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Home My WebLink AboutF & L PIZZA CAFE - FOOD F & L Pizza Cafe 700'Yarmouth Road Hyannis FORMERLY: CAPE PIZZA e BOARD OF HEALTH Town of Barnstable ' O John T. Norman Board of Health Donald A.Gaudagnoli,M.D. RARNSrAtsLL F.P.(Thomas)Lee, j by9 200 Main Street, Hyannis, MA 02601 Daniel Luczkow M.D. Alt. Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstablems Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 18.9A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 33 Issue Date: 01/01/2022 DBA: F & L PIZZA AND CAFE OWNER: F & L PIZZA AND CAFE LLC Location of Establishment: 700 YARMOUTH RD HYANNIS, MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 7 OutdoorSeating: 0 Total Seating: 7 FEES FOOD SERVICE ESTABLISHMENT: $250.00 YEAR. 2022 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: MOBILE-FOOD: MOBILE- ICE CREAM: CQ� FROZEN DESSERT: Thomas A. McKean, IRS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: RESTRICTED TO 7 SEATS- NOVEMBER 1, 1989 ' For Office Initials: Town of Barnstable _ Date Paid Amt Pd$�_ BARN8rAB1.E. : Inspectional Services MARK 1e q. • Check# �FDMAta` Public Health Division Thomas McKean, Director 0 ) 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT DATE 19 `L 8 ^?,/ NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: /" L 12 1 Z167 Q r2d cot ADDRESS OF FOOD ESTABLISHMENT: T y c-) ,-/G Y ►n d L)4+1 rZa H U)1 Yl 13 IM o 2-6 O MAILING ADDRESS(IF DIFFERENT FROM ABOVE):�YC .YLC SC �e �3 P Z a C ) tE-MAIL ADDRESS: c o 7�/ TELEPHONE NUMBER OF FOOD ESTABLISHMENT: TOTAL NUMBER OF BATHROOMS: WELL WATER:YES NO__X ... (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: _ SEASONAL: DATES OF OPERATION: Ul}{�TOmC� 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? /" o IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? � TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING ...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** _REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:\Application FormsTOODAPP 2020.doc OWNER INFORMATION: FULL NAME OF APPLICANT r�` C- P(4 1 V A I�'�'L� �ja I If a VL SOLE OWNER: YES/NO Dq.O.B OWNER PHONE ADDRESS_ l 0 Ci l/IQC�S _ C(/'11�[S M A- Z�o �� ✓1 CORPORATE OWNER: /� N L (Z"ZGt c, Yt-d �cc f L[ c_ CORPORATE ADDRESS: (? l) 1.S U �� I PERSON IN CHARGE OF DAILY OPERATIONS: List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date /l/ Y tic IfZ ° l 2ql 1. �"` if /"�YD,�ceI �3/ �/ / 2. Frct,Vt SW PCx-�j (0 o�/ 2 / SIGNAT 1 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 openins!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter, with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert Permit until the above terms are met. CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering event. You must complete a catering notice found at http://www.townofbarnstable.us/healthdivision/applications.asi). OUTDOOR COOKING: Outdoor cooking,preparation,or display of any food product by a food establishment is prohibited. NOTICE: Permits run annually from January 1st 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 pp INCT TOWN OF BARNSTABLE _ HEALTH,INSPECTORs Establishment Name: � L- �1'Z. �' Date: J6 f f : of v` pk1"p OFFICE HOURS .. - .. . PUBLIC HEALTH DIVISION 13:00-9:30A.M. BARNSTABLE. ` 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 MON.-FRI. No Reference R.-Red Item PLEASE PRINT CLEARLY gb rFDMP�, FOOD ESTABLISHMENT INSPECTION REPORT soa-asz asaa Name Dater J� Tyne of Type of Inspection Operation(s) Routine Address �� Risk Food Service Re-inspection Level Retail Previous Inspection Telephone Residential Kitchen Date: Mobile Pre-operation a Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ is Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ �� f Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) c ❑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) IV Corrective Action Required: ❑ No es Non-critical(N)violations must be corrected immediately or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical, results in an F. 25.Equipment and Utensils (FC-4)(590.005) cited in this report may result in suspension or revocation of the food B=One critical violation and less than o non-critical violations 9 26.Water,Plumbingand Waste if no critical violations observed,4 to 6von-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 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 non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Insp r � n ure rint: 31.Dumpster screened from public view ", Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N / �` Dumpster Screen? Y N v 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* 15 Cooling 590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* � 3-501. g Methods for PHFs Cooked and RTE Foods.* Additives* 19 PHF Hot and Cold Holding 2-103.11 Person-in-Charge Duties 3-302.14 Protection from Unapproved Contamination from Raw Ingredients 1 g Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41*F/45'F 590.004(F) EMPLOYEE HEALTH 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* 2 590.003(C) Responsibility of the Person-in-Charge to - Other* g * 3-501.16(A) Hot PHFs Maintained At or Above 140'F* Require Reporting by Food Employees and Contamination from the Environment 7-102.11 Common Name-Working Containers 3-501.16(A) Roasts Held At or Above 130'F* _ Applicants* - 3=302.11(A) Food Protection* 7-201.11 Separation-Storage* 20 Time as a Public Health Control by Person in Charge* 590.003(F) Responsibility of A Food Employee or An _ 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control* ' Applicant To Report To The Person In Charge* 3-304.11 Food Contact with Equipment and Utensils* 7.202.12 Conditions of Use* ( )- 590.004 11 Variance Requirements 590.003(G) Reportin -- g - Contamination from the Consumer 7-203.11 Toxic Containers-Prohibitions* 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR-- 3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP - 590.003(E) Removal of Exclusions and Restrictions g � ) - Disposition of Adulterated or Contaminated - Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources -g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Wazewashing-Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* Raw Seed Sprouts Not Served 7-206.13 Tracking Powders,Pest Control and 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Wazewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served* 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 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* 3-401.11 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or Equipment 5-101.11 Drinking Water from an Approved System* * gg Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* eg cme innom 4-602.11 Cleaning Frequency of Utensils and Food Animals-155`F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min Eggs* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces 4-702.11 Frequency Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155°F 15 sec.* aces of Equipment* Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 3-201.15 Molluscan Shellfish from NSSP Listed * Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Chemical Ratites-165°F 15 sec* Sources* 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* 3-401.11 2-301.14 When to Wash* A 1 b All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail ( )( )( ) 3-201.17 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 foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the ' 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140'17 to 70`17 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41'F/45'F Hem Good Retail Practices FC 1590.000 * 23. Mana ement and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours 9 * 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 In rediente Supplied with Soap and hand Drying Devices O 9 9 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* _ 8-103.12 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. f TMFT} TOWN OF BARNSTABLE HEALTH wsPECTOR,s Establishment Name: " 'Z-Z Date: / Page:- of OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARNSfABLE. ' 200 MAIN STREET 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified � b39. .0� HYANNIS,MA 02601 MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY'°TFo�nnr a FOOD ESTABLISHMENT INSPECTION REPORT 508$62-0644 Name Date ,� Type of Iyr)e of Inspection n -012er i s Routine Address ¢ � Risk ood Sernc Re-inspection IF t Level Retail Previous Inspection Telephone Residential Kitchen Da Mobile a-o eratio Owner HACCP Y/N Temporary Suspect Illness Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ Action as determined by the Board of Health. Allergen Awareness 590.009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands 1L ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals I 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 8�red items) Corrective Action Required: No ❑ Yes Non-critical(N)violations must be corrected immediately or within 90 days as determined b the Board of Health. Overall Rating Y Y � � ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction: Based on an i .spectton today,the items ❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils FC-4 590.005 B=One critical violation and less than 4 non-critical violations g. ( )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If P 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. on,4 to 8non-critical violations=C. 30.Other DATE OF RE-INSPECTION: Inspector's a re rint: 31.Dugmp/ster screened from public view Permit Posted? 1' Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed_ Frozen Dessert Machines: Outside Dining Y .....� PIC's Si In Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y_ L---N Dumpster Screen? Y NL- 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 7-101.11 Identifying Information-Original Containers* * Other* 3-501.16(A) Hot PHFs Maintained At or Above 140°F 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* * Require Reporting by Food Employees and Contamination from the Environment * 3-501.16(A) Roasts Held At or Above 130°F 7-201.11 Separation-Storage* Applicants* 3-302.11(A) Food Protection* P g 20 Time as a Public Health Control 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-501.19 Time as a Public Health Control* 590.003(G) Reportin Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Requirements 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) g by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Returned Food and Reservice of Food* 7-204.12 Chemicals for Washin Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated g Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and 4-501.111 Manual Wazewashing-Ho[Water 7.206.12 Rodent Bait Stations Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and P * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. L16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of 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 1//1200/ 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 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* 3 401.11(A)(2) Ratites,Injected Meats-155°F 15 sec Shellfish* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS 4-703.11 Methods of Sanitization-Hot Water and StuffingContaining Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- Sources* Ratites-165°F 15 sec* ing,mobile food,temporary and residential 10 Proper,Adequate Handwashing 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under Game and Wild Mushrooms Approved By 2-301.11 Clean Condition-Hands and Arms* Regulatory Authority 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* 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 practiceRequies should 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* P590.0(0)4(E) 2 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 2 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 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 Preventing Contamination from Employees* 16 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 1590.000 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 * 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 3-402.11 Parasite Destruction Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance 590.004(J) Labeling of Ingredients* S Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 sup d e with Soap and hand Drying Dev ices evces 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 129. 1 Special Requirements .009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc *Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. Town of Barnstable BOARD OF HEALTH John T. Norman Board of Health Donald A.Gaudag noli M.D. U NSTABLL Paul J.Canniff,D.M.D. bS, 200 Main Street, Hyannis, MA 02601 F.P. Thomas Lee Alternate Phone: (508) 862-4644 Fax: (508)790-6304 www.townofbarnstable.us Permit to Operate a Food Establishment In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections 305A, 305B, 146, 189 and 189A; Chapter 111, Sections 5 and 127A, a permit is hereby granted to: Permit No: 33 Issue Date: 04/07/2021 DBA: F & L PIZZA AND CAFE OWNER: F & L PIZZA AND CAFE LLC Location of Establishment: 700 YARMOUTH RD HYANNIS MA 02601 Type of Business Permit: FOOD SERVICE Annual: YES Seasonal: IndoorSeating: 7 OutdoorSeating: 0 Total Seating: 7 _ FEES - - - - — FOODSERVICEESTABLISHMENT: $250.00 YEAR. 2021 RETAIL FOOD: COTTAGE FOOD OPERATION: Permit Expires: 12/31/2021 B&B-FULL BREAKFAST: CONTINENTAL BREAKFAST: --- - ----- ------ --- ----- - MOBILE-FOOD: MOBILE-ICE CREAM: Q� FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent FOR ESTABLISHMENTS WITH SEATING: PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE Restrictions: RESTRICTED TO 7 SEATS- NOVEMBER 1, 1989 I v o( o - WS For Office Us • Town of Barnstable Initials: Date Paid Ault Pd$ f ,APM,,M4 : Inspectional Services MAM ►`� Public Health Division Check# t 2(o �3 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 3 '� NEW OWNERSHIP RENEWAL NAME OF FOOD ESTABLISHMENT: F - 1Z Q1vl. ADDRESS OF FOOD ESTABLISHMENT: /OCR Lj MAILING ADDRESS(IF DIFFERENT FROM ABOVE): E-MAIL ADDRESS: � ZCT'a�'� . �,/�n—gr—r"�' G ota�i 1 o TELEPHONE NUMBER OF FOOD•ESTABLISHMENT: U T/O- .3 3 @- k C-tr�,.Oc� • Gam TOTAL NUMBER OF BATHROOMS: WELL WATER:YEAS No (ANNUAL WATER ANALYSIS REQUIRED) ANNUAL: °` SEASONAL: DATES OF OPERATION:j/Z ZI TO JZ/3/ /ZI NUMBER OF SEATS: INSIDE: OUTSIDkALLERIS TOTAL: SEATING: MUST OBTAIN A COMMON VICT LICENSE FROM LICENSING DIV. ***OUTSIDE DINING REMINDER*** OUTSIDE DINING,MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING REQUIREMENTS. IS WAIT STAFF PROVIDED FOR OUTSIDE DINING? IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) FOOD SERVICE RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer) BED&BREAKFAST CONTINENTAL BREAKFAST COTTAGE FOOD INDUSTRY(formerly residential kitchen) MOBILE FOOD FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED) CATERING...(CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2) *** SEASONAL,MOBILE & NEW FOOD ONLY*** REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED PLEASE CALL 508-862-4644 Q:Wpplication FormsTOODAPP 2020.doc OWNER INFORMATION: /� / _ �� / FULL NAME OF APPLICANT J 'r a h C�$C o �a A F� SOLE OWNER: YES/dQ D.O.cB 1 5 A k OWNER PHONE# ADDRESS 16 CV- 62fo 0 CORPORATE OWNER: �✓�'1C\Sc PO J 4k a _j L- u i S a r ya er— CORPORATE ADDRESS: PERSON IN CHARGE OF DAILY OPERATIONS: frt qr C-l SC List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT. **ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You must provide new copies and POST THE CERTIFICATES at your food establishment. Certified Food Managers Expiration Date Allergen Awareness Expiration Date 1. 1, v) S Ng�yae z, / c�� / 1. Kai`\ S 10� .�1 / `/ 02 2. Pi 03 / 19/ )-01-1 SIGNA U + 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 openinQ!! Please call Health Div.at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance. FROZEN DAIRY DI SSERTS: 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.3 1"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN THE COMPLETED APPLICATIONS)AND REQUIRED FEES BY DEC 1 st. Q:\Application FormsTOODAPP REV3-2019.doc BOUDREAU AND BOUDREAU, LLP Attorneys at Law 396 NORTH STREET HYANNIS, MASSACHUSETTS 02601 Philip Michael Boudreau Telephone:(508)775-1085 Mark H. Boudreau Telefax: (508)771-0722 E-MAIL: mark@boudreaulaw.net April 6, 2021 Town of Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Dianna Bellaire, Permit Technician RE: F & L Pizza and Cafe 700 Yarmouth Road, Hyannis Dear Dianna, With reference to the above business, please find the following: 1. Completed Application 2. Payment of$350.00 3. 2 Servsafe Food Manager's — 5 Year certificates- 4. Servsafe Food Manager 5. Copy of seating plan/equipment sheet 6. Copy of Menu My clients are aware that they will need to contact Donald Desmarais prior to opening. The Target date for opening is April 15, 2021. Thank you. Sincerely, Mark H. Boudreau MHB Enclosure ti 1/28/2021 ( OpenGov Town of Barnstable, MA 01/28/2021 B L-363 Business License Status: Complete Date Created: Jan 19, 2021 Applicant Location Mark Boudreau 700 YARMOUTH ROAD mark@boudreaulaw.net Hyannis, MA 396 North Street 3��[Z1 Owner: Hyannis, MA 02601 5087751085 CHARLES WHITE MANAGEMENT INC 330 COMMONWEALTH AVENUE —, BOSTON, MA 02115 ........ . ........ ..._ ................................. ... ......... .... Business Information Business Name DBA Francisco Padilla F& L Pizza and Cafe Business Structure Type of Business Service Individual restaurant Phone Number Is this a New or Existing Business 9735156723 New Is this a Home Occupation EIN # No 070 311643 Restrictions NAICS Title Code Attachments No attachments https:Hbarnstablema.viewpointcloud.io/#/explore/records/1 95552/printable?act=true&app=true&att=true&emp=true&int=true&loc=true&sec=1 011289%... 1/2 PIZZA SM 12" LARGE 16" ➢ Classic(Tom Sauce and Cheese) ➢ Pizza Bia►1ca (White wl, Parm, Mozz Cheese & Ricotta). ➢ Bianca wl Spinach (wl Fresh Sauteed Spinach wl Garlic&Oil) ➢ Bianca wl Broccoli(wl Fresh Broccoli,Sauteed wl Fresh Garlic&Oil) ➢ Buffalo Chicken (Fresh chicken Breast spicy wl Blu Cheese and Mozz Cheese) ➢ Chicken Parmigiana ➢ Pri►17avera(Fresh Peppers, White Onions, Fresh Most& Fresh Broccoli) ➢ Pizza Deluxe (Sausage, Meat Balls, Pepperoni,Onions, Mush & Peppers) ➢ Margarita (Fresh Marinara, Fresh Mozzarella& Fresh Garlic& Fresh Basil) TOPPINGS ➢ Pepperoni, Sausage, Meat Balls, Ham COLD SUBS ➢ .Ham, Salami, Provolone ( Lettuce,Tom &Onions ➢ Turkey wl Lettuce Tom, Onions&Provolone. ➢ Prosciutto wl Fresh Mozz, Red Roasted, Pepper& Balsamic ➢ Fresh Mozz wl Fresh Tom, Red, Roasted Peppers, Fresh Basil & Balsamic HOT SUBS ➢ Chicken Parm ➢ Meat Ball Parm ➢ Chicken Vodka Sauce &Mozz Cheese ➢ Grille Chicken wl Lettuce,Tom, & Mayo ➢ Breeker Chicken Cutlet wl Fresh Mozz, Red Roasted, Peppers& Balsamic ➢ EggPlant Parm ➢ Veal Parm ➢ Stake&Cheese wl Peppers, onions, Mushrooms&cheese Burgers (ALL INCLUDE FRIES) ➢ Deluxe(Cheese, Lettuce,Tom,Onions) ➢ Italian Cheese Burger(wl Sauteed Pepp, Onions&Cheese) ENTREES ➢ Chicken (polio) ➢ Marsala (wl Marsala Brown Sauce wl Mushrooms Over Pasta) ➢ Parmigiana (Tom, Sauce & Mozz Cheese Over Pasta) ➢ Chicken Tuscano (Whitening wl Lemon Sauce, Artichokes, red Roasted Pepp, Spinach Over Pasta) ➢ Chicken Piccata (White Wine Cappers Lemon Sauce, Served With Parmigion Risotto and Vegetables. 3 PASTA ➢ Penne Vodka Sauce wl Shrimp ➢ Penne Vodka Sauce wl Chicken ➢ Penne wl Vodka Sauce ➢ Linguini & Meat Balls )0- Pasta a la Carbonara Tossed wl Pancetta, Cream Sauce and Pecorino Romano Cheese ➢ Gnocchi wl Vodka Sauce ➢ Gnocchi Pesto Sauce ➢ EggPlant Parm Over Pasta ➢ EggPlant Rollentini Over Pasta ➢ Short Ribs Ravioli (Made el Marsala, Brown Sauce wl Gorgonzola Cheese) VITELLO ➢ Veal Piccata (Made wl White Wine and Capers) ➢ Veal Marsala (Made el Marsala Wine in Brown Sauce wl Mushrooms Over Pasta) ➢ Veal Parmigiana (Breaded Veal Catlett,Topped wl Marinara & Mozz Cheese) ➢ Veal Milanese(Veal Cutlet with Baby Arugula,Tomatoes,Capers,sparragos, & Pecorino Romano Cheese) WRAPS ➢ Grilled Chicken Cesar Warps (Romaine, Croutons Caesar Dressing an Parmesan Cheese) ➢ Grilled Chicken (Lettuce,Tom and Mayo) ➢ Grilled Chicken or breaded cutlet (wl Fresh Mozz Red Roasted Peppers and Balsamic. ➢ Grilled Chicken Pesto (Pesto Sauce wl Tomatoes Fresh Mozzarella ➢ Grilled Chicken wl Sauteed Peppers Onions Mush & Mozz Cheese ➢ Steak& cheese wl Sauteed pepp Onions Mushrooms & Mozz Cheese BAKED PASTA IN THE OVEN ➢ Baked Rigatoni wl Marinara Sauce and Melted Mozz Cheese ➢ Baked Cheese Ravioli ➢ Baked Cheese Manicotti ➢ Baked Cheese Staffed Shells ADD Sausage (2) Meat Balls (2). SEA FOOD ➢ Zuppa di Pesce (Clams, Shrimp, Mussels & Calamari on Marinara, Over Pasta ➢ Shrimps Scampi (wl White Wine and Lemon Sauce Over Linguini ➢ Shrimps Fra Diavolo (Sauteed Shrimps wl spicy Marinara Over Home Made Linguini ➢ Calamari Marinara Over Linguini SIDE ORDERS ❖ Spinach, Sauteed Vegetables, Roasted Potatoes, Risotto. BEVERAGES ❖ Soda, Water,Juice, Hot Coffee or Tea WE OPEN 7 DAY'S A WEEK. MON THRU THURSDAY 10:00AM TO 09:00 PM FRIDAY&SAT 10:OOAM TO 10:00 PM SUNDAY 12:OOPM TO 08:OOPM i .RID CEEI qN7 AR NALK_I�UNIT GRID LING AND Fro 4 FkPOSED LIGxnNG-TYPKAL wwSTE Y1D SUPPLY LINES ' l p 1 1 -- / >S II 1 _J__T__I__-_ ARP 711 LQbIM/5T urCNEN wsrz ,�P��' / 1 I I sc I _� 11 KITS �O I,.II ICI- 3 I I fMRAKE _ _ _____________ ' ' - ONRlaon pLLRK I 1 I ® ER f4 SV NKN SEMKE 9FATING AR-7 CQ1NlER II 111 _ I I I C�BEQ PAMITKM HALLS -e' n�� T 1�1� TO CE1LIIIf�immoo ExD n 111u��11 O_ 'n VNYL G O IN' ADJACENT 11 I INTMp TILE F FLOORING TENAM SPALE Q Q f 1 1 1 K'u W O�cl J x =Z a5LALT1 Vq�a IT'-S PLAN W O Q } O CL 0 } a o 0 n fXLF.61D8 TNo Em'�`RT. EQUIPMENT KEY FNISTING N' WAbLK�N UNIT L41dX DER:IOIgN C01R.E CQpIERGULL 'd"p POs STSTen COUNTER KL KITCHEN Ln1wUST HOOD __ _ SELP s[RVICe mlRe OCGI BD/ePwfi 11 i t 1�61 i ®� °seR�"eRDouR 11� E EXISTING it 1 ilQi ID 11 ® AND 1' ' '.i`i I O I I -- -- wstmG 0 STAOceO ou.oLE wEN PROPOSED T 0 _ O L9EM CE ARFAO O KieEI'M1 : O O n CWRFro ER PLANS A PRIBUICYIt PwNGF/OIFN I O n s eAr soa NIrN sDO:IE smE NwRO cATe OO.m: tuml { S�u I E�ilTRANCE 4nTE9S \ � O 1 7 , a 511� S_ R Eyty rIMR rWnED rtlP Swc R�n"s: d I I 2 ® �eS.ETRINVGIC EM OE na:':' r_I e•_n.O•-°' a- -7 tL�Wn W_.SeWuGe nvPw rRa rOceT+e PttsO�nulsSl lEPucODrF tSwT FINISH INISHus rRcU gIeaPDTP OGOwOY nRDl NANpPDERt E S ry > ® ®LM®Fis .� - . CeKnoW9- iWG qa GUD TO REnAW�WST PRLN NIOD 9Ar! ' nLo- gNns 1 1 • • • • • • • • _�F ROMw-RPIS 'AlL xM sTAK[uR0 wTC��,f�L�^ITER P ,a:K,rP,E„ ,,n ,EP Dwn DF,wN TO , N/J.L9 OnSTRn fAP M ROu�w 3GVF: 'JL I BELON T G012q' FNANTICPAGE NOT EKr fND FITOIeN R� �S BLS M Rvwx wwDra. d I I I TO CLILING 111 A-'1 j � O OS D PLAN L F&L Pizza and Cafe 700 Willow ST. Hyannis MA 02601 Phone:508-515-6723 Fax:508-303-8414 f&lpizzaandcafe.com Menu SOUPS APPETIZERS ➢ Pasta Fagrioli ➢ Fried Calamari ➢ Scarole& beans ➢ Mussels Bianco ➢ Chicken Noodle ➢ Mussels Dijon ➢ Lentil ➢ Buffalo Wings ➢ Lobster Bisk ➢ Eggplant Parm ➢ EggPlant Rollentini ➢ Mozzarella Sticks ➢ Meat Balls SALADS ➢ Cesar Salad ➢ Primavera (Lettuce,Tom,Cucumber&Onions). ➢ Venecia Salad. ➢ Caprice Salad. ➢ Antipasto ( Lettuce,tom,onions, cucumbers) Red Roasted Pepper,Salami, Provolone pepperoni,sopressata. PyoFteET��y TOWN OF BARNSTABLE OFFICE OF Bea MASS SBLa, : BOARD OF HEALTH y MA9 . A i639' `00 367 MAIN STREET am HYANNIS, MASS. 02601 November 1, 19-8 9 John Rosario 396 Mitchells Way Hyannis MA 02601 Dear Mr. Rosario: The "DJ'S Wings & Things" food establishment located at your property at 696 Yarmouth Road, Hyannis was visited on October 31, 1989, by Thomas McKean, Director of the Barnstable Health Department, who observed four ( 4) picnic tables of sixteen (16) or more seats. You are reminded of the variance granted to you April 5, 1989 from the Interim Regulation for the Protection of Groundwater Quality within Zones of Contribution to Public Water Supply Wells condition #1 states . . . to reduce the seating in the restaurant from twenty-five ( 25) to seven (7) ." The maximum seating capacity of seven (7) is also printed onto the food service permit. You were told of the exceeding seating limit verbally during September. Your are directed to reduce the seating capacity to seven (7) seats upon receipt of this notice. You may request a hearing if written petition requesting same is received by the Board within seven ( 7) days. Non-compliance may result in the invalidation of the variance granted to you April 5, 1989. Sincerely yours, c.s ` Thomas A. McKean Director of Public Health TM:cst cc: ManugEr DJ' S Wring & Things .. • • T vq l Novgrder 4, 1989 L �flv 7 Mr. Thomas A. McKean Director of Public Health . Board of Health 367 Main Street Hyannis, MA 02601 Dear Mr. McKean: This letter is in response to your letter, dated 11/01/89, regarding seating capacity at D.J.'s Wings & Subs, 696 Yarmouth Road Hyannis, MA 02601. Please let this letter serve as our written petition for a hearing with the Board cf Health. Our non-compliance with the variance granted on 4/5/89 is notflagrant violation to the Board or to the ruling. We are currently using four picnic tables. The main reason these tables were used was financial - at the time of the opening we could not afford tables per se and paid less than $200.00 for the set of tables. Secondly, these tables are used primarily for customers waiting for their orders, as 901. of our business is take-out. This is a convenience to our customers. And finally, the seating capacity is designated by the water consumption per seat, as most of our business is paper, our water consumption, per seat is very low. Based on the above reasons, we are therefore petitioning the Board to review our seating capacity. These are just a few points we would like to discuss with the Board. It is our every intention to fully comply with the results of the hearing. Thanking you in advance. Sincerely, nis D. Carlin President, D.J.'s Wings & Subs 696 Yarmouth Road Hyannis, MA 02601 �Pyoz1HEro�� TOWN OF BARNSTABLE 4- o • OFFICE OF mA86. BsaumBr, BOARD OF HEALTH .�O 1639.a MAY k. 367 MAIN STREET HYANNIS, MASS. 02601 April 5, 1989 Mr. John Rosario 396 Mitchells Way Hyannis, MA 02601 Dear Mr. Rosario: You are granted a variance from the Interim Regulation for the Protection of Groundwater Quality within zones of contribution to public water supply wells, to install a 1,000 gallon grease interceptor to accommodate the flow from a seven (7) seat restaurant at Yarmouth Road, Hyannis, listed as ,parcel 4 on Assessor's map 345, with the following conditions: 1) The "septic upgrade plan" dated December 20, 1989 revised April 3, 1989, must be revised to reduce the seating in the restaurant from 25 to 7. 2) The grease trap must be installed by a licensed Disposal Works Installer after s/he receives a permit to install the interceptor. 3) The applicant shall submit floor plans of the food service establishment. The floor plans must be approved by the Health Department prior to construction of the food service establishment. 4) The grease interceptor shall be pumped at least every three (3) months by a licensed septage hauler. 5) All other regulations contained in 105' CMR 590.000: State Sanitary Code Chapter X - Minimum Sanitation Standards for Food Establishments and Town of Barnstable Board of Health sanitation regulations shall be strickly adhered to. 6) Only paper and plastic plates and utensils are authorized for customer use at the food service establishment. This variance is granted because you were granted approval on or about May 1983 to construct this office building consisting of 30 employees with a sewage flow of. 600 gallons. Your designing engineer calculates the total sewage flow from the porposed use will be approximately the same. Also, no more than a total of eight (8) persons will be employed within the building each day. Since y yours, Grov r C. M. Farrish, M.D. Chairman BOARD OF HEALTH TOWN OF BARNSTABLE GF/bs January 7, 2003 RECENED From: Tanglewood Realty JAN 0 2003 700 Yarmouth Road Hyannis, MA 02601 TOWN HEALTH DiEPT. BLE To: DYs Wings N Subs 696 Yarmouth Road Hyannis, MA 02601 On November 23, 2002 I witnessed the grease traps being pumped and the filter system being cleaned on the septic system at the rear of the building. On my observation I feel as of January 10, 2003, which is the next cleaning and pumping of the system, it shall be cleaned and pumped every month instead of every three months. With the amount of water you are using ,you are taxing the septic system to its maximum. You are overloading the system with grease beyond its capacity. You have been violating the Board of Health regulation that allow you only seven seats. You have had more than seven seats at this location for the last ten years and you are presently violating the seven seats regulation. This septic system will have to be upgraded. Enclosed is a memo I sent you on December 4, 1998 and you were informed the grease trap should be pumped monthly; and this has not been done. Also, enclosing a copy of a letter to your attorney, John Alger , dated November 24, m 1998. On that date you had violated your license for seven seats and had as any as fourteen or more. Your were in violation of your lease then and remain in violation until these matters are resolved. John R ario c Atty Theodore Schilling Barnstable Board of Health A&B Canco • Law:Offices of • TSEODORE A. SCEMUNG, P.C. Center Place Sure 10 1550 Route 28 (508) 715-0700_ Centerville; MA 02632 (508) 775-0792 TELEPHONE FACSEMMLE law®cape.com _P November 24, 1998 EMAIL John Alger,. Esq. 886 Main Street P.O. Box 449 Osterville, MA 02655 Z. RE: DENNIS CARLIN. D.J. WINGS VS. JOHN' R09ARIO NORTH EAST MARKETPLACE � f Dear John: --�\ I have met ,with John Rosario and he informs me that your client has not paid Common Area` charges in excess of the .One Hundred Dollars -($1.00.0.0) a month that are due, as last reported to .you. - He also continues to park his car: in the` fire lane. We -also. have had Cannons inspect the septic system and we have been informed that because. of your clients negligence in 'failure to maintain the grease trap, over the first two`or three years of operation he has caused damage to our septic system. The immediate need is for a Two Thousand Dollar;($2,000.00) cleaning ,which is a direct result of- the grease trap. Your. .client has acknowledged that this is. his' fault.. He also knows' that the system. has to.be reinspected two and. three years.after the cleaning to determine if the system has to be redone do to the grease. Apparently, ( see Town Licenses- enclosed) your'cli:ent is licensed for"seven seats and has been operating for:.:quit some time with fourteen or more seats. John would like him to' - be in compliance with'the law and the•li ense that he is operating under. The excess use of the system and the failure to maintain it has caused substantial damages. We have no..problem with your client continuing his lease provided he. complies with the common charge payments and also with the repair and maintenance. of the septic system. - He:-is now in.violation of the lease and remains in violation until these 'maiters. have been resolved. I hope -that the parties can get together to solve these-problems. _a ^�:"vr«-e.."�'w� .�.,it I look forward to hearing from you. Very tru� :.yo T e' ore A. Schilling J TAS/kc Enclosures cc John Rosario A:\Rosario.ltr.wpd ........... zz o R)Q LIU ------ ............. ;a iz 16.4 Q,- T-Q Gb D C, V D r + T "Is . 6* c +T m :5 -i ZI,3) II TOWN OF BARNSTABLE ., HEALTH INSPECTOR,s Establishment Name: Date: � ge: V. of oil Op THE ., '4 OFFICE HOURS PUBLIC HEALTH DIVISION 8:00-9:30 A.M. BARN5fABLE. • 200 MAIN STREETq10 `/��'y 3:30-a:3o P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified ,63 �•� HYANNIS,MA 02601�. �'`` MON.-FRI. No Reference R-Red Item PLEASE PRINT CLEARLY pTFD MAC° - 508-862-4644 FOOD ESTABLISHMENT INSPECRE OR Name; '/ j i' Dal' Tvoe of Type of Inspection eratio s Routine 4/ Address Risk ; ood Service; Re inspection ° Level Retail re o s nspection Telephone Residential Kitchen Date: Mobile Pre-operation Owner HACCP Y/N Temporary Suspect Illness G�t` Wit✓ Caterer General Complaint Person in Charge(PIC) Time Bed&Breakfast HACCP In: Other Inspector Out: 1 /� 4 Each violation checked requires an explanation on the narrative page(s)and a citation of specific provisions)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 ,t 1.PIC Assigned/Knowledgeable/Duties a ❑ 9 g ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ° , j ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals _ y� FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) , IVL 10 ❑ 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 l� I I . ( ) y ( ) � Corrective Action Re wired.q No Yes ❑ ❑ Non-critical(N)violations must be corrected immediately.or Overall Rating within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today,the items checked indicate violations of 105 CMR 590.000/Federal Food Code. I❑ Embargo ❑ Emergency Closure ❑ Voluntary Disposal ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils (FC 4 590.005 B=One critical violation and less than 4 non-critical violations 9 )( ) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,Lion infestation of rodents or insects;or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to anon-critical violations. If 1 critical refrigeration. within 10 days of receipt of this order. violation,4 to 8nori-critical violations=C. 29.Special Requirements (590.009) Y P 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N P C's�Siignnaatuurre Print: Self Service Wait Service Provided Grease Trap Size Variance.Letter Posted, Y N - f. Dumpster Screen? Y N /f Violations related to Foodtiorne 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 - - - Contamination from Raw Ingredients 1S Poisonous or Toxic Substances 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F EMPLOYEE HEALTH' 590.004(F)- 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers*s 3-302.11(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* Other* 3-501.16(A) Hot PHFs Maintained At or Above 140'F* 2 Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 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 3-304.11 Food Contact with Equipment and Utensils Person In Charge* * 7.202.12 Conditions of Use* 590.00411 Variance Requirements 590.003(G) Reporting by Person in Charge*, 7-203.11 Toxic Containers-Prohibitions* ( ) q Contamination from the Consumer 3 590.003(D) I Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR 3-306.14(A)(B)Resumed 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 F g Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* 4-501.111 Manual Warewashin Hot Water 7.206.12 Rodent Bait Stations* 3-801.11(D) Raw or Partially Cooked Animal Food and g Raw Seed Sprouts Not Served* 3-201.12 Food in a Hermetically Sealed Container* � Sanitization Temperatures* 7-206.13 Tracking Powders,Pest Control and P * 3-201.13 Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* _ . Sanitization Temperatures* TIMEITEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH.tati Proper Cooking Temperatures for PHFs CONSUMER ADVISORY Concentration and Hardness* 16 3-603 ne 22 .11 Consumer Advisory Posted for Consumption of 3-202.16 I Ice Made From Potable Drinking Water* � � � 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved System* 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145*F 15 sec* Equipment* Not Otherwise Processed to Eliminate 590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game Pathogens* Ef i9e 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* 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 9 P 10 Proper,Adequate Handwashing Game and Wild Mushrooms Approved By * 3 401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to 3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* foodborne illness interventions and risk factors. 590.004(C) Wild Mushrooms* 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other 590.009 violations relating to good retail 3-201.17 Game Animals* 11 Good Hygienic Practices 17 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec* 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * ' 3-301.12 Preventing Contamination When Tasting* * (Blue Items 23-30) 3-202.15 Package Integrity g 8 3-403.11(C) Commercially Processed RTE Food-140°F 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands (E) Remaining Unsliced Portions of Beef Roasts* Critical and non-critical violations,which do not relate to the foodborne 3 403.11 g illness interventions and risk factors listed above,can be found in the 6 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 * 3-501.14 A 3-202.18 Shellstock Identification 13 Handwashing Facilities ( ) Cooling Cooked and From 70°F to 41°F/45°F Fr from 140°F to Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and 45 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003 3-402.11 Parasite Destruction* 5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 520511 Accessibility,Operation and Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* - . Within 4 Hours 26. Water,Plumbing and Waste FC-5 .006 590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. 1 Poisonous or Toxic Materials FC-7 1.008 HACCP Plans 6-301.12 1 Hand Drying Provision 129. 1 Special Requirements 1.009 3-502.11 Specialized Processing Methods* 130. 1 Other 3-502.12 Reduced-Oxygen Packaging Criteria* 8-103.12 Conformance with Approved Procedures* S.59OFormback&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. VSHE rpm ,�-_----� TOWN OF BARNSTABLEtR - _T*pe=kInsDection ALTH INSPECTOR'S Establishment Name: 1 y 4f��,/..f�V Date: Page: of ` q _ ��: ICE HOURSPUBLIC HEALTH DIVISIO -9:30A.M. e,nNsrnece. 200 MAIN STREET -4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified HYANNIS,MA 02601 + O8 -FRI.4644 No Reference R-Red Item PLEASE PRINT CLEARLY 50ION.-FRI. 'EON1P�° FOOD ESTA LISHMENT INSPE TName Date a of / p Routin Address Risk r 7.z6d:se_rT.-d -inspe ion Level Previ I s tiq r Telephone d Residential Kitchen Date. - I Mobile Pre opra otl Sus ecClll ess Owner HACCP Y/N Temporary P Q Caterer General Compi nt Person in Charge-(PIC) Time Bed 8 Breakfast HACCP Other InspectorZfi Each violation checked requires an explanation on the narrative p e(s)and a citation of specific provision(s)violated. 4 Violations Related to Foodborne Illness Interventions and Ris Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco - 590.009(F) ❑ - • -- --- -- - A A- --- -- - --- - --- - -- - 41 1 - -- Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ i FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands �14 �{ ❑-1.PIC Assigned/Knowledgeable/Duties CITMI❑ 13.Handwash Facilities f EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives tn� l ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals IP ,* m FOOD FROM APPROVED SOURCE TIMErTEMPERATURE CONTROLS(Potentially Hazardous Foods) i Al 0 ❑ 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) Coe ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY V - ❑ 11.Good Hygienic Practices h - ❑ 22.Posting of Consumer Advisories VIF .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 by the Board of Health. Overall Rating ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension C N Official Order for Correction:Based on an inspection today, Items ❑ Embargo ❑ Emergency Closure [] Voluntary Disposal ❑ Other: checked indicate violations of 105 CMR 590.000/Federal Food Code. 23.Management and Personnel (FC-2)(590.003) This report,when signed below b a Board of Health member or its agent 24.Food and Food Preparation (FC-3 590.004 p g y g A=Zero critical violations and no more than anon-critical violations. F=3 or more critical violations.9 or more non-critical violations, p )( ) constitutes an order of the Board of Health. Failure to correct violations g=One critical violation and less than 4 non-critical violations regardless of the number of critical,resulti;'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. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must 28.Poisonous or Toxic Materials (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 no -critica violations. If 1 critical refrigeration. 29.Special Requirements (590.009) within 10 days of receipt of this order. iolation,4 o 8 non-critical, oIatio =C. 30.Other DATE OF RE-INSPECTION: I e Signatu G9 Print: 31.Dumpster screened from public view 11 Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size 'Variance Letter Posted Y N Dumpster Screen? Y N HEALTH INSPECTOR•s Establishment Name r I Page.:-. ., - of +1 TOWN OF BARNSTABLE. Date: "' OFFICE HOURS PUBLIC HEALTH DIVISION e:00-9:30A.M. 200 MAIN STREET 3:30-4:30 P.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MON.-FRI. HYANNIS, MA 02601 508-862-4644 No Reference R?Red Item PLEASE PRINT CLEARLY 1 FOOD ESTABLISHMENT INSPPI;TION REPORT e Date vope o Type of Inspection ' "Operation(s) Routine dress Risk a Food Service Re-inspection A Level Retail Previous Inspection 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: Other Inspector Out: Each violation checked require an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ Violations marked may pose an imminent health hazard and require immediate corrective Tobacco - - -- 590.009(F) - - --- - - - --- - --- -- - - -- ---------- - - --- -- Action as determined by the Board of Health. Allergen Awareness 590:009(G) FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands ❑ 1.PIC Assigned/Knowledgeable/Duties ❑ 13.Handwash Facilities EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals FOOD FROM APPROVED SOURCE TIME/TEMPERATURE CONTROLS(Potentially Hazardous Foods) ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures ❑ 5.Receiving/Condition ❑ 17.Reheating ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling / ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑ 20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories r Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue&red items) Corrective Action Required: ❑ No ❑ Ye 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. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,-or lack of 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials.. (FC-7)(590.008) be in writing and submitted to the Board of Health at the above address violation,4 t 8 n n-critical violations=C. 29.Special Requirements (590.009) within 10 days of receipt of this order. 30.Other DATE OF RE-INSPECTION: s cto i Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Si na re _ Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y N � Dumpster Screen? Y N v` Las- , .��_�� ; i TOWN OF.BARNSTABLE DJ•'s'Wings_& S:uRFstaurant LOCATION @696 Yarmouth-Road`. .r ;` SEWAGE # 94-251 VILLAGE HYANNIS, MA. �� ASSESSORS MAP & LOT Ensign S. Cash d/b/a Cash Trucking INSTALLER'S NAME & PHONE NO. 508-362-3221 H-20 1,500 gallon holding tank SEPTIC TANK CAPACITY also, cast iron ring & cover LEACHING FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER OWNER John Rosario DATE PERMIT ISSUED: 05-16-94 DATE COMPLIANCE ISSUED• 05-19-94 VARIANCE GRANTED: Yes No r .- ,. l-�G �o� � `'`-- �j . .�,.. r No........ Fus.....1! ............ THE COMMONWEALTH OF MASSACHUSETTS BOARD --OF HEALTH ..--a.U.? OF.........`s.c3..r.k.g..L C-.b1..- .......... Appliration for Mivasal n kii Tallstrnrtion rrmi# Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: k--,M.1*A6.. ...ask............................................... . � f--------------......---- �_( Location-�ddress /'► -� r or Lo No / �—`= �/ 1.. `t ...... - �.►'1.�_s�. _.4,.... r� -•------ caner ! � ..............................•.Address Installer Address U Type of Building Size Lot_/s llo4._ ....... feet Dwellin�No. of Bedrooms`......�... __.__ Expall7s Att' ( Garbage Grinder ( ) pa., Other—Type of Building ._..4.r___.__:___ ersons _ ____ 51howersCafeteria ( ) Q' Other fixtures ....j----•----------------------- - W Design Flow...............//at.S.___...._.......___gallons per person per day. Total daily flow............ .....................gallons. WSeptic Tank—Liquid capacity!_ P_..gallons Length................ Width................ Diameter________-___--- Depth................ x Disposal Trench—No..................... Width..... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No....../------------ Diameter...40..X_,?_.._. Depth below))*et,,.____ Total leaching area.A.0.1......sq. ft. Z Other Distribution box ( ) Dosing tank ) a Percolation Test Results Performed by.__".. _ ............................................ Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ tion of S x1 -----------------------------------•••--•••---•- w U Nature of Repairs or Alterations—Answer when applicable.............................................................................................. --.•••• •--•-•------------------•-------------••--•-------•---------•-•----------•--•----•-•-••---••------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITILE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b sued by e boar of health. Sig d • --•---. •.. Date Date Application Approved By...... �/ ..... ..e.. ...._ . ..4 _ ----- Q ' lam-`_77 Date Application Disapproved for the following reasons:--............................................................................................................. ...-..................................................................................................................................................................................................... Date Permit No......................................................... Issued---•-------•-----•- ------------------•----•--•--------•--• -----•--------------•----•-•-•------- � Date r No........Gt.> '. .... Fxs .......... THE COMMONWEALTH 9 OF MASSACHUSETTS BOARD OF HEALTH +�J-40V... ........OF......... (. i> `" ............. Appliration for Disposal Works, Tonstrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Y ................................................. ...................................... .f!C -!_............................. { Location' ddress / or Lo No/ caner Address T a .................................-------•..................... ...------....._.........._._ Installer n Address �, dType of Building Size Lot_/4Cj?:__1_________Sq. feet Dwelling—No. of Bedrooms._:__ ___Expansion Attic ( ) Garbage Grinder ( ) Other—T e of a —Type Building, !t ____ __ No. of persons____________________________ ShowersCafeteria ( ) d Other fixtures ---- -------------- •---• ------ ------- --- ----- ---- Design Flow............... - gallons per person per day. Total daily flow.___._._ .. ,________________gallons. WSeptic Tank—Liquid capacityl.06.0---gallop Length________________ Width................ Diameter.............. - Depth................ x Disposal Trench No ___Width___ Total Length.................... Total leaching area':__. ._____sq. ft. Seepage Pit No. _.f___-----_____ Diameter_!�!_�_Y+._____ Depth below 1et 01 _ __ ___. Total leaching area: __.._.sq. ft. Z Other Distribution box.( ). Dosing tank 0 ) + ' Percolation Test Results, Performed b ._" _________________________________ Date................ T:est Pit No. 1...... .minutes per inch Depth of Test Pit____________________ Depth to ground water Test Pit No. .2....____........minutes per inch Depth of Test Pit...................:,Depth to ground water-----:.................. O Description of S 1____: . '.._.. '� _ l' J�" '... ......'_� � � , r . ................................. q UNature of -emirs or Alterations—Answer when applicable............................................................................................... ...................... .. _---_. ... Agreement:_ h, The itntlersigned agrees to install the aforedescribed.Itdi,vidual Sewage Disposal System in accordance with the proAsfons of TIT1: 5 of the State Sanitary Code-The undersigned further agrees not to place the system in, operation until a Certificate of Compliance has sued b e� oa of health. Sig ,. .. ........................ ...... ...... Application Approved By... �"; ' -- ._.. �� w......................... -- . " 7...... k Date z'�y�f i Application"Disapproved for the following reasons:-•------- ,-.. Date PermitNo.......... -. �.,,Issued-----------------"--------------------------------•--- Date 4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .... OF:...:. ..... :a........................................ t `TrrtifirFate of TompliFaurr T IN IS TO CE FY at the Ind vid �ewa D�posal System constructed ( ) or Repaired ( ) by.... -�•• �� - -•t.......................................................................... Ins a ler has been installed in a , of dance wltl the provisioi s of T T r. r of The State Sanitary Code as described m the application for Disposal Works Constuction`Permit N _ �.,: '_, 9 �� . ----•••. dated '. ."- -- - --- LK eS � THE ISSUANCE.OE THIS CERTIFICTE SHAL NOT BE CONSTIdANTES THAT THE SYSTEM,WILL FUNCTION SATI,4ACT:ORY. DATE-._. 'Z'-- Inspector- •--•----------------- COMMONWEALTH OF MASSACHUSETTS BOARD HEAL H ' ya OF. . � �!! 55{ ir�r nr ' S nnrua ra` it Permission 's' reby granted!" - = - -- .... �• -_,d_ - toat Construe (y. r e `ir, ( n.In i i al Sewage is al System • r as shown on the application for Disposal `t�orks Construction it o. R ? 'ard of He DATE ........................ ; FORM 1255, HOBBS & WARREN,'INC., PUBLISHERS - ^ !. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A m / IL DATA cU (So to °4J?C 6.f-o. fr:t-I- Ac-E-a _ trio �-,.P. n i �� 1 .cam 425 7r (A� L7A1L-f C=LOB/./ = 3Ua E•.PD. 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I LL O � 3 RoO K PGA - z G.N1 Z�ATS 4EV�A1 - ' lI 83 ,boa uun,�a✓ ,-~L._;� , I i i - /44 ov Q ' �e�` FOYZ - DIE N /Ji GAr.`LI /v 5 SCALE: �r .D'� APPROVED BY DRAWN BY 77�6G7 - DATE: 5- / S,MA LO,-J E DRAWING NUMBER ' 1 i u