
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-(D)
Ratites-165°F 15 sec*
Sources* 10' Proper,Adequate Handwashing ing,mobile food,temporary and residential
Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authors 2-301.11 Clean Condition-Hands and Arms the appropriate sections above if related to
eg ry Authority 3-401.12 Raw Animal Foods Cooked in a Microwave
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
2-401.11 Eating,Drinking or Using Tobacco* * Requirements.
5 Receiving/Condition g, g g 3-403.11(A)&(D) PHFs 165°F 15 sec
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-301.12 PreventingContamination When Tasting* * Blue Items 23.30)
3-202.15 Package Integrity* g 3 403.11(C) Commercially Processed RTE Food-140°F Critical and non-critical violations,which do not relate to the foodbome
3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts*
illness interventions and risk factors listed above,can be found in the
6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 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
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 .0e5
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 .00si
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.
oFiKE Tpk TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: Date: Page: of
d c OFFICE HOURS
PUBLIC F'IEALTH DIVISION 8:00-9:30 A.M.
z BARNSTABLE. = 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
Ma�q �0l HYANNIS,MA 02601 MON.-FRI.508-8624644 No Reference .R-Red Item PLEASE PRINT CLEARLY
FOOD ES BLISHMENT INSPECT ON REPORT
Name Dat i7 Jae of jyj3@=QUqsj3ection
Ile, Routine
Address Risk ice a-i ction
Level Retail Previous Inspection
Telephone Residential Kitchen Date:
Mobile Pre-operation
Owner HACCP Y/N Temporary Suspect Illness
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP
In: 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) 44
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands
❑ 1.PIC Assigned/Knowledgeable/Duties_ ❑ 13.Handwash Facilities
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS
loir
❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives
el o
❑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 01)
❑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
n c
Violations-Related to Good Retail Practices(Blue Items) Total Number of Critical Violations I
Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ Y
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 Order for Correction: Based on an inspection today,the items ® Embargo
checked indicate violations of 105 CMR 590.000/Federal Food Code. F] Emergency Closure El 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 B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F n scored automatically o la hot
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of
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.
violation,4 to 8non-critical violations C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
=
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view, nv,
PermirPosted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print:
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N > /
Dumpster Screen? Y N (((
Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions
Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 1q Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours*
590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs
2-103.11 Person-in-Charge Duties Cooked and RTE Foods.* 3-302.14 Protection from Unapproved Additives* 19 PHF Hot and Cold Holding
Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from EachContainers* 590.004(F)
P 7-101.11 Identifying Information-Original
7-102.11 Common Name-Working Containers*2 590.003(C) Responsibility of the Person-in-Charge[0
Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F*
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F*
7-201.11 Separation-Storage*
Applicants* 3-302.11(A) Food Protection* P 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 * ( ) 9
590.003(G) Reporting by Person in Charge* 7-203.11 Toxic Containers-Prohibitions
Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
q Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served*
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
5-101.11 Drinking Water from an Approved System*
4-601.11(A) Clean Utensils and Food Contactur Eggs Surfaces of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
Equipment* Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eg crave 11112001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs*
4-702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec*
3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment*
Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 590.009 A D Violations of Section 590.009 A D m cater-
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-( ) ( )-( )
Ratites-165°F 15 sec*
Sources* 10 Proper,Adequate Handwashing ing,mobile food,temporary and residential
Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11 A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail
( )( )( )
3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special
2-401.11 Eating,Drinking or Using Tobacco* * Requirements.
$ Receiving/Condition g. g g 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(13) 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* 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
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 004
3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7
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:590Formbacke-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.
HEALTH INSPECTOR'S Establishment Name: Date:
P�oF. roy o TOWN OF BARNSTABLE- OFFICE HOURS Page: of
PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
BARNSTABLE. ' 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
16sq. �0� HYANNIS,MA 508$62-0644
02601 - MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY
�'°len MP+p
FOOD ESTABLISHMENT INSP CTION REPORT
Name Dat Moe of s i n
-1 J7p utine
Address Risk ice Re-inspection .
Lev Re at it 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.
Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) anti-Choking 590.009(E) ❑
Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ C
Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands
❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS
❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives
❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals
FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods)
❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures
❑ 5.Receiving/Condition ❑ 17.Reheating
❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling
❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control
❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
❑9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP
All,IVII'
❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY
❑ 11.Good Hygienic Practices 17122.Posting of Consumer Advisories
Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations
Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required:
Non-critical(N)violations must be corrected immediately or Overall Rating
al!;L A 2
within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction: Based on an inspection today,the items ® Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other:
checked indicate violations of 105 CMR 590.000/Federal Food Code.
23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation t F is scored automatically o la hot
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i cal violations.
If no critical water,sewage back-up,infestation of rodents or insects,or lack of
be in writing and submitted to the Board of Health at the above address violations observed,7 to a non-critical violations. If 1 critical refrigeration.
28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violation,4 to Snon-critical violations=C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
31.Dumpster screened from public view
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y IN
#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 Q
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.* Additives* 19 PHF Hot and Cold Holding
2-103.11 Person-in-Charge Duties � 3-302.14 Protection from Unapproved
Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 590.004(F)
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*
P g
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F*
7-201.11 Separation-Storage*
Applicants* 3-302.11(A) Food Protection* 1 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 Rated or of Food*Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Wafer From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and
3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
Y P 7-206.13 Tracking Powders,Pest Control and
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* r 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 Equipment Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Effective 111n001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22. Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Soo urce 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*
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 AutWildhority
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.
* 2-301.14 When to Wash* 3-401.11 A 1 All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail
590.004(C) Wild Mushrooms ( )( )(b)
3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special
2-401.11 Eating,Drinking or Using Tobacco* * Requirements.
$ Receiving/Condition � g� g 8 3-403.11(A)&(D) PHFs 165°F 15 sec
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-202.15 Package Integrity* ,_ 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30)
12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodbome
3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the
g 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
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70*17 to 41°F/45°F Item Good Retail Practices FC 590.000
TagsiRecords:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004
3-402.11 Parasite Destruction* Temperature Ingredients to 41*F/45°F 25. Equipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1.009
3-502.11 Specialized Processing Methods* 130. 1 Other
3-502.12 1 Reduced-Oxygen Packaging Criteria*
8-103.12 1 Conformance with Approved Procedures* S:590Formback&2doc
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. *Denotes critical Rem in the federal 1999 Food Code or 105 CMR 590.000.
oriHKE rok TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: Page: of
qo OFFICE HOURS
BARNSrABLE. ` PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION /PLAN OF CORRECTION Date Verified
639. e� HYANNIS,MA 02601 5MON.-FRI.08-862-4644 No Reference R-Red Item PLEASE PRINT CLEARLY
FOOD ESTABLISHMENT INSPECTION REPORT
rEc MAr
Name _1_1 AnDat 41114 De ojyge:QSVspection
6 era ion Routine
Address Risk Food Service ion
Level Previous Inspection
Telephon eResidential Kitchen Date:
Mobile Pre-operation 64
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 1 ( . 21
❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling
❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding I I
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control
❑8.Separation/Segregation I 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 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 B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically o la hot
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than i non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of
be in writing and submitted to the Board of Health at the above address violations observed,7 ti 8 non-critical violations. If 1 critical refrigeration.
28.Poisonous or Toxic Materials (FC-7)(590.008 9 violation,4 to Snon-critical violations=C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
30.Other DATE OF RE-INSPECTION: Inspector's Signature Print:
E31.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 Signatu Print: f
Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N C
Dumpster Screen? Y N
r
Violations related to Foodborne Illness Violations Related to Foodborne Illness Interventions
Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to
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 Peison-in-Charge to Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH,., 3-302.11(A)(2) Raw 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 7-102.11 Common Name-Working Containers*
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F*
Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control
(F) Responsibility Employee 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use*
590.003 Res onsibili of A Food Em to ee or An 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use 590.004 11 Variance Requirements
* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q
590.003(G) Reporting by Person in Charge 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 Reted 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 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 HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served*
P 7-206.13 Tracking Powders,Pest Control and
3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIMEiTEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 18 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
Equipment
5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* 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 Surfaces of Equipment*
4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec*
Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or Violations of Section 590.009(A)-(D)in cater-
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* 590.009(A) �)Ratites-165°F 15 sec* in mobile food,temporary and residential
Sources* 10 Proper,Adequate Handwashing g' P �
Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 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 1 Reheating for Hot Holding practices should be debited under#29-Special
2-401.11 Eating,Drinking or Using Tobacco* * Requirements.
5 Receiving/Condition g• g g 3-403.11(A)&(D) PHFs 165°F 15 sec
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* Blue Items 23-30)
12 Prevention of Contamination from Hands * Critical and non-critical violations,which do not relate to the foodbome
3-101.11 Food Safe and Unadulterated* 3-403.11(E) Remaining Unsliced Portions of Beef Roasts illness interventions and risk factors listed above,can be found in the
8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 1 g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
* 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F
3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
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 I FC-7 1.008
HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements 1 1.009
3-502.11 Specialized Processing Methods* 1 130. 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.
r
qh-7
�F.NE rog, TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment Name: Date: _ Page: of
ti OFFICE HOURS
P ° PUBLIC HEALTH DIVISION 8:00-9:30 A.M.
BARNSfABLE. = 200 MAIN STREET 3:3o-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified
,63 `0� MON.-FRI.
9. No Reference R-Red Item PLEASE PRINT CLEARLY
�ar fD M s � HYANNIS, MA 02601 508$62-4644
FOOD ESTABLISHMENT INSPECTION REPORT 90 C^
Name �, Da Type Tyoe of Inspection
=40616-ed-S!,Oice
eAddress Risk ionLeve 4-11�1 All
Previous Inspection
Telephone Date:
Residential Kitchen
Mobile Pre-operation
Owner HACCP Y/N Temporary Suspect Illness -2 42
r
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP
In: Other
Inspector Out:
Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. -�
Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑
Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑
Action as determined by the Board of Health. Allergen Awareness 590.009(G)
FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands
❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities
EMPLOYEE HEALTH PROTECTION FROM CHEMICALS
❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives
❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals
FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods)
1714.Food and Water from Approved Source ❑ 16.Cooking Temperatures
❑ 5.Receiving/Condition ❑ 17.Reheating
❑6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling
❑7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding
PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control
❑8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
❑9.Food Contact Surfaces Cleaning and Sanitizing 17121.Food and Food Preparation for HSP
❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY
❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories
r'
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
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
checked indicate violations of 105 CMR 590.000/Federal Food Code. ® g ❑ g y ❑ ry P ❑ Other:
23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations,
24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical,results in an F.
25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot
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
violations observed,7 to anon-critical violations. If 1 critical refrigeration.
28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address
violation,4 to 8non-critical violations C.
29.Special Requirements (590.009) within 10 days of receipt of this order.
=
30.Other DATE OF RE-INSPECTION: Inspector's 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 nat 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 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45'F
590.004(F)
K' 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 Pelson-in-Charge to 7-102:11 Common Name-Working Containers* *
Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F
* 7-201.11 Separation-Storage*
Applicants 3-302.11(A) Food Protection* 20 Time as a Public Health Control
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(13) 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
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 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*
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* 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
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155'F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
5-101.11 Drinking Water from an Approved System*
4-601.11(A) Clean Utensils an SurfacesEggs d Food Contact of E s-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
Equipment* Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff-twe 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 Surfaces of Equipment*
4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec*
f
Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS
3-201.15 Molluscan Shellfish from NSSP Listed Chemical*
Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater-
Sources* ing,mobile food,temporary and residenti
Game and Wild Mushrooms Approved By al
10 Proper,Adequate Handwashing Ratites-165°F 15 sec*3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors.
590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail
3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special
2-401.11 Eating,Drinking or Using Tobacco* * Requirements.
$ fieceiving/Condition g• g g 3-403.11(A)&(D) PHFs 165'F 15 sec
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 Preventing Contamination When Tasting* 3-403.11 C CommerciallyProcessed RTE Food-140°F* (Blue Items 23-30)
3-202.15 Package Integrity ( ) Critical and non-critical violationsi which do not relate to the foodborne
* 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts*
3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factois,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
3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance
Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 b05
Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006
590.Q04(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with roved Procedures/ 6-301.11 Handwashing Cleanser,Availability
Approved 26. Poisonous or Toxic Materials FC-7 .00§ .,
HACCP Plans 6-301.12 1 Hand Drying Provision 29. Special Requirements .009
3-502.11 Specialized Processing Methods* 30. Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc
`Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.
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ANTIPASTI Ceviches
ASPARAGUS WRAPED WITH PROSCIUTTO, GRILLED ARTICHOKE
W/ ASIAGO CHEESE, ROASTED RED PEPPER VINAIGRETTE 9.99
CLAMS PECORINO, BAKED LITTLE NECKS, GARLIC SPINACH,
RED PEPPER ,PECORINO ROMANO CHEESE, LEMON TYME 10.99
SAUTEED CALAMARI MARINARA, SERVED W/GARLIC PARMESAN CROSTINI 9.99
SCALLOPS CARPACIO , GRILLED SCALLOPS , GRILLED ENDIVE, ROASTED PEACH TRUFLE
VINAIGRETTE 10.99
YELLOW FIN TUNA TARTARE TOSSED W/LIGHT RADISH DIJON VINAIGRETTE, SEA SALT
CRACKER 11.99
CEVICHE DE PESCADO , FISH TARTARE, COOK IN LEMON JUICE ,PEPPERS ,MICRO
GREENS ONION SALAD 10.99
STEAM BLACH MUSSELS ,Smoke tomato ,white wine , fresh basil ,grilled
crostini 9.99
CEVICHE DE SALMON , salmon cooked in lemon juice ,grilled endive ,ahi
amarillo and choclo
CEVICHE CRIOLLO, Mussels ,clams,srimp,and fish ,with micro greens ,bermuda
onions ,and sweet potatoes
STUFFED ARTICHOKES ,stuffed with proscuitto,roasted peppers ,ricota cheese
ANDEAN TAMALES ,Two home hade tamales ,cheese and ahi amarillo sauce
SOUPS
OYESTER CHOWDER
GLUTEN FREE LOBTER BISQUE
PASTA E FAGIOLI
*Before plaan.g your-order inform you-r--se-- r if a.n_y person in your party
has a food-al-lergy:Consuming-rc�w or under_cook_rn_ea_ts,poutrmseafood or
sellfish may-increa-se-risk�of-fiood-borne`illness
i
INSALATE
CLASSIC CEASAR SALAD , PECORINO RAMONO, WHITE ANCHOVY DRESSING
8.99
SPINACH SALAD,WHITE BALSAMIG VINAGRETTE,CARAMELIZED PECANS, SUN
DRIED cranberries, GOAT CHEESE 8.99
TUSCAN SALAD, LETTUCES CALAMANTA OLIVOS TOMATOES CUCCUMBER
TOSSED W/ FETA VINAGRETTE 9.99
TUSCAN TROPICAL SALAD FRESH IN SEASON FRUITS, ROASTED ALMONDS
SHAVED HOUSE CHEESE, DRIZZELED W/ AGE BALSAMI GLAZE 9.95
TUSCAN CAPRESE VINE RIPE TOMATOES ,BUFFALO MOZARELLA,BASIL,BABY
ARUGULA,AGED BALSAMIC GLAZE 10.99
HOUSE MADE
PASTAS E RISITTOS
SHRIMP FRA DIAVOLO, OVER HOUSE MADE LINGUINI 19.99
SHRIMP SCAMPI, OVER HAUSE LINGUINI 19.99
RISOTTO DI ARAGOSTA.GRILLED 1LB LOBSTER ,PECORINO
ROMANO ,SPINACH 21.99
GHOGGI AMATRICIANA,. HOME MADE POTATO GHOGGI ,PANCHETTA ROASTED
PLUM TOMATOES ,PECORINO ROMANO17.99
RAVIOLI DI ARAGOSTA ,HOUSE MADE LOBSTER RAVIOLI STUFFED WITH
RICOTA ,FRESH LOBSTER MEAT ,SPINACH , SAFFRON CREAM
SAUCE.21.9
CLAMS FLORENTIN, LITTLE NECKS ,SPINACH, FRESH MOZZARELLA ,WHITE
WINE LEMON SAUCE ,HOUSE FETTUCHINE 20.95
POLLO E ARAGOSTA ,ORGANIC CHICHEN BREAST,HALF LOSTER TAIL ,SAFRON
BROTH HAUSE FETUCHINNI 23.99
LINGUINE VERDE ,Peruvian spinach pesto ,pecorino romano and
roasted garlic
ARROZ CON PATO, Braised duck leg in a peruvian beer ,cilanctro
jasmin rice
LOMO SALTEADO, Sautee steak with peppers ,soy sauce ,ahi amarillo
over rice and french fries
ARROZ CON MARISCOS, Littl clams srim , alamary, rilled
lobster tail ,ahi panca and 'asmin-r ce
ENTREES
F IGNIO ,ROSTED SHALLOTS RED WIN EDUCION ,WHIPPED YUKON
POATAT RUFLE CAKE
LED ATLANTIC SWORD FISH ,LUMP CRAB MEAT,RAINBOW
CHARD,ROASTED POTATOES ,GINGER L -E-B:R.OT
PAN ROASTED HADOCK...OVER ROC RIMP RISOTO, RESERVED LEMON
GRILLED 120Z PRIME SIRLION, SHITA MS ,ROASTED GARLIC
BUTTER ,ASPARRAGUS,ROASTED POTATOES
FRUTA DEL PESCATORE ,SH RIM P,MUSSEL,LITTLE NECKS,SCALLOPS ,GRILLED
LOBSTER TAIL IN A RICH TOMATO BROTH HOUSE LINGUINI
PAN SEARED DAY BOAT SCALLOP, PERUVIAN FRIED RICE ,AHI LIMO AND
SHITAKE MUSHROOMS
LED 12oz RIBEYE, PERUVIAN YELLO OTAPOES PURE,GRILLE SPARRA
GUS ,CHIMICHURRI SAUCE
VITELLO SALTIM L SCALOPINI WITH
PROCIUTTO,SPINA ASSIAGO- HESSE MADEIRA SAGE DEMIGLAZE ,ROASTED
POTATES ,HARRICOBER
VITELLO ALA TUSCANY ,PROCIUTO ,FRES �IOTZARELLA GRILLED
EG"GPLA SHITAKE MUSHROOMS DEMIGLAZE SUACE ,F NGERLIN POTATOES
SPINACH
PAN SEARED SOLE MANIQUTARA , LITTLE N RESERVED LEMON ,BABY
BOCHOY ,FINGERLINE POTATOES, RED BUTTER SAUCE
SUDADO DE PESCADO, BROILED HADDOCK ,TO S,ONIOS,FINGERLIN
POTATOES AND SPINACH
POLLO ALA BRAZA,ROASTED WHOL CHIKEIV ,ONION SALAD ,FRENCH FRIES
AND LEMON THYME SAUCE
PERUVIAN CANGRE]O, KING CRAB LEGS ,LEMON CAPER SAUCE ,TOMATOES
OVER ESCAVECHE LINGUINE
` 1lJ M I
PRIM I INSALATA
ASPARAGUS PROSCIUTTO,Wrapped asparagus with prosciutto, CAESAR,White anchovy dressing,focaccia croutons,shaved pecorino
wood grilled artichokes,asiago cheese tomato vinaigrette 9 romano cheese 8
LITTLE NECKS FLORENTINE,8 baked little necks,garlic spinach, ARUGULA,Wood grilled peaches,lemon caper vinaigrette,crispy
pecorino romano,lemon thyme 9
pancetta,cherry tomatoes,asiago crisp 9
PAPA RELLENA,Stuffed potato(spinach and ricotta cheese)served ROMA CAPRESE,Baby arugula,vine ripened tomatoes,fresh
with onion salad,topped with spicy rocoto sauce 9 mozzarella cheese,fresh fig glaze 9 ,
ANTICUCHOS,(From streets of Peru)Wood grilled 3 strip steak QUINOA,Bermuda onions,romesco pepper,lime,wood grilled romaine
skewers,marinated with Andean spices,served with choclo,sweet
potato,aji Amarillo sauce 10 hearts,ricotta salata 9
FRIED CALAMARI,Served with aji amarillo,aioli 7 SPINACH,Roasted shiitake mushrooms,artichokes,goat cheese,white
balsamic dressing,sundried cranberries 8
'MUSSELS,Aji Amarillo, butter,fritada(bacon),pecorino crisp 9 BEET,Mesclun greens,roasted beet,caramelized pecans,wood grilled
SALMON CAKES,Wood grilled peaches,huacatay sauce 9 tomato vinaigrette,feta cheese 9
ZUPPA
EGGPLANT ROLLATINI,Fried eggplant rolled with spinach,ricotta
,heese,topped with marinara and mozzarella cheese 8 Spicy crab and plantain 5
Gluten free lobster bisque 7
PERUVIAN CAUSA,Golden Peruvian potato cake,topped with tuna Sou of the day market
mW,huancaina sauce,avocado 10 p y
PULPO,Wood grilled octopus,fingerling potatoes,lemon caper
✓inaigrette 11 CONTORNI '
LOBSTER RAVIOLI,Homemade ravioli,stuffed with ricotta,spinach, Wood grilled asparagus 5
esh lobster meat,light Dijon mustard sauce,grilled artichokes and Homemade pasta 6
shaved pecorino 11
Parmesan Risotto 5
PASTAS E RISOTTOS
FETTUCCINE CARBONARA,Homemade fettuccine,pancetta,parmigiano-reggiano cream sauce 15
YUCA GNOCCHI,Homemade yuca,spinach and ricotta gnocchi,aji amarillo cream sauce 16
QUINOASOTTO,Vegetables,quinoa,wood grilled asparagus,wood grilled endive,roasted mushrooms 15
LOBSTER RISOTTO, 1.1/2 lbs.wood burning grilled lobster,spinach,roasted shiitake mushrooms,pecorino romano 24
LOBSTER RAVIOLI,Homemade ravioli stuffed with ricotta cheese,spinach,fresh lobster meat,light Dijon butter sauce,
grilled artichokes,pecorino romano 20
FUSILLI AMATRICIANA,Homemade fusilli pasta,pancetta,marinara sauce tossed with parmigiano-reggiano 15
PENNE A LA VODKA,Homemade penne rigatti,prosciutto,vodka marinara cream sauce,parmegiano-reggiano 15
PAPPARDELLE,Homemade pappardelle,wild mushrooms,black pepper corn,brandy demi-glaze,touch cream 15
SPINACH CAVATELLI,Homemade cavatelli,classic veal bolognese,ricotta salata cheese 17
SHRIMP SCAMPI,Sautded shrimp,Cape Cod ability tomatoes,homemade spinach linguini,white wine lemon sauce 20
SHRIMP FRA DIABLO,Sautded shrimp in a spicy marinara sauce,hot cherry peppers,homemade linguini 20 r
LINGUIM RED OR WHITE CLAMS,Fresh littlenecks,sauteed with white wine butter or marinas sauce,over homemade linguini pasta 18
CHICKEN AND SHRIMP SALTADO,Sautded with onions,tomatoes,red wine vinegar,soy sauce,tossed with homemade fettuccini pasta22
SECONDI
PAN SEARED SCALLOPS,Over homemade pappardelle,mushrooms,black pepper corn demi-glaze sauce 21
GRILLED SALMON ANDINO,Wood grilled filet salmon,Peruvian tacu tacu(caramelized rice and lentils),sauteed grapes,
red wine vinaigrette reduction 20'
.e
140Z NEW YORK STRIP,Wood grilled steak,roasted potatoes,chimichurri sauce,sauteed spinach 23
10OZ.FILET MIGNON, Wood grilled filet, Montepulciano sauce, wood grilled asparagus, organic carrot pure, roasted
potatoes 27
BEEF BRACIOLE, Rolled with Italian meats, mozzarella cheese, roasted garlic, roasted red pepper, spinach, served with
homemade fusilli,garlic and oil 20
ARROZ CON PATO,Duck leg confetti,cilantro,Peruvian rice,chicha de jora,salsa criolla 18
LAMB OSSO BUCCO,Peruvian style,braised lamb shank with aji amarillo,Peruvian beer,vegetables,cilantro,served with
shiitake mushrooms risotto,white kidney beans pure 20
PERUVIAN PAELLA, Shrimp, scallops, clams, mussels, 'rz wood grilled lobster tail, calamari, jazmin rice, aji panca,
romesco pepper 26
FRUTTA DEL PESCADOR, Shrimp, mussels, scallops, clams, '/2 wood grilled lobster tail,wood grilled octopus, light
marinara sauce served over homemade linguini 26
PERUVIAN PARRILLADA FOR TWO, 8oz filet mignon, 12oz New York strip, grilled shrimp served with roasted
potatoes, sauteed spinach, choice.sauce (chimichurri, black pepper com demi-glaze, montepulciano, gorgonzola demi-glaze)
45
BRANZINO,Pan seared branzino,pancetta orzo with touch of cream,grilled asparagus,lemon butter 24
LOMO SALTADO, Sauteed beef tenderloin, tomatoes,onions, aji amarillo, soy sauce, served with roasted garlic rice and
wood grilled potatoes 18
JALEA,Peruvian fried seafood(flounder,scallops,shrimp,calamari,little necks),served with choclo and caramelized yucca 24
PARIHUELA,Peruvian style cioppino,little necks,clams,shrimp,wood grilled lobster tail,wood grilled octopus,aji panca,
light tomato broth served with white rice. 26
ti
VEAL SALTIMBOCA CHICKEN
Layered with prosciutto,spinach,asiago cheese,sage marsala demi-glaze,fingerling potatoes,asparagus
20 19
PARMESAN
Breaded,pan fried topped with marinara,mozzarella cheese served with homemade linguini
18 17
PICATTA&LOSTER
Lemon caper sauce,fresh lobster meat,homemade saffron fettuccini,sauteed spinach
26 24
MILANESE
Served with wood grilled asparagus,shaved pecorino,asiago crisp,cherry tomatoes lemon caper vinaigrette
20 19
*Consuming raw or undercook meats,poultry,seafood,
spew-vir or eggs may increase your risk of foodborne illness.
Menu is subject to change-Please inform your server if anyone
in your party has a food allergy.
r .
CEVICHE
Ceviche ("seh-BEE-chay") is a hugely popular dish in South America. The basic ingredient is raw fish,
cut into bite-size pieces and marinated in the juice of an acidic fruit (usually lime), salt, and seasonings
(usually chile peppers). The citric acid in the juice changes the texture of the fish, without changing its
"raw" taste. Ceviche is an old tradition in South America, dating back to the earliest inhabitants. The
Incas preserved their fish with fruit juice, salt and chile peppers, and later the Spanish conquerors
introduced the now essential limes
CEVICHES
TUNA,Fresh lime juice, cucumber, aji amarillo,passion fait, arugula 11
TRADITIONAL,Fresh fish of the day, choclo, sweet potato, onions,cancha, fresh lime juice 10
SHRIMP,Aji Amarillo sauce, fried leeks,onions,wood grilled artichokes, fresh lime juice 10
SCALLOPS,Light grilled scallops,grilled endive, fresh lime juice, fried calamari, aji limo, choclo10
OYSTER,Lemon juice, cucumber,onion salad,prosecco, romesco peppers, cancha 11
MIXTO, Shrimp,fish of the day,mussels, calamari, lime juice, aji amarillo, sweet potatoes, onion 14
LITTLE NECKS,Fresh little necks, aji rocoto, crispy yuca, onion salad, greens 8
PULPO,Wood grilled octopus, zucchini, lime juice,romesco pepper, sweet potatoes 10
PERUVIAN INGREDIENTS
AJI AMARMLO,spicy Peruvian yellow pepper
AJI ROCOTO,spicy Peruvian red pepper
CANCHA,toasted Peruvian corn
AJI PANCA,sundried Peruvian red pepper
CHOCLO,Peruvian white corn
CHICHA MORADA,Peruvian purple corn juice
CIUCHA DE JORA,Peruvian corn beer,fermented maize
*Consuming raw or undercook meats,poultry,seafood,
shellfish or eggs may increase your risk of foodborne illness.
Menu is subject to change.Please inform your server if anyone
in your party has a food allergy
1
WINES BY THE GLASS
WHITES REDS
Estandon,Cote De Provence"ROSE" 9
2011 Zinfandel,Brazin(Cody) 8
NV Prosecco,Zardetto(Italy) 8 2009 Chianti Classico,Piccini(Tuscany) 8
2012 Chardonnay,La Crema(Sonoma) 9 2011 Malbec,Bodega Catena(Argentina) 9
2011 Pinot Grigio,Cantina(Abruzzo) 9 2006 Rioja Riserva,Ramon billbao(Spain) 10
Sauvignon Blanc,Lobster Reef(Australia) 8 2011 Pinot Nior,Terranoble,Reserva(Chile) 8
Riesling,prinz hessen(Germamy) 8 2011 Sangiovese,Sassoregale Di Marema(Italy) 8
Sauvignion Blanc,Haras De Pique(Chile) 7 2010 Chianti Classico,Rufino Ducale Riserva(Italy) 12
SPECIALTY DRINKS
TRADITIONAL PISCO SOUR,Peruvian Pisco,Fresh Lime Juice, Egg White, Simple Syrup,Bitters 10
CHMCANO,Pisco, Fresh Lime Juice,Ginger Ale,Bitters 10
PISCO PUNCH,Pisco,Fresh Pineapple,Fresh orange,Fresh Lime,Pineapple Syrup 11
CHOLOPOLITAN,Pisco,Cointreau,Cranberry and Lemon Juice 10
PISCOMOJITO,Pisco,Fresh Lime Juice,Fresh Mint Leaves, Club Soda 9
MORIR EN PISCO,Pisco,Milk,Orange Juice, Simple Syrup 8
CAIPIRINKA, Pisco,Mango, Simple Syrup, Fresh lime 9
MENAGE A TROIS,Pisco,Riesling, Simple Syrup,Fresh Lime Juice,White Seedless Ripe Grapes 11
PISCO APPLETINI,Pisco,Apple Liqueur and Apple Juice 9
PERU LIBRE,Pisco,Coke,Fresh Lime 8
DEVIL'S PUNCH,Pisco,Cinnamon,Malbec, Syrup, Fresh Lemon, Sherry 11
GOLDEN TUMI,Pisco,Tequila,Passion Fruit,Hum Liqueur,Fresh Lime,Little Egg White 11
NEGRONI,Campari,Gin, Sweet Vermouth,Prosecco(optional) 10
LEMONTINI,Absolut Citron,Limoncello,Splash Lime 10
CHOCOLATE MARTINI,Godiva Chocolate Liqueur,Absolute Vanilla,Bailey's and Kahlua 13
ESPRESSO MARTINI,Absolute Vanilla,creme de Cacao,Frangelico,Fresh Shot of Espresso 13
GRAPEFRUIT MARTINI,Fresh Squeezed Pink Grapefruit, Splash of Elder Flower Liqueur,Ketel One 13
POMARITA,Tequila,Triple Sec,Lime Juice Pomegranate Extract 10
POMEGRANATE MARTINI,Pomegranate Extract,Gray Goose,Splash Simple Syrup,Freshly Squeezed Lime 13
BEERS
Corona,Heineken,Moretti,Amstel Light, Samuels Adams 5
Budweiser,Bud Light 4
JUICES: Chicha Morada,Cranberry Juice,Apple,juice,Orange Juice 1.5
Wadlington, Ellen
From: McKean, Thomas
Sent: Friday, April 25, 2014 2:07 PM
To: McKenzie, Marybeth
Cc: Wadlington, Ellen
Subject: Fw: 592 Main St, Hyannis - Proposed Restaurant
----- Original Message -----
From: Anderson, Dave
To: McKean, Thomas; Jenkins, Ed; Amara, William
Cc: Crocker, Sharon; Shea, Sally; Parsons, Roger
Sent: Fri Apr 25 12 :44 :47 2014
Subject: 592 Main St , Hyannis - Proposed Restaurant
This office has reed a proposed grease trap installation for a proposed restaurant at 592
Main St ( rear ) , Hyannis. The proposed GT will be tied-in to muni sewer. This office
has been contacted by the bldg owner several times over the last few weeks.
Because of those conversations, I've become concerned and wish to make sure that every
Dept that needs to be contacted, has been contacted.
Has the Health Dept seen the design for the proposed grease trap ? Is the Health Dept
satisfied with the size and location of the GT ?
Has the plumbing and Building Dept seen the design for the proposed grease trap ? Are
these two Depts satisfied with the proposed design ?
If every one is comfortable with the proposed restaurant and the grease trap, I will
probably be issuing a Sewer Connection Permit within the next few weeks. Pls contact me
if you have any additional concerns or questions.
Dave Anderson
Constr Proj Inspector
Barnstable DPW
1
I _
Item: ^
•
Garland Quantity:
Project: V
G Series 36" Gas Approval: -S
Date:
Restaurant Range r
w
Models: ON
❑ G36-613 ❑ G36-6S ❑ G36-6T ❑ G36-40213 ❑ G36-2G24R ❑ G36-1153613
❑ G36-4G12S ❑ G36-2G24S ❑ G36-G36S ❑ G36-4G12T ❑ G36-2G24T ❑ G36-G36T
Uh S Standard Features: Large porcelain oven interior,fits stan-
dard sheet pans in both directions for
Large 27 (686mm)work top surface
standard ovens
Stainless steel front and sides Strong,keep-cool oven door handle /�
3 Stainless steel 5" kguard)plate rail Convection oven w/3 nickel plated oven t V
• Stainless steel backguard,w/removable. racks.and removable rack guides in lieu V)
stainless steel shelf of standard oven w/1/3HP 120v 60 Hz rt
12"(305mm)section stamped drip trays single phase fan motor,change suffix R
w/dimpled bottom to C
• 6"(152mm)adj.stainless steel legs
t"`• --- Large easy-to-use control knobs Optional Features:
ii Gas regulator ❑ Convection oven motor 240v 50/60HZQJ
4 Standard on Applicable Models: single phase
Cabinet base:in lieu of oven,suffix S ❑ Snap action modulating griddle control
• Modular top(Suffix T)with stain- 175°to 425°F r—t
less steel low profile backguard&4" ❑ Grooved griddle in 1/2 or full plate sec-
(102mm)adjustable metal legs tion widths
• Ergonomic split cast iron top ring grates ❑ Hot top 12"(305mm)plate in lieu of two
33,000 Btuh/9.67 kW 2 piece cast iron open burners,manual valve controlled
Starfire=Pro open top burner w/18,000 Btuh/5.27 kW cast iron"H"
• 5/8"(15mm)thick steel griddle plate w/ burner standard on left side
manual hi/lo valve control,23"(584mm) ❑ Low profile 9-3/8"(238mm)backguard
working depth surface,Standard on stainless steel front and sides 1 V
right,optional on left ❑ Stainless steel back for high shelf,low ► v
Model G36-6R 4-1/4"(108mm)wide grease trough profile backguard or range
18,000 Btuh/5.27 kW cast iron"H"style ❑ Additional oven racks
griddle burner per 12"(365mm)width of ❑ 6 (152mm)levelling swivel casters(4),
NOTE:Ranges supplied with casters. griddle w/front locking
must be installed with an approved 38,000 Btuh/11.13 kW cast iron"H"style ❑ Flanged deck mount_legs
restraining device. oven burner ❑ Two stainless steel doors for storage
Snap action modulating oven thermo- base models
stat low to 500•F ❑ Intermediate stainless steel shelffor
• Nickel plated oven rack and 3-position: storage base models
removable oven rack guide ❑ Celsius temperature dials
Specifications: iron"H"oven burner rated 38,000 Btuh/1:1.13 kW(natural
Gas restaurant series range with large capacity(standard) gas)Oven controlled by even bake,fast recovery snap action
.modulating oven thermostat.Available with convection oven,
oven.35 7/16' (900mrn)wide,27"(686mm)deep work top storage base or modular top model in lieu of oven.
surfaces.Stainless steel front,sides and 5"wide front rail.6"
(152mm)legs with adjustable feet.Six Starfire-Pro 2 piece,
33,000 Btuh/9.67 kW(natural gas),cast open burners set in
split cast iron ergonomic grates.Griddle or optional hot-top
with cast iron"H style burners,18,000 Btuh/5.27 kW(natural
gas) in lieu of open burners.One piece oven with porcelain • NIUS
interior and heavy duty, keep cool door handle.Heavy castC
Garland Garland Commercial Ranges Ltd
1333 East 179th Street 1177 Kamato Road,
Cleveland, 24 24110 Mississauga,Ontario Canirow0c
Phone:800-4-4242411 L4W1X4CANADA
Fax:800-624-02 18 Phone:905-624-0260
Fax:905,624-5669
G)
'Garland*
Model Total Shipping Burner Ratings(BTU/Hr/kW)
Number Description BTU/Hr Information
N Burner Natural Propane
Natural Lbs/KgCu Ft' V)
G36-613' Six OB w/26"Oven 236,000 430/195 37 Open 33,000/9.67 26,000!7.61
G36-6S Six OBs w/SB 198,000 310/141 37 Griddle/Hot Top 18,000/5.27 18,000/5.27
G36-6T Six OB MT 198,000 190/86 17 Oven 38,000/11.13 32,000/9.38 _
G36-4G12R' 12"G,Four OB w/.26"Oven 188,000 460/209 37
G36-4G12S 12"G Four OB w/SB 150,000 340/154 37 Manifold ^
G36-4G12T 12"GFour OB M GT 150,000 220/100 17 Operating Pressure )
G36-2G24R' 24"G,Two OB w/26"Oven 140,000 495/225 37 Natural Propane 1)
G36-2G24S 24"G Two OB w/S3 102,000 375/170 37 4.5"WC 10.0"WC Ln
G36-2G24T 24"GTwo OB MT 102,000 255/116 17 11 mbar 25 mbar T
G36-G36R' 36"Gw/26"Oven 92,000 530/240 37 Gas input ratings shown for installations up to 2000 �v
G36-G36S 36"G w/SB 54,000 410/186 3 ft.,(610m)above sea level.Please specify altitudes over
7 2000 ft.
G36-G36T 36"G MT 54,000 296/132 17 r�
'Available with convection oven=hange R to C
Z Ranges with Convention Ovens"C"are 57 Cu Ft Model Width Depth Height Oven Interior
OB=Open Burner, SS=Space Saver Type w/LPBG° Height Depths Width
SB=Storage Base MT=Modular Top G=Griddle Range 35-1/2" 34-1/2" 45-3/8" 13" 26" 26-1/4"
This product is not approved for residential use. Base (900mm) (876mm) (1153mm) (330mm) (660mm) (667mm)
Note:Installation clearance reductions are applicable Modular 35-1/2" 34-1/2" 25" N/A N/A N/A D
only where local codes permit. I Top (900mm) (876mm) I (654mm) I r—t
3 Convection oven base models add 3 7/8"(98mm)to the depth of the unit
6'POWER CORD 3-1/2" 4 LPBG=Low Profile Backguard 5 Convection oven depth 22"(559mm)
(FOR OPTIONAL 18` m1 2-1/4"
CONVECTION MOTOR .I�j57mm] Model Combustible Wall Clearance Entry Clearances
Type Sides Rear Crated Uncrated
Range 14" 6" 37" 361/2" Q0
27-1/4" Base (356mm) (152mm) (940mm) (927mm) rn
341/2" [692mm] Modular 6" 6" 16" 12" 1 V
[876mm] Top 1 (152 mm) I (152mm) (406mm) (305rrim)
Convection ovens with 120V,60 Hz,1 phase,3.4 amps motors are supplied
with 671829mm cord and plug(NEMA 5-15P);240V,50/60 Hz,1 phase motors
—L�
5„ are not supplied with cord and plug and must have direct connect.
127mm]
35-1/2"
[900mm] 12-1/8
9-3/8"(238mm) [307mm]
15-5/8"
21" [396mm]
1 1/2" (534mm] 18 3/8" 51"
[39mm [466mm] [1296mm]
Modular Top Side View STD BACKGUARD
3/4"N.P.T. w/4"[102mm]Adj.Legs W/HIG SHELF
REAR GA
INLET M M M
39-3/8"
30" [1000mm]
(763 m] LOW PROFILE
23" BACK UARD
[586mm]
L13-7/8"
6„ [352mm] :�a-7/8"[98mm]
152mm] ADD WHEN 31-1/8" ADDFOR
DOOR OPEN [791 mm] CONVECTION OVEN
Form#G36(01/05/11)
Garland Garland Commercial Ranges Ltd
1333 East 179th Street 1177 Kamato Road,
Cleveland,Ohio 4110 Mississauga,Ontario Canitalwoc
Phone:800-424-2411 L4W 1X4 CANADA
Fax:800-624-0218 Phon a:905-624-0260
Fax:905-624-5669
AZTEC GRILLS : '
SIX MODELS TO CHOOSE FROM,
PLUS A MODEL FOR BACKYARD GRILLING
Six different models assure that you can choose the right capacity firebox and grilling
surface for your-needs.Note that all Aztec modcls are the same depth and height.The difference
between Aztecs is in the width, giving you the choice of finding just the right model for ,
your operations. (The smallest unit is 30"wide, the largest 66'/2"wide.)The two larger ,
units have double fueling doors. We can advise you on the proper unit for your kitchen.
l'
The Rest Chefs Want the Best:
The Aztec Grill
1 While cooking times are faster than standard grills,the Aztec ,
/ Grill's controlled,moist heat is the reason foods are c
For ease of monitoring and � � tender and � ••.•� -
handling foods,the top surface
of Aztec commercial model grills
are slanted up from front to back.
29';" 30"
36" 42'/a"
4 y
a
�► ST 30 ST 36 A ST 42
;r
TRY A► LITTLE T E N D E R N E S S : Controlled Moist Heat:
Why Aztec Delivers a Flavorful Product
WHY AZTEC GRILLS DELIVER A SUPERIOR PRODUCT
w The secret of turning out such delicious foods on an Aztec Grill is in the
Grilling over a wood fire is one of the oldest and yet one of the trendiest methods of quality of the heat itself—a product of Aztec's unique,patented air-flow
system,which concentrates three kinds of cooking heat on the food:
cooking And one of the most profitable. (1)Radiant,(2)Conducted,and(3)High-Velocity Hot Air.
Since the Aztec Giill was launched in the early 1980s,Aztec has become the choice of
Americas finest chefs.Aztec continues to feed the demand as the<popularity for foods Radiant and Conducted Heat
grilled over wood just keeps growing.
The depth of the Aztec's firebox lets you control the radiant heat and
' the heat conducted by the grill surfaces.Radiant and conducted heat
Rugged Aztec Grills are designed for fuel efficiency,low fuel consumption,grilling provides 40 percent of the cooking energy.
comfort and ease, as`well as for low maintenance and longevity.What matters most,
however, is what your Aztec Grill delivers: foods that are succulent and tender, and _ I High-Velocity Hot,Moist air
imbued with a flavor that,only wood grilling;produces.
Some 60 percent of the grilling heat is high-velocity,hot,moist air,delivered
- � -
by a patented air-flow system.Air is moist because,(1)it's pulled in from
And what a varied bill of fare you can offer! Steaks, ribs, chops, tenderloin, the outside of the grill through baffles,and is therefore not dry from
seafood,poultry,fajitas,game,vegetables, fantastic burgers.Theres no limit for the pre-heating.(2)It travels 16-18 inches after heating and before reaching
creative chef, as an Aztec Grill will fire up your imagination;and know-how. ., the food and in the process is re hydrated.
f
,
r ,
.. - :. ..• ,-.- P ,. 4 � li`eworw.r 1f'fMiYWwiM
Simple, Reliable, Chef-Friendly, Cost-Effective:
Why Aztec Delivers a Profitable Product
The Aztec Grill is designed for safety, efficiency, durability and ease of use and maintenance. In a quarter century of use by America's leading chefs and
restaurants,Aztec has delivered on these benefits—which add up to a cost effectiveness and profitability.
■ Chef-Friendly , . s Simplicity Itself
Aztec Grills are easy to use .� The Aztec Grill is an insulated,
and maintain.The grilling heavy-gauge stainless steel
surface is slightly slanted up firebox in which you build a
to the rear of the rill for ease of
g fire of wood or charcoal.Open
monitoring and handling foods. rA the front-loading door to add
A stainless steel rim around
fuel.Pull out the stainless steel
grilling grates makes for easier
• • drawer at the bottom for easy
cleaning and maintenance. ash disposal.No electricity.
The Aztec has 6-inch,heavy- No moving parts.Simple.
duty locking casters for ease of
installation and for moving to a Rugged, Built to Last
clean or relocate. �r ~ , --.-- -- _--' �_-�-•.. _�_ �,.
From the inside out:the Aztec
� r i Grill is lined with heat-holding,
® Cost Effective _ ,., _ fire shielding 2-inch firebrick.
.. .x. ._ •�......�,..�...
The patented Aztec air Flow _ Then 3 inches of insulation
system assures maximum fuel f b * sandwiched between double
utilization:Aztec consumes far -- I walls of stainless steel.The
less fuel than competing grills, l'l � fuel and cooking grates are
i
but yields the most Btus per , cast heavy-duty nickel-alloy
pound of fuel than any other - - w 1 and withstand heat in excess of
wood-burning grill.And with 1500`F in sustained use.
the vertical heat dissipation,
the heat goes to the grilling , -� I "``"'"" tF
surfaces.Cooler on the griller.
Fewer breaks.
9
! k
The Aztec Grill has been carefully designed and skillfully engineered to meet the most exacting needs of every kitchen requirement.
Specifications
ITEM MODEL
Aztec ST 30 ST 36 ST 42 ST 48 ST 54 ST 66
Width—Overall 30 in. 36 in 421/o in 48 in 54 in 661/2 in
Depth—Overall 29/e in. 293/4 in 291/sin 29/e in 29/s in 29/s in
Height—with Legs 37 in.—back 37 in.—back 37 in.—back 37 in.—back 37 in.—back 37 in.—back
34 in.—front 34 in.—front 34 in.—front 34 in.—front 34 in.—front 34 in.—front
Height—without Legs 27 in.—back 27 in.—back 27 in.—back 27 in.—back 27 in.—back 27 in.—back
24 in.—front 24 in.—front 24 in.—front 24 in.—front 24 in.—front 24 in.—front
Number of Cooking Grates 4 5 6 7 8 10
Size of Cooking Grates 53/4 in.x 24 in 53/o in x 24 in 53/4 in x 24 in S'/a in x 24 in 53/o in x 24 in 53/o in x 24 in
Cooking Surface 576 sq.in. 720 sq.in. 864 sq.in 962 sq.in 1152 sq.in 1440 sq.in
Number of Fuel Grates 4 6 7 9 10 13
Size of Fuel Grates 4 in.x 197/e in. 4 in x 197/8 in 4 in 4 in x 197/8 in 4 in x 197/e in 4 in x 197/e in
Interior Body Construction 12 ga.C.R.S. 12 ga C.R.S. 12 ga C.R.S. 12 ga CRS 12 ga C.R.S. 12 ga C.R.S.
Exterior Body Construction 14 ga.Stainless Steel 14 ga Stainless Steel 14 ga Stainless Steel 14 ga Stainless Steel 14 ga Stainless Steel 14 ga Stainless Steel
Standard Finish Stainless Steel Stainless Steel Stainless Steel Stainless Steel Stainless Steel Stainless Steel
cfms Required 1450 1600 1725 1975 2175 2475
Shipping Weight 500 lbs. 600 Ibs 700 lbs 785 tbs. 875 tbs. 1,000 lbs
e Easy Operation a No Electricity Required Best Warranty in the Industry
m Front Loading a Portability 3 Year Limited Warranty
® Chef-friendly Heat Concentration o Perfect Grilling of Many Types
Aztec Grill warrants its standard
m Low Fuel Consumption of Food grill to its original purchaser to
o Simple Ash Disposal o Operates on Variety of Fuels - repair or replace at its option,
e Stainless Steel Finish Wood, Coal, Charcoal any part found to be defective
in material or workmanship
f with the exception of*grates,
wamodc Mersey ! bricks, casters and brick
�
retainer ca p.
V * *90 day warranty applies to these parts
P.O.Box 820037 Dallas,Texas 75382 1 214.343.1897 1 1.800.346.8114 1 Fax 214.341.9996
www.aztecgrill.com
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1
Annex OM ES
Approximately 3,352 &rnss Square Feet
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' # 586
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5:
GREASE TRAP PLAN
59k(R) MAW STREET
HYANMS, MA
Scale:I*=20'
0 10 20 30 40 50 FEET
\\SERVER\Land Projects 20071BARNSTA3lE GIAdwg\base30g GTAv%11x17,2/2WWl49.1222 PM,Tabbid,l:1
Item #
6 Quantity
C.S.I. Section 1140(
%IIHOBART/ AM SELECT =
701 S Ridge Avenue,Troy,OH 45374 DISHWASHER O
1-888-4HOBART•www.hobartcorp.com
STANDARD FEATURES MODEL
■ .74 gallons per rack final rinse water ❑ AM15
■ 58 racks per hour—hot water sanitizing
■ 65 racks per hour—chemical sanitizing OPTIONS AT EXTRA COST
■ NSF pot and pan listed for 2-, 4-&6- minute ❑ Gas heat
cycles ❑ Sense-A-Temp'" 70°F rise electric booster heater
■ Timed wash cycles for 1, 2, 4 or 6 minutes ❑ Single point electrical connection for booster
■ Solid state, integrated controls with digital status equipped machines(3 phase only)
indicators
■ Self-draining, high efficlency stainless steel pump
and stainless steel impeller ACCESSORIES
■ Stainless steel drawn tank, tank shelf, chamber, ❑ 1/4" pressure regulator valve
trim panels, frame and feet ❑ Peg rack
■ Spring counterbalanced chamber with ❑ Combination rack
polyethylene guides ❑ Splash shield for corner installations
■ Revolving, interchangeable upper and lower anti- ❑ Flanged and seismic feet
clogging wash arms ❑ End of cycle audible alarm (field activated)
■ Revolving, interchangeable upper and lower rinse ❑ Delime notification (field activated)
arms
❑ Drain water tempering kit
■ Slanted, self-locating, one-piece scrap screen
and basket system Specifications,Details and Dimensions on Inside and Back.
■ Automatic fill
■ Door actuated start r,
■ Automatic drain closure
■ Vent fan control NSF. c �L us m
■ External booster activation LISTED ® mE"aeP
■ Delime cycle D
■ Service diagnostics
■ NAFEM Data Protocol capable
■ Straight-through or corner installation m
■ Hot water or chemical sanitation m
n
VOLTAGE
� v
❑ 208-240/60/1 '
❑ 208-240/60/3 '`
❑ 480/60/3 u`�
❑ 200-240/50/3*
❑ 380-415/50/3* D
"Not submitted for UUCUL Listing 2
m
F-40078—AM Select Dishwasher Page 1 of 8
4
F
M SELECT HOBARTISHWASHER 701 S Ridge Avenue,Troy,OH 45374
1-888-4HOBART•www.hobartcorp.com
The microcomputer-based control system is built into the WASH: Hobart revolving stainless steel wash arms with un-
AM Select dishwasher. It is available in standard electrical restricted openings above and below provide thorough distri-
specifications of 208-240/60/1,208-240/60/3,480/60/3, bution of water jets to all dishware surfaces.Arms are easily
200-240/50/3,380-415/50/3 and is equipped with a reduced removable for cleaning and are interchangeable.Stainless steel
voltage pilot circuit transformer. tubing manifold connects upper and lower spray system.
*CAUTION:CERTAIN MATERIALS,INCLUDING SILVER, RINSE:Rotating rinse arms, both upper and lower,feature 14
ALUMINUM AND PEWTER ARE ATTACKED BY SODIUM rinse nozzles.The stainless steel upper and lower rinse arms
HYPOCHLORITE(LIQUID BLEACH)IN THE CHEMICAL are easily removable without tools for inspection and are
SANITIZING DISHWASHER MODE OF OPERATION.WATER interchangeable. Diaphragm-type rinse control solenoid valve
HARDNESS MUST BE CONTROLLED TO 4-6 GRAINS FOR mounted outside machine. Machine is equipped with special hot
BEST RESULTS. water vacuum breaker on downstream side of rinse valve-
CONSTRUCTION:Drawn tank,tank shelf and feet constructed mounted 6" above uppermost rinse opening. Easy open brass
of 16 gauge stainless steel.Wash chamber and front trim panel line strainer furnished.
above motor compartment are polished,satin finish.Frame is FILL: Microcomputer controlled fill valve installed on upstream
12 gauge stainless steel,chamber is 18 gauge,and removable side of rinse vacuum breaker. Ratio fill method is used giving
trim panels are 20 gauge. the correct fill at any flowing water pressure.(20 PSIG minimum
CHAMBER LIFT:Chamber coupled by stainless steel handle, necessary for proper rinsing.)
spring counterbalanced.Chamber guided for ease of operation DRAIN AND OVERFLOW:Large bell type automatic overflow
and long life. and drain valve controlled from inside of machine. Drain
PUMP:With stainless steel pump and impeller, integral with automatically closed by lowering chamber. Drain seal is large
motor assures alignment and quiet operation.Pump shaft seal diameter, high temperature"O"ring.Cover for overflow is
with stainless steel parts and a carbon ceramic sealing interface. integral part of the standpipe.
Easily removable impeller housing permits ease of inspection. STRAINER SYSTEM: Equipped with large,exclusive self-flush-
Capacity 160 GPM. Pump is completely self-draining. ing,easily removable perforated stainless steel,one-piece
MOTOR: Built for Hobart,2 H.P.,with inherent thermal strainer and large capacity scrap basket.Submerged scrap
protection,grease-packed ball bearings,splash-proof design, basket minimizes frequent removal and cleaning.
ventilated.Single-phase is capacitor-start, induction-run type. HEATING EQUIPMENT:Standard tank heat is 5KW electric
Three-phase is squirrel-cage, induction type. -immersion heating element. Regulated power infrared gas
MICROCOMPUTER CONTROL SYSTEM: Hobart immersion tube system is optional at extra cost.A solid-state
microcomputer controls,assembled within water-resistant igniter board controls the gas valve and provides flame ignition.
enclosure, provide built-in performance and reliability. A transformer steps the control circuit voltage down to 24 volts
The microcomputer control,relays and contactors are housed to power the igniter board and gas valves.
behind a stainless steel enclosure, hinged to provide easy Gas Heated Dishwasher: For natural gas,gas pressure
access for servicing.The line voltage electrical components are (customer connection)not to exceed 7"W.C. For liquefied
completely wired with 105*C,600V thermoplastic insulated wire petroleum,gas pressure to burner(customer connection)not to
with stranded conductors and routed through listed electrical exceed 11"W.C. If gas pressure is higher than 7"W.C.natural
conduit. Electrical components are wired with type ST cord. or 11"W.C. LP,a pressure regulating valve must be supplied
Line disconnect switch NOT furnished. (by others)in the gas line to the dishwasher.Water temperature
CYCLE OPERATION:The microcomputer-timing program is regulation is controlled by thermistor sensor in combination with
started by closing the doors,which actuates the door cycle microcomputer controls.The tank heat and positive low water
switch.The microcomputer energizes the wash pump motor protection microcomputer circuits are automatically activated
contactor during the wash portion of the program.After the when the main power switch is turned"on". If tank is accidental-
wash,a dwell permits the upper wash manifold to drain.At the ly drained, low water protection device automatically turns heat
end of the dwell,the final rinse solenoid valve is energized.After off.Gas immersion tube is additionally protected by a high limit
the final rinse valve closes,Sani-Dwell(Hot Water Mode only) device mounted on the surface of the tube.These features are
permits sanitization to continue.The Rinse display remains on standard with the Hobart Microcomputer Control System.
during this period,completing the program. If the microcom- OPTIONAL EQUIPMENT AT EXTRA COST-ELECTRIC
puter is interrupted during a cycle by the door-cycle switch, BOOSTER HEATER:Electric booster with Sense-A-TempTM
the microcomputer is reset to the beginning of the program. technology adequately sized to raise 110°F inlet water to 180OF
Hot Water Sanitizing(58 racks per hour)-57 seconds:38 (not available on gas heat machines).
Second Wash,2 Second Dwell,10 Second Rinse,7 Second ACCESSORIES: 191/4"x 19%" peg and combination dish racks.
Sani-Dwell.Chemical Sanitizing(65 racks per hour)-50 Splash shield for corner installations.End of cycle audible alarm
Seconds:38 Second Wash,2 Second Dwell, 10 Second Rinse. (field activated). Delime notification(field activated). Desirable
Other programs can be pre-selected by your Hobart service functional accessories can be furnished at added cost.See
technician. listed options and accessories on this specification sheet.Write
Manual wash cycle selector also provides selection of 2-,4-or to the factory for special requirements not listed above.
6-minute wash cycles for heavier washing applications.
As continued product improvement is a policy of Hobart,specifications are subject to change without notice.
Page 8 of 8 F-40078-AM Select Dishwasher
F-40078(REV.05/11) LITHO IN U.S.A.(H-01) 10 Printed On Recycled Paper
PERUVIAN CEVICHE
Ceviche ("seh-BEE-chay") is a hugely popular dish in South America. The basic ingredient is raw fish,
cut into bite-size pieces and marinated in the juice of an acidic fruit (usually lime), salt, and seasonings
(usually chile peppers). The citric acid in the juice changes the texture of the fish, without changing its
"raw" taste. Ceviche is an old tradition in South America, dating back to the earliest inhabitants. The
Incas preserved their fish with fruit juice, salt and chile peppers, and later the Spanish conquerors
introduced the now essential limes
I
KEYWORDS
All numbers with (')and(") mean distance from each other, and measurement from one side to the
other.
A : 1 woodburning grill 42"x29" ,2 fryers 2 'long xl'2"each ,2 6 burners stove standar oven
5'9x2'4"and blogget pizza oven 5' long x 3" wide
B: stailess steel hood fan for woodburning grill 4' long x 3'6wide and 1 F hoodfan x3'6 for,fryers,stove
and oven
C: 2 Rack shelving 72 " long x 18"wide x 6" high ,and F distace from each other
D : 3 'x 1'8x 5'high enployess loker
E : Mop Sink T long x 1'8" x 36" high
F: 1 reach-in refrigerator 2 door 4'6"x2'3" ,and 1 reach-in refrigerator 3 door 5'6" x2'3" and 7"high
G: lreach-in freezer 2 door 4'6x2'3" and Thigh
H: 3 bay sink 5'9"x 2'6" wide.......Sanitizing conpartment ...18"x18 "bowl ��-CL �����lS
I : Rince compartment 18" x 18" tk
J : Wash compartment 18"18" Ov� � S t �
K : 3 bay prep sink 5'9"x2'6 wide ..18x 18" bowl
L: Diswasher area , 6long x 5' wide, and 24"x24"wash sinkspray, water system , dishwasher24"x24"
M:diswasher machine low temp 24x 25, " " 7 r vn�"t w +
i •N. Clean area 24x24 Clean table plates 32 2
U,
P x3
P: 2 Distance from prep sink
F5" Distance from 3 bay sink and diswasher
R: 4'x2'prep table, and 2' distance from wash hand sink and F distance from prep table
S: Distance between sinks and coolers 73"
T: Distance between dish area and coolers 49" walk way
U : FF handwash sink distance from prep sink
V: 2 Handwash sinks 1'5x1'5 ,all handwash sink will have, automatic paper towel dispenser
W: 1'5" Distance handwash sink from pizza oven
X: 1 , 2 door sandwich unit standA top 44"00" and 1 for ceviche bar same dimencions
Y: 2, 3 door sandwich unit standar top 72"x29"
Pl: 15' long x 3'wide ,kitchen walk line , and 9'long x 3'wide kitchen to dining room
P2:4'6" walk way in to the kitchen
P3: 15' long x 3' wide hallway between bantrooms
HE 23" long x20 wide 1 conperment sink
RE cold plate ice bin 28" long 00" wide
Vl:handwash sink bar 1'5"xl'5"
Ll:bar dishwasher 24"x24"
X1:bar beer cooler 4' long x21/3" wide
P4: 12' long x3'wide walk line behind bar
P5: walk way behind ceviche bar , 9' long and 3'6" wide
1" BEHIND BAR :1 ' distance fron each other
C2: 4'wall long x2" wide and 40"high
P6: 2' distance from ceviche bar to small kitchen wall fromC2
C3:8'long x Pwide and 5'high,wood stained shelving
All bathrooms,toilets,handwash sink automatic sensor,automatic sensor tawell dispensor,attached
lids paper can,hand soaps,and mirrors.
a: 4 toilets
b: 4 hand wash sink
d. 6, 10"x 10"round attached lids paper cans -jv S(`- Ca-v-\
e: 1, trash can,l'5"long zl'wide x2'7"high
g: I,trash can,1'5"long xl'widex2'7"high
m: ],trash barrel 2'x2'round,and 4'distance from sanitaiser compartment sink
h: l,soup warmer 1'101/a"long x1'2112 "wide
g: trash can for outside 6'21h"long x 5'6112"wide,fenced all aroud.
TUMI CEVICHE BAR RISTORANTE
FLOOR
KITCHEN : 40x 12 Quarry Tile
STORAGE : 25x13x5 Vinyl, Commercial VCT
BATHROOMS 4 Bath ,2 7x5and the other 2 ,7x6 and 140 hallway ,Vinyl ,Commercial VCT
BAR,CEVICHE BAR Bar,12x6 ,Quarry Tile .Ceviche Bar 9x6 ,Quarry Tile
WALLS
KITCHEN : 18x8. stainless steel wall fJ ,�,,
FOOD PREP : ALL WALLS ,FIBERGLASS ,20x7 h U'?
STORAGE :ALL WALLS ,FIBERGLASS,20x7 hr��
BATHROOMS :ALL WALS ,DRY WALLS AND FIBE GLASS ,4 BATH ,2,7X6 AND
2, 7X5 X9 H
BAR 8f x Behind the bar,fiberglass
CEALING
KITCHEN : 40x 12 Dry-Wall Epoxy
STORAGE :1Ox15 Dry-Wall Epoxy
BATHROOMS :All bathrooms ,Dry-Wall Epoxy
BAR,CEVICHE BAR : 14X6 bar ,Dry-wall Epoxy, 9x6 Ceviche Bar Dry wall Epoxy
NEW KITCHEN WALL,BATHROOMS WALL
25 ft kitchen wall ,2x6wide x9'highwall ,Dry-Wall ,fiberglass
4 bathrooms ,2bath 60'and 2x4" widewall, 9' high and 3' doors ... and the other two
7x5', 2x4"wide x9' high walls and 2'7 doors
HAND WASH SINKS : TOTAL 7
4 automatic sensors sinks for restrooms and 2 hand washers sink for food prep.All hand washer
sinks
automatic sensors,and one for the bar
(00/4& Ile (uG�'o� S�STevi^l. �e` �- G�JSi� c�t�aY�Scx DiS �d,SJe
Town of Barnstable 4731
Department of Public Works Permit Number
Sewer Connection 8t Trench Opening Permit
Connection Disconnect Mod or Repair X
Map It Parcel# : 308 - 73 - 01 Water Supplier DPW - Water Div
Street 592 Main Street ( rear ) Sewer Account#
Village Hyannis_ Permit Fee Et check# : $ 50.00 Chck # 6110
1. Residential Bldg Fee-$420.00 ; Commercial/Industrial IBldg Fee-$875.00
Septic Abandonment Permit# N/A 2. Surcharge for Each Additional Bldg on Same Service-$200.00
3. Surcharge for Pump Station-$300.00
4. Minor Repair or Disconnect of Existing Service-$50.00
Project Contact Information
Contractor Name : Robt B Our Co Inc
Owner Name : S Ravelson - 592 Main LLC Contact Name : Abby Our Rose
Mailing Address : 22 Comeau Street Business Address : 24 Great Western Road
Wellesley , Mass 02481 Harwich , Mass 02645
Contact Phone : 508 - 432 - 0530
Telephone : 781 - 237 - 9522 Contact Fax : 508 - 432 - 4385
Property Use Information
Residential : Commercial : FX--1 Commercial Use : Restaurant
Industrial Standard Industrial Code
Number of Bldgs 1 Size of Parcel (acres) 1/4 Acres
Pipe Dia Er Material 4" SDR35 Pipe Length
Before excavating in a Town Way or on Town owned property, the sewer installer must obtain a Road Opening/Trench
Permit and comply with the Construction Standards£t Specifications outlined therein. Applicant must notify DPW
48 hours prior to installation. Failure to comply with the regulations shall be grounds to revoke this permit.
The Sewer Et Trench Permit is valid for 180 calendar days from DPW approval and the installation must be completed within
that time period. Engineered drawings must be submitted, with this application form, to the DPW for all commercial or
industrial installations. The drawings must be approved before a permit will be issued.
Contractor Signature Ex Date : Abiggail Rose 5/2/2014
DPW Approval Signature a Date : Barb A Childs 5/2/2014
Sewer Permit Expires : Nov , 2014
Sewer Connection Form (Rev; 2010) Page :: 1 of 4
r TOWN OF BARNSTABLE
Date: 05/02/14 DEPARTMENT OF PUBLIC WORKS Permit: 4731
SEWER CONNECTION COMPLIANCE
Installer: Robt B Our Co Inc
Property Owner: S Ravelson - 592 Main LLC
Property Location: 592 Main Street ( rear ) Village: Hyannis
Map It Parcel : 308 - 73 - 01 Pipe Length: 11 ft Pipe Dia&Material: 4 C 4
The work has been done in conformance with the Rules and Regulations of the Department of Public Works
Signature: DJ Anderson Date: 20-May-14
Department of Public Works
See Attached Sheet
for
Sketch
Sewer Connection Form (Rev; 2010) Page 1 of 4
Town of Barnstable , Mass
Department of Public Works
,,at
3. I O
Him Elev- 2.46
Inv E1P2.21 tied-In
J�M&P 308 - 73 - 1 _ May16,2014
d I jj (� cicieao.�:jI — —
7 tT #592 at 4 it deep 6I 3,000 gat GT
7 �
yj
CD I (p 4' Xh40
CD
L --J MH 1-78.4 No
Existing 2-Water
(SheetA7) — North Street
Wye 3.64.5
Wye 0,00 No / I Parking Lot
I
O Wye 1M7 No
i #586 / I
I To North Street --- >
II MM0-32No M&P 308 - 68
o
Existing MH _
I
Plan View
Scale: 1"=30'
Grease Trap Installation for
592 Main Street , Hyannis
I
A .• , ,
��mEry Town of Barnstable
t Regulatory Services Department
-
s M l 200 Main Street,Hyannis MA G2601
PLICATION FOR OUTSIDE DINING/SIDEWALK CAFE
LOCATIO
Property Address: `� 2 ('2 cS i�t 3 1'� ( (.4 Ycr n'z'3
Name of Establishment: a y Nt. r DO V�1y A/ Aa S 1 cr✓l 1
APPLICANTS NAME: vd,,AQ ii _ Phone# -3
' SEATING � �V
FACILITIES/EQUIPMENT
Total#of Seats Existing Q #of Rest rooms Provided
Size of Grease Trap
Total#of Seats Proposed Air GVrtains(Yes or No) 2S
(Total means overall number of seats indoors'and outdoors) Hose Bib (Yes or No) -_
Screens (Yes or No) %
Brief Description of Seating Arrangement,Type of Furniture Proposed,Hours of Operation,Projected
Op and Closing Date
s1-4
Uwe the undersigned certify that the above information which Uwe provided is correct. Uwe have read and
fully understand the procedures as established by the Town of Barnstable in accordance with Chapter II,
Article 8,Section 2 of the General Bylaws and the Board of Health Regulation#14.,and further
understand that failure to comply with said procedures may result in the immediate revocation of this
permit
Signature of Applicant(s): A i Date: 5
Date:
IlYIPO:3Copies
NT-PLEASE REllliEllriBER TO INCLUDE:
opies of the Neatly Drawn Sketch Plan of the Outside Dining Area Showing Separation
ances to Curbing,Trees,Rubbish Containers and any other Obstacles in Pedestrian Walkway
of Pictures.of.the Proposed Outside Dining Location(Front and Side Views)
opy of the Menu
THIS SECTION BELOW IS FOR OFFICIAL USE ONLY
Town Manager Approval: Public Health Division:
Licensing Board Approval: Certificate of Insurance:
License Agreement:
Comments:
(OVER)
1
BOARD OF HEALTH REGULATION,PART II,STCTION 1.00,914,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 ConaLn�TictuaUer's License.
•1
(d) 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.
(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 kept
outside. All food must be prepared inside the facility's kitchen and kept inside until served.
(g) 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.
(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 adequate
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 in a
clean and sanitary condition.
(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. r
(I) 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 Massachusetts,
Department of Health Sanitary Code.
(m) Outside food handlers must have easy access to handwash sinks and cleaning cloths. Facilities for
preparation and disposal of sanitizing solutions must be.accessible. I
i
(n) 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.
i
r
Invoice
Fire&Water- Cleanup& RestorationTM' Date Invoice#
Emjay,Inc. DBA 11/13/2020 699
SERVPRO®of Mid-Outer Cape Cod
PO Box 2110
South Dennis,MA 02660
Office:50.8-778-7378
Bill To: Job Address:
Tumi Ceviche Bar&Ristorante 592 Main Street
George Siguencia Hyannis MA 02601
508-360-9521
siguencia23@gmail.com
tumiceviche@gmail.com
Terms Job Date Rep Location
50%in Advance
Balance upon 11/12/20 MJ 10877
completion
Description Amount
Disinfect restaurant consisting of approximately 1800 sqft including customer seating, $ , 900 00•
bar,kitchen,and rest rooms
1)Cleaning and disinfectant wipe down of high touch surfaces including tables,chairs,
countertops,bar and kitchen fixtures,appliance exteriors,cabinet door handles , ,
bathroom fixtures, door handles,light switches,and handrails
2 Disinfectant misting fog of accessible interior surfaces including walls,floors,
and furniture
k"
E Y
'✓' ^au«9 ems..
Total
Payments/Credits -
Balance Due $ 900 00
N
Each SERVPRO®Franchise is Independently Owned and Operated
Please Note: Credit card payments will show as Emjay, Inc.on your transaction register
R•- •v a ,f n
-;
Town of Barnstable , Mass
Department of Public Works
i p
SL32.46�
Rimnv I tied in - l
M&P 308 - - May16,2°"
73 1
I
n
NI - #592 at 4 it deep 1 3,000 gal GT .
�
4' $ch90
(D
MH 1178.4 No
Existing 2'Water
(Si,eet A7, North Street
Wye 3-64.5
Wye 0
.00 No I I - Parking Lot
............. I p
Wye 1«7 No / I
I #586
_ ► To North Street --- >
MH 0..32 No /
M&P 308 - 68
' Existing MH / Q •')
I
l
I
Plan View
Scale: t"=30•
Grease Trap Installation for
592 Main Street , Hyannis
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Message A Page 1 of 1
l
Miorandi, Donna
From: Anderson, Dave
Sent: Tuesday, September 22, 2015 11:26 AM
To: Miorandi, Donna
Subject: RE: Grease Trap connection
A 4" Cl pipe was installed, from a 3,000 gal grease trap up to and in to the front section of the
bldg, in May, 2014. 1 was satisfied with the outside work performed by the contractor.
Any work, to connect the front section of the bldg to the grease trap, would have been interior
work. I'm assuming that a 'Plumbing Permit' was pulled for that work and that it was inspected
by the plumbing inspectcr.
I was not involved connecting the front section of the bidg, because it should have been all
done on the inside.
DJA
-----Original Message-----
From: Miorandi, Donna
Sent: Tuesday, September 22, 2015 9:10 AM
To: Anderson, Dave
Subject: Grease Trap connection
Good Morning Dave: ;,an you tell me has the new French bakery "C'est La Vie" located at 592 Main St.,
Hyannis connected to the grease trap?
Thanks! They want to open this Saturday!!
Donna Miorandi
9/22/2015
L
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BUILDING t 71TLE:
__ EX. PLANTER EX. PLANTER
FLOOR PLAN
NEW 48" HIGH
METAL GATE
DATE ISSUED:
12/03/2014
PROPOSED FLOOR PLAN : a' REVISION&
DRAWN BY.
PROJECT
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NEW 48' HIGH
METAL GATE
DATE ISSUED:
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P 0P05ED FLOOR PLAN /^ REVISIONS
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