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Home My WebLink AboutCAPE FISH & LOBSTER CO. - FOOD CAPE FISH & LOBSTER CO. M 14 �4q 33 ..,_M W._Main St.,`HYM�S - i Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARNSTABLE. F.P.(Thomas)Lee,. MASaS Daniel Luczkow,M.D. Alt. 200 Main Street, Hyannis, MA 02601 A ° A Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30513, 146, 189 and 189A; Chapter 111,Sections 5 and 127A, a permit is hereby granted to: Permit No: 999 Issue Date: 01/01/2022 DBA: CAPE FISH & LOBSTER CO. OWNER: JOHN CARDARELLI Location of Establishment: 626 WEST MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: RETAIL WITH FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $200.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE- ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: j PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE I Restrictions: � oFTHe r Initials:� Town of Barnstable Date Paid Amt Pd$D__ I BARNSPABLE, Inspectional Services 9� Od Public Health Division check# ArEo�r p Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: C R aP li S h (L1'� LybS mil" ADDRESS OF FOOD ESTABLISHMENT: lQZ(P W eSfi m Ct, 1 Yt MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: 3-ray-G, CLr el 1 Cap�Q-GI sG, r,r,d 10105+e r - CD►M f TELEPHONE NUMBER OF FOOD ESTABLISHMENT: S( dS)-7-11 TOTAL NUMBER OF BATHROOMS: WELL.WATER: YES NO x ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: }c SEASONAL: DATES OF OPERATION: / / 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 REOUIREMI NTS. 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*** REOUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q\Application FormsTOODAPP 2020.doc OWNER INFORMATION: r FULL NAME OF APPLICANT 10 r 4 SOLE OWNER: YES/NO D.O.B OWNER PHONE # ADDRESS / CORPORATE OWNER: c►//f— �,17 S r CORPORATE ADDRESS: r-aU Q LS - �/r 16 S PERSON IN CHARGE OF DAILY OPERATIONS: List (2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Diva will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. A-A&%r Mu(+I riS l lotd 31. C.a ✓ MAf*inS (' 2. SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments, including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at htti)://www.townofbarnstable.us/healthdivision/applications.asi). OUTDOOR COOKING: Outdoor cooking,preparation, or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec. 31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc TOWN OF BARNSTABLE HEALTH INSPECTOR-s Establishment Name: Date: Page: _of ' . %h OFFICE HOURS BARNSTABLE p. PUBLIC 0 MAN STREEETSION 3: -s:30 A.M. :300-4:30 P.M.- .M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � HYANNIS,MA 02601 M-8 -FRI. No Reference: R-Red Item PLEASE PRINT CLEARLY FOOD ESTABLISHMENT INSPECTION REPORT sobs2 asaa Name Date 2 Tyve o Type of Inspection ^' Address Risk pod Service e-inspectlo Level Retail Previous nspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP YIN Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: rV`1OtherInspector � Out: Each violation checked requir s an explanation on the narrative page(s)and a citation of specific provision(s)violated. Y� Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Atr /'l 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 Q ❑ 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) S j 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 checked indicate violations of 105 CMR 590.000/Federal Food Code. 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 4npn-critical violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to 8 non-critical violations=C. 3 .Other DATE OF RE-INSPECTION: Inspector's Ignature Print/ 31.Dumpster screened from public view l/ Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered #Seats Observed Frozen Dessert Machines: Outside Dining Y Pr in N PI t: 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) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each p 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 590.003(C) Responsibility of the Person-in-Charge to 7-]02.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g * 20 Time as a Public Health Control O Responsibility Employee 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use 590.003 F Res onsibilit 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) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations * 3-201.12 Food in a HermeticallySealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 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 -601.11 A Clean Utensils and Food Contact Surfaces of * Animal Foods That are Raw,Undercooked or 4 5-101.11 Drinking Water from an Approved System* ( ) Eggs-Immediate Service 145°F 15 sec Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Eff cti a 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 incater- 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( ) ( ) ( )- * - 10 Ratites-165°F 15 sec* in mobile food,temporary and reside ntial Sources 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. * 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 ( )( )( ) 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding Requ rementpractices sld 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 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 * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) € illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* L18 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 Supplied with Soap and hand Drying Devices Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements .009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. �np114E Tp TOWN OF BARNSTABLE, _. HEALTH INSPECTOR'S Establishment Name: Date: Page:_ ( of OFFICE HOURS -�- ,, ° PUBLIC HEALTH DIVISION 8:00-9.30'A.M. BARN STABLE. • 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified p e39. �0� - HYANNIS,MA 02601 sos-asz-4sa4 No Reference R.--Red_Item PLEASE PRINT CLEARLY ,FDMP, FOOD ESTABLISHMENT INSPECTION REPORT Name . ` Date LID Type of T fInspection 7V1.1- Routine AddressLe `�S�' Risk Food Servi rl = ection ] Level a ad Previous Inspection Telephone Residential Kitchen S Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness LL ,h Caterer General Complaint Jam' I ` )" Person in Charge(PIC) Time Bed&Breakfast HACCP �. C In: Other Inspector � I Out: _1,d Each violation checked re uires an explanation on the narrative page(s)and a citation of specific provision(s)violated. h� 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 O ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals .n 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 n �� ,_ / _ 4 _ ! AkAK��I ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding Alt r '/tA 4J C,Q, f�/ /Ifi3' PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control j J I (X�7 l ❑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 ne- ❑ 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 f within 90 days as determined by the Board of Health. `� ` ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an nSpec ion today,the items Embargo checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (16-3)(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 6=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-7j(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, 29.Special Requirements (590.009) within 10 days of receipt of this order. o 8 non-critical violations=C. Print:" Sig ature 30.Other DATE OF RE-INSPECTION: Inspect 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 ature 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 4� Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) l FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION f PROTECTION FROM CHEMICALS 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) Assignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Law Cooled to 41'F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.42 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 590.004(F) Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45'F EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590,003(C) Responsibility of the Person-in-Charge to Other* * 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7-20 Require Reporting by Food Employees and Contamination from the Environment 7-]01.11.11 Separation-Storage* Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* � p g 20 Time as a Public Health Control 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* _ Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetical] Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served* Y P 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of Eggs F 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' 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* Effective 11112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 see* 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 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* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 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 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercial] Processed RTE Food-140•F* (Blue Items 23-30) 3-202.15 Package Integrity Y Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3-403.11E Remaining Unsliced Portions of Beef Roasts* 3-101.11 Food Safe and Unadulterated ( ) g illness interventions and risk factors listed above,can be found in the 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 3-202.18 Shellstock Identification* 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 1590.000 3-203.12 Shellstock Identification Maintained* Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 * 5-205.11 Accessibility,Operation and Maintenance 3-402.12 Records,Creation and Retention Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. 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. °pIME rotiti TOWN OF BARNSTABLE _ HEALTH,INSPECTOR•s Establishment Name: Date OFFICE HOURS r Pa ge:Z of PUBLIC HEALTH DIVISION s 00'9:30'A.M. BARNSTABLE. • 200 MAIN STREET , 3 30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. �r MON.-FRI. �p 039..0 HYANNIS,MA 02601 sob-8s2 4s4a No Reference R-Red Item PLEASE PRINT CLEARLY, , 'FDN1P` FOOD ESTABLISHMENT INSP CTION REPORT Name � �Q/ Date to Type of TYPe of Inspection w��i , ` � r U cvv� kt� f I I Operation(s) Routine rA Address I ,Ji1 Risk Food Service Re-inspection t/" Level Retail . Previous Inspection `� Telephone Residential Kitchen Date: \ �. Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness l�Girl.✓ ,i Caterer General Complaint L I Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other ts Inspector Out: ""� 1/lCLPI L,4, l ✓tC' 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 0 ❑ 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 r( O ,� q a - FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) �(�� 77 ❑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 El Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating y ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N - Official Order for Correction:Based on an inspection today,the items Embargo❑ 9 ❑ Emergency Closure Voluntary Disposal Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. g y ❑ ry p ❑ 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations B=One critical violation and less than 4 non-critical violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC-7 590.008 g = 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 non-critical violations C. 30.Other DATE OF RE-INSPECTION: Inspector' ignature - Print: d �' 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N pIC I na ure Print: #Seats Observed Frozen Dessert Machines: Outside Dining Y N g 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) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Aiiimal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 2 590.003(C) Responsibility of the Person-in-Charge[0 7-102.11 Common Name-Working Containers* 3-501.16(A) Hot PHFs Maintained At or Above 140°F Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 Separation-Storage* Applicants* 3-302.11(A)- Food Protection* P g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) � Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004(]]) Variance Requirements 590.003(G) Reporting by Person in Charge * 3-304.11 Food Contact with Equipment and Utensils 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 or 590.003(E) Removal of Exclusions and Restrictions g 3-306.14(A)(B)Returned Food and Reservi of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP � Disposition of Adulterated or Contaminated Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004 A-B Compliance with Food Law* * 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 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* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°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* E&,ra�uuzooi 4-602.11 Cleaning Frequency of Utensils and Food Animals-OFF 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 * 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec Shellfish* 3-40L11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section temporary and - ide in cater- Ratites-165°F IS sec* Sources* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodbome illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity* g 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 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 an P d Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients' Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 1 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* 5:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. `Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. IIE► TOWN OF BARNSTABLE HEALTH INSPECTOR,s Establishment N of � ame: ��1�-'Date: 10151 11. Page: of 1 OFFICE HOURS ' BARNE.O` J- PUBLIC OMA N LSTRTH DEETSION 8:00-9:30 A.M. - 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS.�679• HYANNIS,MA 02601 MON.-FRI.� 508�62-0644 No Reference R-Red Item PLEASE PRINT CLEARLY - „rFD MPS a FO D ESTABLISHMENT INSP C ION REPORT Name Date Tyoe of Type of Inspection Routine Address Risk Food Service Re-inspecti n 19 Level Previo pgc' Telephone Residential Kitchen Date: Ica, Mobile Owner HACCP Y/N Temporary Suspect Illness Caterer nt Person in C e(PIC) Cy Time Bed&Breakfast HACCP Other InspectOLVONN _0 fn Each violation checked requires an explanation on the narrative age(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 :jw .f - n ❑3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) 1714.Food and Water from Approved Source ❑ 16.Cooking Temperatures i ❑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 r J V ❑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.ProperAdequateHandwashing CONSUMER ADVISORY I 't)hh ❑ 11.Good Hygienic Practices ❑22.Posting of Consumer Advisories LJ✓ 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 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-cr'Ical viol lions. If 1 critical refrigeration. 28.Poisonous or Toxic Materials (FC 7)(590.008) 9 vl on,4 to 8 non-critical violat' ns= 29.Special Requirements (590.009) within 10 days of receipt of this order. c 30.Other DATE OF RE-INSPECTION: Ins ctor's ure 31.Dumpster screened from public view . Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N 'v #Seats Observed Frozen Dessert Machines: Outside Dining Y N C's nature 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 ColorAddltives Law Cooled to 41°F/45°F Within 4 Hours* 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs Cooked and RTE Foods.* * 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 590.004(F) EMPLOYEE HEALTH: 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to Other* g3-501.16(A) Hot PHFs Maintained At or Above 140°F* 7- Require Reporting by Food Employees and Contamination from the Environment 7-2001.11.11 Separation-Storage*Common Name-Working Containers* 3-501.16(A) Roasts Held At or Above 130°F* Applicants* 3-302.11(A) Food Protection* P 8 20 Time as a Public Health Control O Responsibility Employee 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 590.003 F 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) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g ) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and 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* * 3-801.11(D) Raw or Partially Cooked Animal Food and ( ) P 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations 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. 1g Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of * 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System gg Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* 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-1 155 F 1 min Eggs* 4 702.11 Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats- 55° 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- Sources * Proper,Adequate Handwashing 10 Ratites-165°F g' Por 15 sec* in 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* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* C Commercial] Processed RTE Food-140°F* (Blue Items 23-30) 3-403.11( ) y Critical and non-critical violations,which do not relate to the foodborne * 12 Prevention of Contamination from Hands 3403.11E 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* 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 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 H;CCP 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. pptNE Tp�, TOWN OF BARNSTABLE.` HEALTH INSPECTOR'S Establishment Name: \ /'I'1�T7/ LU 6Z e: / Page: of ti OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30A.M. BARNSfABLE. ` 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified "'A9 HYANNIS,MA 02601 M-8 -46FRI4 No Reference R-Red Item PLEASE PRINT CLEARLY �A .as9•> 508-862-4644 'FON1P� FOAD FSTABLISHMENT INSP C ION REPORT Name Da Tvpe of Type of Inspection g Routine I _ _ Address p e Risk I Food Serv'' ctio Date: is J} xv Telephone f I - Residential Kitchen Date: Mobile Pre-o i el Owner HACCP Y/N Temporary Suspect Illness 711 Caterer General Complaint Person in Charge(PIC) ) Time Bed&Breakfast HACCP 17 Inspector ,j )f -;70 f-\ V ( Each violation c ecked requires an explanation on the narrative ge(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) ❑ P FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable./Duties ❑ 13.Handwash Facilities i EMPLOYEE HEALTH PROTECTION FROM CHEMICALS �- a ❑2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) AYA ❑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 I �j �) ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories I'..�h I\ 7l �3 9 ��y Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations (V l! Il r� Critical(C)violations marked must be corrected immediately. (blue&red items) Correc ive Ac ion Required: ❑ No ❑ Yes Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,t e it ms Embar o checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ 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 9 re ardless of the number of critical,results in an F 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food 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 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-cri' al viol ons. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. on,4 to 8 non-critical viola s= 30.Other DATE OF RE-INSPECTION: 1 In ctor' e 4 t: 31.Dumpster screened from public view. ! Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N r #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' gn ture _I % Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N Dumpster Screen? Y N 1 -. :.r. .-. _:.-'�+'-:-.�1"•e,f-.,.: •"^ __ L'iy`.-vim:..t�t.,si„/'-V.'.,, ,+�.;_ - �.�.:-+r 7.-r�-s�•."L..,�,.. _ •,.rs.-,-�.:. _ -w,.y.�`•.. sue.'?-S` �.?.-)r^ - '- _ - •....•. '^ �,. 1" -�`� . - �;• s 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) jDerronstration 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 2-103.1 I Person-in-Charge Duties - - 3-302.14 Protection from Unapproved Additives Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41'F/45'F - - 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*, Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge[0 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-Presence3-501.19 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 Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS(HSP) Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 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* Raw Seed Sprouts Not Served* 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-561.112 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* Eggs 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* Effective 1112001 4-602.11 Cleaning Frequency of Utensils and Food Animals-155'F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surf 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155`F 15 sec* faces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* 10 Proper,Adequate Handwashing Ratites-165°F 15 sec* ing,mobile food,temporary and residential Game and Wild Mushrooms Approved By 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms* 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165'F* foodbome illness interventions and risk factors. 590.004(C) _ Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b)All Other PHFs-145'F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* Ell Good Hygienic Practices -17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. $ Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose'and'Mouth* 3-403.11(B) Microwave-165'F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES 3-301.12 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 12 3-101.11 Food Safe and Unadulterated* 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* F 1g Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 13 Handwashing Facilities 3-202.18 Shellstock Identification 3-501.14(A) 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. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision l 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:590Forinback6-2doc *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 C O&�Fti£ Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. * B.aRNsraHe.L Paul J.Canniff D.M.D. MASS, 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, 3056, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 999 Issue Date: 01/01/2021 DBA: CAPE FISH & LOBSTER CO. OWNER: JOHN CARDARELLI Location of Establishment: 626 WEST MAIN STREET HYANNIS„ MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $200.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: 4 V r, OFTNE For OfficeInitials: Town of Barnstable Date Paid I Amt Pd$ DutJ : . ,CAB Inspectional Services /r Check# - A�fo��a Public Health Division Thomas McKean,Director 4 . 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 r+• F- APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: tt�Q, �v l�.e. ( L v 15 C. ('-C' ADDRESS OF FOOD ESTABLISHMENT: (g2—(4 L4-- MeA.i 4x �X MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: C !{-n.t0 x(Le.(G (. Ccc(J.e<E t SiA q,g/lA L435 A-e( , C a"'L TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO A ...(ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: _ SEASONAL: DATES OF OPERATION:—/—/_ TO NUMBER OF SEATS: INSIDE: OUTSIDE TOTAL: SEATING: MUST OBTAIN A C64 ON 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 Q1Application FormsTOODAPP 2020.doc i OWNER INFORMATION: FULL NAME OF APPLICANT o l+` CAA.V�h12�- t-L SOLE OWNER: YES/NO D.O.B OWNER PHONE# ADDRESS CORPORATE OWNER: e0�-- r c if -� Ly3 C k,1r ev 14c , CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: ZAy,014 CA 9,()-Ji26-L C 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 2. F SIGNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1st. Q:\Application FormsTOODAPP REV3-2019.doc p4 Town of Barnstable BOARD OF HEALTH John T.Norman Board of Health Donald A.Gaudagnoli,M.D. BARNStAHM Paul J.Canniff,D.M.D. MAML 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, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 999 Issue Date: 12/10/2019 DBA: CAPE FISH & LOBSTER CO. OWNER: JOHN CARDARELLI Location of Establishment: 626 WEST MAIN STREET HYANNIS, MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 FEES FOOD SERVICE ESTABLISHMENT: $200.00 YEAR. 2020 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2020 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE-ICE CREAM: FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: Oq Town of Barnstable For Office Initials: Date Paid Amt Pd scRb MANST,B,E, . Inspectional Services ;� 'J. MAs8. '°39'•`e� Public Health Division check# Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 t..7 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE io ZZ i c( NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: ePrP& F%S (i j,- Lo_bS ;-e,r C e fir t e ADDRESS OF FOOD ESTABLISHMENT: Lalz& (6k_� WAA i A S'T MAILING ADDRESS(IF DIFFERENT FROM ABOVE):?.0, I-� - IS 5. cm 4CA V 1, E-MAIL ADDRESS: '� r�(I f'2 I L �a &A-0e &4,4ial Lo bI TELEPHONE NUMBER OF FOOD ESTABLISHMENT: �g TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO_ ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION:_/ /_ 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. 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 d�, bL RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) C1 � BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ... (MONTHLY LAB ANALYSIS REQUIRED) CATERING ... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 QAApplication FormsTOODAPP 2020.doc 9 1 • f 1 OWNER INFORMATION: FULL NAME OF APPLICANT S J Vt O Qxj,ou��( (6 SOLE OWNER: YES/NO D.O.B OWNER PHONE# ADDRESS " CORPORATE OWNER: f"% C 1'1 4— Lr��S' �--C.i �, _ "OL4 C-- CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: PV+ 3A,4,,rVVAf--C L"1 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 ry 2. C� X1 > / 93 SIGNATU OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE: All seasonal food establishments,including mobile4trucks must be inspected by the Health Div. prior to openin¢!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1 st to Dec.3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st. Q\Application FormsTOODAPP REV3-2019.doc SEAFOOD HACCP ALLIANCE .—in cooperation with a THE ASSOCIATION OF FOODrAND DRUG OFFICIALS ` = present this K _ 1 N ertificate`of HAccpicdliet om letion to r S^ .; A G -W G�YG�J ent. .> having completed the Association_ of Food and Drug Official's/Seafood HACCP-•Alliance "Basic Course'; m seafood Hazard Analysis and Critical Control Point theory and practical a lication. This course develo ed throe h .~ i M -r a Nation 1 Sea'Grant Colle>e-Program project contained the core training manual and `- p he nce to. teach'HACCP- concepts for food 'and incorporated cumculum developed by the Seafood#HACCP�Allial y safety. This 'curriculum referenced ry p iy.a ,,.g` z..,-for foods, the U.S. Food and rug Adininistration's Fish , e National Adviso Committee on Mcrobiolo ical•Critena g recommendations and concepts from the � ( Part 123),and: and,'F�slzety Pro"ducts'Hazards and Control Guide, the U S .Food and Drug Admu�i tratiori s mandatory seafood HACCP re ulations 21 CFRYyN p ,p y, # g t �. g g expert . . g p¢ and, various HACCP:modeis re ared-b the overnmental a encies, trade associations academia and in haven sex ert knowled a of;the conce is a f application of HACCP. This course satisfies the mandatory training requirement contained m 21 CFR,part 1.23.10. 1 'ram ,.w a, •,� "'*w`",?...w "'�. 7u , o *'� 5126-050905-0013 : • r FA 'Certificate fi umber e N a=. i a,,• d a - A- 44- Oa ws - - ids• �` i ":M. .. - - :i.- _ Q _e fi 'Na �ett ode Island 5/9/2005 _ rraY ins Rh x Tratriii Location and Da �Associatiori'of Food and Drug Officials (AFDO),' ` , 4 - g to } r i { x u ;r... t ter. � ,.. - ,F ,.�. 4 � - - . - iri conjunction with Northeast Food and Drug Officials°Association a w" � x -, •,>:, ..ti-.r ...:. ,_,.n?:-s "' -` .,. r... a [fj'.i }, `J - ,i ft'y --_yam _ �e3 e t ,.i. V y a SEAFOOD) HAC.CP ALLIANCE in c®opeiation with j THE ASS C ATION.OF',FOOD AND DRUG OFFICIALS Crt�fic�y #e ®f HACCP..0 arse C®rripletin to ' 1VIiC11ae1 '04C®nnel9r# y having completed the Association of Food and Drug,Officials/Seafood HACCP'^AIIlance "Basic. Course" in seafood Hazard Analysis and Critical Control Point theory and practical applicati®n. This course de loped through a National Sea Grant College Program'p<roject contained the core training manual and curriculum developed by the Seafood HACCP Alliance to.'teach'HACCP-'concepts for food safety. ".This-, curriculum referenced and incorporated recommendations and concepts from`the National.Advisory Committee on Microbiological Criteria for Foods, the U.S. Food and Drug Administration's Fish and Fishery Products Hazards and,aCont►ol.Garde,the U.S. Food and Drug`Administration's iandatory seafood HACCP'regulations (21 CFR Part 123), and various HACCP models prepared by the governmental agencies; trade associations, academia and individuals having expert knowledge of the concepts and application of HACCP. This course satisfies the mandatory training requirement contained'in 21 CFR;part_1.23.10. r. 5078 120298-II>fl '06 ,- `ti 'Certificate Number E Buzzards Bay,MA 12/2/98 ssociation i Food and Drug Officials(AFDO) Training.Location and Date i conjunction'with North ast Food&Drug Offcials'Association r, Town of Barnstable BOARD OF HEALTH Paul 1 Canniff,D.M.D. Board of Health Donald A.Gaudagnoli,M.D. t uAnNsT Btz John T. Norman MA& 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 30513, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 999 Issue Date: 12/20/18 DBA: CAPE FISH & LOBSTER CO. OWNER: JOHN CARDARELLI Location of Establishment: 626 WEST MAIN STREET HYANNIS MA 02601 Type of Business Permit: RETAIL FOOD Annual: YES Seasonal: IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0 _ FEES � T FOOD SERVICE ESTABLISHMENT: $200.00 YEAR: 2019 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2019 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: - --- - - - -- - - - MOBILE- FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent TOBACCO SALES: FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: i FTNE � For Office Use Onlv: Initials: o� Town of Barnstable Date Paid�9 Amt I'd$ � MASS. Inspectional Services U110 i639• ♦� °TFo �" Public Health Division } Thomas McKean Director ') 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 a;7 • �H'S APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE tl Q NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: l I�(�P .S h Gt i'1� I,nIf�S f— CO• , Inc— ADDRESS OF FOOD ESTABLISHMENT: 4o a(Q' OeS.-A- Akk t rn' !&jy-t e-)c - MAILING ADDRESS(IF DIFFERENT FROM ABOVE): :PQ 1 S Cey4CVQ i(I-e E-MAIL ADDRESS: TELEPHONE NUMBER OF FOOD ESTABLISHMENT: CauD7�- ( a- TOTAL NUMBER OF BATHROOMS: WELL WATER: YES NO ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: SEASONAL: DATES OF OPERATION: / / TO NUMBER OF SEATS: INSIDE: OUTSIDE: TOTAL: O SEATING: MUST OBTAIN A COMMONVICTUALLER'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) TOBACCO SALES ... (ANNUAL TOBACCO SALES APPLICATION REQUIRED) *** SEASONAL,MOBILE &NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED Q:\Application Forms\FOODAPPREV2018.doc it i�}y PLEASE CALL 508-862-4644 OWNER INFORMATION: FULL NAME OF APPLICANT- CG(,CACLf e✓ I SOLE OWNER: YES/NO D.O.B OWNER PHONE # ADDRESS CORPORATE OWNER: FEDERAL ID NO. : Qq-- 3a CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least (1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date ler en Awareness Expiration Date 1. ® 'a tv>°CL r� /a /aaa v 1. C,r4 4 P L I o/ I J col c! 2. r O,ns (Q / 13 / dod�t-P,l. 3 It SfdNATURE OF APPLICANT DATE ***FOOD POLICY INFORMATION*** SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by the Health Div. prior to opening!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asp. OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. TOBACCO ESTABLISHMENTS: All tobacco establishments must complete an Application for Tobacco Sales Permit and Employee Signature Form. NOTICE: Permits run annually from January 1 st to Dec. 3151 each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC I st. Q:\Application FormsTOODAPPREV2018.doc ° 105 CMR: DEPARTMENT OF PUBLIC HEALTH 105 CMR 590.000: STATE SANITARY CODE CHAPTER X —MINIMUM SANITATION STANDARDS FOR FOOD ESTABLISHMENTS Section 590,001: Adoption of Federal Edition of the Federal 1999 Food Code 590.002: Purpose and.Definition—Federal 1999 Food Code Chapter 1 590.003: Management and Personnel—Federal 1999'Food Code.Chapter 2. 590,004: Food—Federal.1999 Food Code Chapter 3 590.005: Equipment,Utensils and Linen-Federal 1999 Food.Code Chapter.4 590:006: Water,.Plumbing and Waste-Federal 1999 Food Code Chapter.5 590.007: Physical Facilities-Federal 1999 Food Code Chapter 6 590.008: Poisonous or Toxic Materials-Federal 1999 Food Code.Chapter 7 590.009: Special Requirements 590010: Code Applicability.—Federal 1999 Food Code Chapter 8-1 590.011: Plan Submission and Approval—Federal 1999 Food Code Chapter 8.2 590.012: Permit to Operate—Federal 1999 Food Code Chapter 8-3 .590.013: Inspection and Correction of Violations—Federal 1999 Food Code Chapter 8-4 590.01:4: Permits: Suspension and Revocation 590.015: Service of Orders/Hearings 590.01.6: Examination and Embargo of Food 590.017; Prevention of Foodborne Disease Transmission by Employees-Federal 1999 Food Code Chapter 8-5 590.018: Vending Machines ¢ 590.019: CriminalPenalties 590.020: Advisory Committee 5.90.021: Severability. 590,001: Adoption of Federal Edition of the Federal 1999 Food Code 9 In'addition.to the provisions set forth in 105 CMR 590.002 through 590,021,the Department 1 of Public Healtfi:hereby adopts and incorporatesby reference.the fIederal1999 Food Code(not including Annex 1-7)published by the United States Department ofHealth and Human:Services, Public Health Service, Food:and Drug Administration,.Washington,.D;C. 20204 provided,. however;that the.Department does not adopt those provisions of.the.federa1.1999 Food Code, which are specifically stricken or modified by 105 CMR 590.000. Copies of the federal 1999 Food Code are available on-line:. federal 199.9 Food•Code inHTML or PDF versions.(1.Mb;1.2Mb uncompressed)and Word Perfect 6/7/8,version compressed in self-extracting zip format(523Kb;2Mb uncompressed) are available on-line and can be downloaded from the following FDA website- http://Vm.cfsarLfda;gov/�-dms/foodeode.btml#get99 Copies of the federal 1999 Food Code may also be ordered from The State Book Store;Room 116,Massachusetts State House,Boston,Massachusetts,`617- 3 i 727-2834,the.Western Office of the Secretary of the Commonwealth,•436 Dwight Street, Springfield, MA, 413.784-1376, or the Southeast District of the Secretary of the ? Commonwealth at.218 South Main Street, Suite 206, Fall River, MA, 508-646.1374. Additional information on purchasing the 1999 Food Code and. Massachusetts State 1 Regulations is available online at the Secretary of the Commonwealth's Homepage: www.state.ma.us/sec. i National Technica I Information Service(NTIS). For ordering options,callNTIS at 1-800- 553-6847 or 703-605-6000. To order directly on-line, go to the NTIS website. at http://www.ntit.gov,lyellowbk/1nty83 Lhtm. i 2W PT�` „ 105 CMR: DEPARTMENT OF PUBLIC HEALTH 590.001: continued Or wrketo:National Technical Information Service(NTIS),U.S.Department ofCommerce, 5285 Port Royal Road,Springfield,VA 22161. Spiral bound order number:PB99-115925, Electronic Edition on CD-ROM(also includes the Adobe Reader,Draft HACCP Guide,and Plan Review Manual) order number:PB99-500506;Electronic Edition on Diskette order number:PB99-501033;WordPerfect on Diskette order number:PB99-501025. 590.002: Purpose and Definitions—Federal 1999 Food Code Chapter 1 (A) FC 1-1 Purpose. The purpose of 105 CMR 590.000 is stated within FC 1-101.10 Food Code,FC 1-102.10 FoodSafety,Illness Prevention,and Honest Presentation and FC 1-103.10 Statement. (B) Definitions. For the purposes of 105 CMR 590.000,the following terms shall have the meanings hereinafter specified, These definitions shall be in addition to or a substitution for the same definition in federal 1999 Food Code section 1-201.10 entitled Definitions. Citations to the federal 1999 Food Code shall be referenced FC followed by the section number(e.g. FC 1- 201.10). Some paragraphs of the federal 1999 Food Code(FC)are repeated to give context to the supplemental provisions. Provisions of the federal 1999 Food Code,which are repeated in their entirety in 105 CMR 590.000,will be referenced as(FC). Adulterated means the definition in M.G.L.c.94,§186. Bed and Breakfast Establishment means a private owner-occupied house where four or more rooms are let and a breakfast is included in the rent. Bed and Breakfast Home means a private,owner-occupied house where three or fewer rooms are let and a breakfast is included in the rent. Board of Health means the appropriate and legally designated health authority of the city,town, or other legally constituted goverrnnentalunit within the Commonwealthhaving the usualpowers and duties of the board of health of a city or town, Bottled Drinking Water means,in addition to the definition set forth in the federal 1999 Food Code,the definition in 105 CMR 570.000: The Manufacture,Collection,and Bottling of Water and Carbonated Nonalcoholic Beverages. Business Days means Monday through Friday excluding legal holidays. Caterer means any person who prepares food intended for individual portion service,transports and serves it at another location,or who prepares and serves food at a food establishment,other than one for which he holds apermit,for service at a single meal,party or similar gathering, Commissioner means the Commissioner of the Massachusetts Department of Public Health, Continental Breakfast means a breakfast meal restricted to the following foods: (1) Beverages such as coffee,tea and fruit juices; (2) Pasteurized Grade A milk; (3) Fresh fruits; (4) Frozen and commercially processed fruits; (5) Baked goods, such as pastries,rolls,breads, and muffins which are non-potentially hazardous food; (6) Cereals; (7) Homemade or commercial jams,jellies,honey and maple syrup; (8) Pasteurized Grade A creams and butters,non-dairy creamers or similar products; (9) Commercially manufacturedhard cheeses,commercially manufactured cream cheese and commercially manufactured yogurt, P�- t r 105 CMR: DEPARTMENT OF PUBLIC HEALTH 590.002: continued Critical Item means,in addition to the definition set forth in the federal 1999 Food Code,any other violation of 105 CMR 590.000 so designated by the board of health after written notice to the permit holder that the violation has the potential to seriously affect the public health. DEP means the Massachusetts Department of Environmental Protection. Department means the Massachusetts Department of Public Health. Director means the Director of the Division of Food and Drugs. Drinking Water means water that meets 310 CMR 22.00: Drinldng Water, a FC-Regulatory Authority means for the purpose of 105 CMR 590.000, in addition to the definition set forth in FC 1-201.10,the board of health. Food Code Interventions means the following set of preventive measures: p) Demonstration of Knowledge 1 (2) Employee Health j (3) Hands as a Vehicle of Contamination k (4) Time-temperature Relationships (5) Consumer Advisory 1 Food Employee means anindividual working with unpackaged food,food equipment or utensils, or food-contact surfaces. This could include the owner, individual having supervisory or management duties,person on the payroll,family member,volunteer,person performing work under contractual agreement,or any other person working in a food establishment. In health ca_e ; facilities,this includes those who set up trays for patients to eat,feed or assist patients in eating, s give oral medications or give mouth/denture care.In day care operations,schools and long term care facilities,which are licensed food establishments,this includes those who prepare food for clients to eat,feed or assist clients in eating or give oral medications. Food Establishment. (1) Food establishment means an operation that stores,prepares,packages,serves,vends, or otherwise provides food for human consumption: s (a) Such as a restaurant;satellite or catered feeding location when these locations are 3 equipped with facilities to prepare,store or serve food;catering operation ifthe operation f provides food directly to a consumer or to a conveyance used to transport people;market; j retail bakery;vending location; institution;food bank;residential kitchens in bed and breakfast homes and bed and breakfast establishments;residential kitchens for retail sale and, (b) That relinquishes possession of food to a consumer directly,or indirectly through a delivery service such as home delivery of grocery orders or restaurant takeout orders,or delivery service that is provided by common carriers.rn� (2) Food establishment includes: (a) An element of the operation such as a transportation vehicle or a central preparation facility that supplies a vending location or satellite feeding location unless the vending or feeding location is permitted by the regulatory authority;and crc> (b) An operation that is conducted in a mobile,stationary,temporary,or permanent facility or location; where consumption is on or off the premises; and regardless of whether there is a charge for the food. (3) Food establishment does not include: (a) A produce stand that only offers whole,uncut fresh fruits and vegetables; (b) A food processing plant; (c) A kitchen in a private home if only food that is not potentially hazardous is prepared for sale or service at a function such as a religious or charitable organization's bake sale; (d) A kitchen in a private home that prepares,foo d for distribution to a charitable facility in accordance with M.G.L c.94,§328; 105 CMR: DEPARTMENT OF PUBLIC HEALTH 590.002: continued (e) An area where food that is prepared as specified in 105 CMR 590.002: Food Establishment(3)(c)is sold or offered for human consumption; (f) A kitchen in a private home, such as a family day-care provider; or a bed and breakfast home that serves only a continental breakfast;or, (g) A private home that receives catered or home-delivered food.(c) Food Processing Plant means in addition to the definition set forth in FC 1-201.10,the definition of Food Processing Operation in 105 CMR 500.000, Full Breakfast means a breakfast meal including foods other than those listed in 105 CMR 590,002: Continental Breakfast. Maior'FoodAllergen means: (1) Milk,eggs,fish(such as bass,flounder,or cod),crustaceans(such as crab,lobster,or shrimp),tree nuts(such as almonds,pecans,or walnuts),wheat,peanuts,and soybeans;and (2) A FOOD ingredient that contains protein derived from a FOOD named in 105 CMR 590.002: Major Food Allergen(1). Major Food Allergen does not include: (a) Any highly refined oil derived from a FOOD specified in 105 CMR 590.002 Major Food Allergen(1)or any ingredient derived from such highly refined oil;or (b) Any ingredient that is exempt under the petition or notification process specified in the federal Food Allergen Labeling and Consumer Protection Act of 2004(Public Law 108-282).. Menu means a printed list or pictorial display of a food item or items and their price(s)that are available for sale from a food establishment and includes menus distributed or provided outside of the establishment. Menu Board means any list or pictorial display of a food item or items and their price(s)posted within or outside a food establishment. Menu Item means any individual food item,or combination of food items,listed or displayed on a menu board or menu. Misbranded Food means the definition in M.G,L. c.94,§ 187. Residential Kitchen means a kitchen in a private home. Risk Factors (1) Risk Factors mean improper practices or procedures,which have been identified by the Centers for Disease Control and Prevention(CDC),through epidemiological data as the most prevalent contributing factors of foodborne illness or nijury. (2) Risk Factors include: (a) Poor personal hygiene; (b) Food from unsafe source; (c) Inadequate Cooking; (d) Improper holding temperatures;and (e) Contaminated equipment. School Kitchen means the kitchen area used during the course of the regular school day to prepare or serve breakfast,lunch,or dinner to students in an elementary,middle,high,charter, or innovation school operated by a public school district or board of trustees pursuant to M.G.L.c.71. School Kitchen does not include: (1) Kitchens used by culinary arts programs, (2) Kitchens used exclusively for or by faculty or staff,or (3) Kitchens used to prepare or serve food outside of the regular school day. �I I Town of Bamstable, MA Page 1 of 5 Town of Barnstable,MA Wednesday,January3,2018 Chapter 318. Fee Schedule [HISTORY:Adopted by the Town of Barnstable Board of Health 12-i6-2003,effective 7-i-2004(Section i of Part I of the 1991 Codification as updated through 6-1-i996);amended in its entirety 3-ib-2009. Subsequent amendments noted where applicable.] GENERAL REFERENCES Schedule of Fees—See Ch.76,Art. I. § 318-1. Fees enumerated. [Amended 6-i8-2013;7-8-2014;3-i0-2015;11-i0-20151 Type Fee Surcharge Fees Application fee/plan review:new establishment, $ioo renovation,or new applicant(body art,camp,disposal installer license,horse stable,retail food market, motel,hotel,new food service establishment with no floor plan changes) less than 8,00o square feet Application fee/plan review:new establishment or $200 renovation (retail food market,motel,hotel,new food service establishment with no floor plan changes) 8,00o square feet or greater Application fee/plan review:new establishment, renovation,new floor plan or changes(swimming pool,food service establishment,supermarket) less $300 than 8,00o square feet Application fee/plan review:new establishment, renovation,new floor plan or changes (food service $500 establishment,supermarket) 8,00o square feet or greater Bed-and-breakfast permit $55 Body art establishment permit $100 Late charge for Body art practitioner permit $50 renewals:add$io if received after March i Burial permits $5 Camp permit $75 Computer print-out copies(page) $0.50 Continental breakfast permit $30 Disposal system construction permit: new $150 construction without I/A or S.T.U.components ',++„v-/Aimrnronnri,-un rpm/printIRA')041?(mir`l=Fi5Fi1151 /1018 t M\ Town of Barnstable, MA Page 2 of 5 Type Fee Surcharge Fees } Disposal system construction permit: new $200 construction with I/A component(s) Disposal system construction permit:new construction with S.T.U. component(s) $��5 After hours inspections Weekday 4:30 p.m. inspection Additional$5o Weekend,holiday inspection Additional$15o Disposal system construction permit:minor repair (i.e., replacement of distribution box,replacement of $75 Piping) Disposal system construction permit:repair[repair of conditionally passed systems and failed systems] $1bo without I/A or S.T.U.components Disposal system construction permit:repair[repair of conditionally passed systems and failed systems]with $150 I/A components Disposal system construction permit:repair[repair of conditionally passed systems and failed system]with $175 S.T.U.components After hours inspections Weekday 4:30 p.m.inspection Additional$5o Weekend,holiday inspection Additional$15o Disposal works construction permit plan review fee: $50 additional$5o each time plan requires a revision due to failure to meet 310 CMR 15.220,Preparation of Plans and Specifications(two or more errors or omissions on.plan) Disposal system abandonment permit $25 Disposal system construction permit reinspection $25 Disposal system installer's license $75 Late charge for renewals:add$10 if received after January 1 Establishment monthly inspection fee:monthly $5oo for up to three inspections ordered by the Board of Health during a monthly inspections, public hearing due to two or more failed inspection plus$too for each reports (i.e.,at food establishments,motels,horse additional monthly stables,swimming pools,etc.). Fee due within 7 days ' inspection required after hearing date. after three Failed establishment inspection fee: requiring more $100 than two routine inspections per year(i.e.,at food establishments,motels,horse stables,swimming pools,etc.).This fee is to cover costs associated with an additional routine inspection to occur within one to three months after a failed inspection,if additional inspection is required as determined by Health Agent. httnc•/Axnuw Pr.nHP160 r.nm/nrint/RA2043?auid=6561351&children--true 1/31/2018 Town of Barnstable, MA Page 3 of 5 Type Fee Surcharge Fees Fee due within 7 days of receipt of failed inspection report. Faxing a copy of an as-built card $3 File search fee Mailing a copy of an as-built card $3 File search fee Fishing boat registration $60 Food/cold storage permit $20 Food service permit 0 to 49 seats $250 Late charge for 50 or more seats $300 renewals:Add$io if received after January 1;also surcharge fee Of$35 for each additional Food service permit(temporary):preapproved events $40(i day);$50 (2+ reinspection applies only days) after one inspection Food service permit(temporary):preapproved events plus one reinspection. only,once/week/18 weeks maximum/same location, same vendors with same menus only Only,during business hours(held during daytime hours on weekdays) $i8o Held during nonbusiness hours (i.e.,during Saturdays,Sundays,holidays,nighttime) $ioo per vendor s- Food service permit(charity) $5 Frozen dessert license $30 Funeral director license $40 Garbage packer license (per truck) $35 Hazard analysis critical control point(H.A.C.C.P.) plan $goo review Hazardous materials use/storage Late charge for renewals:add$io if received after July i 26 to i10 gallons $50 i1i to 499 gallons $125 500 gallons or more $150 Housing inspection (rental registration) $go for the first Late charge for dwelling unit or renewal:add$io if rooming unit plus received after Jan i $25 for each additional unit on same property,only when the inspections can be - \ consolidated with �J the applicant(s)to be scheduled and inspections htrnc //.anznar Pr.nrlP�(i(1 v.nTn/nrint1RA?.n437miid=6561351&childrett=true 1/31/2018 I ✓ 1 � ./�\f i �. r�' ! `7-T '�' �"J f `r-t yi�`� ��La+� ft S� ��a s� e^ .''� fr' �� d S �'�/ .� tt- � f '.! 3a i•.} t/r}M �t° .t {N r ,, t�t t� frrP m ilt+y��'t8 l�rr�ty'.29r t.� f 1i9 r �� 4n 0 .f & '{J h• f N -'1'l 4^ 2 t W I .. W ti ,y7 F fOt V�ifris Irririr �• t r + rV'ri!i k '"�t_I r,tr;°•� w� R\ � T , Cape Fish Lobster .i 406 West Main Street Hyannis, Massachusetts 02601 !; (508) 771-1122 1 T! �i. ` t (508) 790-1439 \y 1{ tea. f l f l.itF't � • � ��. Certificate of Compliance This document serves to certify that Cape Fish'& Lobster is t CS Jt ri ff= r operating under the Federally mandated seafood HACCP : regulation. 4tiY ' Cape Fish &Lobster has conducted a.hazard._analysis for all items, . developed an HACCP plan;.where applicabl' ;,,written and t >mpiemented Sainitatiori Standard Operating T'rocedures and follows ijlt t<` the Good Manufacturing Practices as oil li d by`the U.S. Food Drug Administration..: �r y IN Please include this document as part of.your HACCP file. For ,, 't ` further questions or comments please call Ralph Cardarelli, HACCP Coordinator at (508) ,7714122 or write to us at the above address 3 f t A� �' Sincerely, m a»{7 T\i� j Ralph Cardarelli eg' ` ~- FDA Fs et -. ; HACCP Coordinator f Program r , v4QCc c1®7 %�" ,ivi,' This Certificate of Compliance has'been issued by Factory Data Acquisition based upon the guidelines i�"4 set forth in the U.S. food& Drug Administration's mandatory seafood.HACCP regulations (21 CFR Part 123), and various HACCP models prepared by governmental agencies and trade associations. Factory Data �hsc ff t�!'7}h Acquisition is nether assodated with nor endorsed by any government regulatory agency. �n ry\ t err "` tar lift/r✓A as v 54�11 r'��r ..`ir +r i r , P r r �.. r s >,4 -S a✓r lYttit lL, p nay: \t 9Y , } t tt"!. •,�. �.1 7 i� t r r( 1 � q if;rsr 4 Y( r 7rr A �q i ; f � 1' } + it iyY{ , W „s .4 •y Sr[+.; t r W,y { { r P 6s -st t �`. 'i�;ff