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TOWN OF BARNSTABLE ._ HEALTH INSPECTOR'S Establishment Name: S 51_14A; Date: of '
Qp THE r - - -
_W ..... � . . - -- OFFICE HOURS ..
PUBLIC HEALTH DIVISION e60 .9:30A.M.
BARNSTABLE. ` 200 MAIN STREET 3.30-4:30 F.M. Item Code C-Critical Item DESCRIP PfION OF VIOLATION/PLAN OF CORRECTION Date Verified
MASS. MON.-FRI.
94, ,e,y.aim HYANNIS,MA 02601 5 _ 644 No Reference .;R;-,Red-Item PLEASE PRINT CLEARLY
08 862-4
FOOD ESTABLISHMENT INSPECTION REPORT.
Name 1. Dat a ofe of Inspection
Operation(s)
ns
Routine,
.Address Risk o e Re-inspection
Previous Inspection
Level Retail -, -
Telephone Residential'Kitchen Date:
Mobile56
re-o era
Owner^ "" HACCP YIN Temporary, Suspect Illness
�• Caterer General Complaint
Person in Charge.(PIC) �S¢j���.f� Time Bed&'Breakfast- HACCP
Other
In:
Inspector Out:
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)
_. " Cap" �
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
Violations Related to Good Retail Practices Blue Items) Total Number of)ritical 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 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 CM R 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 norf-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. _
6=One critical violation and less than 4nori-critical violations 9
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 6rion=critical violations=B.
26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If Seriously Critical Violation F is scored automatically if: no hot
27.Physical Facility (FC-6)(590:007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of
be in writing and submitted to the of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration.
28.Poisonous or Toxic Materials (FC-7)(590.008) 9 violatio on-critical violations=C.
29.Special Requirements. (590.009) within 10 days of receipt of this order.
30.Other DATE OF RE-INSPECTION: Inspec Signat e \
31.Dumpster screened from public view. : - 7T4vyx�
de
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
.-,,,.-_i....rk:� _.�--.wa..,°e. ��.�_..-��. � �-, - _ .,aafyrt.°,,,.�:r.r,. _.�.,`�.�- - ,----- _ _� � � - r. -. - _ � _ .. „_ �- __ 'a„��:.�a - s'_t.r...,.+��t•:�:__ _ .. _.. ...-_
7
Violations related to.Foodborne Illness Violations Related to Foodborne Illness Interventions
Inten!endgns and.Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Coot.)
FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS
- 3-501.14(C) PHFs Received at Temperatures According to
890.003(B) Demonstration of Knowledge*1 590.003(A) Assignment of Responsibility* $ Cross-contamination 14 Food or Color Additives Law Cooled to 41°F/45°F Within 4 Hours*
3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives* 3-501.15 Cooling Methods for PHFs
2-10.3.1.1 Person-in-Charge Duties Cooked•and RTE Foods.* 19 PHF Hot and Cold Holding
- 3-302.14- - Protection from Unapproved Additives*Contamination from Raw Ingredients 15 Poisonous or Toxic Substances 3-501.16(B) Cold MIN Maintained At or Below 41°F/45°F
EMPLOYEE HEALTH- 3-302.11(A)(2) Raw Animal Foods Separated from Each 590.004(F) _
2 590.003(C) Responsibility of the Person-in-Charge to Other* 7-]Ol.l1 _ Identifying Information Original Containers*
3-501.16(A) Hot PHFs Maintained At or Above 140°F*
Require Reporting b Food Employees and 7=102.11 -Common Name-Working Containers* --
P g YContamination from the Environment 3=501'16(A) Roasts Held At or Above 130°F*
Applicants* 7-201.11 Se aration-Stora e*
3-302.11(A) Food Protection* P g T' Public Health C
590.003(F) Responsibility of A Food Employee or An 7-202.11 Restriction-Presence and Use* -" Time as a u isontrol
-20 -.
I 3-302.15 Washing Fruits and Vegetables *
Applicant To Report To The Person In Charge* 7.202.12 Conditions-of Use* 3-501.19 Time as a Public Health Control
3-304.11 Food Contact with Equipment and Utensils*. _
59.0.003(G) Reporting by Person in Charge* R 7-203.11 -Toxic Containers-Prohibitions* 590.004(11) Variance Requirements
3, 590.003(D) Exclusions and_Restrictions* Contamination from the Consumer 7-204.11 Saiiitizers;Criteria Chemicals*
3-306.14(A)(B)Returned Food and Reservice of Food* .1._ REQUIREMENTS-FOR ;
590.003(E) Removal of.Exclusions and Restrictions Disposition of Adulterated or Contaminated 7-204.12 Chemicals for Washing Produce,Criteria* - HIGHLY SUSCEPTIBLE POPULATIONS(HSP)
Food 7-.204.14 Drying Agents Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED,SOURCE 3-701.11 Discarding.or Reconditioning Unsafe-Food* 7-205.I1 Incidental Food Contact,Lubricants* Beverages with Warning Labels*
4. Food and,Water From Regulated Sources g Food Contact Surface's 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs*
590.004(A7B) Compliance with Food Law* 4-501:111- Manual Warewashin Hot Water * 3-801.11
g- 7.206.12 Rodent Bait Stations (D) Raw or Partially Cooked Animal Food and
3-261.12 Food in a Hermetically Sealed Container* Sanitization Temperatures* .. Raw Seed Sprouts Not Served,*
7-206.13 Tracking Powders,Pest Control and
3-201.13. Fluid Milk and Milk Products* 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served*
3-202.13 Shell Eggs* Sanitization:Temperatures* TIME/TEMPERATURE CONTROLS
3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical S'anitization=Temp.,pH. 16 Proper Cooking Temperatures for PHFs - CONSUMER ADVISORY
3-202.16 Ice Made From Potable Drinking Water* Concentration and Hardness* 3-401.11A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of
5-101.11 Drinking Water from an Approved.System* 4-601.11(A) Clean r
Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or
Equipment Not Otherwise Processed to Eliminate
590.006(A) Bottled Drinking Water* 3-401.11(A)(2) Comminuted Fish,Meats&Game �c""e nrzoor
* _ 4-602.11 Cleaning Frequency of Utensils and Food Animals-155°F 15 sec* Pathogens* e 590.006(B). Water Meets Standards in 310 CMR 22.0 Contact Surfaces of ui
E9 Prrient* I Shellfish and Fish From an Approved Source. 3-401.11(B)(1)(2) Pork and Beef Roast-130°F 121 min* 3-302.13 Pasteurized Eggs Substitute1orRaw�Shell
4-702.11 Frequency of Sanitization of Utensils and Food Eggs*-Fish and Recreationally Caught Molluscan 3-401.11(A)(2) - Ratites,Injected Meats-155°F 15 sec*
Contact Surfaces of Equipment* C.°�,23rw ` _r_r_'�kK
Shellfish* 4-703.11 Methods of Sanitization-Hot Water and 3-401.11(A)(3j Poultry,Wild Game,Stuffed PHFs �- SPECIAL REQUIREMENTS
3-201.15 Molluscan Shellfish from NSSP Listed Chemical* Stuffing Containing Fish,Meat,Poultry or 590.009
Sources* Ratites-165°F 15 sec A* ( )-(D) Violations of Section 590.009(A)-(D)in cater-
Game Proper,Adequate Handwashing ing,mobile food,temporary and residential )
Game and Wild Mushrooms Approved By * 3-401.11(C)(3) Whole-muscle,Intact Beef Steaks 145'F* kitchen orations should be debited under
Regulatory Authority 2-301.11 Clean Condition' Hands and Arms Pe
* 3 401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to i
3-202.18 Shell-stock Identification Present* 2-301.12 Cleaning'Procedure 165°F* foodbome illness interventions and risk factors. a
590.004(C) Wild Mushrooms* 2-301.14 When to Wash* * Other 590.009 violations relating to good retail
3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec -- - g g 1
3-201.17 Game Animals* 11 Good Hygienie Practices 17 Reheating for Hot Holding practices should be debited under#29-Special
5 Receiving/Condition 2-401.11 _ Eating Drinking or Using Tobacco* 3-403.11 A& Requirements.
( ) (D) PHFs 165°F 15 sec*
3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the,Eyes,.Nose and Mouth* 3-403.11(B) Microwave--165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES '3-202.15 Package Integrity* 3-301.12 Preventing Contamination When Tasting* 3 403.11(C) Comrriercially Processed RTE Food-140°F* Blue Items 23-30)
3,-101.11 Food Safe and Unadulterated* 12 Preventlon'of Contamination'from Hands Critical and non-critical violations,which do not relate to the foodbome
3-403.11(E) - Remaining Unsliced Portions of Beef Roasts*
6, illness interventions and risk factors listed above,can be found.in the
Tags/Records:$hellstoek 590.004(E) Preventing Contamination from Employees* 1$''. Proper Cooling of PHFs following sections of the Food Code and 105 CMR 00 90 0
3-202:18,. Shellstock Identification* 13 HandweshingFacilifies"
5
3-501.14(A) Cooling Cooked PHFs from 140°F to 70717
3_203.12 Shellstock Identification Maintained* Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000
Tags/Records:Fish Products 5-203.11 Numbers and Capacities* _ Within 4 Hours* 23. Management and Personnel FC-2 .003
3-402.11 - Parasite Destruction* 5-204:11 Location and Placement* 3-501.14(B) Cooling PFIFs Made from Ambient 24. Food and Food Protect on FC-$ .004
3-402:12 Records,Creation and Retention* 5-2.05_.11 Accessibility,Operation and'Maintenance Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 k
590.004(I) Labeling:of Ingredients'- Supplied with'Soap and hand Drying Devices Within 4 Hours* 26: Water,Plumbing arid-Waste FC-5--- .006
7 Conformance with�Approved.Proeeduresel- 6-301.11 Handwashing Cleanser,Availability 27. Physical Facility FC.;-6 .007 i
HACCP;Plans_ 28. Poisonous or Toxic Materials FC-7 .008
6-301.12 Hand Drying Provision
3-502.11 Specialized Processing Methods* 29. Special Requirements
3-502:12 Reduced-.Oxygen Packaging Criteria* 30. Other
e
_ $
8-10312 1 Conformance.with Approved Procedures*� .,,. ,-•.. _ .
S:590Forrnback6-2doc
•Denotea.critical,item•in the federal 1999'Food:_Code or•105"CMR 590.000.< •Denotes critical item in the federal 109 Food Code or 105 CMR 590.000. ;
IKE Town of Barnstable BOARD OF HEALTH
John T.Norman
Board of Health Donald A.Gaudagnoli,M.D.
nvsrt6 :` F.P.(Thomas)Lee
t.e.
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: 1150 Issue Date: 05/23/2022
DBA: TRAVELING TAPAS LLC
OWNER: TRAVELING TAPAS LLC
Location of Establishment: 616 AIRLINE ROAD S. DENNIS MA 02660
Type of Business Permit: FOOD SERVICE
Annual: YES Seasonal:
IndoorSeating: 0 OutdoorSeating: 0 Total Seating: 0
FEES
FOOD SERVICE ESTABLISHMENT: $250.00 'YEAR. 2022
RETAIL FOOD:
COTTAGE FOOD OPERATION: Permit Expires: 12/31/2022
B&B-FULL BREAKFAST:
CONTINENTAL BREAKFAST:
MOBILE-FOOD:
MOBILE-ICE CREAM: C�n
FROZEN DESSERT: Thomas A. McKean, RS, CHO, Health Agent
FOR ESTABLISHMENTS WITH SEATING:
PERMIT IS NOT VALID UNLESS ISSUED IN CONJUNCTION WITH A COMMON VICTUALER LICENSE
Restrictions:
For Office Use Only: .Initials:
s"�'�� Town of Barnstable
' Inspectional Services Date P'aid5 ) mod$ Z�_
�STAS : ns p
MAM
a`0� Chi, k#�
Public Health Division
Thomas McKean;Director a 103 01q,!y 18"7-7.7="t)w —
200 Main Street, Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
APPLICATION FOR PERMIT TO OPERATE A FOOD ESTABLISHMENT
DATES I0 ZZ NEW OWNERSHIP -VI"'
RENEWAL
NAME OF FOOD ESTABLISHMENT: .t-CA V P,�6�I(r t•{�� �-�'
ADDRESS OF FOOD ESTABLISHMENT: b A66-a ,6-A'jC6 W 4 X . kY4-?g p JS M- O 0 1
MAILING ADDRESS(IF DIFFERENT FROM ABOVE): 614 Ai 0�r 6v& Af'A'j S66,7 K bGrrJ If ®Z&E.o
E-MAIL ADDRESS: o 4A r4 — °tom'A VIE�-,L.1 f�a�s m--`( A-PA-S Co AA
TELEPHONE NUMBER OF FOOD ESTABLISHMENT: (z2) �T� - 7 KZID 1-
TOTAL NUMBER OF BATHROOMS:
WELL WATER: YES NOS (ANNUAL WATER ANALYSIS REQUIRED)
ANNUAL: SEASONAL: DATES OF OPERATION: /- / TO
NUMBER OF SEATS:INSIDE:_ OUTSIDE: TOTAL: t
SEATING: MUST OBTAIN A COMMON VICTUALLER'S LICENSE FROM LICENSING DIV.
***OUTSIDE DINING REMINDER***
OUTSIDE DINING MUST BE APPROVED BY THE HEALTH DIV.AND LICENSING,AND MEET OUTSIDE DINING
REQUIREMENTS.
IS WAIT STAFF PROVIDED FOR OUTSIDE DINING?
IS AN AIR CURTAIN PROVIDED AT WAITSTAFF SERVICE DOOR(S)?
TYPE OF ESTABLISHMENT: (PLEASE CHECK ALL THAT APPLY BELOW)
FOOD SERVICE
RETAIL FOOD-ONLY required for TCS foods(foods requiring refrigeration/freezer)
BED&BREAKFAST
CONTINENTAL BREAKFAST
COTTAGE FOOD INDUSTRY(formerly residential kitchen)
MOBILE.FOOD
FROZEN DAIRY DESSERT MACHINES... (MONTHLY LAB ANALYSIS REQUIRED)
i/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 FormsWOODAPP REV3-2019.doc
OWNER INFORMATION:
FULL NAME OF APPLICANT _T4NyI lJ iL.i•-f i tom+
SOLE OWNER YE /NO OWNER P.HONE# 7 j q- q-g 7 7 r0 2
ADDRESS 616 A rqe ap� Sb,j Ttf 1)O 4 3Q(S , vet.1- 0-2 -6 6o
,o r
CORPORATE OWNER: Ki!r
CORPORATE ADDRESS: 6--s. AAFe�G,
PERSON IN CHARGE OFDAILY OPERATIONS��� C�
List (2) Certified Food Protection Managers AND at least(1)Allergen Awareness Certified Staff
All FOOD ESTABLISHMENTS must have 1 Certified Food Protection Manager PER SHIFT.
**ATTACH COPIES OF CERTIFICATES** The Health Div. will NOT use past years' records. You
must provide new copies and POST THE CERTIFICATES at your food establishment.
Certified Food Managers Expiration Date Allergen Awareness Expiration Date
.2, 2.--7
2.
SIGNATURE OF APPLICANT DATE
***FOOD POLICY INFORMATION***
SEASONAL FOOD SERVICE:All seasonal food establishments,including mobile trucks must be inspected by.the Health Div.
prior to opening!! Please call Health Div. at 508-862-4644 to schedule your inspection. Please call at least(7)days in advance.
FROZEN DAIRY DESSERTS: Frozen desserts must be tested by a State Certified lab prior to opening and monthly thereafter,
with sample results submitted to the Health.Div. Failure to do so will result in the suspension or revocation of your Frozen Dessert.
Pennit 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 httD://www.townofbarnstable.us/healtiadivision/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 I st.to Dec.31'each calendar year. IT IS YOUR RESPONSIBILITY TO"RETURN
THE COMPLETED APPLICATI.ON(S)AND REQUIRED FEES BY DEC I st.
Q:\Appfication FonnsTOODAPP REV3-2019.doc
TRAINING "
LEAK 2SERVE FOOD PROTECTION MANAGER CERTIFICATION
This certifies that
John Bradina
has achieved the title of
Certified Fend Protection Manger
issue Date: 05/02/2022
Certificate number: L2SC-3-020354
Test Name: Form B 24
W' o
097
Samantha Montalbano, Ch f Operating Officer
THIS CERTIFICA TE IS NON-TRAli SFERABL E& VAPID UPTO 5 YEARS FROM THE-ISSUE DA TE
DEPENDING ON YOUR LOCAL HEAL Ti4 DEPARTMENTS REC UIREMEN TS.
5000 Plaza on the Lake Suite 305 i Austin,TX 78746 1877.681.2235 1 vv)w v.36atratningxorn
CERTIFICATE OF
ALLERGEN AWARENESS TRAINING :
�.rj OF" rvA
'e�
Name of Recipient JOHN GRADING ,
Certificate*Numbyer` 56079oa
Date of Co mI pletibri:s 12022 t"
Date of t'N'— anon ' °;' , r �
OF
Issued _.
Issued By: ( �
?he above-named person is hereby issued this certocate (NATIONAL
for completing an allergen awareness training program } RESTAURANTLIZ :--�
�4, eesme.ertc ff recognized by the Massachusetts Department of PublicASSOCIATION,
Health -.....-.. �- °""`°"����-���� ,
in accordance with 105 CMR 590.009(G)(3)(a). Massachusetts Restaurant Association 800.765.2122
333 Turnpike Road,Suite 102 www.restaurant.org
Southborough,MA 01772
This cert�ficate will be valid forfive(5)years from date ofcompletion. 508-303-9905
r � \ www marestaurantassoc.org------------------------
-- -- - --- -
--- - -- - - -- - - - -
r
DocuSign Envelope ID: ED49lC6C-4E86-443F-91B9-40E24E3A5A19
Wo SHARED KITCHEN USE AGREEMENT
THIS AGREEMENT is made on May1, 2022, by and between Cape Cod Culinary Incubator(referred to as
"Kitchen") and Traveling Tapas LLC 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
will not permit a partial month 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 1 st, and all rights 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.
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 5/16/2022 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
membership 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
Additional fees are outlined in the Kitchen Operations Manual.
6. Deposit. Member shall pay 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 a refund the following items need to
be completed by Member's last day of membership:
a) Member's property has been removed from the kitchen and the area has been cleaned following
Member's last use of kitchen.
b) Keys have been returned and Kitchen has been notified in writing of Member's cancellation.
DocuSign Envelope ID:ED491C6C-4E86-443F-91B9-40E24E3A5A19
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
h' Agreement.
obligation to do so under this A ee
9 9
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 the 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 Kitchen address (as long 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 security 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.
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.
Member's insurance carrier will need the following information to add additionally insured as Certificate
Holders:
ACORD Certificate#1
Cape Cod Culinary Incubator
PO Box 647
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
restricted due to causes, such as a power outage or weather events, Kitchen will notify members of the
DocuSign Envelope ID:ED491C6C-4E86-443F-91B9-4JE24E3A5A19
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. Member is obligated to maintain a valid health permit with
the Town of Barnstable or any health permit affiliated with Kitchen address, and are expected to
provide copies of active permits with Kitchen at all times. Furthermore, Kitchen will 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 other than 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
and are in common use b all
f certain proprietary storage areas are common areas,
exception o ce p p y gY
members.
17. Repairs and Maintenance. Member 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. Member should report equipment/facility repair issues or operational concerns to
Kitchen Manager.
18. Alterations. No alterations may be 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:ED491C6C4E86-443F-91B9-40E24E3A5A19
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) andlor 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 Release/Waiver. 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 toIfollow 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, in writing, any amended
Rules to the Member within ten (10) days of finalizing and implementing the amended Rules. If Member
chooses to discontinue use of Kitchen due to rules change, no additional monthly dues will be collected
and this agreement will be dissolved.
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.
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:ED491C6C-4E86-443F-91B9-4OE24E3A5A19
effect as physical delivery of that paper document bearing an original signature. Both Member and
Kitchen will sign below to indicate Member's 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.
John Bradi U
Name: oocusi9ned by:
Signature: J66, EYak
Date: 5/16/2022
Company Name (legal entity) Doing Business As (if different):
_Traveling Tapas LLC
Company Mailing Address City, State, and Zip Code:
616 Airline Road, South Dennis, MA 02660
ON BEHALF OF CAPE COD CULINARY INCUBATOR
Linda Dave
Name: oocusigned by:
Signature:
Date: 5/16/2022
Bellaire, Dianna
From: Desmarais, Donald
Sent: Tuesday, May 24, 2022 10:31 AM
To: Bellaire, Dianna
Subject: RE:Traveling Tapas @ Kams CC incubator kitchen - NEW
Can you put his permit on my desk, I am meeting him tomorrow
Sent from my Verizon, Samsung Galaxy smartphone
-------- Original message --------
From: "Bellaire, Dianna" <Dianna.Bellaire@town.barnstable.ma.us>
Date: 5/24/22 10:21 AM (GMT-05:00)
To: "Desmarais, Donald" <Donald.Desmarais@town.barnstable.ma.us>
Cc: "Bellaire, Dianna" <Dianna.Bellaire@town.barnstable.ma.us>
Subject: FW: Traveling Tapas @ Kams CC incubator kitchen-NEW
Donny,
He emailed his menu to us. I have my stuff. Are you inspecting these incubator people separately? Do you want to
schedule a meeting with him? Please email him back if you do.
Thanks.
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.barnstab:le.ma.us
The information contained in this electronic transmission("c-mail"),including any attachment(the."Information"),maybe confidential or
other«-ise exempt from disclosure.It is for the addressee only.This Information may be privileged and confidential work-product or a
privileged and confidential communication."The Information may also be deliberative anal pre-decisional 1n.nature.As such,it is for
internal use only..The Information may not be disclosed wtthout the prior written consent of the Director of Public Health and/or the.
Town Attorneys Office of the'Town of Barnstable.If you have received this e-mail by mistake,please notify the sender and delete it from
your systenn. Please do not copy or forward it.Thank you for your cooperation.
From: John Brading [mailto:john@traveling-tapas.com]
Sent: Tuesday, May 24, 2022 10:20 AM
To: Bellaire, Dianna
Cc: Desmarais, Donald; 'Linda Davey'
Subject: Re: Traveling Tapas @ Kams CC incubator kitchen - NEW
i
Good morning.
Is there any update on the status of my permit? I have a large catering event coming up on Friday and I'll need
to let my customer know if I can't cater it.
Thank you
John Brading
Traveling Tapas LLC
From:John Brading
Sent: Monday, May 23, 2022 9:00:33 AM
To: Bellaire, Dianna <Dianna.Bellaire@town.barnstable.ma.us>
Cc: Desmarais, Donald <Donald.Desmarais@town.barnstable.ma.us>; 'Linda Davey'<Lnda@capeculinary.org>
Subject: RE:Traveling Tapas @ Kams CC incubator kitchen - NEW
Thank you Diana.
I understand that if I am unable to provide the food service, it will shut down until I can resume the service.
I am only supplying one dish at present: paella.This comprises the following ingredients:
Rice
Chicken
Pork
Shellfish
Squid
Vegetables
Pulses
Garlic
Spices
Lemons
Bread
Please let me know if you need any further information.
Best regards,
John
John Brading
Maestro de Cocina,Traveling Tapas LLC
Email: iohn@traveling-tapas.com
Cell: +1 (774)487 7802
From: Bellaire, Dianna <Dianna.Bellaire@town.barnstable.ma.us>
Sent: 23 May 2022 08:54
To:John Brading<john@traveling-tapas.com>
Cc: Bellaire, Dianna <Dianna.Bellaire@town.barnstable.ma.us>; Desmarais, Donald
<Donald.Desmarais@town.barnstable.ma.us>; 'Linda Davey'<Lnda@capeculinary.org>
Subject:Traveling Tapas @ Kams CC incubator kitchen - NEW
Importance: High
Good Morning.
2
I have reviewed your application and applied the payments. I understand you are a one person operation. This is
acceptable, however if you are not able to work the food service must be shut down. If you have a second food
protection manager,you may provide the certificate. Please provide a copy of a menu that you would be serving. You
may email it. Please contact your health inspector, Mr. Donald Desmarais, copied on this email or call him at 508-862-
4740.
Once Mr. Desmarais gives approval, I can release the permit.
Thank you.
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 transmission("e-mail"},including any attachment(the"Information"),maybe confidential or
otheivvise exempt from disclosure.It is for the addressee only.This Information may be privileged and confidential work-product or a
privileged and confidential communication.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 x6thout the prior written consent of the Director of Public Health and/or the
Town Attorneys Office of the Town of.Barnstable. If you have received tbis 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.
CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open
attachments or reply, unless you recognize the sender's email address and know the content is safe!
3