HomeMy WebLinkAboutCAPE COD VEGAN BAKER - FOOD - FOODulcope Cc-)d �/2CQ.A -acL�l 1 0— 1
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OgtFi Town of Barnstable BOARD OF HEALTH
John T.Norman
Board of Health Donald A.Gaudagnoli,M.D.
BARNWABL& F.P.(Thomas)Lee
200 Main Street, Hyannis, MA 02601 Daniel Luczkow,M.D.,Alt.
Phone: (508) 862-4644 Fax: (508)790-6304
www.townofbarnstable.us
Permit to Operate a Food Establishment
In accordance with regulations promulgated under authority of 105 CMR 590.000 M.G.L. Chapter 94 Sections
305A, 305B, 146, 189 and 189A; Chapter 111,Sections 5 and 127A,a permit is hereby granted to:
Permit No: 1149 Issue Date 05/12/2022
DBA: CAPE COD VEGAN BAKER
OWNER: ASHLEY CALISE
Location of Establishment: 100 MEADOWLARK LANE OSTERVILLE MA 02655
Type of Business Permit: FOOD SERVICE
Annual: YES Seasonal:
IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0
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: C��
FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent
FOR ESTABLISHMENTS WITH SEATING:
PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE
Restrictions:
For Offlice Us Initials:
.�`"�"�'�.o Town of Barnstable �2
Da S
? HARNWAsre Inspectional Services
'b'a A` Public Health Division- check#
p ✓
Thomas McKean,Director
200 Main Street,Hyannis, A 02601, t l VI—owl M
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT^ TO OPERATE A FOOD ESTABLISHMENT/
DATE I �2L NEW.OWNERSHIP V RENEWAL _.
NAME OF FOOD ESTABLISHMENT: es C�UI V ""I a 1
ADDRESS OF FOOD ESTABLISHMENT: A(�(�re_q a 1 t WCk ) 014 o n n 1's MA 02,601
MAILING ADDRESS(IF DIFFERENT FROM ABOVE): [b'O ly I w o w I ar�- Ln D`S-} yj.f I N1A-
E-MAIL ADDRESS:
TELEPHONE NUMBER OF FOOD ESTABLISHMENT:
TOTAL NUMBER OF BATHROOMS: _
WELL WATER: YES NO \/ ... (ANNUAL WATER ANALYSIS REQUIRED)
ANNUAL: V SEASONAL: DATES OF OPERATION:_/_/ TO
NUMBER OF SEATS: INSIDE: 0 OUTSIDE: 0 _TOTAL: 0' '
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? IV
IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)? N
TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW) l
X FOOD SERVICE
RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer)
BED&BREAKFAST
CONTINENTAL BREAKFAST
COTTAGE FOOD INDUSTRY(formerly residential kitchen)
MOBILE FOOD
FROZEN DAIRY DESSERT MACHINES ...(MONTHLY LAB ANALYSIS REQUIRED)
CATERING... (CATERING NOTICE REQUIRED BEFORE EVENT(SEE PAGE#2)
*** SEASONAL,MOBILE & NEW FOOD ONLY***
REQUIRED TO CALL HEALTH DIV.FOR INSPECTION PRIOR TO PERMIT BEING ISSUED
PLEASE CALL 508-8624644
Q:\Application FormsTOODAPP REV'3-2019.doc
OWNER INFORMATION:
FULL NAME OF APPLICANT-' S1'1Ie Cal 15�
SOLE OWNER: 0/NO ' OWNER PHONE#
ADDRESS Ioo MW0wlaXk lP OS46Nllt MA- 07it055
CORPORATE OWNER:
CORPORATE ADDRESS:
PERSON IN CHARGE OF DAILY OPERATIONS:
List(2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff
All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT.
**ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You
must provide new copies and POST THE CERTIFICATES at your food establishment.
Certified Food Managers Expiration.Date Allergin-Avvareness Expiration Date
p� ,p �1 � f p r,,
1. Tt���1,� l.lJ� 6�SL / �P / ��", 1. �'� 11�I��i. / 1-3 / 2
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 openint!! Please call Health Div.'at 508-8624644 to schedule your inspection. Please call at least(7)days in advance.
FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter,
with sample results submitted to the Health Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert
Permit until the above terms are met. '
CATERING POLICY: Anyone who caters within the Town of Barnstable must notify theTown by fax or mail prior to catering -
event. You must complete a catering notice found at httu://vvwn.todt nofbarnstablg.us/hc lthdivision/auplications,as,u.
OUTDOOR COOKING: Outdoor cooking,preparation,or display of any'food product by a food establishment is prohibited,
NOTICE: Permits run annually from January 1st to Dec. 31"each calendar year. IT IS YOUR RESPONSIBILITY TO RETURN
THE COMPLETED APPLICATION(S)AND REQUIRED FEES BY DEC 1st.
Q;\Applicafion FonnsTOODAPP REV3-2019.doo
5/10/22,3:08 PM
F`"E'° Town of Barnstable
�AaysrAg� : Massachusetts
y A4ASS °
q,A 1639. �e° Business Certificate
rF0 NA'�G.
Permit Number: BL-924
Permit Issued: May 10,2022
Permit Expires: May 10,2026
In conformity with the provisions of Chapter One Hundred and Ten(110),Section Five(5)of the General Laws,as amended,the undersigned hereby declare(s)that a
business is conducted under the title below,located as shown,by the following named person,persons or corporation:
Please Note:A Business Certificate Indicates that the named person(s)Is(ars)doing business under a name different than his/her personal name(s). It does
not Imply that the applicants)has(have)met all license,permit and other permissions required by the Town of Barnstable Building,Health,and Licensing
Departments for the legal operation of this Business at the stated location.
Granted To: Ashley Calise
100 MEADOWLARK LANE,Osterville MA
DBA: Cape Cod Vegan Baker
Owner: Timothy and Ashley Calise
100 Meadowlark Lane 100 MEADOWLARK LANE,Osterville MA 02655
Restrictions: Administrative offices only.All cooking,inventory and food prep to be done offsite at 6 Aggregate Way.
Ann M. Quirk
Town Clerk
In accordance with the provisions of Chapter 337 of the Acts of 1086 and Chapter 110,Section 5 of the Mass General Laws,Business Certificates shall be In
effect for four years from the date of Issue and shall be renewed each four years thereafter. A statement under oath must be filed with the city clerk upon
discontinuing,retiring or withdrawing from such business or partnership.
Copies of such certificates shall be available at the address at which such business Is conducted and shall be furnished on request during regular business
hours to any person who has purchased goods or services from such business.
Violations are subject to a fine of not more than three hundred dollars($300)for each month during which such violation continues.
1i1
DocuSign Envelope ID:C4665334-861F-4517-80OF-EE418147CD94
V
:" SHARED KITCHEN USE AGREEMENT
THIS AGREEMENT is made on_May 5, 2022 , by and between Cape Cod Culinary Incubator
(referred to as"Kitchen") and _Cape Cod Vegan Baker 'referred to as ("Member")
1. Premises. Member shall be granted access to and use of, on a non-exclusive time-sharing basis with
other members, use of commissary kitchen space located at the rear of 6 Aggregate Way, Hyannis, MA
02601.
2. Term and Termination. This Agreement shall be a month-to-month Agreement and shall automatically
renew on a monthly basis. Member understands that,this agreement may be canceled by Kitchen, with
or without cause, at any time. Kitchen may terminate this Agreement for any egregious material breach
of this Agreement immediately.upon providing notice to the;Member. Member may terminate.this
Agreement, with or without cause, only by providing 1 month advance written notice to Kitchen. Kitchen
r, will not permit a partiallmonth cancellation, therefore any termination of this Agreement by Member .
shall be effective at the end of the full month following Kitchen's receipt of.Member's notice of
termination. For example, if Member provides-notice of termination to•Kitchen on the 2nd of any month,
then payment will still be due the following!month.on the 1st, and allsights and duties under.this
Agreement shall continue until the termination date. There are no refunds for membership fees,-,and
Kitchen will not prorate a canceled membership.
r
3. Special Termination Clause. Should Kitchen cease operations for any reason, this entire agreement
_becomes immediately null and void.
.4.. Commencement Date. The Commencement,Date of,this agreement is May 9,.2022
Once Agreement is signed, Member's,commencement date cannot be moved or changed and
Member's duties and responsibilities, including the payment of monthly dues,shall begin on the
Commencement Date.
5. Fees. The following fees describe the fees agreed to at the time of the signing of this agreement.
Membership fees: (per month)
Basic $50 access to mentorship with board members; assistance with business model J
membershi canvas; ability to rent kitchen by the hour once paperwork is in order
Starter bundle $250 10 hours of kitchen time per month; 1 dry shelf; 1 cold shelf
Lite bundle $500 20 hours of kitchen time per month; 1 dry shelf- 1 cold shelf
Pro bundle $850 40 hours kitchen time per month; 1 dry shelf; 2 cold shelves i-
Additional fees are outlined in the Kitchen Operations Manual
6. Deposit.A deposit of$250.00. The deposit is fully refundable, except for any unpaid fees, damages, or
other breaches to agreement. In order to receive your refund the following items need to be'completed
by your last day of membership:
a) Member's property has been removed from the kitchen, the area has been cleaned, and Kitchen
has been notified in writing. _
b) Keys have been returned and Kitchen has been notified in writing. `
DocuSign Envelope ID:C4665334-861 F-4517-80OF-EE418147CD94
c) Member has notified the Town of Barnstable Health Department or any health permit/license
affiliated with our address, that it is no longer using the kitchen. We must receive proof that this
notification has been filed.
Please be advised that the Kitchen does not hold deposited funds in trust or reserve and has no duty or
obligation to do so under this Agreement.
7. Fee Adjustments by.Kitchen. Kitchen reserves the right to adjust its fees periodically, and agrees to., .
give Member 60-days notice before implementing any adjusted fees.
8. Address Usage. Cape Cod Culinary Incubator's address can in no way be used as Member's business
contact or mailing address. Kitchen does not receive business mail for Members at our kitchen.
Member must use their business PO Box or personal home mailing address for all business
' communications. The only times Cape Cod Culinary Incubator's-address can be utilized is for the
following: "Address of Food Establishment"for your Town of Barnstable Food Permit application;
Vendor'deliveries at our kitchen address (as Ion g'as you have an employee present for receiving these
items or have arranged for the Kitchen Manager to receive delivery).
9. Registration of Employees. Member is required to submit a photo ID and contact phone number to
Kitchen for every employee who works on the premises. This is required for insurance purposes, as .
well as security system compatibility and securitj'on the�premises. If`an employee is'working'on the
premises without Member•notification of registration;Kitchen reserves the right to remove said
employee from the premises. -* � . •"' - - r
4
10. Time Selection. Member agrees to work only during reserved hours and vacate its station daily no
later than the end time, leaving the space cleaned and ready for use by the next member.
11. Insurance. Member shall maintain public liability and product liability insurance with a minimum policy
limit of$1,000,000 for bodily injury and death, and shall name Cape Cod Culinary Incubator as
additionally insured. Member shall furnish Kitchen a certificate indicating that the insurance policy is in
full force and effect, the Kitchen has been named as an additional insured, and that the policy may not
be canceled unless ten (10) days prior written notice of the proposed cancellation has been given to
Kitchen.
Your insurance carrier will need the following information to add additionally insured as Certificate
Holders: -
ACORD Certificate#1
Cape Cod Culinary Incubator
PO Box 647 r
Barnstable, MA 02630
ACORD Certificate#2
GEMAC, INC
54 A Meetinghouse Ln.
Sagamore Beach, MA 02562
Additional Insureds on Certificate#2: KAM Appliances, 6 Aggregate Way, Hyannis, MA 02601
12. Access & Business Interruption. Kitchen shall have the right to enter the premises at all reasonable
times for the purpose of inspection or of making repairs, additions or alterations, to show the premises
to prospective members, or for any other purpose. in the event that access or use of the premises is
DocuSign Envelope ID:C4665334-861F-4517-800E-EE418147CD94
restricted due to causes, such as a power outage or weather events, Kitchen will notify members of the
outage via Food Corridor/email. Kitchen.may not be held liable for Member's lost product in the event of
such access restriction. Member is responsible to move its own refrigerated or frozen food in this case.
Members who have refrigerated or frozen inventory of any significant value should ensure its business
insurance covers these types of events or other business interruptions.
13. Health Department Permits and Liability. Members are obligated to maintain a valid health permit
with the Town of Barnstable or any health permit affiliated with our address, and are expected to
provide copies of active permits with Kitchen at all times. Furthermore, Kitchenwill.not be held liable"for
any issues or claims involving health permitting or lack of.health permitting for Member.
14. Building Access. Member and its employees shall have access to the building during posted building
hours. Although Member may access facility at times otherthan those reserved, Member shall only
perform work at the kitchen during scheduled,,approved time slots specified in Food Corridor software.
Member promises to maintain an active employee list with Kitchen and to notify Kitchen of employee
changes.
15, Utilities. General utility costs (electricity;water, garbage, recycling, compost) are included in the fees.
16. Common Areas. The building is operated as a shared kitchen facility, and as such all areas with the
exceptionof certain proprietary storage areas are common areas, and are in commoWuse by all.
members.
17. Repairs and Maintenance. Premises have been inspected and are accepted-by Member in their
present condition. Members will at all times keep the premises neat, clean, and in a sanitary condition,
and keep and use the premises in accordance with all applicable laws, ordinances, rules, regulations,
and requirements of governmental authorities. Member is responsible for any and all damages, beyond
wear and tear, to the facility and equipment caused by its employees or contractors and associates.
Members should report equipment/facility repair issues or operational concerns to Kitchen Manager.
18. Alterations. No alterations maybe made.to premises without prior written consent of Kitchen. If
alterations are approved, Member agrees in the performance of such work, to comply with all laws,
ordinances, rules and regulations of any proper public authority, and to hold Kitchen harmless from
damage, loss or expense. Upon termination of this agreement and at Kitchen's request, or approval,
Member shall remove such improvements and restore the premises to the original condition not later
than the termination date, and at member's sole cost and expense. Any improvements not so removed
shall be removed at Member's expense provided that Member shall pay for any damage caused by
such removal.
19. Incoming and Outgoing Deliveries.�Member agrees to direct any delivery companies (example:
Guaranteed Fresh Produce, Sysco, etc.) to deliver products to the facility entrance at the rear of the
building.
20. Drugs and Alcohol: For the safety of all of its members, Cape Cod Culinary Incubator is a drug and
alcohol-free environment and use of drugs or alcohol at the-Kitchen are not permitted.
21. Responsibility of Employee Actions. Member.promises to be responsible for,the actions of its
employees and.employee behavior. Member understands that if any wrongdoing or disruption should
ever occur by a particular individual, that the Kitchen reserves the right to ask Member to not allow a
certain employee to return to the kitchen. Further, Member,agrees to replace any property if it is
damaged or goes missing. If any egregious theft occurs of another member's personal property or of
Kitchen property, this entire agreement may be subject to cancellation.
DocuSign Envelope ID:C4665334-861F-4517-800E-EE418147CD94
22:Accidents and Liability. Kitchen or its agent shall not be liable for, and Member agrees to defend and
.hold Kitchen, and its-agents harmless from any claim, action, loss, cost, liability, expense (including
consequential damages) and/or:judgments for damages to property or injury to persons suffered or
alleged to be suffered on the premises by any person, firm or corporation, relating to or arising from
Member's or its agents, employees or invitees' actions or omissions, unless caused solely by Kitchen's
negligence or misconduct.
23. Photo ReleaseNVaiver. In the spirit of supporting each other's businesses, Kitchen and Member,grant
each other mutual general permission to share each other's public photos, social media posts and
information about upcoming events on social media and website platforms.
24. Rules. Member agrees to follow and abide by all rules set,by Kitchen: Kitchen may unilaterally amend
- _ and update the Rules at will, and at its own discretion. Kitchen shall deliver any amended Rules to the
Member within ten (10) days of finalizing and implementing the amended Rules.
25. Amendments and/or Modifications. Neither this Agreement nor any term or provision hereof may be
changed, waived, discharged, amended, modified or terminated-orally or in any other manner other
than by an instrument in writing signed by all the Parties hereto.
26. No Third-Party Beneficiaries. This Agreement is not intended-to confer upon any person or entity
other than the Parties hereto any rights or remedies hereunder. - 4 .
27. Governing Law.,This Agreement shall be construed in accordance with and governed by the laws of
the Commonwealth of Massachusetts. -
28. Benefits. This Agreement shall be binding upon and inure to the benefit of the Parties, their successors
and assigns.
29. Severability. In the event a court of competent jurisdiction should find part of this Agreement invalid
and unenforceable,-such part shall be fully-severable and this Agreement shall be construed and
.enforced as if such invalid, or unenforceable provision had never comprised a part of the Agreement.
The remaining provisions hereof shall remain in full force and effect and shall not be affected by the
invalid or unenforceable provision or by the severance herefrom:
30. Headings. The headings in this Agreement are for convenience only, and shall not restrict or otherwise
modify the.terms of this Agreement.
31. Gender and Number. When the context requires, the masculine gender will be deemed to include the
feminine and the neuter genders and-vice versa; and the singular will•be deemed to include the plural
and vice versa. -
32.Waiver of Breach. No provision of this Agreement may be waived except in writing, signed by the
-waiving Party. Failure to enforce any provision of this Agreement shall not constitute a waiver of such
provision. Any waiver shall not operate as, or be construed to be, a waiver of any subsequent breach.
33. Counterparts.This Agreement may be executed in counterparts; and each executed counterpart shall
have the same force and effect as an original instrument as if all Parties to the counterparts had signed
the same instrument: Counterpart signature-pages to this Agreement transmitted by facsimile
transmission,by electronic mail in "portable document format" (.pdf) or by any other electronic means
-intended to preserve the original graphic and pictorial appearance of a document, will have the same
DocuSign Envelope ID:C4665334-861F-4517-800E-EE418147CD94
effect as physical delivery of that paper document bearing an original signature. Please sign below to
indicate Members agreement with the terms outlined in this agreement.
MEMBER I am authorized to sign agreements on behalf of the company. I agree to all of the terms outlined.
Name: Ashley C U&Signedby;
Signature: QS caLiSr✓
Date: 5/10/2022
Company Name (legal entity) Doing Business As (if different):
Calise Bakery, LLC DBA Cape Cod Vegan Baker
Company Mailing Address City, State, and Zip Code:
100 Meadowlark Lane, osterville, MA 02655
ON BEHALF OF CAPE COD CULINARY INCUBATOR
Linda Davey
Name: DocuSigned by: i
Signature: �� V
Date: 5/10/2022
Cape Cod Vegan Bakery Menu
All vegan baked goods, made to order.
Vegan Pastries (available in quantities of 6 or more)
Plain Croissant $5
Chocolate Croissant $6
Everything Bagel Croissant $6
Cinnamon Roll $4
Seasonal Berry Pop Tart $4
Chocolate Chip Cookie $3
Specialty Desserts
Vegan Lemon Meringue Tart $30
Vegan Key Lime Tart $30
Vegan Cakes
All cakes are made to order and available in 6"and 8" sizes
Carrot Cake $50 $65
(Can be made with OR without nuts)
Lemon Cake $45 $60
Add fresh fruit compote-additional $5
Cookie Butter Cake $50 $65
Cookies and Cream Cake $50 $65
Chocolate and Peanut Butter Cake $50 $65
Tiramisu Cake $50 $65
Sprinkle Cake $55 $70
(Can be made with funfetti, chocolate or vanilla cake and frosting combinations.)
Create Your Own Cake $50 $65
Choose from the following:
Vegan Cake Flavors: Vanilla, chocolate, lemon, cinnamon, funfetti
Vegan Buttercream Frosting Flavors: vanilla, chocolate, coffee, cream cheese, lemon, peanut butter,
cookie butter
Add fresh fruit compote-additional $5
Add chocolate ganache drip-additional $5
Vegan Cupcakes $3.75 ea (available in quantities of 6 or more)
Can be made in all cake flavors
** Most baked goods can be made nut free. Please request when the order is placed. Please be
aware that it is not a nut free facility.
i
Bellaire, Dianna
From: Desmarais, Donald
Sent: Tuesday, May 24, 2022 3:01 PM
To: Bellaire, Dianna
Subject: RE: Cape Cod Vegan Baker @ Kams
I inspected her yesterday. Give permit
Sent froth my Verizon, Sarnsung Galaxy smartphone
-------- Original message --------
From: "Bellaire, Dianna" <Dianna.Bellaire@town.barnstable.ma.us>
Date: 5/24/22 2:29 PM (GMT-05:00)
To: 'Ashley Calise' <ashleycalise@gmail.com>
Cc: "Bellaire, Dianna" <Dianna.B ellaire@town.bamstable.ma.us>, "Desmarais, Donald"
<Donald.Desmarais@town.barnstable.ma.us>
Subject: RE: Cape Cod Vegan Baker @ Kams
I just need Donny to give me his approval.
Dianna Bellaire
Permit Technician
Town of Barnstable
Health Division
200 Main Street
Hyannis, MA 02601
P:508-862-4643
Fax:508-790-6304
Email:Dianna.Bellaire@town.barnstable.ma.us
The information contained in this electronic transinission("e-mail"),including airy at:tacluncrit(t:he"Information"),may be confidential or
otherwise exempt from disclosure.It is for the addressee only.This Information may be privileged and confidential work-product or a
privileged and confidential commurucation."The Information may also be deliberative and Pre-decisional in nature.As such,it is for
internal use only.The Information cnay not be disclosed without,the prior written consent of the Director of Public Health and/or the
Town \ttorney's Office of the Town of Barnstable.If you have received this e mail by mistake,please notify the sender and delete it:from
your system.Please do not copy or forward it.'Thank you for your.cooperation..
From: Ashley Calise [mailto:ashleycalise@gmail.com]
Sent: Tuesday, May 24, 2022 2:01 PM
To: Bellaire, Dianna
Subject: Re: Cape Cod Vegan Baker @ Kams
Good afternoon Dianna,
i
Don was in the space with me yesterday and signed off on the paperwork. Is there anything else you need from
me before the permit is issued?
Thank you,
Ashley
On May 16, 2022, at 9:46 AM, Bellaire, Dianna<Dianna.Bellaire a,town.barnstable.ma.us> wrote:
Donald.desmarais@town.barnstable.ma.us
Dianna Bellaire
Permit Technician
Town of Barnstable
Health Division
200 Main Street
Hyannis, MA 02601
P:508-862-4643
Fax:508-790-6304
Email:Dianna.Bellaire@town.barnstable.ma.us
The information contained to this electronic transmission ("e-mail"),Including any attachment(the "Information"),may
be confidential or otherwise exempt from disclosure. It is for the addressee only."1'h.is Information may be privileged
and confidential work-product or a privileged and confidential commuiiication.The Information may also be
deliberative and pre-decisional in nature.As such,it is for internal use only.The Information may not be disclosed
without the prior written consent of the Director of Public Fleal.th and/or the Town Attomey's Office of the Town of
Barnstable. If you have received this e-mail by mistake,please notify the sender an.d.delete it from your system.Please do
not copy or forward it.Thank you for your cooperation.
From: Ashley Calise [mailto:ashleycalise@gmail.com]
Sent: Monday, May 16, 2022 8:53 AM
To: Bellaire, Dianna
Subject: Re: Cape Cod Vegan Baker @ Kams
Good morning Dianna,
Could you please send me Mr. Desmarais' email address? I would like to contact him to
schedule a walk through.
Ashley Calise
On Fri, May 13, 2022 at 10:07 AM Bellaire, Dianna<Dianna.Bellaire a,town.barnstable.ma.us>
wrote:
Thank you. This is what I needed to complete the application.
Dianna Bellaire
Permit Technician
Town of Barnstable
Health Division
2
oF. rq, TOWN OF BARNSTABLE. HEALTH INSPECTOR'SEstablishment Name: � ate: Pge: . - of
OFFICE HOURS -
P ° PUBLIC HEALTH DIVISION 8:06-6:30 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
639. HYANNIS,MA 02601 ._ .: M°N._FRI. No Reference. R-Red Item- - - PLEASE PRINT CLEARLY
508-862-4644 -
FOOD ESTABLISHMENT INSP CTION REPORT
Namesr Date ' of Inspection
g Routin -
Address Risk Food e-inspection
Level Retail Previous Inspection J
Telephone Residential Kitchen Date:
Mobile Pre-operation
Owner HACCP Y/N Temporary Suspect Illness
Caterer General Complaint
Person in Charge(PIC) Time Bed&Breakfast HACCP
In: Other
Inspector Out:
Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated.
Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑
Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑
Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ LL
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 POP LA IZNS(H(SP)
❑9.Food Contact Surfaces Cleaning and Sanitizing ❑ 21.Food and Food Preparation for HSP❑ 10.ProperAdequate Handwashing CONSUMER ADVISORY (J/�/v�,
❑ 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: o El Yes
Non-critical(N)violations must be corrected immediately or Overall Rating
within 90 days as determined by the Board of Health. ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspension
C N Official Order for Correction:Based on an inspection today,the items 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 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 suspensi on or revocation of the food B=One critical violation and less than 4 non-critical violations
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot
27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical water,sewage back-up,infestation of rodents or insects,or lack of
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 da s of recei t of this order. violation,4 to on cal violations=C.
29.Special Requirements (590.009) y P
30.Other DATE OF RE-INSPECTION: pector's ' na re Pri
31.Dumpster screened from public view LP
_91T �Qr
Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N
#Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC' Signature Print: I
Self Service Wait Service Provided Grease.Trap Size Variance Letter Posted- Y N S h e Ca
`I S
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.l l(A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers*
2 590.003(C) Responsibility of the.Person-in-Charge to Other* g7-]02.11 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*
Applicants* 3-302.11(A) Food Protection* 7-201.11 Separation-Storage*g 20 Time as a Public Health Control
590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 7-202.11 Restriction-Presence and Use* 3-501.19 Time as a Public Health Control*
Applicant To Report To The Person In Charge* * 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements
590.003(G) Reporting by Person in Charge
* 3-304.11 Food Contact with Equipment and Utensils 7-203.11 Toxic Containers-Prohibitions* ( ) q
Contamination from the Consumer
3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR
3-306.14(A)(B)Returned Food and Rrated or of Food* 7-204.12 Chemicals for WashingProduce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP
590.003(E) Removal of Exclusions and Restrictions Disposition of Adulterated or Contaminated � )
Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and
FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4 Food and Water From Regulated Sources F9 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 Nut Re-Served*
3-202.13 Shell Eggs* Sanitization Temperatures* TIME/TEMPERATURE CONTROLS "
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY
* Concentration and Hardness* 22 3-603.11 Consumer Advisory Posted for Consumption of
3-202.16 Ice Made From Potable Drinking Water 3-401.11A(1)(2) Eggs-155°F 15 sec Animal Foods That are Raw,Undercooked or
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* Eff vi°e 11112001
4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec*
590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* 3-302.13 Pasteurized Eggs Substitute for Raw Shell
Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* Eggs*
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
Stuffing Containing Fish,Meat,Poultry or 590.009(A)-(D) Violations of Section 590.009 A
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* ( )-(D)in cater-
* Ratites-165°F 15 sec* in mobile food,temporary and residential
Sources 10 Proper,Adequate Handwashing g' P
Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F* kitchen operations should be debited under
Regulatory Authority 2-301.11 Clean Condition=Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to
3-202.18 Shellstock Identification Present* 2-301.12 Cleaning Procedure* 165°F* 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 practices should be debited under#29-Special
Requirements.
5 Receiving/Condition 2-401.11 Eating,Drinking or Using Tobacco* 3-403.11(A)&(D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3-403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES
* 3-301.12 Preventing Contamination When Tasting* 3-403.11 C Commercial] Processed RTE Food-140°F* (Blue Items 23-30)
3-202.15 Package Integrity ( ) Y Critical and non-critical violations,which do not relate to the foodborne
3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands ( ) g Unsliced Portions of Beef Roasts*3-403.11E Remainin illness interventions and risk factors listed above,can be found in the
8 Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000
* 13 Handwashing Facilities 3-501.14 A CoolingCooked PHFs from 140°F to 70°F
3-202.18 Shellstock Identification ( ) Item Good Retail Practices FC 590.000
3-203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours* 23. Management and Personnel FC-2 .003
5-204.11 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protecton FC-3 .004
3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005
3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006
590.004(J) Labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007
7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008
HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009
3-502.11 Specialized Processing Methods* 30. Other
3-502.12 Reduced-Oxygen Packaging Criteria*
8-103.12 Conformance with Approved Procedures* S:590Formback6-2doc
*Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000.